Bontrager Ch.8 Workbook

Name the following parts of the sternum or associated topographic landmarks. Upper portion of sternum:

MANUBRIUM

B. List the inner aspects of the intervertebral disk

Nucleus pulposus

Match the following topographic landmarks to the correct vertebral level. Thyroid cartilage

C4-C6

Which region of the spine must be demonstrated with a cervicothoracic lateral position

C5 to T3

List the number of bones found in each division in the adult vertebral column- Cervical

7 (breakfast)

Which of the following projections delivers the greatest skin dose to the patient

. Cervicothoracic lateral position

List the number of bones found in each division in the adult vertebral column- Coccyx

1

List the number of bones found in each division in the adult vertebral column- Sacrum

1

What central-ray angulation (amount and direction) must be used with a posterior oblique projection of the cervical spine

15 degrees cephalad

List the number of bones found in each division in the adult vertebral column - Thoracic

12 (lunch)

For the central ray to pass through and "open" the intervertebral spaces on a 45-degree posterior oblique projection of the cervical vertebrae, what central-ray angle (if any) is required

15 degrees cephalad

How much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position

20 degrees from lateral position (70 degrees from plane of table or wall bucky)

What central-ray angle must be used with the AP axial-vertebral arch (Pillars) projection

20- to 30-degree caudad

List the number of bones found in each division in the adult vertebral column- Lumbar

5 (dinner)

\What is the recommended SID for the cervicothoracic position of the cervical spine

60 to 72 inches (152 to 183 cm)

the thoracic vertebrae are at a ______ degree angle to the midsagittal plane.

70-75

The zygapophyseal joints for the second through seventh cervical vertebrae are at a ______ degree angle to the midsagittal plane

90

3. Indicate which two portions of the vertebral column are classified as secondary or compensatory curves

A. Cervical B. Lumbar

What are two important benefits of using an SID 60 to 72 inches (152 to 183 cm) for the lateral cervical spine projection

A. Compensates for increased object image receptor distance (OID); reduces magnification B. Less divergence of x-ray beam to reduce shoulder superimposition of C7

List the two advantages of using higher kV exposure factors with high-latitude analog (film-screen) systems imaging for spine radiography, especially on an anteroposterior (AP) thoracic spine radiograph.

A. Increase in exposure latitude (wider range of densities) B. Decrease in patient dose

List the two primary or posterior convex curves seen in the vertebral column

A. Thoracic B. Sacral

List three features that make the cervical vertebrae unique.

A. Transverse foramina B. Bifid spinous process C. Overlapping vertebral bodies

Which AP projection of the cervical spine demonstrates the entire upper cervical spine with one single projection

AP "wagging jaw" projection (Ottonello method)

List the outer and aspects of the intervertebral disk

Annulus fibrosus

A short column of bone found between the superior and articular processes in a typical cervical vertebra is called

Articular pillar

Which of the following structures is best demonstrated with an AP axial vertebral arch projection

Articular pillars (lateral masses) of the cervical spine

What is the name of the joint found between the superior articular processes of C1 and the occipital condyles of the skull

Atlanto-occipital articulation

alternative names C1:

Atlas

alternative names C2:

Axis

Match the following topographic landmarks to the correct vertebral level. Vertebra prominens

C7-T1

Name the following parts of the sternum or associated topographic landmarks. Center portion of sternum:

BODY

The two main parts of a typical vertebra are the ______________ and the

BODY ; VERTEBRAL ARCH

For an AP axial of the cervical spine, a plane through the tip of the mandible and the __________________________ should be parallel to the angled central ray.

Base of skull

Match the following topographic landmarks to the correct vertebral level. Mastoid tip

C1

Match the following topographic landmarks to the correct vertebral level. Gonion

C3

Match the correct aspect(s) of the vertebral column with the following characteristics. Develops as child learns to hold head erect

Cervical Spine

Match the correct aspect(s) of the vertebral column with the following characteristics. Concave curve (with respect to posterior)

Cervical/Lumbar

Match the correct aspect(s) of the vertebral column with the following characteristics. Secondary curve

Cervical/Lumbar

Which two things can be done to produce equal density along the entire thoracic spine for an AP projection (especially for a patient with a thick chest)

Correct use of anode-heel effect and use of compensating (wedge) filter

The modified body of C2 is called the

Dens or odontoid process

The lateral projection of the cervical spine should be taken during __________(inspiration, expiration, or suspended respiration). Why

EXPIRATION ; MAXIMUM SHOULDER DEPRESSION

True/False: The zygapophyseal joints of all cervical vertebrae are visualized only in a true lateral position.

FALSE (between C1 and C2 visualized on a frontal or AP projection)

True/False: Only T11 and T12 have full facets for articulation with ribs.

FALSE (T1, T10 to T-12 have full facets)

True/False: If close collimation is used during conventional (analog) radiography of the spine, the use of lead masking (blockers) is generally not required.

FALSE (Lead masking should be used even if close collimation is used.)

True/False: The tip of the odontoid process does not have to be demonstrated on the AP "open mouth" projection, because it is best seen on the lateral projection.

False. The entire dens or odontoid process must be demonstrated. If trauma or injury is ruled out, the technologist could perform the AP or PA projection for the odontoid process to demonstrate the tip.

The condition involving a "slipped disk" is correctly referred to as

Herniated nucleus pulposus (HNP)

Which of the following projections is considered a "functional study" of the cervical spine

Hyperextension and hyperflexion lateral positions

Two small notches on the superior and inferior aspects of the pedicles create the

INTERVERTEBRAL foramina.

