Vertebral and Spine

The structure transverse process is labeled _____.

A

How much obliquity of the body is required for posterior oblique positions for the sacroiliac joints? a. 45° b. 10° to 15° c. 60° to 70° d. 25° to 30°

D. 25-30

Along with the upper incisors, what other bony landmark must be aligned for the AP open-mouth projection? a. Base of skull b. Tip of mandible c. Inferior margin of lower incisors d. Thyroid cartilage

a. Base of skull

Where is the articular pillar located on a cervical vertebra? a. Between the superior and inferior articular processes b. Between the pedicle and the body c. Between the spinous process and the lamina d. Nowhere

a. Between the superior and inferior articular processes

The most prominent aspect of the thyroid cartilage corresponds to the vertebral level of: a. C5. b. C1-2. c. C6-7. d. C7-T1.

a. C5.

Which factor is most important to open up the intervertebral joint spaces for a lateral thoracic spine projection? a. Use sufficiently high kV. b. Collimate the spine region to reduce scatter. c. Keep vertebral column parallel to tabletop. d. Angle the central ray (CR) 5° to 10° caudad.

c. Keep vertebral column parallel to tabletop.

The spinal cord tapers off to a point distally at the vertebral level of: a. lower L5. b. L2-3 intervertebral space. c. L1-L2. d. L4-5 intervertebral space.

c. L1-L2.

What is the term for the superior aspect of the coccyx? a. Base b. Apex c. Superior margin d. Sacrococcygeal junction

A. Base

Which of the following pathologic conditions is defined as "a condition of the spine characterized by rigidity of a vertebral joint"? A. Spondylitis B. Ankylosing spondylitis C. Spondylosis D. Scheuermann disease

A. Spondylitis

Another term for a breathing technique during exposure is the orthostatic technique. a. True b. False

A. True

The LPO position for sacroiliac joints will best demonstrate the right joint. a. True b. False

A. True

The pelvis must remain stationary for the AP right and left bending projections of the scoliosis series. a. True b. False

A. True

A young female patient comes to radiology for a scoliosis study. The patient has had this series performed frequently. How much will the breast dose be decreased if a PA rather than an AP projection is taken? a. 15% b. 90% c. 35% d. It will not make a significant difference with good collimation.

B. 90

Which of the following is the first compensatory spinal curvature to develop in the young child? a. Thoracic b. Cervical c. Sacral d. Lumbar

B. Cervical

The "nose" of the Scottie dog represents the spinous process of a lumbar vertebra. a. True b. False

B. False

The PA projection (Judd method) is intended to demonstrate the atlantoaxial joints between C1 and C2. a. True b. False

B. False

The long axis of the sacrum is generally angled more posteriorly in males than females. a. True b. False

B. False

The use of digital radiography is not recommended for studies of the sacrum and coccyx. a. True b. False

B. False

An RPO position of the cervical spine requires a 45° oblique of the body with a 15° caudad CR angle. a. True b. False

B. False-cephalid

The most posterior aspect of a typical vertebra is the: a. pedicle. b. spinous process. c. lamina. d. body.

B. Spinous process

Which specific aspect of the sacrum articulates with the ilium to form the sacroiliac joint? a. Promontory b. Cornu c. Auricular surface d. Inferior articular processes

C. Auricular surface

The gonion corresponds to the vertebral level of: a. C1. b. C4-5. c. C3. d. C7.

C. C3

Which of the following fractures is due to a hyperflexion force injury? a. Compression fx b. Burst fx c. Chance fx d. Metastatic fx

C. Chance fx

Scoliosis is defined as an abnormal or exaggerated _____ curvature. a. concave b. convex c. lateral d. "swayback" lumbar

C. Lateral

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 lateral projection of the thoracic spine reveals that the upper aspect, which is a primary area of interest on this patient, is obscured by the patient's shoulders. Which of the following changes will best demonstrate this region of the spine? a. Use a compensating (wedge) filter and repeat the exposure with increased kV. b. Angle the CR 10° to 15° cephalad. c. Perform the projection with the patient erect and holding weights in hand during exposure. d. Perform a cervicothoracic (swimmer's) lateral position.

d. Perform a cervicothoracic (swimmer's) lateral position.

