Midterm Radiographic Procedures Spring Semester 2

Spine

The soft, semi-gelatinous inner aspect of the intervertebral disk is called?

Nucleus pulposus

The intervertebral joints are classified as what joint type?

Amphiarthrodial

A comminuted fracture of the anterior and posterior arches of C1 is termed?

Jefferson fracture

What additional measure can be taken if the patient cannot depress the shoulders adequately for the cervicothoracic (swimmer’s) lateral projection?

Angle the CR 3-5 degrees caudad

What spinal curvature is characterized by an abnormal lateral curvature?

Scoliosis

The zygapophyseal joints are classified as what joint type?

Diarthrodial + Synovial

A fracture that extends through the pedicles of C2, with or without subluxation of C2 onto C3, is called?

Hangman’s fracture

A fracture that involves the dens and can extend into the lateral masses or arches of C1 is termed?

Odontoid fracture

What CR angle is used for an AP axial projection of the cervical spine?

15 to 20 degrees cephalad

What type of CR angle is used for a cervicothoracic (swimmer’s) lateral of the cervical spine?

No angle; CR perpendicular

Enter at T1, which is approximately 1” above jugular notch, and anteriorly at the level of the vertebra prominens

What is the benefit of utilizing a breathing technique for the lateral position of the thoracic spine?

To blur unwanted rib and lung markings overlaying the thoracic vertebra

The intervertebral foramina of the lumbar spine are located and an angle of __ in relation to the MSP.

90 degrees

An LPO position of the lumbar spine reveals downside pedicle is projected too far posterior on the vertebral body? How is this corrected?

Decrease body rotation

(T/F) A 5-8 degree angle on a lateral sacrum/coccyx is needed for a diagnostic x-ray.

False

If the intervertebral foramen are not open and visualized on an lumbar spine projection, how is this corrected?

Increase waist support with a sponge

Angle CR 5-8 degrees caudal

The small section of bone found between the superior and inferior articular processes of the lumbar spine is termed?

Pars interarticularis

A comminuted fracture of the ring of C1 is termed?

Jefferson’s fracture

The anterior projecting bony process of the sacrum that forms part of the inlet and true pelvis is the?

Promontory of the sacrum

Which specific aspect of the sacrum articulates with the ilium to form the sacroiliac joint?

Auricular surface

What is the term for the superior aspect of the coccyx?

Base

The intervertebral joints in the lumbar spine are classified as?

Cartilaginous + amphiarthrodial

What palpable landmark corresponds with the L4-L5 vertebral level?

Iliac crest

The radiographic appearance of an oblique lumbar spine in which the neck of the Scotty dog appears broken suggests the presence of what pathology?

Spondylosis

The average degree of rotation required to demonstrate the L3-L4 zygapophyseal joints is?

45 degrees

Why are the hips and knees flexed for an AP projection of the lumbar spine?

To reduce the lumbar curvature

For patient comfort

(T/F) The anterior oblique (RAO and LAO) positions of the lumbar spine will demonstrate the zygapophyseal joints closest to the IR.

False

Which of the following is done to reduce scatter from reaching the IR for a lateral lumbar projection?

1. Using a lower technique

2. Placing a lead mat on the tabletop behind the patient

3. Increase the SID to 44”

4. Utilizing a smaller image receptor

2. Placing a lead mat on the tabletop behind the patient

How many segments, on average, make up the adult coccyx?

4

(T/F) If the waist is supported properly with a sponge, when performing on an average-sized patient, it does not require any CR angulation.

True

The breast and thyroid dose is reduced by how much by performing a scoliosis study PA instead of AP?

90 percent

(T/F) The AP and lateral projections for a pediatric scoliosis study should include the entire lumbar and thoracic spine.

True

A fracture through the vertebral body and posterior elements caused during sudden deceleration in an auto vehicle accident is?

Chance fracture

What is a condition, of unknown cause, in which calcifications of the bony ridges of the vertebrae negatively impact mobility?

Ankylosing spondylitis

What is an anterior wedging of vertebrae with a loss of body height and without neurologic symptoms called?

Compression fracture

Sciatic-type pain resulting from a slipped vertebral disk indicates?

Herniated nucleus pulposus

What is the small section of bone found between the superior and inferior articulating process of the lumbar spine called?

Par interarticularis

The zygapophyseal joint of the upper lumbar vertebrae are located how many degrees in relation to the MSP?

50 degrees

An abnormal increase in the convexity of the thoracic spine is termed?

Kyphosis

There are how many foramina located in the cervical vertebra?

3

How many degrees is the body rotated for a PA axial projection of the cervical spine?

45 degrees

How many degrees is the body rotated from the lateral position to demonstrate the zygapophyseal joint of the thoracic spine?

15-20 degrees

Spina bifida is a congenital deformity of the vertebral column in which the __ fail to unite?

Lamina

The articulations between the articular process of the vertebral arches form what joints?

Zygapophyseal joints

What are the articulating surfaces of the articular processes of the vertebrae covered with fibrocartilage called?

Facets

How many degrees is the CR angled for an AP axial cervical vertebrae?

15-20 degrees cephalad

The intervertebral foramina of the cervical spine are open _ degrees anteriorly and _ degrees inferiorly.

45

15

The first cervical vertebrae is termed?

Atlas

The openings in the cervical vertebrae for the transmission of the vertebral artery and vein are called?

Transverse foramen

The superior and inferior articular processes of the cervical spine form thick columns called?

Articular pillars

C7 is also called the?

