Clinical: Imaging Basics

Question 1

What anatomical plane divides the body into anterior and posterior parts?

Answer 1

Coronal plane

Question 2

What anatomical plane divides the body into superior and inferior parts?

Answer 2

Transverse plane

Question 3

What anatomical plane divides the body into left and right parts?

Answer 3

Sagittal plane

Question 4

What anatomical directional term refers to being further from the point of origin?

Answer 4

Distal

Question 5

What anatomical directional term refers to being closer to the point of origin?

Answer 5

Proximal

Question 6

What anatomical directional term refers to being further from a true sagittal?

Answer 6

Lateral

Question 7

What anatomical directional term refers to being closer to a true sagittal?

Answer 7

Medial

Question 8

What anatomical directional term refers to being closer to the head or further from the “tail”?

Answer 8

Cranial

Question 9

What anatomical directional term refers to being further from the head or closer to the “tail”?

Answer 9

Caudal

Question 10

What anatomical directional term refers to being further from the head or closer to the feet?

Answer 10

Inferior

Question 11

What anatomical directional term refers to being closer to the head or further from the feet?

Answer 11

Superior

Question 12

Anatomical plane(s) similar to the sagittal plane include:

Answer 12

• Lateral plane (divides the body or any of its parts into right and left sides; aka sagittal plane)
• Median plane (passing through midline; aka midsagittal plane)
• Parasagittal plane (alongside or parallel to the midsagittal plane, but not passing through the midline)

Question 13

Anatomical plane(s) similar to the coronal plane include:

Answer 13

• Frontal plane (divides the body or any of its parts into anterior and posterior portions; aka coronal plane)

Question 14

Anatomical plane(s) similar to the transverse plane include:

Answer 14

• Axial plane (divides the body or any of its parts into upper and lower parts; aka transverse plane)

Question 15

What is the difference between radiography and fluoroscopy?

Answer 15

• Radiography uses gamma rays to develop a static image of the internal structure of a body (aka static X-ray)
• Fluoroscopy obtains moving images of the inner part of the body; when an X-ray beam is used for live “video” format

Question 16

Locate the 12^th rib in this AP, X-Ray (anteroposterior, radiograph)

Answer 16

12^th rib

Question 17

Locate the pedicles in this AP, X-Ray (anteroposterior, radiograph)

Answer 17

Pedicles

Question 18

Locate the spinous processes in this AP, X-Ray (anteroposterior, radiograph)

Answer 18

Spinous processes

Question 19

Locate the transverse processes in this AP, X-Ray (anteroposterior, radiograph)

Answer 19

Transverse processes

Question 20

Locate the pars interarticularis (aka pars) in this AP, X-Ray (anteroposterior, radiograph)

Answer 20

Pars interarticularis (aka pars)

Part of the vertebra located between the superior and inferior articular processes

Question 21

Locate the inferior articulating processes in this AP, X-Ray (anteroposterior, radiograph)

Answer 21

Inferior articulating processes

Question 22

Locate the superior articulating processes in this AP, X-Ray (anteroposterior, radiograph)

Answer 22

Superior articulating processes

Question 23

Locate the facet joint space in this AP, X-Ray (anteroposterior, radiograph)

Answer 23

Facet joint space

Question 24

Locate the interlaminar space in this AP, X-Ray (anteroposterior, radiograph)

Answer 24

Interlaminar space

Question 25

Locate the **pedicles** in this **Lateral, X-Ray** (radiograph)

Answer 25

Pedicle

Question 26

Locate the **spinous processes** in this **Lateral, X-Ray** (radiograph)

Answer 26

Spinous processes

Question 27

Locate the **vertebral bodies** in this **Lateral, X-Ray** (radiograph)

Answer 27

Vertebral bodies

Question 28

Locate the **superior articulating processes** in this **Lateral, X-Ray** (radiograph)

Answer 28

Superior articulating processes

Question 29

Locate the **inferior articulating processes** in this **Lateral, X-Ray** (radiograph)

Answer 29

Inferior articulating processes

Question 30

Locate the **facet joint space** in this **Lateral, X-Ray** (radiograph)

