CHAPTER 8 BONTRAGER WB

An abnormal lateral curvature of the spine is called

Scoliosis

Which imaging modality is ideal for detecting early signs of osteomyelitis

nuclear medicine

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

False

Match the following topographic landmarks to the correct vertebral level 1. Gonion A. C7-T1 2. xiphoid process/tip B. T2-T3 3. Thyroid cartilage C. C1 4. Jugular notch D. T4 - T5 5. Sternal Angle E. T9-T10 6. Mastoid Tip F. C4-C6 7. Vertebra Promines G. T7 H. C3 8. 3 to 4 inches below the jugular notch

1. h 2. e 3.f 4.b 5. d 6. c 7. a 8. g

List 3 features that make the cervical vertebrae unique.

1. transverse foramina 2. bifid spinous process tips 3. overlapping vertebral bodies

Name the following parts of the sternum or associated topographic landmarks A. upper portion of sternum: B. superior margin of this upper section (landmark): C. center portion of sternum: D. Joint between top and center portions (landmark): E. most inferior aspect of sternum (landmark):

A. manubrium B. jugular notch C. Body D. sternal angle E. xiphoid Tip/Process

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

A. medulla oblongata B. lower border of L1 C. Conus Medullaris

For an AP axial of the cervical spine, a plane through the tip of the mandible and the __________ should be parallel to the angled CR A. Mastoid Tip B. Gonion C. Base of skull D. External auditory meatus (EAM)

C. base of skull

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

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

False- T1, T10 to T12 have full facets

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

Herniated Nucleus Pulposus (HNP)

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

Lordosis

The modified body of C2 is called the: _____ or ______

Odotoid Process or Dens

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

Spinal canal

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

T5-T8

True/ False To a certain degree, MRI and CT are replacing myelography as the imaging modalities of choice for the diagnosis of a ruptured intervertebral disk

True

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

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

True

True/False: when using digital imaging for spine xrays it is important to use close collimation, grids, ad lead masking.

True

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

articular pillar

List the number of bones found in each division in the adult vertebral column: Cervical Thoracic Lumbar Sacrum Coccyx Total

cervical: 7 thoracic: 12 lumbar: 5 sacrum: 1 coccyx: 1 total: 26

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

facets for articulation with RIbs

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

intervertebral

What is the term for the articular pillar for the C1 vertebra

lateral masses

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

lower margin of upper incisors and base of skull

which structures pass through the intervertebral foramina?

spinal nerves and blood vessels

in addition to the gonads, which other radio-sensitive organs are of greatest concern during cervical and thoracic spine radiography

thyroid, breast, parathyroid glands

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

to open the intervertebral joint spaces

Performing the cervicothoracic projection is often required to demonstrate the C7/T1 region for the obese Pt.

true

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

true

to ensure the interverterbal joint spaces are open for lateral thoracic spine projections, it is important to... a. keep the vertebral column parallel to the IR b. use a small focal spot c. use a breathing technique d. angle the CR caudad

a. keep the vertebral column parallel to the IR

The two main parts of a typical vertebra are the _______ and the ________.

body vertebral arch

The zagapophyseal joints for the 2nd through 7th cervical vertebrae are at a _________ degree angle to the midsagittal plane and the thoracic vertebrae are at a ________ degree angle to the midsagittal plane

1. 90 degrees 2. 70-75 Degrees

Match the correct aspect(s) of the vertebral column with the following characteristics. (may be more than one correct answer) 1. Convex Curve (posterior) A. Cervical Spine 2. Concave curve (posterior) B. Thoracic Spine 3. secondary curve C. Lumbar Spine 4. primary curve D. Sacrum 5. develops as a child learns to hold head errec

1. B and D 2. A and C 3. A and C 4. B and D 5. A

What CR angulation must be used with a PA oblique projection of the cervical Spine

15 degrees cephalad

List the alternative names for the following cervical vertebrae. A. C1: B. C2: C. C7:

A. Atlas B. Axis C. Vertebra Prominens

List the outer and inner aspects of the intervertebral disk A. Outer aspect: _________ B. Inner aspect:_________

A. Annulus Fibrosis B. Nucleus Pulposus

List the conventional projections for the following clinical indications A. Scoliosis B. Teardrop burst Fx C. Jefferson fx D. Scheuermann disease E. Unilateral subluxation of cervical spine F. Herniated nucleus pulposus (HNP)

A. Erect (AP/PA) with bending laterals and lateral B. Lateral Cervical C. AP open mouth C1-C2 D. Scoliosis series E. lateral cervical spine F. AP and lateral of affected spine

What are two important benefits of using an SID of 60 -72 inches for the lateral cervical spine projection?

A. reduces magnification B. reduces the superimposition of C7

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

Atlanto-occiptial

For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail by:(more than one answer choice is correct) A. keeping the vertebral column parallel to the IR B. use a small focal spot C. increasing the SID D. using a breathing technique

B&C

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

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 LAO position of the cervical spine?

Left intervetebral foramina (downside)

what are the major differences between spondylitis and spondylosis

Spondylitis: inflammitory process of vertebrae characterized by bony ridges between vertebrae Spondylosis: condition of the spine characterized by decreased vertebral joint space and arthritic changes of the zygapophyseal joints

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

Thoracic sacral

Match each the following clinical indications of the spine to the correct definition A. fracture through the pedicles and anterior B. inflammation of the vertebrae C. abnormal or exaggerated convex curvature of the thoracic spine D. comminuted Fx of the vertebral nbody with posterior fragments displaced E. Avulsion Fx of the spinous process of C7 F. abnormal lateral curvature of the spine G. a form of rheumatoid arthritis H. impact Fx from axial loading of the anterior and posterior arch of C1 I. Mild form of scoliosis and Kyphosis during adolescence J. Produces the "bow tie: sign 1. ankylosing spongdylitis 2. clay shovelers Fx 3. unilateral subluxation 4. kyphosis 5. scheuermann disease 6. scoliosis 7. jefferson fx 8. teardrop burst fx 9 hangmans fx 10. spondylitis

a. 9 b. 10 c.4 d.8 e. 2 f. 6 g. 1 h. 7 i. 5 j. 3

which of the following is found between the superior and inferior articular processes? A. intervertebral joints B. Articular Joints C. Zygapophyseal Joints D. Intervertebral facets

c. Zygapophyseal joints

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

cervical lumbar

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

myelography

Which foramina are demonstrated with a LPO position of the cervical spine

right inervertebral foramina (upsdie)

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 the oblique projections?

rotate skull into near lateral position

The 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