*Basic Procedures- Exam 5 Thoracic Vertebrae

Top of IR for AP thoracic spine:

1.5-2" above shoulders

Top of IR for Lateral thoracic spine:

1.5-2" above shoulders

IR size for Swimmers method:

10x12 LW

The 10th, 11th, and 12th thoracic vertebral bodies have a single whole facet at the superior margin for articulation with the ____ and ____

11th & 12th ribs

The zygapophyseal joints of the thoracic region (except the inferior articular processes of the ____ vertebra) angle ____ approximately 15-20 degrees to form an angle of 70-75 degrees (open ____) to the midsagittal plane of the body.

12th Anteriorly Anteriorly

IR size for AP thoracic spine:

14x17 LW

IR size for Lateral thoracic spine:

14x17 LW

The zygapophyseal joints of the thoracic region (except the inferior articular processes of the 12th vertebra) angle anteriorly approximately ____ degrees to form an angle of ____ degrees (open anteriorly) to the midsagittal plane of the body.

15-20 70-75

The bodies of the ____ thru ____ thoracic vertebrae contain demifacets superiorly and inferiorly

2nd- 8th

SID for AP thoracic spine:

40"

SID for Lateral thoracic spine:

40"

SID for Swimmers method:

40"

Degree of angulation for Swimmers method:

5 degrees caudal

From the ____ to the ____ vertebrae, the spinous processes project sharply inferiorly and overlap each other, but they are less vertical above and below this region

5th- 9th

To show the zygapophyseal joints of the thoracic region radiographically, the patients body must be rotated ____ degrees from the anatomic position or ____ degrees from the lateral position

70-75 15-20

For Lateral thoracic spine adjust the patients arms to ____ to elevate the ribs enough to clear the ____

90 degrees Intervertebral foramina

The intervertebral foramina are clearly shown radiographically with the patient in ____ position

A true Lateral

Evaluation criteria for AP thoracic spine: (5)

All 12 thoracic vertebrae Thoracic bodies Intervertebral disk spaces Transverse processes Costovertebral articulations

The ____ is a variation in intensity of the X-ray beam from the anode to the cathode end

Anode heel effect

The thorax is thinner at the superior than the inferior end, which means we use the ____ to attain uniform density on the image

Anode heel effect

With the exception of the 11th and 12th pairs, each transverse process has on the ____ surface of its extremity a small concave facet for articulation with the ____ of a ____

Anterior Tubercle Rib

For Lateral thoracic spine there needs to be about an inch of light ____ the patient

Behind

The palpable tip of each spinous process of the 5th- 9th thoracic vertebrae corresponds in position to the interspace ____ the vertebra from which it projects

Below

The ____ of the thoracic vertebrae Increase in size from the first to the twelfth vertebrae. They also vary in form, with the superior thoracic bodies resembling cervical bodies and the inferior thoracic bodies resembling lumbar bodies.

Bodies

Breathing instructions for Lateral thoracic spine:

Breath normally to obliterate vascular markings and ribs OR Exhalation- for more homogenous

The laminae are ____ and ____, and they overlap the subjacent lamina

Broad Thick

The swimmers technique is performed when shoulder superimposition obscures ____ on a ____ Cervical spine projection or when a lateral projection of the ____ vertebrae is needed

C7 Lateral Upper thoracic

CR for Swimmers method:

C7-T1 (meat area on depressed shoulder) 3-5 caudal angle Center 2" above jugular notch (Perpendicular is the Shoulder is depressed enough)

What types of joints are intervertebral joints?

Cartilaginous- symphysis

The rays towards the ____ end of the tube are more intense because in a diverging beam, the rays which are parallel or near parallel to the anode (which is at an angle) get ____ by the anode

Cathode Absorbed

Structures shown for Swimmers method:

Cervicothoracic vertebrae between the shoulders

The posterolateral margins of each thoracic body have ____ for articulation with the heads of the ribs

Costal facets

Summary of anatomy of thoracic vertebrae: (2)

Costal facets Demifacets

The articulation of the rib and vertebral body is ____ which are ____ joints

Costovertebral Synovial- gliding

Absorption by heel of target results in ____ X-ray intensity on ____ side of beam

Decreased Anode

The bodies of the second thru eighth thoracic vertebrae contain ____ superiorly and inferiorly

Demifacets

A more uniform ____ of the thoracic vertebrae can be obtained if the anode heel effect of the tube is used. With the tube positioned so that the cathode end is toward the ____, the greatest percentage of radiation goes through the ____ part of the thorax

Density Feet Thickest

For Swimmers method what needs to happen with the shoulder that's facing up?

