C Spine/thoracic Flashcards
(136 cards)
0
Q
List the four anteroposterior curves of the vertebral column and indicate if thy are kyphotic or lordotic
A
Cervical curvature ➡️ lordotic
Thoracic curvature➡️ kyphotic
Lumbar curvature ➡️ lordotic
Sacral curvature➡️ kyphotic
1
Q
List the 5 regions of the vertebral column and list the number of vertebrae in each
A
Cervical (true) ➡️7 vertebrae Thoracic (true) ➡️ 12 vertebrae Lumbar (true) ➡️ 5 vertebrae Sacrum (false) ➡️ 5 that fuse to 1 Coccyx (false) ➡️ 3-5 that turn to 1
2
Q
The _______ and ______ curves are primary curves present at birth
A
Thoracic and sacral
3
Q
The _________ curve is a secondary curve that develops when a baby begins to lift his head
A
Cervical
4
Q
________is an abnormal exaggerated thoracic curve or “humpback”. It is a (convex/concave) forward curve.
A
Kyphosis / convex
5
Q
__________ is an abnormal exaggerated lumbar curve or “sway back”. It is a (convex/concave) forward curve.
A
Lordosis/ concave
6
Q
_________ is an abnormal lateral curvature of the spine.
A
Scoliosis
7
Q
The ______ process is the process extending posteriorly from the vertebral arch.
A
Spinous
8
Q
The two ________ processes extend laterally from the vertebral arch
A
Transverse
9
Q
The vertebral body is located on the (anterior/posterior) aspect of the verteba
A
Anterior
10
Q
The _________ of the vertebra above articulates with the superior articular facet of the vertebra below to form the _______joint in the articulated vertebral column
A
Inferior articular/vertebral process
Zygapophyseal
11
Q
The two _______ are the portions of the vertebral arch that extend posteriorly from the postero lateral margin of the vertebral body
A
Pedicles
12
Q
The upper surface of the pedicle is the _______.
A
Superior vertebral notch
13
Q
In the articulated vertebral column, the superior vertebral notch and the inferior vertebral notch of the vertebra above form an opening termed the _________.
A
Intervertebral foramen
14
Q
What passes through the intervertebral foramen?
A
Spinal nerves and blood vessels
15
Q
What are found between the vertebral bodies of the articulated vertebral column
A
Intervertebral disks
16
Q
The inner portion of the intervertebral disk is the semi-gelatinous ________ and the outer is a tough fibrous ______.
A
Nucleus pulposus
Annulus fibrosis
17
Q
When the inner portion escapes its confines and bulges out causing pressure on spinal nerves it is called ______or slipped disc
A
Herniated nucleus pulposus (HNP)
18
Q
What is the structural classification, mobility, and movement type between the vertebral bodies
A
Mobility= amphiathrodial Structural= cartilaginous Movement = n/a
19
Q
What is the structural classification, mobility, and movement type of the zygapophyseal joints
A
Mobility=diarthrodial
Structural=synovial
Movement=plane/gliding
20
Q
What is the structural classification, mobility, and movement type of the atlantooccipital joint
A
Mobility = diarthrodial Structural = synovial Movement = ellipsis
21
Q
What is the structural classification, mobility, and movement type of the atlantoaxial joint
A
Mobility = diarthrodial Structural = synovial Movement = trochoid/pivot
22
Q
Which joint allows the movement of the head when you say “no”
A
Atlantoaxial / C1-C2
23
Q
Which joint allows the movement of the head when you say “yes”
A
Atlantooccipital
24
Another name for C1
Atlas
25
Another name for C2
Axis
26
Which cervical vertebrae has many features of a thoracic vertebrae, including a long spinous process.
C7
27
Describe how the transverse foramina of cervical vertebrae are unique
Only the C spine has 3 foramen
| Thoracic and lumbar only have 1
28
Describe how the spinous processes of the cervical vertebrae are unique
They are shorter and have bifid tips
29
The short column of bone located at the junction of a pedicle and a lamina of a cervical vertebrae is termed the _______ and is composed of _______and ______
Articular pillar
| Inferior articular process and superior articular process
30
Which cervical vertebrae lacks both a vertebral body and a spinous process
Atlas /C1
31
The atlas is a ring made of the _______ anteriorly and _________posteriorly and two lateral masses
Anterior arch
| Posterior arch
32
What is the distinctive feature of C2 that is a process of bone projecting superiorly from the body
Dens / odontoid
33
The spinous process of C7 is located at the level of the body of
T1
34
Which vertebrae is located at the level of the mastoid tip
C1
35
The palpable landmark that lies at the level of C3 is the
Gonion / angle of mandible
36
Which vertebrae is located at the level of the thyroid cartilage
C4-C5
37
What anatomy is demonstrated in a lateral c-spine (joints/foramina)
Zygapophyseal joints
38
What anatomy is demonstrated in RAO c-spine (joint/foramina)
Right intervertebral foramina
39
What anatomy is demonstrated in LAO c-spine (joint/foramina)
Left intervertebral foramina
40
What anatomy is demonstrated in RPO c-spine (joint/foramina)
Left intervertebral foramina
41
What anatomy is demonstrated in LPO c-spine (joint/ foramina)
Right intervertebral foramina
42
On a trauma patient with neck injury, which projection should be done first and why?