An abnormal, or exaggerated, "sway back" lumbar curvature is called

LORDOSIS

When should the Judd or Fuchs method be performed

If unable to demonstrate the upper portion of the odontoid process (dens) with the AP "open mouth" projection

Name the following parts of the sternum or associated topographic landmarks. Superior margin of this upper section (landmark):

JUGULAR (SUPRASTERNAL) NOTCH

To ensure that the intervertebral joint spaces are open for lateral thoracic spine projections, it is important to:

Keep the vertebral column parallel to the image receptor (IR)

The _______ are two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline.

LAMINA

Which foramina are demonstrated with a left anterior oblique (LAO) position of the cervical spine

LT Intervertebral foramina(DOWNSIDE)

What is the term for the same structure, identified in the previous question, for the C1 vertebra

Lateral mass

Which specific projection must be taken first if trauma to the cervical spine is suspected and the patient is in a supine position on a backboard

Lateral, horizontal beam projection

What ancillary device should be placed behind the patient on the tabletop for a recumbent lateral projection of the thoracic spine

Lead mat or masking

Which two landmarks must be aligned for an AP "open mouth" projection

Lower margin of upper incisors and base of skull

The spinal cord begins with the (A) ________________ of the brain and extends down to the (B) ____________ vertebra, where it tapers and ends. This tapered ending is called the (C) __________

MEDULLA OBLONGATA ; LOWER BORDEROF L1; CONUS MEDULLARIS

What is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space

MYELOGRAPHY

Which skull positioning line is aligned perpendicular to the IR for a PA (Judd) projection for the odontoid process

Mentomeatal line (MML)

Which imaging modality is ideal for detecting early signs of osteomyelitis

NUC MED

What is the unique feature of all thoracic vertebrae that distinguishes them from other vertebrae

Presence of facets for articulation with ribs

Which zygapophyseal joints are best demonstrated with an LPO position of the thoracic spine

Right

Which zygapophyseal joints are demonstrated in a right anterior oblique (RAO) projection of the thoracic spine

Right (downside)

Which foramina are demonstrated with a left posterior oblique (LPO) position of the cervical spine

Right intervertebral foramina (upside)

In addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the upper cervical vertebrae for oblique projections

Rotate the skull into a near lateral position

A lack of symmetry of the zygapophyseal joints between C1 and C2 may be caused by injury or may be associated with

Rotation of the skull

An abnormal lateral curvature seen in the thoracolumbar spine is called

SCOILIOSIS

Which structures pass through the intervertebral foramina

SPINAL NERVES & BLOOD VESSELS

Name the following parts of the sternum or associated topographic landmarks. Joint between top and center portions (landmark):

STERNAL ANGLE

What are the major differences between spondylosis and spondylitis

Spondylitis is an inflammatory process of the vertebrae characterized by bony bridges between vertebrae (advanced stages). Spondylosis is a condition of the spine characterized by decreased vertebral joint space and arthritic changes of the zygapophyseal joints.

The common name of the method for the cervicothoracic lateral position is the

Swimmer's method

Match the following topographic landmarks to the correct vertebral level. Jugular notch

T2-T3

Match the following topographic landmarks to the correct vertebral level. . Sternal angle

T4-T5

Which specific thoracic vertebrae are classified as typical thoracic vertebrae (i.e., they least resemble cervical or lumbar vertebrae)

T5 to T8

Match the following topographic landmarks to the correct vertebral level. 3 to 4 inches (8 to 10 cm) below jugular notch

T7

Match the following topographic landmarks to the correct vertebral level. Xiphoid process (tip)

T9-T10

True/False: Many geriatric patients have a fear of falling off the radiographic table.

TRUE

True/False: Nuclear medicine is often performed to diagnose bone tumors of the spine.

TRUE

True/False: To a certain degree, magnetic resonance imaging (MRI) and computed tomography (CT) are replacing myelography as the imaging modalities of choice for the diagnosis of a ruptured intervertebral disk.

TRUE

True/False: When using digital imaging for spine radiography, it is important to use close collimation, grids, and lead masking.

TRUE

Match the correct aspect(s) of the vertebral column with the following characteristics. Convex curve (with respect to posterior)

Thoracic/Sacrum

Match the correct aspect(s) of the vertebral column with the following characteristics. Primary curve

Thoracic/Sacrum

In addition to the gonads, which other radiosensitive organs are of greatest concern during cervical and thoracic spine radiography

Thyroid, parathyroid glands, and breasts

Where should the central ray be placed for a cervicothoracic lateral position

To T1; 1 inch (2.5 cm) above the jugular notch anteriorly and level of vertebra prominens posteriorly

What is the purpose of using an orthostatic (breathing) technique for a lateral projection of the thoracic spine

To blur out rib and lung markings that obscure detail of thoracic vertebrae

What is the purpose of the 15- to 20-degree cephalad angle for the AP axial projection of the cervical spine

To open up the intervertebral disk spaces

True/False: Performing the cervicothoracic projection is often required to demonstrate the C7/T1 region for the obese patient.

True

True/False: The thyroid dose delivered during a posterior oblique cervical spine (LPO or RPO) projection is greater than the thyroid dose for an anterior oblique (RAO or LAO) projection of the cervical spine.

True

For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail. This can be done by (more than one answer may be used):

Using a small focal spot Increasing the source image receptor distance (SID)

The opening, or passageway, for the spinal cord is the

VERTEBRAL (SPINAL) CORD

alternative names C7:

Vertebra prominens

Name the following parts of the sternum or associated topographic landmarks.Most inferior aspect of sternum (landmark):

XIPHOID PROCESS

Which of the following is found between the superior and inferior articular processes

Zygapophyseal joints

True/False: Less CR angle is required for the AP axial projection of the cervical spine if the examination is performed supine rather than erect.

true