Bontrager Chapter 8

Which of the following clinical conditions will require a decrease in manual technical factors? (a) advanced osteoporosis (b) severe scoliosis (c) moderate lordosis (d) Scheuermann disease

(a) advanced osteoporosis

Which of the following positions will best demonstrate the left zygapophyseal joints of the thoracic spine? (a) LPO (b) RPO (c) RAO (d) Lateral

(b) RPO

Which of the following factors does not apply to a lateral projection of the cervical spine? (a) Use a 72" SID (b) Suspend respiration upon full inspiration (c) Perform horizontal-beam lateral projection if trauma is suspected (d) Center CR to thyroid cartilage

(b) Suspend respiration upon full inspiration

Which of the following thoracic vertebra(e) possess no facets for costotranserse joints? (a) T9-10 (b) T11-12 (c) T1 (d) none of the above

(b) T11-12

A radiograph of an AP thoracic spine projection reveals that the upper thoracic spine is overexposed. The lower vertebrae have acceptable density & contrast. Which one of the following modifications will improve the visibility of the upper thoracic spine? (a) place the upper spine under the cathode side of the tube (b) use a compensating (wedge) filter (c) increase the kV to decrease the contrast of the upper spine (d) use a breathing technique

(b) use a compensating (wedge) filter

Which of the following projections will best demonstrate the zygapophyseal joints of the cervical spine? (a) AP axial (b) Posterior oblique (c) Lateral (d) Anterior oblique

(c) Lateral

A digital (CR) image taken of a lateral thoracic spine projection demonstrates poor visibility of the spine. The image was taken on a full 14" x 17" IR. The following factors were used during the exposure: 80 kV, 80 mAs, 40" SID, & collimation to the size of the IR. Which of the following modifications will result in a more diagnostic image? (a) Decrease kV (b) Decrease mA (c) Collimate to spine (d) Increase SID

(c) collimate to spine

Which of the following factors will enhance the visibility of the vertebral bodies during a lateral projection of the thoracic spine? (a) high kVp (b) increase SID (c) use a breathing technique (d) flex the spine

(c) use a breathing technique

Which of the following positions will demonstrate the left intervertebral foramina of the cervical spine? (a) RAO (b) LPO (c) Lateral (d) LAO

(d) LAO

Which of the following features makes the cervical vertebra unique as compared with other vertebrae? (a) Transverse foramina & double (bifid) tips on spinous processes (b) Overlapping vertebral bodies (c) Presence of zygapophyseal joints (d) all of the above

(d) all of the above

Which of the following is NOT a correct evaluation criterion for the AP axial C-spine projection (a) C3 to T2 vertebral bodies should be visualized (b) Spinous processes are seen to be equal distances from the vertebra body lateral borders (c) Center of the collimation field is at C4 (d) All of the above are correct criteria

(d) all of the above are correct criteria

What type of CR angle is required for posterior oblique (LPO)/(RPO) positions of cervical spine?

15^ cephalad

How much CR angulation is required for the AP axial projection for the cervical spine?

15^ to 20^ cephalad

What type of CR angle is recommended when performing the AP axial C-spine projection erect?

20^ cephalad

On average, how many separate bones make up the vertebral column?

26

How much rotation of the body is required for an LAO projection of the thoracic spine (from the plane of the table)?

70^

A patient comes to radiology for a thoracic spine routine. The patient has a history of arthritis of the spine. The radiologist requests that additional projections be taken to demonstrate the zygapophyseal joints. What positions and/or projections would be ideal to demonstrate these structures?

70^ oblique projections

The zygapophyseal joints for the thoracic spine lie at an angle of _______ in relation to the midsagittal plane.

70^ to 75^

The zygapophyseal joints for the typical cervical vertebra lie at an angle of __________ in relation to the midsagittal plane.

90^

A lateral projection of the thoracic spine reveals that the upper aspect, which is a primary area of interest on the patient, is obscured by the patients shoulders. What position will best demonstrate this region of the spine?

A cervicothoracic (swimmers) lateral position

What position or projection of the cervical spine will best demonstrate the zygapophyseal joint spaces between C1 and C2?

AP open mouth

Which of the following projections will project the dens within the shadow of the foramen magnum?

AP projection (Fuchs method)

The gonion corresponds to the vertebral level of:

C3

The most prominent aspect of the thyroid cartilage corresponds to the vertical level of:

C5

Which of the following is the first compensatory spinal curvature to develop in the young child?

Cervical

A radiograph of an AP open-mouth projection reveals that the base of the skull is superimposed over the dens. What positioning error led to this radiographic outcome?

Excessive extension of the skull

T/F an RPO position of the cervical spine requires a 45^ oblique of the body with a 15^ caudad CR angle.

False

T/F the PA projection (Judd method) is intended to demonstrate the atlantoaxial joints between C1 and C2.

False

T/F the anterior oblique thoracic spine demonstrates the upside zygapophyseal joints.

False

T/F the intervertebral disks are tightly bound to the vertebral bodies to prevent movement within the vertebral column.

False

A patient comes to radiology for a follow-up study of the C-spine. The patient had a spinal fusion between C5-6 performed 6 months ago. His physician wants to assess the C-spine for anteroposterior mobility. Which projection would provide this assessment?

