positioning spine cervical and thoracic Flashcards

1. How many bones make up the cervical spine?

2. How many bones make up the thoracic spine?

3. How many bones make up the lumbar spine?

4. How many bones make up the sacrum?

5. How many bones make up the coccyx?

6. What is the total number of bones in the adult vertebral column?

What is the name of the condition that results in
the forward slipping o one vertebra on the one
below it?
(A) Spondylitis
(B) Spondylolysis
(C) Spondylolisthesis
(D) Spondylosis

Which o the ollowing is (are) well demonstrated
in the lumbar spine pictured in Figure 2-8?
1. Zygapophyseal articulations
2. Intervertebral foramina
3. Pedicles
(A) 1 only
(B) 1 and 2 only
(C) 2 and 3 only
(D) 1, 2, and 3

Which of the following projections can be used to
supplement the traditional “open mouth” projection when the upper portion o the odontoid process cannot be well demonstrated?
(A) AP or PA through the foramen magnum
(B) AP oblique with right and le head rotation
(C) Horizontal beam lateral
(D) AP axial

The CR is parallel to the intervertebral foramina in
the following projection(s)
1. Lateral cervical spine
2. Lateral thoracic spine
3. Lateral lumbar spine
(A) 1 only
(B) 1 and 2 only
(C) 2 and 3 only
(D) 1, 2, and 3

Structures comprising the neural, or vertebral, arch
include
1. pedicles
2. laminae
3. body
(A) 1 only
(B) 1 and 2 only
(C) 2 and 3 only
(D) 1, 2, and 3

The thoracic zygapophyseal joints are demonstrated with the
(A) coronal plane 90 degrees to the IR.
(B) midsagittal plane 90 degrees to the IR.
(C) coronal plane 20 degrees to the IR.
(D) midsagittal plane 20 degrees to the IR.

The long, at structures that project posteromedial from the pedicles are the
(A) transverse processes
(B) vertebral arches
(C) laminae
(D) pedicles

Which of the following should be per formed to
rule out subluxation or fracture of the cervical
spine?
(A) Oblique cervical spine, seated
(B) AP cervical spine, recumbent
(C) Horizontal beam lateral
(D) Laterals in flexion and extension

A kyphotic curve is formed by which of the
following?
1. Sacral vertebrae
2. Thoracic vertebrae
3. Lumbar vertebrae
(A) 1 only
(B) 1 and 2 only
(C) 3 only
(D) 1 and 3 only

In Figure 2-27, the structure indicated as number 7
is which of the following?
(A) Neck of rib
(B) tubercle of rib
(C) transverse process
(D) Head of rib

In the anterior oblique position of the cervical
spine, the structures best seen are the
(A) intervertebral foramina nearest the IR
(B) intervertebral foramina furthest from the IR
(C) interarticular joints
(D) intervertebral joints

Which of the following is (are) demonstrated in an
AP axial projection of the cervical spine?
1. C3–7 cervical bodies
2. Intervertebral foramina
3. Zygapophyseal joints
(A) 1 only
(B) 1 and 2 only
(C) 2 and 3 only
(D) 1, 2, and 3

The structure labeled 3 in Figure 2-32 is the
(A) spinous process of C2
(B) body of C2
(C) body of C1
(D) posterior arch of C1

The structure labeled 1 in Figure 2-32 is the
(A) Zygapophyseal joint
(B) Intervertebral foramen
(C) Intervertebral disc space
(D) Vertebral body

Which of the following is (are) appropriate technique(s) or imaging a patient with a possible traumatic spine injury?
1. Instruct the patient to turn slowly and stop if
anything hurts.
2. Maneuver the x-ray tube instead of moving the
patient.
3. Call or help and use the log-rolling method to
turn the patient.
(A) 1 and 2 only
(B) 1 and 3 only
(C) 2 and 3 only
(D) 1, 2, and 3

In the anterior oblique position of the cervical
spine, the CR should be directed.
(A) parallel to C4
(B) perpendicular to C4
(C) 15 degrees cephalad to C4
(D) 15 degrees caudad to C4

Which of the following is a functional study used
to demonstrate the degree of AP motion present in
the cervical spine?
(A) Open-mouth projection
(B) Moving-mandible AP
(C) Flexion and extension laterals
(D) Right and le bending AP