Cross table lateral, so the radiologist/dr can determine if the spinal chord is compromised
43
List the routine for a trauma c-spine
Lateral
Both obliques
AP
Odontoid
44
What SID is a lateral c-spine and why?
72"
| To reduce magnification caused by OID
45
Gould the lateral c-spine be taken on inspiration or expiration and why?
Expiration
| To relax the shoulders down
46
The most inferior interspace that should be visualized on the x-table lateral c-spine is
C7-T1
47
If the interspace between c7-T1 cannot be visualized with a lateral c-spine, which position should you do?
Swimmers
48
To position the patient for the open mouth odontoid, the flexion of the head should be such that the____________ line is perpendicular o the IR
Lower margin of the base of the incisors to the mastoid tips
49
List the routine projections for the routine c-spine
Lateral
Both obliques
AP
+/- odontoid
50
On the AP axial c-spine, the CR is angled ________ degrees to enter the MSP just below the thyroid cartilage and to exit at the level of _________
< 15-20
| C4
51
How do you determine the patient was in a true AP with no rotation on the AP axial C-spine image?
Spinous process and SC joints equidistant
| Mandible and base of skull superimposed over C1-C2
52
The patient is rotated ______ degrees for the RAO or LAO c-spine and the CR is directed _________degrees (cephalad/caudad) to exit at the level of the thyroid cartilage
45
15-20
Caudad
53
How do you determine that the patient properly extended their chin on the RAO c-spine image?
The jaw line does not superimpose on the vertebrae
54
When performing the erect lateral c-spine, the top of the IR should be placed at the level of the
Ear attachment
55
When positioning the patient for the erect lateral c-spine, the coronal plane passing through the _________ should be centered to the middle of the IR
C4 thyroid cartilage
56
How do you determine the patient was in the true lateral position with no rotation or tilt on the erect lateral c-spine image
Intervertebral joint spaces are clearly seen.
Bodies should be free of superimposition of articular pillars
Posterior boarders of bodies are superimposed
Superimposition of right and left zygapophyseal joints
57
Why do you have to angle c-spine AP an oblique
Because the vertebral bodies overlap
58
Avulsion (pulling or tearing away) fracture of the spinous process of any vertebra C6-T1; may see double spinous process sign on AP radiograph bc of displacement of avulsed fractured segment
Clay shovelers fx
59
Wedge shaped vertebral body from lateral perspective; irregular spacing from AP perspective
Compression fx
60
Fx of the anterior C2 arch, usually also with anterior subluxation (partial dislocation) of C2 on C3
Hangmans fx
61
Bilateral offset or spreading of the lateral masses of C1 relative to dens
Jeffersons fx
62
Possible narrowing in disk spacing between vertebrae and protrusion of disk into spinal canal on CT or MRI
Herniated nucleus pulposus (HNP)
63
Abnormal or exaggerated convex thoracic curvature
Kyphosis
64
Abnormal or exaggerated lateral curvature of spine
Scoliosis
65
Degeneration of cartilage and formation of osteophytes (bony outgrowths)
Osteoarthritis
66
Most common radiographic examination for clay shoveler's fx
Lateral and AP c-spine
| CT
67
Most common radiographic examination for compression fx
Lateral and AP of affected spine
| CT
68
Most common radiographic examination for hangman's fx
Lateral c-spine
| CT
69
Most common radiographic examination for jefferson's fx
AP open mouth (odontoid) of C1-C2
Lateral x table
CT
70
Most common radiographic examination for herniated nucleus pulposus (HNP)
AP and lateral of affected spine
| MRI
71
Most common radiographic examination for kyphosis
Lateral t-spine
| Scoliosis series, including lateral bending
72
Most common radiographic examination for osteoarthritis
AP and lateral C and/or T spine
73
Most common radiographic examination for osteoporosis
DXA bone density exam of AP L-spine and lateral hip
74
The two main parts of a typical vertebra are the
Body and vertebral arch
75
The ________ are two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline
Lamina
76
The ______ foramina are created by two small notches on the superior and inferior aspects of the Pedicles.