The posterior cervical oblique projections demonstrate the intervertebral foramina and pedicles on the side closest to the image receptor. a. True b. False

False

The structure pedicle is labeled _____

L

The zygapophyseal joints of the upper lumbar vertebrae are ____ in relationship to the midsagittal plane. a. 30° b. 50° c. 45° d. 90°

b. 50°

How much CR angulation is required for the AP axial projection for the cervical spine? a. CR is perpendicular to the image receptor. b. 5° to 10° cephalad c. 15° to 20° cephalad d. 15° to 20° caudad

c. 15° to 20° cephalad

The zygapophyseal joints for the thoracic spine lie at an angle of ____ in relation to the midsagittal plane. a. 45° b. 60° c. 70° to 75° d. 90°

c. 70° to 75°

Radiographs of oblique projections of the SI joints do not clearly demonstrate the inferior/distal aspect of the joints. What can the technologist do to better demonstrate this region? a. Increase rotation of the pelvis. b. Initiate exposure upon expiration. c. Angle CR 15° to 20° cephalad. d. Perform positions erect.

c. Angle CR 15° to 20° cephalad.

Which imaging modality will best demonstrate herniated nucleus pulposus in the cervical spine? a. Computed tomography (CT) b. Hyperflexion and hyperextension lateral projections c. Magnetic resonance imaging (MRI) d. Nuclear medicine

c. Magnetic resonance imaging (MRI)

The structure labeled A, which should be well demonstrated on this projection, is the: a. pedicle. b. lamina. c. Odontoid process d. inferior articular process.

c. Odontoid process

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

B. T11-12

The xiphoid process corresponds to the vertebral level of: a. T8. b. T 9-10. c. T7. d. T12.

B. T9-10

A radiograph of an AP thoracic spine projection reveals that the upper thoracic spine is overexposed. The lower vertebrae have acceptable density and 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

Along with increasing the source image receptor distance (SID), what other factor(s) will improve spatial resolution for lateral and oblique projections of the cervical spine? a. Increasing object image receptor distance (OID) b. Using a small focal spot c. Using higher kV, lower mAs d. Using a breathing technique

B. Using a small focal spot

On average, how many separate bones make up the adult vertebral column? a. 33 b. 28 c. 26 d. 31

C. 26

The body of C2 is labeled _____.

D

The zygapophyseal joints for the typical cervical vertebra lie at an angle of ____ in relation to the midsagittal plane. a. 45° b. 60° c. 70° to 75° d. 90°

D. 90

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

D. LAO

The superior articular facet is labeled _____.

G

The structure anterior arch of the atlas is labeled _____.

H

Stress from a severe whiplash type of injury may cause a fracture of the structure labeled _____.

I

The structure lamina is labeled _____.

M

The part vertebral foramen is labeled _____.

O

The structure transverse foramen is labeled _____.

Q

Where is the CR centered for posterior oblique projections of the SI joints? a. 1 inch (2.5 cm) medial to upside ASIS b. 2 inches (5 cm) medial to upside ASIS c. Centered at upside ASIS d. 1 inch (2.5 cm) medial and inferior to upside ASIS

a. 1 inch (2.5 cm) medial to upside ASIS

Which aspect of the scottie dog is the transverse process? a. A b. B c. C d. D

a. A

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

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? a. Increase the extension of the skull. b. Increase the flexion of the skull. c. Angle the CR 3° to 5° caudad. d. Have the patient hold 5 to 10 lb in each hand.

a. Increase the extension of the skull.