Answer 30

Facet joint space

Question 31

Locate the **disc space** in this **Lateral, X-Ray** (radiograph)

Answer 31

Disc space

Question 32

Locate the **sacrum (1^st segment)** in this **Lateral, X-Ray** (radiograph)

Answer 32

Sacrum (1^st segment)

Question 33

Locate the **pars interarticularis (aka pars)** in this **Lateral, X-Ray** (radiograph)

Answer 33

Pars interarticularis (aka pars)

Question 34

What **2 imaging tools** are typically used to verify hypertrophic ligamentum flavum (HLF) in symptomatic lumbar spinal stenosis (LSS) patients?

Answer 34

* **Computerized tomography (CT)** - can be used if an MRI is contraindicated (i.e., metal implants) * **Magnetic resonance imaging (MRI)** - provides best images of soft tissues (i.e., ligamentum flavum)

Question 35

What is a **CT scan** (or CAT scan)?

Answer 35

**CT scans** combine series of X-ray images taken from different angles around the body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside the body

Question 36

Describe the following image:

Answer 36

Coronal CT (moving from anterior to posterior)

Question 37

What area is highlighted on this **coronal CT**?

Answer 37

Vertebral body

Question 38

What area is highlighted on this **coronal CT**?

Answer 38

Transverse processes

Question 39

What area is highlighted on this **coronal CT**?

Answer 39

Sacrum

Question 40

Describe the following image:

Answer 40

Sagittal CT (moving from medial to lateral)

Question 41

What area is highlighted on this **sagittal CT**?

Answer 41

Disc space

Question 42

What area is highlighted on this **sagittal CT**?

Answer 42

Lamina

Question 43

What area is highlighted on this **sagittal CT**?

Answer 43

Spinous processes

Question 44

Describe the following image:

Answer 44

Axial CT (moving from superior to inferior)

Question 45

What area is highlighted on this **axial CT**?

Answer 45

Vertebral body

Question 46

What area is highlighted on this **axial CT**?

Answer 46

Facet joints (articulation of superior and inferior facet surfaces)

Question 47

What area is highlighted on this **axial CT**?

Answer 47

Pedicles

Question 48

What is an **MRI**?

Answer 48

**MRIs** use magnets and radio waves to create pictures of the structures that make up the spine, the spinal cord, and the spaces between the vertebrae, through which the nerves travel

Question 49

What are the 2 most common **types** of magnetic resonance images (MRIs)?

Answer 49

* **T1-Weighted MRI:** fluid shows up black / dark * **T2-Weighted MRI:** fluid shows up white / bright

Question 50

Describe the following image:

Answer 50

T1 Sagittal MRI

Question 51

Describe the following image:

Answer 51

T2 Sagittal MRI

Question 52

Describe the following image:

Answer 52

T2 Axial MRI

Question 53

What is highlighted in this T2 Axial MRI of the lumbar spine?

Answer 53

Compressed thecal sac

Question 54

What is highlighted in this T2 Axial MRI of the lumbar spine?

Answer 54

Hypertrophic facets

Question 55

What is highlighted in this T2 Axial MRI of the lumbar spine?

Answer 55

Hypertrophic ligamentum flavum (HLF)

Question 56

What should you be looking for in a sagittal MRI?

Answer 56

* Level(s) of stenosis * Listhesis (possible spinal instability) * Epidural lipomatosis * Prior surgery * Other spinal abnormalities

Question 57

What should you be looking for in a **parasagittal MRI**?

Answer 57

* Laminar shelves visible * Space / access between laminar shelves

Question 58

What should you be looking for in an **axial MRI**?

Answer 58

* HLF thickness * Unilateral or bilateral decompression needed (based on symptomology)

Question 59

What are some examples of myelographically compatible contrasts that are safe for intrathecal use?

Answer 59

* Omnipaque 180 * Omnipaque 240 * Omnipaque 300 * Isovue M 200 * Isovue M 300

Question 60

What contrast is not recommended for intrathecal use due to potential adverse reactions?

Answer 60

Gadolinium / Magnevist