Vertebra prominens

The zygapophyseal joints of the thoracic spine form an angle of how many degrees to the MSP?

70-75 degrees

The zygapophyseal joints of the vertebral column are classified as?

Synovial + gliding

How many degrees is the CR angled for an AP projection of the dens (fuchs) method?

0 degrees

Where are the arms positioned for a lateral projection of the thoracic spine?

Flexed and at right angled to the body

Which intervertebral foramina are demonstrated on an AP axial oblique projection of the cervical spine?

Farthest from the image receptor

What breathing technique can be used for a lateral projection of the thoracic vertebrae?

Suspended inspiration and/or quiet breathing

Which landmark line must be perpendicular to the IR for the AP “open mouth” odontoid projection?

Line drawn from the lower ridge of the upper incisors to tip of mastoid

Which body plane is perpendicular to the tabletop for a lateral lumbar spine?

MCP

Which projection(s) of the thoracic spine is improved with the use of a compensating filter?

Lateral cervicothoracic region + AP thoracic

Which thoracic vertebrae contain costal facets on the transverse process?

T1-T10

At which vertebral level does the solid spinal cord terminate?

L1

What divisions of the spine are primary curves?

Thoracic

Sacral

What divisions of the spine are secondary curves?

Cervical

Lumbar

(T/F) The lumbar possesses a concave posterior spinal curvature.

True

An abnormal or exaggerated thoracic spinal curvature with increased convexity is called?

Kyphosis

What is the correct term for the condition involving a “slipped disk”?

Herniated nucleus pulposus

The superior and inferior vertebral notches create which foramina?

Intervertebral

Which joints are found between the superior and inferior articular processes?

Zygapophyseal joints

What artery and vein pass through the cervical transverse foramina?

Vertebral

(T/F) The thoracic spine possesses facets for rib articulations and bifid spinous processes.

False

The intervertebral foramina for the cervical spine lie at a __ degree angle to the MSP.

45

Which ligament holds the dens against the anterior arch of C1?

Transverse atlantal ligament

The large joint space between C1 and C2 is called?

Atlantoaxial (zygapophyseal) joint

Two partial facets found on the thoracic vertebrae are called?

Demi facets

Which thoracic vertebrae do not possess a facet for the costotransverse joint?

T11

T12

What are three distinctive features of all cervical vertebrae that make them different from the other vertebrae?

Presence of the transverse foramina (3 foramina)

Presence of bifid spinous processes

Overlapping of the vertebral bodies

What is one specific feature of all thoracic vertebrae that makes them different?

Possess facets for articulations with the ribs

Which position of the thoracic spine best demonstrates the intervertebral foramina?

Lateral

Which position/projection of the cervical spine best demonstrates the zygapophyseal joints (between C3-C7)?

Lateral

What joint spaces are visualized with an LAO projection of the thoracic spine?

Left (closest) zygapophyseal joints

What joint spaces are visualized with an RAO projection of the thoracic spine?

Right (closest) zygapophyseal joints

An avulsion fracture of the spinous process of C6-T1 is called?

Clay shoveler’s fracture

(T/F) Herniated nucleus pulposus most frequently develops at the L2-L3 vertebral level

False (L4-L5)

What two things can be done to minimize the effects of scatter radiation on lateral projections of the thoracic and lumbar spines?

Tight horizontal collimation

Utilize lead mats behind patient (absorb scatter)

Which position/projection best demonstrates the zygapophyseal joints between C1 and C2?

AP open mouth (odontoid)

How many degrees and in which direction is the CR angled for an anterior oblique projection of the cervical spine?

15 degrees caudad

How many degrees and in which direction is the CR angled for a posterior oblique projection of the cervical spine?

15 degrees cephalad

Which projection of the cervical spine demonstrates the left intervertebral foramina?

LAO

In addition to using a longer SID, what are two positioning techniques that can be used to lower the shoulders to help visualize C7-T1 for a lateral projection of the cervical spine?

Suspend respiration on full expiration

Utilize weights affixed to the wrists

What position/projection demonstrates the lower cervical and upper thoracic spine (C4-T3) in a lateral perspective?

Lateral swimmer’s

(A fracture/subluxation must be ruled out)

What two positions/projections will project the dens in the center of the foramen magnum?

Judd (PA)

Fuchs (AP)

A lateral cervical spine radiograph demonstrates that the zygapophyseal joint spaces are not superimposed. What positioning error is present?

Tilt and/or rotation of the spine

A radiograph of a lateral thoracic spine projection shows that the intervertebral foramina and joints spaces are not clearly demonstrated. What positioning error can cause this outcome?

The spine is not parallel to the IR and/or CR is not aligned perpendicular to the spine

A radiograph of an AP open mouth projection of the cervical spine demonstrates the upper incisors superimposed over the top of the dens. What positioning error is present in the radiograph?

Excessive flexion of the skull

(Extend skull slightly back to demonstrate dens)

Compared with the spinous processes of the cervical and thoracic spines, the lumbar spinous processes are:

1. Smaller

2. Pointed more inferior

3. Larger and more blunt

4. Absent

3. Larger and more blunt

The anterior/superior ridge of the upper sacrum is called?

Promontory

Each sacroiliac (SI) joint opens obliquely __ degrees posteriorly.

25-30

The angle of the mid-lumbar spine zygapophyseal joints in relation to the MSP is how many degrees?

45 degrees

Where is the pars interarticularis found?

Between the superior and inferior articular processes

The zygapophyseal joints of the lumbar spine are classified as what joint type?

Synovial