Positioning - Cervical and Thoracic

15-20 degrees cephalic

The AP axial projection of the cervical spine will utilize a CR angulation of _________

Axis

The dens is a structure of the _________ (name of the vertebrae)

PA

When performing the Judd method for the odontoid process, the _________ projection is utilized

Zygapophyseal joints

What cervical spine structure will be demonstrated when the patient is rotated 90 degrees?

72

An SID of _________ inches should be used for lateral projections of the cervical spine.

The width of the shoulders results in OID from the cervical spine to the plate. The magnification caused by the OID can be reduced by increasing the SID.

Why is an SID of 72 inches used for a lateral cervical spine?

Tip of chin to mastoid process

What line should be positioned perpendicular to the IR when performing the Fuchs Method for the cervical spine?

15-20 caudal

The CR angle for PA projection oblique cervical radiographs should be _________ degrees _________

LAO

What position of the patient will best demonstrate the left cervical intervertebral foramina when using a caudal CR angle?

Occlusal plane and the occipital bone of the skull

What two structures should be superimposed when performing the AP open mouth position?

Pawlow

The method name for the recumbent swimmers position is _________

Thyroid cartilage

When performing the AP Axial projection of the cervical spine, the CR should be directed to _________

Widely separated from one another

When performing the lateral cervical with flexion, how will the spinous processes be demonstrated?

5 degrees caudal

The Twining method uses a CR angle of _________ if the patient’s remote shoulder cannot be adequately depressed.

Kasabch

The _________ method will utilize an AP axial oblique projection in order to demonstrate the odontoid process and the atlanto-axial space

Closest

When performing oblique positions of the cervical spine with the patient in an erect, prone position, which foramen is best demonstrated?

Demonstrate movement or lack of movement due to trauma or disease

Why are flexion/extension views performed when doing lateral cervical spine studies?

Raise chin or extend the neck

If an AP open mouth position is performed and the resulting image shows teeth over the atlanto-axial space, what positioning improvements should be made to improve the image?

Avoid overlap of gonion of mandible and spine

Explain why the chin should be jutted up and forward when performing the oblique images of the cervical spine

Ottonello method; motion allows for all 7 cervical vertebrae to be shown

What is the method name for the wagging jaw? What is special about this view?

Occlusal plane

According to Merrill’s, what line/plane should be placed perpendicular to the IR when performing the AP open mouth cervical spine position?

When C1-C2 joint space is visible on AP open mouth, but tip can’t be seen even when positioned properly

When should the Fuch’s method be performed?

Lateral Extension

Which lateral projection/position of the cervical spine will show the intervertebral spaces widely separated from one another?

Phonate ahh to keep tongue on floor of mouth

What can be done to eliminate the tongue from obscuring atlanto-axial space?

Atlanto-occipital joint

What’s the name of the joint space between the cervical spine and the skull

Within the foramen magnum

Where will the dens be demonstrated when the Fuchs or Judd methods are performed

Lordotic/secondary

What type of curvature is present on the cervical spine?

False

True/False: All 7 cervical vertebrae will be demonstrated in the routine AP axial projection

True

True/False: According to Merrill’s the CR should be perpendicular to the IR if the Fuchs is properly positioned

True

True/False: The Ottonello method is a form of automography

False

True/False: It is appropriate for the technologist to remove a cervical collar if radiographs are cleared by physician

When T1 or the joint space between C7-T1 is obscured by the shoulders on a lateral image

When should a swimmers position be performed?

Oblique

Intervertebral foramen of the cervical spine are best demonstrated when the __________ position is performed

15-20 cephalic

When performing AP axial oblique projections of the cervical spine on a patient who is lying on an exam table, the CR should be directed to C-4 at an angle of __________ degrees __________.

Elevated

When performing the pawlow method for cervical spine the adjacent arm should be __________ (depressed or elevated)

45

The patient should be rotated __________ degrees when oblique cervical spine views are performed

Should not

The patient (should OR should not) turn the chin laterally when performing the oblique cervical spine positions. This causes slight rotation of the superior vertebrae

intervertebral foramen; furthest from

When performing the AP axial cervical obliques, the __________ that is __________ (closest to/furthest from) the IR will be best demonstrated

Entire cervical to upper thoracic to easily count vertebrae

When doing the Pawlow or Twining methods, the book states that only the only the lower cervical and upper thoracic is needed on the image, but in clinicals, what from what to what is typically included and why?

Eccentric Tube Angulation involves moving/angling the CR in order to get the images needed when the patient can’t move themselves. For obliques, need to angle the tube 45 degrees laterally and 15-20 degrees cephalic.

When a patient can neither be erect nor rolled for oblique cervical radiographs due to a trauma situation an ETA must be utilized to obtain oblique radiographs. What does ETA stand for and briefly describe what needs to be done to achieve this.

Lateral

In order to demonstrate the intervertebral foramina of the thoracic spine, the patient should be placed in the __________ position.

20 posterior

To demonstrate the thoracic apophyseal joint that is furthest from the IR with a patient that starts in the lateral position, the patient should be rotated __________ degrees __________.

AP thoracic

Which projection best demonstrates the anode heel effect

Half way between the xyphoid and manubrial notch

For the AP projection of the thoracic spine, the CR should be centered to what?

Long exposure with quiet, normal breathing to blur pulmonary markings and ribs

State the preferred respiration used for lateral thoracic spine and explain why

Twining - Erect, Pawlow - Recumbent

List the two method names for the swimmer’s position and explain difference between two

Head of rib and body of vertebra

What articulates to form a costovertebral joint?

Tubercle of rib and transverse process of vertebra

What articulates to form a costotransverse joint?

2 inferior articulating processes with 2 superior articulating processes

What 2 structures articulate to form the apophyseal joints in the vertebral column?

Kyphotic; Lordotic

What’s the curvature type of the thoracic spine? What’s the curvature type of the lumbar spine?

Parallel

The thoracic spine exam requires that the MSP be placed __________ to the IR.

closest to

When performing prone obliques of the thoracic spine, the apophyseal joint demonstrated will be the one that is __________ (closest to/furthest from) the IR.

Superimposed posterior ribs

What anatomy/criteria should you see on a lateral thoracic spine radiograph that shows they are properly positioned and not rotated?

T7

For a lateral thoracic spine, the CR should be direct to what vertebral level

Bisecting T2-T3 (jugular notch) and T10-T-11 (Xiphoid process)

When centering for an AP thoracic spine, you can find T7 (inferior angle of scapula) by doing what (list vertebral level and anatomic structure)?

Elevate the waist or angle 10-15 degrees cephalic

If a patient has very broad shoulders and the spine is not horizontal when performing a lateral thoracic spine, what can be done to correct this problem?

1.5 to 2 inches above relaxed shoulders

Where should the top of the IR be when positioning for the thoracic spine?

Thicker part of the filter at chest with the thinner part of the filter over the lower chest/abdomen

Explain the proper use of the wedge filter when imaging an AP thoracic spine

Suspend after full expiration to decrease difference in beam attenuation and make a more uniform exposure OR normal, quiet breathing to obscure lung markings and ribs

What are the 2 breathing options used for thoracic spine imaging and why they’re performed

Shoulders tend to obscure upper thoracic vertebra in the lateral view, so a swimmer’s is needed to show the cervicothoracic region

Why is a swimmers performed as part of the routine thoracic spine?

2 vertebral notches

What structures make up the intervertebral foramen?