Depressed (use 5 degree caudal angle to make humeral heads not superimposed)

For Lateral thoracic spine place a pillow under the patients head to keep the long axis of the vertebral column horizontal

Either use pillow regularly OR fold pillow in half

During inspiration, the ribs are ____

Elevated

Breathing instructions for AP thoracic spine:

Exhalation (helps make Chest more homogenous) Or breathing technique helps obliterate lung detail & ribs

(T/F) intervertebral foramina are parallel to MSP

False Perpendicular

The body of the first thoracic vertebra presents a whole costal facet near its superior border for articulation with the head of the ____ and presents a demifacet (half-facet) on it's inferior border for articulation with the head of the ____

First rib Second rib

The posterolateral margins of each thoracic body have costal facets for articulation with the ____ of the ____

Heads Ribs

From the 5th to the 9th vertebrae, the spinous processes project sharply ____ and overlap each other, but they are less vertical above and below this region

Inferiorly

The anode heel effect is a variation in ____ of the X-ray beam from the ____ to the ____ end

Intensity Anode Cathode

The arms must be raised enough to elevate the ribs, which otherwise cross the _____

Intervertebral foramina

For AP thoracic spine is patient is supine, rest their head on the table and flex their ____

Knees (This helps to reduce Kyphosis curvature)

T3-T9 are wedge shaped to allow for natural ____ curvature

Kyphotic

What method has the CR not directly on the MCP or MSP?

Lateral thoracic 1" posterior to spine

Because of the overlapping shoulders, the upper vertebrae may not be shown in the ____ position. If the upper thoracic area is of interest, the _____ may be included with the examination

Lateral thoracic spine Swimmers lateral

What is used for Lateral thoracic spine to help with scatter?

Lead strip (place behind patient, just outside of light field) Because they are in their side, it's such a thick part to penetrate which creates more scatter

Which side down for Lateral thoracic spine?

Left (to place heart closer to IR which minimizes overlapping of the vertebrae by the heart)

The spinous processes are ____

Long

The ____ thoracic vertebra has only a superior demifacet

Ninth

The transverse processes of the thoracic vertebrae project ____, ____, and ____

Obliquely Laterally Posteriorly

Two types of swimmers techniques (methods):

PawLOW- Lateral recumbent Twining- Lateral upright

The intervertebral foramina of the thoracic region are ____ to the midsagittal plane of the body

Perpendicular

CR for Lateral thoracic spine:

Perpendicular to T7 Posterior to MCP about 1"

CR for AP thoracic spine:

Perpendicular, halfway between the jugular notch and the xiphoid process (Perpendicular to the MSP at T7)

Centering for lateral imaging of thoracic spine will be slightly ____ to the ____

Posterior MCP

The 12 thoracic vertebrae have 12 corresponding pairs of ___

Ribs

Why the 5 degree angulation for Swimmers method?

Shows the intervertebral disk spaces

For Lateral thoracic spine collimate:

Side to side But leave some light behind patient

Collimation for AP thoracic spine:

Side to side Leave enough room for marker at the top of the shoulder

T10-T12 have single while facets at the ____ margins

Superior

T9 has only one ____ demifacet

Superior

The thorax is thinner at the ____ than the ____ end, which means we use the anode heel effect to attain uniform ____ on the image

Superior Inferior Denisty

T1 has a whole facet on ____ border and a demifacet on the ____ border

Superior Inferior

T2-T8 have demifacets ____ and ____

Superiorly Inferiorly

Breathing instructions for swimmers method:

Suspend

What types of joints are zygapophyseal joints?

Synovial- gliding

For Lateral thoracic spine ____ vertebrae are not well seen

T1-3

____ have articulating facets on each ____ that articulate with the tubercles of the ribs forming the ____ joints, which are also synovial-gliding

T1-T10 Transverse process Costotransverse

Typical thoracic vertebrae:

T3-9

For Swimmers method (recumbent) what does the patient do with their arms?

The left arm (side touching IR) goes under pillow The right arm goes straight down by side

Evaluation criteria for Lateral thoracic spine:

Thoracic bodies Disk spaces Intervertebral foramina Lower spinous processes Superimposition of the shoulders on upper vertebrae (T1-T3)

The bodies of the typical (third thru ninth) thoracic vertebrae are approximately ____ in form. These vertebral bodies are deeper posteriorly than anteriorly, and their posterior surface is ____ from side to side

Triangular Concave

T1-T10 have articulating facets on each transverse process that articulates with the ____ of the ____ forming the costotransverse joints, which are also ____ joints

Tubercles Ribs Synovial- gliding

The body of the first thoracic vertebra presents a ____ near its superior border for articulation with the head of the first rib and presents a ____ on it's inferior border for articulation with the head of the second rib

Whole costal facet Demifacet (half-facet)

The _____ of the thoracic region (except the inferior articular processes of the 12th vertebra) angle anteriorly approximately 15-20 degrees to form an angle of 70-75 degrees (open anteriorly) to the midsagittal plane of the body.

Zygapophyseal joints

To show the _____ of the thoracic region radiographically, the patients body must be rotated 70-75 degrees from the anatomic position or 15-20 degrees from the lateral position

Zygapophyseal joints