Vertebrae Anatomy
Extend the neck so that the line between the occlusal surface of the upper teeth and the base of the occipital bone is parallel to the floor.
An AP projection of the upper cervical spine is unsatisfactory because the patient's upper teeth are superimposed over the atlas and the dens. How should you adjust the position for a satisfactory radiograph?
The lateral projection in the neutral position should be produced and shown to the physician before proceed- ing with the flexion and extension positions. If there is an unstable cervical spine fracture, these positions could cause subluxation of the spinal vertebra, placing pressure on the spinal cord and risking paralysis or death.
An order for radiographic examination of the cervical spine includes a request for lateral flexion and extension posi- tions. The patient was in a car accident this morning. What precautions are needed? Why?
Inferior midpoint of the lower jaw
On your own body, indicate the locations of the mental point
The cervical and lumbar spines have a lordotic curve.
Which have a lordotic curve?
B
A shallow breathing technique is used to advantage when taking a lateral projection of the A. cervical spine. B. thoracic spine. C. lumbar spine. D. sacrum
C
A supine position with the central ray directed 10 degrees caudad 1 inch inferior to the anterior superior iliac spine is used to demonstrate an: A. AP axial projection of the lumbosacral joint. B. AP axial projection of the sacrum. C. AP axial projection of the coccyx. D. AP projection of the pelvis.
B
For which of the following projections is it most important to consider the anode heel effect when positioning the patient? A. AP projection of the lower cervical spine B. AP projection of the thoracic spine C. Lateral projection of the thoracic spine D. AP projection of the lumbar spine
The atlas has no body, and its superior articular processes are set at a different angle from the superior articular processes of the other cervical vertebrae. The atlas is capable of rotation on the axis. This is a far greater degree of rotation than is possible between any of the other vertebral bodies.
How do the atlas differ from the other cervical vertebrae?
The axis has a superior projection from the body, called the dens, that passes through the ring of the atlas. The atlas is capable of rotation on the axis. This is a far greater degree of rotation than is possible between any of the other vertebral bodies.
How do the axis differ from the other cervical vertebrae?
4 segments
How many segments are there in the: Coccyx
5 segments
How many segments are there in the: Sacrum
12 vertebrae
How many vertebrae are there in the Thoracic Spine
7 vertebrae
How many vertebrae are there in the: Cervical Spine
5 vertebrae
How many vertebrae are there in the: Lumbar Spine
The patient should be instructed to disrobe except for underpants and put on a gown. Specifically, her bra. must be removed. Shoes should be removed for upright examinations.
How would you instruct a female patient to prepare for a lumbar spine examination?
Cervical ribs: riblike structures attached to C7
List and describe three common congenital anomalies of the spine. Cervical Ribs
riblike structures attached to L1
List and describe three common congenital anomalies of the spine: Lumbar
failure of the first sacral segment to fuse with the body of the sacrum
List and describe three common congenital anomalies of the spine: Lumbarization of S1
fusion between one or both transverse processes of L5 and the sacrum
List and describe three common congenital anomalies of the spine: Sacralization of L5
an extra lumbar vertebra occurring in the presence of the proper number of segments
List and describe three common congenital anomalies of the spine: Six lumbar vertebrae
failure of the posterior elements of a vertebra to fuse and form a solid vertebral arch
List and describe three common congenital anomalies of the spine: spina bifida
Cervical spine Thoracic spine Lumbar spine Sacrum Coccyx
List the sections of the spine and state the number of vertebrae or vertebral segments in each.
Cervical ribs Lumbar ribs Sacralization of L5 Lumbarization of S1 Six lumbar vertebrae Spina bifida occulta
List three common congenital anomalies of the spine.
Hypertrophic arthritic changes, such as bony spurs on the vertebrae, may cause stenosis (narrowing) of the intervertebral foramina. Misalignment of vertebrae, subluxation, or spondylolisthesis may cause crowding of the nerve pathways. Disk herniation is also a common cause of nerve root compression
List two possible causes of nerve root compression and four possible symptoms.
LATERAL projection
Name and describe positions that will demonstrate each of the following structures: the cervical zygapophyseal joints,
LT anterior Oblique (LAO) RT posterior Oblique (RPO)
Name and describe positions that will demonstrate each of the following structures: the left cervical intervertebral foramina
LT posterior OBLIQUE (LPO) RT anterior OBLIQUE (RAO)
Name and describe positions that will demonstrate each of the following structures: the left lumbar zygapophyseal joints,
LATERAL projection
Name and describe positions that will demonstrate each of the following structures: the lumbar intervertebral foramina
AP Axial projection of the lumbosacral joint &/or POSTERIOR OBLIQUE position- LT POSTERIOR OBLIQUE (LPO) for RT SI joint RPO for LT SI joint
Name and describe positions that will demonstrate each of the following structures: the sacroiliac joints.