Hyperflexion & hyperextension projection

A radiograph of an AP axial projection of the cervical spine reveals that the intervertebral joints are not open. The following analog factors were used. 5^ cephalic angle, 40" SID, grid, slight extension of the skull, and the CR centered to the thyroid cartilage. What modification should be made during the repeat exposure?

Increase the CR angulation

A radiograph of a lateral projection of the cervical spine reveals that the ramus of the mandible is superimposed over the spine. What could the technologist have done to prevent this?

Increase the extension of the skull

A radiograph of an RAO of the cervical spine reveals that the lower intervertebral foramina are not open. The upper vertebral foramina are well visualized. Which positioning error most likely lead to this radiographic outcome?

Insufficient rotation of the upper body

What factor is most important to open up the intervertebral joint spaces for a lateral thoracic spine projection?

Keep vertebral column parallel to tabletop

The spinal cord tapers off to a point distally at the vertebral level of?

L1-L2

A patient comes to radiology for a follow-up study for a clay shoveler's fracture. Which of the following projections will best demonstrate the extent of this fracture?

Lateral cervical spine

Which of the following projections will best demonstrate a compression fracture of the thoracic spine?

Lateral projection

For an average-size adult, which of the following would receive the highest skin dose? (a) AP "wagging jaw" cervical spine, 3-sec. exposure time (b) AP thoracic spine (c) Lateran cervical spine at 72" (d) Lateral thoracic spine

Lateral thoracic spine

A patient enters the ER because of a motor vehicle accident. The patient is on a backboard & is wearing a collar. The tech is concerned about the artifacts that the collar will project on the spine during the horizontal beam lateral projection. What should the tech do in this situation?

Leave the collar on during the exposure

Which image modality will best demonstrate herniated nucleus pulpous in the cervical spine?

MRI

Which aspect of the intervertebral disk is composed of semigelatinous material?

Nucleus pulposus

A patient enters the ER with a cervical spine injury as a result of a fall. The initial horizontal beam lateral projection reveals no subluxation or fracture. The ER physician is concerned about a whiplash injury. Which routine would besot helpful in diagnosing this type of injury?

Patient in hyperflexion & hyperextension lateral positions

A patient comes to the radiology department for a cervical spine routine. The study is ordered for non trauma reasons. The AP open-mouth projection reveals that the base of the skull and upper incisors are superimposed, but they are obscuring the upper portion of the dens. On the repeat exposure, what should the technologist do to demonstrate the entire dens?

Perform the Fuchs or Judd method

A patient enters the ER due to an MVA. He is on a backboard and in a cervical collar. The initial lateral C-spine projection demonstrates C1 to C6. The patient has broad & thick shoulder. Because the hospital is in a rural setting, no CT scanner is available. What modification would best demonstrate the lower cervical spine.

Perform the horizontal beam cervicothoracic (swimmers) lateral position

A radiograph of a lateral thoracic spine reveals that there is excessive density along the posterior aspect of the spine. Even with good collimation, the scatter radiation reaching the IR obscures the spinous process. What can the technologist do to improve the visibility of the posterior elements of the spine?

Place a lead mat on the tabletop just posterior to the patient

The xiphoid process corresponds to the vertebral level of:

T9-10

Which term best defines or describes the vertebral body of C-1?

There is no vertebral body at C-1

T/F all thoracic vertebrae have at least one facet for rib articulation

True

T/F another term for a breathing technique during exposure is the orthostatic technique.

True

T/F the transverse processes extend laterally from the junction of the pedicles and laminae

True

Along with increasing the SID, whoosh other factor(s) will improve spatial resolution for lateral & oblique projections of the cervical spine?

Using a small focal spot

Kyphosis is defined as a(n)?

abnormal thoracic curvature with increased convexity

The AP axial-vertebral arch projection may be performed to better demonstrate the:

articular pillars of C4-7

Along with the upper incisors, what other bony landmark must be aligned for the AP open-mouth projection?

base of skull

Where is the articular pillar located on a cervical vertebra?

between the superior & inferior articular processes

T/F the posterior cervical oblique projections demonstrate the intervertebral foramina and pedicles on the side closest to the image receptor

false

T/F transverse processes are present only on thoracic vertebrae containing rib connections

false

T2-3 intervertebral disk space is found at the level of the:

jugular notch

Scoliosis is defined as an abnormal or exaggerated ____________ curvature.

lateral

The thyroid dose for a posterior cervical oblique is ____________ greater than that of the anterior oblique.

more than 10 times

The bony structures connected directly to the vertebral body are the:

pedicles

The chin is extended for a lateral projection of the cervical spine to:

prevent superimposition of the mandible upon the spine

Why are the anterior oblique projections (RAO/LAO) preferred of the the posterior oblique projections of the cervical spine?

reduce thyroid dose

A radiograph of an AP open-mouth projection of the cervical spine reveals that the zygapophyseal joints are not symmetric. No fracture or subluxation is present. What positioning error most likely led to this?

rotation of the spine

The most posterior aspect of a typical vertebra is the:

spinous process

Which pathologic condition is defined as a "a condition of the spine characterized by rigidity of a vertebral joint"?

spondylosis

The joints between articular processes of vertebra are termed ________ joints.

zygapophyseal