A patient comes to radiology for a follow-up study of the lumbar spine. The patient had a spinal fusion performed at the L3-4 level 4 months earlier. Which of the following would best demonstrate the degree of movement at the fusion site? a. Lateral hyperextension and hyperflexion projections b. Ferguson method c. AP and lateral erect projections d. Right and left 45° oblique projections

a. Lateral hyperextension and hyperflexion projections

A patient enters the emergency department (ED) because of a motor vehicle accident (MVA). The patient is on a backboard and wearing a cervical collar. The technologist is concerned about the artifacts that the collar will project on the spine during the horizontal beam lateral projection. What should the technologist do in this situation? a. Leave the collar on during the exposure. b. Remove the cervical collar but be careful not to move the patient's head. c. Ask the patient to remove the collar herself (for liability reasons). d. Ask the ED physician to remove the collar and to hold the patient's head while the technologist is initiating the exposure.

a. Leave the collar on during the exposure.

Which one of the following structures of the sacrum is considered to be the most posterior? a. Median sacral crest b. Promontory c. Superior articular processes d. Spinous processes

a. Median sacral crest

Which aspect of the intervertebral disk is composed of semigelatinous material? a. Nucleus pulposus b. Annulus fibrosus c. Conus medullaris d. Cauda equina

a. Nucleus pulposus

A geriatric patient comes to radiology for a lumbar spine series. She has severe kyphosis of the thoracolumbar spine. Which one of the following modifications should be applied to this patient? a. Perform all positions erect. b. Perform all positions recumbent, include flexion and extension projections. c. Include the entire spine for all projections regardless of what was ordered by the physician. d. Use high (90 kV) for all projections.

a. Perform all positions erect.

Which of the following structures is located at the level of the ASIS? a. S1-2 b. tip of coccyx c. promontory of sacrum d. L4-5

a. S1-2

Which of the following statements is true for a typical adult vertebra? a. The transverse processes extend laterally from the junction of the pedicles and laminae. b. The transverse processes are present only on thoracic vertebrae containing rib connections. c. The spinous process extends posteriorly from the body of the vertebra. d. All of the above are true statements.

a. The transverse processes extend laterally from the junction of the pedicles and laminae.

T2-3 intervertebral disk space is found at the level of the: a. jugular notch. b. sternal angle. c. xiphoid process. d. 2 inches (5 cm) below the jugular notch.

a. jugular notch.

The bony structures connected directly to the vertebral body are the: a. pedicles. b. articular processes. c. laminae. d. transverse processes.

a. pedicles.

The anterior projecting bony process of the sacrum that forms part of the inlet of the true pelvis is the: a. promontory of the sacrum. b. body of S1. c. apex of coccyx. d. sacral foramina.

a. promontory of the sacru

The joints between articular processes of vertebra are termed _____ joints. a. zygapophyseal b. fibrous c. intervertebral d. synarthrodial

a. zygapophyseal

A patient comes to radiology for a study of the lumbar spine. He has a clinical history of spondylolisthesis of L5. Which of the following projections will best demonstrate the severity of this condition? a. 30° oblique projections b. 50° oblique projections c. Lateral L5-S1 projection d. AP axial L5-S1 projection

b. 50° oblique projections

Which of the following statements is true? a. All adult vertebrae are separated by intervertebral disks. b. All thoracic vertebrae have at least one facet for rib articulation. c. The intervertebral disks are tightly bound to the vertebral bodies to prevent movement within the vertebral column. d. All of the above are true statements.

b. All thoracic vertebrae have at least one facet for rib articulation.

A patient comes in with a possible compression fracture of L3. Which one of the following positioning routines would best demonstrate the body of L3 and the intervertebral joint spaces above and below it? a. Collimated R and L posterior oblique and AP projections b. Collimated PA and lateral projections c. Erect AP and lateral projections d. Collimated LPO and RPO positions

b. Collimated PA and lateral projections

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? a. Excessive flexion of the skull b. Excessive extension of the skull c. Excessive CR angulation d. Rotation of the skull

b. Excessive extension of the skull

The anterior oblique thoracic spine demonstrates the upside zygapophyseal joints. a. True b. False

b. False - remember when patient is PA: Down, Down, Up, Down

A patient comes to the radiology department for a cervical spine routine. The study is ordered for non-traumatic 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? a. Increase the flexion of the skull. b. Increase the extension of the skull. c. Perform the Fuchs or Judd method. d. Perform the AP chewing projection.

b. Increase the extension of the skull.