Intervertebral
77
The opening or passageway for the spinal cord is the
Vertebral spinal canal
78
The spinal cord begins with the ______ of the brain and extends down to the ______ vertebra, where it tapers and ends. This tapered ending is called the ________
Medula oblongata
Lower boarder of L1
Conus medullaris
79
What is found between the superior and inferior articular processes
Zygapophyseal joints
80
T/F the zygapophyseal joints of all vertebrae are visualized only in a true lateral position
False
| C1-C2 is visible with AP or frontal projection
81
A short column of bone found between the superior and articular processes in a typical cervical vertebra is called
Articular pillar
82
What I the term for the articular pillar for the C1 vertebra
Lateral masses
83
The zygapophyseal joints for the second through the seventh cervical vertebrae are at ________ degree angle to the midsagittal plane
90
84
The thoracic vertebrae are at a _______ degree angle to the midsagittal plane
70-75
85
What is the name of the joint found between the superior articular processes of c1 and the occipital condyles of the skull
Occipitoatlantal articulation
86
The modified body of C2 is called the
Dens or odontoid process
87
A 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
88
Which specific thoracic vertebrae are classified as typical thoracic vertebrae (I.e. They least resemble cervical or lumbar vertebrae)
T5-T8
89
For the central Ray to pass through and "open" the intervertebral spaces on a 45 degree angle posterior oblique projection of the cervical vertebrae, what central Ray angle is required
15 degree cephalad
90
The upper portion of the sternum
The mandibrum
91
The superior margin of the mandibrum
Jugular notch / suprasternal notch
92
The center portion of the sternum
The body
93
The joint between top and center portion of the sternum
Sternal angle
94
The most inferior aspect of the sternum
Xiphoid process (tip)
95
The gonion is at what vertebral level
C3
96
The xiphoid process is at what vertebral level
T9-T10
97
The thyroid cartilage is at what vertebral level
C4-C5
98
The jugular notch is at what vertebral level
T2-T3
99
The sternal angle is at what vertebral level
T4-T5
100
The mastoid tip is at what vertebral level
C1
101
The vertebral prominence is at what vertebral level
C7-T1
102
3-4inches below the jugular notch is at what vertebral level
T7
103
What organs are radiosensitive and of greatest concern during cervical and thoracic spine radiography
Gonads, thyroid, parathyroid, and breast
104
Two advantages of using higher KVP exposure factors for spine radiography, especially on AP thoracic spine
Increased density
| Decrease in pt dose
105
T/F When using digital imaging for spine radiography, it is important to use close collimation, grid, and lead masking
True
106
To ensure that the intervertebral joint spaces are open for lateral thoracic spine projections it is important to
Keep the vertebral column parallel to the IR
107
For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail by
Using small focal spot and increasing SID
108
Differences between spondylitis an spondylosis
Spondylitis is an inflammatory process of the vertebrae
| Spondylosis is a condition of the spine characterized by rigidity of a vertebral joint
109
Most geriatric pts have a fee of falling of the table
True
110
What is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space
Myelography
111
Which imaging modality is ideal for detecting early signs of osteomyelitis
Nuclear medicine
112
Which two landmarks must be aligned for an AP "open mouth" projection
Lower margin of upper incisors and base of skull
113
What is the purpose of the 15-20 degree angle for the AP axial projection of the cervical spine
To open up intervertebral disk spaces
114
For an AP axial of the cervical spine, a plane through the tip of the mandible and __________ should be parallel to the angled central Ray
Base of the skull
115
T/F less CR angle is required for the AP axial projection of the cervical spine of the examination is performed supine rather than erect
True
116
What are the two important benefits of a SID longer than 40 inches for the lateral cervical spine projection
Compensates for increased OID; reduces magnification
| Less divergence of xray beam to reduce shoulder superimposition of C7
117
Which foramina are demonstrated with a LPO position of the cervical spine
The right intervertebral foramen (upside)
118
Which foramina are demonstrated with a LAO position of the cervical spine
Left intervertebral foramen (downside)
119
In addition to extending the chin, which additional position technique can be performed to ensure that the mandible is not superimposed over the upper cervical vertebrae for the oblique projections
Rotate the skull to a near lateral position
120
What is the recommended SID for a lateral projection o the cervical spine
60-72 inches
121
The lateral projection I the cervical spine should be taken on inspiration or expirariton and why
Expiration to bring the shoulders all the way down
122
The proper name for the swimmers position is
Twining method
123
Where should the CR be for swimmers
T1 1 in above the jugular notch or level of vertebral promines
124
Which region of the spine must be demonstrated with the swimmers position
C5-T3
125
Which projection is considered a "functional study" of the cervical spine
Hyperextention and hyper flexion lateral positions
126
When should the Judd or Fuchs method be performed
If unable to demonstrate the upper part of the debs with the open mouth AP
127
Which AP projection of the cervical spine demonstrates the entire upper cervical spine with one single projection
Wagging jaw
128
Which two things can be done to produce equal density along the entire thoracic spine for the AP projection (especially for a pt with a thick chest)
Correct use of anode-heel effect; use of compensating wedge filter
129
Which zygapophyseal joints are demonstrated in a RAO projection of the thoracic spine
Right (downside)
130
Which projections delivers the greatest skin dose to the Pt
Cervicothoracic lateral positions
131
T/F The thyroid dose used during a posterior oblique cervical spine projection is more than 10 times greater than the dose used for an anterior oblique projection of the cervical spine
True
132
Which structures are best demonstrated with an AP axial vertebral arch projection
Articular pillars (lateral masses)
133
What CR angle must be used with the AP axial vertebral arch projection
20-30 degrees Caudad
134
Which zygapophyseal joints are best demonstrated with a LPO position of the thoracic spine
Right
135
How much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position
20 degrees from a lateral position
