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
