RTBC Spine
Which two of the following demonstrate the correct positioning guidelines for performing a lateral thoracic spine radiograph with the patient in a recumbent position? (Select two)
- Arms forward and positioned perpendicular to the body with elbows flexed - Hips and knees are flexed
Which two of the following are the appropriate breathing techniques for a lateral thoracic spine? (Select two)
- Normal breathing - Suspended breathing
Which two of the following are appropriate evaluation criteria for an anteroposterior (AP) axial projection of the sacrum? (Select two)
- Sacrum free of superimposition by the pubic symphysis - Symmetrical sacroiliac (SI) joints
Proper central ray (CR) placement for an anteroposterior (AP) oblique projection with the patient in a right posterior oblique (RPO) position of the sacroiliac (SI) joint is perpendicular and:
1 inch medial to the anterior superior iliac spine (ASIS)
For the lateral projection of the L5-S1 joint, the central ray should be directed:
1.5 inches inferior to the iliac crest and 2 inches posterior to the anterior superior iliac spine (ASIS)
What is the correct central ray (CR) placement for an anteroposterior (AP) axial projection of the sacroiliac (SI) joints?
1.5 inches superior to the pubic symphysis
What is the appropriate central ray angulation and entrance point for an anteroposterior (AP) axial projection of the coccyx?
10 degrees caudad entering midsagittal plane at a level 2 inches superior to the pubic symphysis
When performing a posteroanterior (PA) axial oblique projection, right anterior oblique (RAO) position of the cervical spine, what is the appropriate angulation of the central?
15 - 20 degree caudal angle
When performing an anteroposterior (AP) axial projection of the cervical spine, what is the correct degree and angulation for the x-ray tube?
15 - 20 degree cephalic angle
What is the correct central ray angulation for an anteroposterior (AP) projection of the sacrum?
15 degrees cephalad
Where does the central ray enter for an anteroposterior (AP) projection, right posterior oblique (RPO) position of the lumbar spine?
2 inches medial to the left anterior superior iliac spine (ASIS) and 1.5 inches superior to the level of the iliac crest
What is the degree of rotation for an anteroposterior (AP) oblique projection of the sacroiliac (SI) joints with the patient in a right posterior oblique (RPO) position?
25 - 30 degrees
How is the x-ray tube angled during a cervicothoracic spine, Swimmers, radiograph?
3 - 5 degrees caudad
What is the proper central ray (CR) placement for a lateral sacrum radiograph?
3.5 inches posterior to the anterior superior iliac spine (ASIS)
What is the correct central ray (CR) placement for a lateral coccyx radiograph?
3.5 inches posterior to the anterior superior iliac spine (ASIS) and 2 inches inferior
What is the correct central ray (CR) angle for an anteroposterior (AP) axial projection of the sacroiliac (SI) joints?
30 - 35 degrees cephalic
What is the source-to-image distance (SID) for a lateral projection of the sacrum?
40 inches
What is true recommended source-to-image distance (SID) for anteroposterior (AP) oblique projection of the sacroiliac (SI) joints?
40 inches
When performing a right anteroposterior (AP) axial oblique projection, right posterior oblique position (RPO) cervical spine radiograph, the patient should be rotated:
45 degrees
When performing an anteroposterior (AP) projection, right posterior oblique (RPO) position of the lumbar spine, the patient's body should be rotated so that the midsagittal plane (MSP) forms what degree of angulation within the image receptor (IR)?
45 degrees
Which of the following is the recommended tube angulation for a lateral radiograph of the L5/S1 vertebrae?
5 - 8 degrees caudal
What is the recommended source-to-image distance (SID) for a cross-table lateral cervical spine radiograph with a horizontal beam?
72 inches
When using the wall Bucky to perform a cross-table, lateral cervical spine radiograph with a horizontal beam, what is the recommended source-to-image distance (SID)?
72 inches
Which of the following statements is true for both oblique and lateral projections of the cervical spine?
A 72-inch source-to-image distance (SID) should be used when erect images are obtained
Where should the central ray enter when performing a lateral lumbar spine?
At the midcoronal plane
For a cervical thoracic spine (Swimmers) lateral radiograph, a three-to-five degree caudal angulation may needed to:
Better visualize the C7 - T1 articulation
What anatomical structure(s) should be visible on a diagnostic anteroposterior (AP) sacroiliac joints (SI) radiograph?