Which of the following projections will best demonstrate a compression fracture of the thoracic spine? a. AP projection b. Lateral projection c. Posterior oblique positions d. Anterior oblique positions

b. Lateral projection

A patient comes to radiology for a follow-up study for a clay shoveler'sfracture. Which of the following projections will best demonstrate the extent of this fracture? a. AP cervical spine b. Lateral thoracic spine c. Lateral cervical spine d. AP axial-vertebral arch projection

b. Lateral thoracic spine

A radiograph of the left sacroiliac joint demonstrates it open and clearly seen. Which of the following positions was performed? a. LPO b. RPO c. RAO d. AP

b. RPO

Which of the following factors does not apply to a lateral projection of the cervical spine? a. Use a 72-inch (183 cm) 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.

What is the joint classification of the zygapophyseal joints? a. Cartilaginous/amphiarthrodial b. Synovial/diarthrodial c. Fibrous/synarthrodial d. Symphyses/amphiarthrodial

b. Synovial/diarthrodial

Why are the anterior oblique projections (right anterior oblique [RAO]/left anterior oblique [LAO]) preferred over the posterior oblique projections of the cervical spine? a. To make the patient more comfortable b. To reduce the thyroid dose c. To prevent overlap of the mandible over the spine d. To place the zygapophyseal joints closer to the image receptor

b. To reduce the thyroid dose

The AP axial-vertebral arch projection may be performed to better demonstrate the: a. C1 and C1-2 atlantoaxial joint spaces. b. articular pillars of C4-7. c. open intervertebral disk spaces of C3-T1. d. dens within the foramen magnum.

b. articular pillars of C4-7.

What type of joint movement occurs with the zygapophyseal joints? a. ginglymus b. plane c. ellipsoidal d. trochoidal

b. plane

A patient enters the ED with a cervical spine injury as a result of a fall. The initial horizontal beam lateral projection reveals no subluxation or fracture. The ED physician is concerned about a whiplash injury. Which of the following routines would be most helpful in diagnosing this type of injury? a. Patient in the swimmer's lateral position b. Oblique projections of the cervical spine c. Patient in hyperflexion and hyperextension lateral positions d. AP Ottonello method

c. Patient in hyperflexion and hyperextension lateral positions

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. Which one of the following positioning errors most likely led to this radiographic outcome? a. Excessive CR angulation b. Insufficient CR angulation c. Rotation of the head d. Excessive flexion of the head

c. Rotation of the head

The intervertebral joints in the lumbar spine are classified as: a. synovial/diarthrodial b. fibrous/synarthrodial c. cartilaginous/amphiarthrodial d. fibrous/amphiarthrodial

c. cartilaginous/amphiarthrodial

Another term for the sacral horns is the: a. base of the sacrum. b. promontory of the sacrum. c. cornu of the sacrum. d. median sacral crest.

c. cornu of the sacrum.

For a lateral L5-S1 projection, the CR must be parallel to the: a. midsagittal plane. b. midcoronal plane. c. interiliac line. d. transverse plane

c. interiliac line.

The thyroid dose for a posterior cervical oblique is ____ greater than that of the anterior oblique. a. two times b. one fourth c. more than 10 times d. None of these; there is no significant difference with proper collimation.

c. more than 10 times

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? a. Pillar view projection of interest region b. Swimmer's lateral projection c. Spot AP and lateral projections of interest region d. 70° oblique projections

d. 70° oblique projections

The intervertebral foramina of the lumbar spine are located at an angle of _____ in relation to the midsagittal plane. a. 45° b. 30° to 35° c. 70° to 75° d. 90°

d. 90°

Which position or projection of the cervical spine will best demonstrate the zygapophyseal joint spaces between C1 and C2? a. Anteroposterior (AP) axial b. Lateral c. 45° posterior or anterior oblique d. AP open mouth

d. AP open mouth

Which of the following features makes the cervical vertebra unique as compared with other vertebrae of the spine? a. Transverse foramina and 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.