"Corner" of the lower jaw beneath the ear lobe
On your own body, indicate the locations of the angle of the mandible
U-shaped bony structure at the base of the throat
On your own body, indicate the locations of the jugular (sternal) notch
"Adam's apple" in the center of the anterior neck
On your own body, indicate the locations of the laryngeal (thyroid cartilage) prominence
Bony projection behind the ear lobe
On your own body, indicate the locations of the mastoid process
B
Patient breathing instructions for all projections of the lumbar spine should include: A. suspend breathing on inspiration. B. suspend breathing on expiration C. breathe shallowly. D. all of the above.
D
Spine radiography may be preformed with the patient: A. upright B. supine C. prone D. all the above
D
The articular surfaces of the articular processes of the vertebrae are called: A. spinous processes. B. transverse processes. C. laminae. D. facets.
B
The axis is another name for which vertebra? A. C1 B. C2 C. T1 D. L5
D
The central ray for a lateral projection of the lumbar spine is centered: A. perpendicular to the IR through L4 B. perpendicular to the IR through L3. C. in the midaxillary line. D. both A and C.
A
The cylindrical anterior portion of a typical vertebra is called the: A. body. B. lamina. C. pedicle. D. articular process.
C
The number of vertebrae in the normal cervical spine is: A. 4 B. 5. C. 7. D. 12.
D
The positioning steps for the AP projection of the upper cervical spine open-mouth technique include which of the following? A. Align the midsagittal plane perpendicular to the IR. B. Align the occlusal plane and base of the skull parallel to the horizontal plane. C. Use close collimation D. All of the above.
B
The projection commonly called the swimmer's technique will demonstrate which region of the spine? A. Cervical region B. Cervicothoracic region C. Thoracic region D. Lumbar region
C
The region of the spine that consists of five vertebrae and has a lordotic curve is the: A. cervical spine. B. thoracic spine. C. lumbar spine. D. sacrum
D
The toothlike projection on the axis, around which the atlas rotates, is called the: A. spinous process. B. facet C. articular process. D. dens or odontoid process.
Spinous process (bifid)
What is #1
dens (odontoid process)
What is #1
posterior arch
What is #1
spinous process
What is #1
body
What is #10
transverse process
What is #10
transverse process
What is #11
vertebral notch
What is #11
facet
What is #12
vertebral notch
What is #12
inferior articular process
What is #13
spinous process
What is #14
lamina
What is #15
superior articular process
What is #16
lamina
What is #2
transverse process
What is #2
vertebral foramen
What is #2
inferior articular process
What is #3
superior articular process
What is #3
transverse foramen
What is #3
transverse process
What is #3
body
What is #4
facet
What is #4
transverse atlantal ligament
What is #4
vertebral foramen
What is #4
Pedicle
What is #5
anterior arch
What is #5
superior articular process
What is #5
superior costal facet
What is #5
Lateral mass
What is #6
facet
What is #6
transverse process
What is #6
dens (odontoid process)
What is #7
superior articular process
What is #7
transverse foramen
What is #7
Lamina
What is #8
body
What is #8
articular pillar
What is #9
transverse foramen
What is #9
Compression fractures with wedging of midthoracic vertebral bodies are common among older women with osteoporosis.
What type of spinal fracture is common among older women with osteoporosis?
C
When an anteroposterior (AP) projection of the cervical spine is performed, the central ray is directed: A. perpendicular to the image receptor (IR). B. 15 degrees caudad. C. 15 degrees cephalad. D. 25 degrees cephalad.
B
When the midsagital plane of the body is parallel to the IR and the central ray is directed perpendicular to C4 the resulting image will be a(n): A. AP projection of the lower cervical spine. B. lateral projection of the cervical spine. C. anterior oblique projection of the cervical spine. D. AP projection of the upper cervical spine (open mouth).
A
When the posterior portions of the neural arch fail to close during early embryonic development, the condition is known as: A. spina bifida. B. meningomyelocele. C. herniated nucleus pulpous D. stenosis.
lordotic curve
Which curve is #1
kyphotic curve
Which curve is #2
lordotic curve
Which curve is #3
kyphotic curve
Which curve is #4
D
Which of the following conditions is demonstrated by magnetic resonance imaging or computed tomography but is not normally seen on routine radiography? A. Compression fracture B. Spondylosis C. Spina bifida D. Disk herniation
A
Which palpable landmark would be used when positioning for an AP projection of the lumbar spine? A. Iliac crest B. Jugular notch C. Xiphoid process D. Lower costal margin
B
Which region of the spine is the most common site of pathologic compression fractures of vertebral bodies due to osteoporosis in elderly women? A. Cervical region B. Thoracic region C. Lumbar region D. Sacral region
The thoracic spine has a kyphotic curve. The sacrum and coccyx together form a kyphotic curve.
Which spinal segments have a kyphotic curve?