Which of the following is (are) demonstrated in a
lateral projection of the cervical spine?
1. Intervertebral foramina
2. Zygapophyseal joints
3. Intervertebral joints
(A) 1 only
(B) 1 and 2 only
(C) 2 and 3 only
(D) 1, 2, and 3

to demonstrate the first two cervical vertebrae in
the AP projection, the patient is positioned so that
(A) the glabellomeatal line is vertical
(B) the acanthiomeatal line is vertical
(C) a line between the mentum and the mastoid
tip is vertical
(D) a line between the maxillary occlusal plane
and the mastoid tip is vertical

T e number 2 in Figure 2-40 represents which o
the following structures?
(A) Body
(B) Pedicle
(C) Inferior articular process
(D) Superior articular process

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

What condition is commonly caused by motor vehicle accidents?
a. Jefferson fracture
b. Hangman fracture
c. Spondylolysis
d. Spina bifida

What condition is caused by acute hyperextension of
the head on the neck and a fracture of the arch of C2?
a. Jefferson fracture
b. Hangman fracture
c. Spondylolysis
d. Spina bifida

What is a defect of the posterior aspect of the spinal
canal caused by failure of the vertebral arch to form
properly?
a. Jefferson fracture
b. Hangman fracture
c. Spondylolysis
d. Spina bifida

What is a defect in the pars articularis?
a. Jefferson fracture
b. Hangman fracture
c. Spondylolysis
d. Spina bifida

What is a comminuted fracture of the ring of the atlas
that involves both anterior and posterior arches and
causing displacement of the fragments?
a. Jefferson fracture
b. Hangman fracture
c. Spondylolysis
d. Spina bifida

For a lateral projection of the cervical spine, which of
the following statements are true?
1. The patient may be upright, seated, or supine,
depending on his or her condition
2. SID of 72 inches should be used because of
increased object-to-image receptor distance
3. The shoulders should lie in the same plane

4. The cervical collar should be removed so that it
does not obstruct pertinent anatomy
5. The chin should be in contact with the chest
a. 1, 2, 4
b. 1, 2, 3
c. 1, 2, 3, 5
d. 1, 2, 4, 5

For a lateral projection of the thoracic spine, which of
the following statements are true?
1. The head and spine should be in the same plane
2. The central ray is directed to T7, at a cephalad
angle of 10 degrees
3. The patient should continue shallow breathing
during exposure
4. The exam should not be performed in a room with
a falling load generator, if possible
a. 1, 2
b. 1, 3
c. 1, 3, 4
d. 1, 2, 3

Structure B is the:
a. Intervertebral foramen
b. Spinous process
c. Pedicle
d. Lamina

Structure C is the:
a. Intervertebral foramen
b. Spinous process
c. Pedicle
d. Lamina

Imaging of what pathologic condition would require
radiography of the cervical spine?
a. Talipes
b. Colles fracture
c. Ankylosing spondylitis
d. Jefferson fracture

Imaging of what pathologic condition would require
radiography of the entire spine?
a. Talipes
b. Colle fracture
c. Boxer fracture
d. Ankylosing spondylitis

The structure designated as I is the:
a. Pedicle
b. Superior vertebral notch
c. Interior vertebral notch
d. Lamina

The structure designated as II is the:
a. Pedicle
b. Superior vertebral notch
c. Interior vertebral notch
d. Spinous process

The structure designated as III is the:
a. Lamina
b. Spinous process
c. Superior articular process
d. Pedicle

The structure designated as IV is the:
a. Superior vertebral notch
b. Superior articular process
c. Transverse process
d. Spinous process

The structure designated as V is the:
a. Lamina
b. Spinous process
c. Inferior vertebral notch
d. Inferior articular process

For AP projection of the cervical spine, the central ray
is directed:
a. 10 degrees cephalad
b. Parallel to C4
c. 15 to 20 degrees caudad
d. 15 to 20 degrees cephalad

For lateral projection of the cervical spine, the central
ray is directed:
a. Perpendicular to C4
b. Parallel to C4
c. 15 to 20 degrees caudad
d. 20 to 25 degrees cephalad

For AP projection of the thoracic spine, the central
ray is directed:
a. 5 degrees cephalad
b. Parallel to T7
c. 3 to 4 degrees caudad
d. Perpendicular to T7

Which of the following is (are) demonstrated in the lateral projection of the thoracic spine?

1. Intervertebral spaces
2. Apophyseal joints
3. Intervertebral foramina

A 1 only

B 2 only

C 1 and 3 only

D 1, 2, and 3

The RPO position of the cervical spine requires which of the following combinations of tube angle and direction?