A female patient is brought to the emergency department (ED) because of a MVA (motor vehicle accident). Her chief complaint is pain in the lower lumbar region. The ED physician orders a lumbar series. Upon questioning, the technologist learns that the patient is pregnant. The ED physician is made aware of the pregnancy but still wants the lumbar spine series performed. What can the technologist do to minimize dose to the fetus and mother? a. Use higher kV than normal, reduce mAs accordingly. b. Use smallest IR possible. c. Collimate as much as feasible. d. All of the above should be done.

d. All of the above should be done.

Which aspects of the scottie dog is the inferior articular process? a. A b. B c. C d. D

d. D

A patient comes to radiology for a follow-up study of the cervical spine. The patient had spinal fusion between C5-6 performed 6 months earlier. His physician wants to assess the cervical spine for anteroposterior mobility. Which of the following projections would provide this assessment? a. Cervicothoracic projection b. AP axial-vertebral arch projection c. Judd or Fuchs projection d. Hyperflexion and hyperextension projections

d. Hyperflexion and hyperextension projections

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 for this projection: 5° cephalad angle, 40-inch (100 cm) SID, grid, slight extension of the skull, and the CR centered to the thyroid cartilage. Which of the following modifications should be made during the repeat exposure? a. Keep the CR perpendicular to the image receptor. b. Increase the SID to 72 inches (183 cm). c. Center the CR to the gonion. d. Increase the CR angulation.

d. Increase the CR angulation.

A patient enters the ED due to an MVA. He is on a backboard and in a cervical collar. The initial lateral cervical spine projection demonstrates C1 to C6. The patient has broad and thick shoulders. Because the hospital is in a rural setting, no CT scanner is available. Which of the following modifications would best demonstrate the lower cervical spine? a. Repeat the exposure and increase kV. b. Repeat the exposure but ask the patient to stand up and do the lateral projection erect. c. Repeat the exposure but have a student pull down on the arms during the exposure. d. Perform the horizontal beam cervicothoracic (swimmer's) lateral position.

d. Perform the horizontal beam cervicothoracic (swimmer's) 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 image receptor obscures the spinous processes. What can the technologist do to improve the visibility of the posterior elements of the spine? a. Use higher-speed screens and film. b. Increase the kV, lower the mAs. c. Use a higher-ratio grid. d. Place a lead mat on the tabletop just posterior to the patient.

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

Which term best defines or describes the vertebral body of C1? a. The smallest of all vertebral bodies b. A column of bone supported by an intervertebral disk c. A large bony mass d. There is no vertebral body at C1.

d. There is no vertebral body at C1.

Kyphosis is defined as a(n): a. normal lumbar curvature. b. normal convex sacral curvature. c. normal compensatory curve of thoracic spine. d. abnormal thoracic curvature with increased convexity.

d. abnormal thoracic curvature with increased convexity.

which of the following topographic landmarks corresponds with the L4-5 vertebral level? a. diploid process b. lower costal margin c. ASIS d. iliac crest

d. iliac crest

The small section of bone found between the superior and inferior articular processes of the lumbar spine is termed: a. pillar. b. transverse processes. c. articular facets. d. pars interarticularis.

d. pars interarticularis.

The chin is extended for a lateral projection of the cervical spine to: a. open up the C1-2 joint space. b. demonstrate the articular pillars. c. open up the intervertebral joint space. d. prevent superimposition of the mandible upon the spine.

d. prevent superimposition of the mandible upon the spine.

Which aspect of the Scottie dog is the superior articular process? a. A b. B c. C d. D e. E

e. E