Both sacroiliac joints and the open intervertebral disk space between L5 and S1
For lateral flexion images of the cervical spine, the central ray (CR) should be directed to the level of:
C4
When performing a cross-table lateral cervical spine radiograph, where should the beam be centered?
C4
When performing the lateral cervical thoracic spine (Swimmers), where should the central ray be centered?
C7
When performing an anteroposterior (AP) projection, open-mouth of the cervical spine, the central ray must be positioned at the:
Center of the open mouth
The primary reason for having the patient flex the knees for an anteroposterior (AP) projection of the thoracic spine while in the supine position is to:
Decrease object-to-image distance (OID)
To reduce air volume and create a uniform brightness on an anteroposterior (AP) projection of the thoracic spine, which of the following is the most appropriate breathing instruction?
Expose at the end of expiration
Which side of the patient will be demonstrated on an anteroposterior (AP) oblique projection of the sacroiliac (SI) joint with the patient in a right posterior oblique (RPO) position?
Farthest side from the image receptor (IR) with the SI joint open
Identify the structure that is represented by the letter (D) in the following image:
Inferior articular process
Identify the structure that is represented by the letter (B) in the following image:
Intervertebral disc space
Identify the structure that is represented by the letter (C) in the following image:
Intervertebral disc space of C5 - C6
What anatomical structure does the letter (A) represent in the following image?
Intervertebral foramen
How should a patient be positioned for an anteroposterior (AP) projection of the sacroiliac (SI) joints?
Lying supine on the radiographic table
Where does the central ray enter when performing an anteroposterior (AP) axial projection of the sacrum?
Midsagittal plane, 2 inches superior to the pubic symphysis
Where should the central ray be directed for anteroposterior (AP) projection of the thoracic spine?
Midway between the xiphoid and the jugular notch
What degree of tube angulation is needed for an anteroposterior (AP) oblique projection of the sacroiliac (SI) joint with the patient in a right posterior oblique (RPO) position?
No tube angulation
Are there any changes that should be made to the patient's position after reviewing the following lateral sacrum image?
No, all required anatomy is included and the patient is correctly positioned
For anteroposterior (AP) axial projection of the cervical spine, which of the following statements is accurate regarding the centering of the x-ray beam to the part?
Patient's midsagittal plane (MSP) should be centered to the middle of the (IR)
Identify the structure that is represented by the letter (D) in the following image:
Pedicle
When performing an anteroposterior (AP) projection, posterior oblique position of the lumbar spine, the vertebral anatomy resembles a "Scotty dog". What does the eye of the Scotty dog represent?
Pedicle
Identify the structure that is represented by the letter (B) in the following image:
Pedicle of C5
What bony landmark lies at the same level as the superior border of the pubic symphysis?
Prominence of the greater trochanter
Ensuring that the patient is in a true lateral position when performing lateral thoracic spine radiographs is vital to ensure:
Proper visualization of the open intervertebral disk spaces
How should the patient's chin be position during a lateral extension cervical spine radiograph?
Raised to the ceiling
Consider the following scenario: You view the following anteroposterior (AP) axial sacroiliac (SI) joints radiograph and recognize that the marker was mistakenly cut off the image. Using your knowledge of AP projections, what is the structure that is represented by the letter (A)?
Right sacroiliac (SI) joint
What anatomical detail should be visible in a diagnostic lateral extension, cervical spine radiograph?
Seven spinous processes in profile, depressed and closely spaced
Identify the structure that is represented by the letter (D) in the following image:
Spinous process of C6
Lateral flexion images of the cervical spine will demonstrate which of the following?
Spinous processes well separated
What is the correct patient position when performing an anteroposterior (AP) projection of a thoracic spine view?
Standing at the upright bucky or supine on the table
Identify the structure that is represented by the letter (D) in the following image:
Superior articular process
Routine frontal lumbar spine images are typically performed with the patient in which of the following positions?
Supine on table with knees flexed
Which of the following indicates the appropriate breathing instructions for an anteroposterior (AP) axial projection of the sacrum?
Suspend breathing
Where is the central ray direction for a lateral thoracic spine radiograph?
T7
Which anatomical structures are demonstrated on a correctly positioned lateral cervical spine exam?
Vertebral bodies and spinous processes in profile