A 15 to 20 degrees caudad

B 15 to 20 degrees cephalad

C 25 to 30 degrees caudad

D 25 to 30 degrees cephalad

Which of the following is (are) well demonstrated in the oblique position of the cervical vertebrae?

1. Intervertebral foramina
2. Disk spaces
3. Apophyseal joints

A 1 only

B 1 and 2 only

C 1 and 3 only

D 1, 2, and 3

Which of the following is (are) demonstrated in the lateral projection of the cervical spine?

1. Intervertebral joints
2. Apophyseal joints
3. Intervertebral foramina

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

Which of the following is (are) demonstrated in a lateral projection of the cervical spine?

1. Intervertebral foramina
2. Apophyseal joints
3. Intervertebral joints

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

To demonstrate the first two cervical vertebrae in the AP projection, the patient is positioned so that

A the glabellomeatal line is vertical.

B the acanthiomeatal line is vertical.

C a line between the mentum and the mastoid tip is vertical.

D a line between the maxillary occlusal plane and the mastoid tip is vertical.

Which of the following is (are) demonstrated in an AP projection of the cervical spine?

1. Intervertebral disk spaces
2. C3–7 cervical bodies
3. Apophyseal joints

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

In the anterior oblique position of the cervical spine, the structures best seen are the

A intervertebral foramina nearest the IR

B intervertebral foramina furthest from the IR

C interarticular joints

D intervertebral joints

A kyphotic curve is formed by which of the following?

1. Sacral vertebrae
2. Thoracic vertebrae
3. Lumbar vertebrae

A 1 only

B 1 and 2 only

C 3 only

D 1 and 3 only

Which of the following should be performed to rule out subluxation or fracture of the cervical spine?

A Oblique cervical spine, seated

B AP cervical spine, recumbent

C Horizontal beam lateral

D Laterals in flexion and extension

The thoracic apophyseal joints are demonstrated with the

A coronal plane 90 degrees to the IR

B midsagittal plane 90 degrees to the IR

C coronal plane 20 degrees to the IR

D midsagittal plane 20 degrees to the IR.

Structures comprising the neural, or vertebral, arch include

1. pedicles
2. laminae
3. body

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

Which of the following projections can be used to supplement the traditional “open-mouth” projection when the upper portion of the odontoid process cannot be well demonstrated?

A AP or PA through the foramen magnum

B AP oblique with right and left head rotation

C Horizontal beam lateral

D AP axial

What is the name of the condition that results in the forward slipping of one vertebra on the one below it?

A Spondylitis

B Spondylolysis

C Spondylolisthesis

D Spondylosis

Which of the following vertebral groups form(s) lordotic curve(s)?

1. Cervical

2. Thoracic

3. Lumbar

A 1 only

B 2 only

C 1 and 2 only

D 1 and 3 only

The apophyseal articulations of the thoracic spine are demonstrated with the

A coronal plane 45° to the IR.

B midsagittal plane 45° to the IR.

C coronal plane 70° to the IR.

D midsagittal plane 70° to the IR.

The right anterior oblique of the cervical spine requires which of the following combinations of tube angle and direction?

A 15° to 20° caudad

B 15° to 20° cephalad

C 25° to 30° caudad

D 25° to 30° cephalad

Fracture through the pedicles and anterior arch of C2 with forward displacement upon C3

Inflammation of the vertebrae

Abnormal or exaggerated convex curvature of the thoracic spine

Comminuted fracture of the vertebral body with posterior fragments displaced into the spinal canal

Avulsion fracture of the spinous process of C7 (or C6 through T1)

Abnormal lateral curvature of the spine

A form of rheumatoid arthritis

Impact fracture from axial loading of the anterior and posterior arch of C1

Mild form of scoliosis and kyphosis developing during adolescence

Produces the "bow tie" sign

Wedge-shaped vertebral body (from lateral perspective)

Fracture line through base of dens, possibly extending into lateral masses or arches of C1

Bow-tie deformity because vertebra is rotated on its axis

Jumped deformity because entire vertebra is located more anteriorly than it should be

Possible narrowing in disk spacing between vertebrae and protrusion of disk into spinal canal on CT or MRI

Degeneration of cartilage and formation of osteophytes (bony outgrowths)

Bone mineral density (BMD) loss

Bony projections extended laterally from transverse processes

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

Mentomeatal line (MML)

Teardrop burst fracture

Clay shoveler's fracture

herniated nucleus pulposus

Gonion is at what vertebral level

T12

L6

C1

C3

A radiograph of a RPO cervical spine projection reveals that the lower intervertebral foramina are NOT open. The upper intervertebral foramina are well visualized. What positioning error most likely led to this radiographic outcome.

When the lower intervertebral foramina are narrowed while the upper foramina are well demonstrated, often over rotation of the upper body occured.

Use a compensating filter with thicker part of filter placed over the upper thoracic spine to equalize the density along the T-spine.

Spondylitis is an inflammatory process of vertebrae and spondylosis is a condition of the spine characterized by rigidity of vertebral joint.

compensates for Increased OID and less divergence of x-ray beam to reduce shoulder superimposition of C7

What is the term for the Articular pillar for the C1 vertebra?

Lateral mass

lateral cervical

Twinning method

In addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the upper vertebrae for oblique projections?

Perform either a AP Fuchs or PA Judd method.

Rotate the skull into a near lateral position

Keep the vertebral column parallel to the IR

Annulus fibrous and inner aspect nucleus pulposus

True or 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.

True

False

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

Thoracic and Sacral

cervical and thoracic

sacral and lumbar

Cervical and Lumbar

What is found between the superior and inferior articular processes?

Vertebra prominence

Ankylosing spondylitis

Zygapophyseal joints

(downside)

A patient comes to the radiology department with a clinical history of Scheuermann disease. Which radiographic procedure is often performed for this condition?

vertebral canal only

Scoliosis series

lumbar AP and lateral

Cervical Spine

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

Presence of the facets for articulation with ribs

AP axial - vertebral arch (pillar) projection

Annulus fibrous and inner aspect nucleus pulposus

AP, Open mouth C1, C2 Tomography for lateral

A patient comes to the ER with a possible Jefferson fracture. Other than a lateral projection or a CT scan, what specific radiographic projection will best demonstrate this type of fracture?

Horizontal beam lateral projection

AP openmouth projection (carefully)

Herniated Nucleus Pulposus (HNP)

Lateral, horizontal beam projection

To ensure the intervertebral joint spaces are open for lateral thoracic spine projection, it is important to

Keep the vertebral column parallel to the IR

AP axial - vertebral arch (pillar) projection

AP, Open mouth C1, C2 Tomography for lateral

Annulus fibrous and inner aspect nucleus pulposus

True or 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

False

This condition is characterized by loss of bone mass. Bone loss increases with age, immobilization, long-term steroid therapy, and menopause. The condition predisposes individuals to vertebral and hip fractures. Bone densitometry has become the gold standard for measuring the degree.

Osteoporosis

hypostasis

Osteoarthritis

Scoliosis

Which zygapophyseal joints are best demonstrated with an LPO position of the thoracic spine

left

C4-C6

T4-T5

Right

What is the purpose of using an orthostatic (breathing) technique for a lateral projection of the thoracic spine?

Use of an orthostatic (breathing) technique to blurr lung markings and ribs more effectively.

To blurr out rib and lung markings that obscure detail of the thoracic vertebrae.

Which foramina are demonstrated with a left anterior position of the cervical spine?

Left intervertebral foramina (downside)

Right intervertebral foramina (upside)

Which projection delivers the greatest skin dose to the patient?

Mentomeatal line (MML) position

Cervicothoracic lateral position

lumbar and sacrum position

Cervical and Lumbar position

True or False: If close collimation is used during conventional radiography of the spine, the use of lead masking is generally not required.

True

False

A radiograph of an AP axial projection of the cervical spine reveals that the intervertebral disk spaces are not open. The following positioning factors were used. Extension of the skull, central ray angles 10 degrees cephalad, central ray centered to the thyroid cartilage, and no rotation or tilt of the spine. Which factor must be modified to produce a more diagnostic image?

AP, Open mouth C1, C2 Tomography for lateral

Perform either a AP Fuchs or PA Judd method.

AP axial - vertebral arch (pillar) projection

Increase CR angulation to 15 degrees cephalad

The anterior oblique thoracic spine demonstrates the upside zygapophyseal joints.

True

False

The spinal cord tapers off to a point distally at the vertebral level of:

C7

T9-T10

C4

L1-L2

Which of the following projections will project the dens within the shadow of the foramen magnum?

PA

AP extension

AP axial

AP projection (Fuchs method)

Which of the following projections will best demonstrate the zygapophyseal joints of the cervical spine?

PA

AP

OBLIQUE

Lateral

Lateral masses

C1

C2

C4

C7

A patient comes to radiology for a follow-up study of the cervical spine. The patient had spinal fusion between C5-6 performed 6 months earlier. His physician wants to assess the cervical spine for anteroposterior mobility. Which of the following projections would provide this assessment?

AP and hyperextension

Hyperflexion only

Hyperflexion and hyperextension

AP with 15 to 20 cephalad

Which of the following thoracic vertebra(e) possess no facets for costotransverse joints?

T12 only

T1-T2

T11-12

T9-T10

A patient comes to the radiology department for a cervical spine routine. The study is ordered for nontraumatic reasons.The AP open-mouth projection reveals that the base of the skull and upper incisors are superimposed, but they are obscuring the upper portion of the dens. On the repeat exposure, what should the technologist do to demonstrate the entire dens?

increase CR angle cephalad

perform AP extension

Perform the Fuchs or Judd method

increase the CR angle caudad

Why are the anterior oblique projections (right anterior oblique [RAO]/left anterior oblique [LAO]) preferred over the posterior oblique projections of the cervical spine?

easier patient positioning

improved compensating (wedge) filter.

To reduce the thyroid dose

smaller focal spot

The zygapophyseal joints for the thoracic spine lie at an angle of ____ in relation to the midsagittal plane.

25-45

20-35

45 to 55

70 to 75

Which of the following positions will demonstrate the left intervertebral foramina of the cervical spine?

RPO

LAO

Which of the following clinical conditions will require a decrease in manual technical factors?

Nucleus pulposus

spinous process.

Advanced osteoporosis

Lateral projection

The PA projection (Judd method) is intended to demonstrate the atlantoaxial joints between C1 and C2.

a. True

b. False

Which of the following positions will best demonstrate the left zygapophyseal joints of the thoracic spine?

RPO

LAO

An RPO position of the cervical spine requires a 45 oblique of the body with a 15 caudad CR angle.

True

False

What type of CR angle is required for posterior oblique (left posterior oblique [LPO]/right posterior oblique [RPO]) positions of the cervical spine?

15 cephalad

10 cephalad

20 cephalad

25 cephalad

A patient comes to radiology for a follow-up study for a clay shoveler’s fracture. Which of the following projections will best demonstrate the extent of this fracture?

70 oblique projections

15 to 20 cephalad

AP open mouth

Lateral cervical spine

How much rotation of the body is required for an LAO projection of the thoracic spine (from the plane of the table)?

50 degrees

70 degrees

60 degrees

45 degrees

113. Which AP projection of the cervical spine demonstrates the entire upper cervical spine with one single projection?

AP projection

AP wagging jaw ottonello method

Cervical and Lumbar spine projection

flexion and extension

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

carpal tunnel

spinal pillar

vertebral canal

Articular pillar

Which aspect of the intervertebral disk is composed of semigelatinous material?
1. Nucleus pulposus
2. Annulus fibrosus
3. Conus medullaris
4. Cauda equina

Which of the following pathologic conditions is defined as “a condition of the spine
characterized by rigidity of a vertebral joint”?
a. Spondylitis
b. Ankylosing spondylitis
c. Spondylosis
d. Scheuermann disease

Which of the following is NOT a correct evaluation criterion for the AP axial C spine
projection?
a. C3 to T2 vertebral bodies should be visualized.
b. Spinous processes are seen to be equal distances from the vertebra body lateral
borders.
c. Center of the collimation field is at C4.
d. All of the above are correct criteria.

What type of CR angle is required for posterior oblique (left posterior oblique [LPO]/right
posterior oblique [RPO]) positions of the cervical spine?
a. 15° cephalad
b. 15° caudad
c. 5° to 10° cephalad
d. None; the CR is perpendicular to the image receptor (IR).

This radiographic image represents which of the following projections and/or positions?
a. AP Fuchs method
b. AP pillar projection
c. AP axial C spine projection
d. AP open-mouth projection

A critique of the image demonstrates which repeatable error?

a. Excessive flexion of the skull
b. Excessive extension of the skull
c. Mouth not open far enough
d. None of the above are repeatable errors.

The structure labeled A, which should be well demonstrated on this projection, is the:
a. pedicle.
b. lamina.
c. Odontoid process
d. inferior articular process.

Which imaging modality will best demonstrate herniated nucleus pulposus in the cervical
spine?
a. Computed tomography (CT)
b. Hyperflexion and hyperextension lateral projections
c. Magnetic resonance imaging (MRI)
d. Nuclear medicine