Midterm

Question 1

Platybasia

Answer 1

flattening of the sphenoid bone and/or occipital bone
 Determined by:
 Martin’s Basilar Angle
 NR: 123-152 degrees
 McGregor’s Line
 N: not greater than 8 mm for males
 not greater than 10 mm for females

Question 2

Spina bifida occulta

Answer 2

small opening due to the failure of fusion of the lamina

 no clinical significance

Question 3

Spinal bifida Vera

Answer 3

large defect with no
protection of the spinal cord
 this may allow protrusion of the meninges and/or spinal cord
 thought to be caused by deficiency of folicacid in 1st trimester

Question 4

Posterior spondyloschisis

Answer 4

posterior cleft of the
posterior arch of C-1
 sometimes referred to as “non union of theposterior arch”

Question 5

Blocked vertebrae

Answer 5

two or more segments joined ogether
2 Types:
 Congenital block: concavity on the ant surface  Acquired block: many presentations

Question 6

Schmorl’s node

Answer 6

nucleus pulposus herniates through the vertebral endplate
 Some think that the trauma is the cause
 Y&R list it as a birth defect
 TRIAD OF FEATURES:
 decreased disc space
 most commonly found on the ant/sup surface Increased A-P body width
DIFFERENTIATE WITH:
 Nuclear Impression: entire endplate is
depressed
 Schmorl’s node: pencil eraser through the endplate

Question 7

Occipitalization

Answer 7

fusion of the atlas with the
occipital bone
 sometimes called “most cephalic” block
 in young children is usually asymptomatic
 in older children/young adults there are
symptoms
 Headaches, visual and upper extremity issues Next clinical protocol: flexion/ext study

Question 8

Cervical rib

Answer 8

a separate piece of bone 
that articulates with the  transverse 
process of cervical vertebra (points down)and is present in 0.5% of the population 
 Differentiate With:   
 Elongated tp: no joint space 
 Rudimentary thoracic rib: tp points up

Question 9

Posterior ponticus

Answer 9

calcification of the oblique portion of the atlanto-occipital ligament
 forms an “arcuate foramen”
 seen in 14% of the population
 Vertebral artery is entrapped on some
people
 Contraindication to some types of rotaryadjustments

Question 10

Butterfly vertebrae

Answer 10

segment takes on the
appearance of separate triangular portionson the A-P view
 different theories of why this occur
 Notice how the endplates of the adjoining
segments fill in the gaps

Question 11

Limbus bone

Answer 11

migration and herniation of 
nuclear material through the secondary 
growth center of the vertebral body 
 results in non-union of the secondary 
growth center 
 Differentiate with:  
 Avulsion fractures: jagged edges and located on the inferior/anterior aspect of the vertebralbody

Question 12

Knife clasp

Answer 12

spina bifida of the 1st sacral
segment with an enlarged spinous processof the last lumbar
 extremely painful

Question 13

Hemivertebra

Answer 13

triangular deformity of the
vertebral body
 3 Types:
 Lateral: seen on A-P view
 Dorsal: seen on Lateral view; back portion of the vertebral body is complete
 Ventral: seen on Lateral view; front portion ofthe vertebral body is complete
 - causes structural scoliosis

Question 14

Transitional segment

Answer 14

SEGMENT HAS 
CHARACTERISTICS OF ANOTHER 
AREA 
 MOST COMMON AREA IS THE 
LUMBOSACRAL 
 COMMON TERMS: LUMBARIZATION 
AND SACRALIZATION 
 MOST IMPORTANT: BIOMECHANICS ISDIFFERENT

Question 15

OS ODONTOIDEUM vs OSSICULUMTERMINALE PERSISTENS

Answer 15

Both are non-union of the odontoid process to the vertebral body C2
What makes them different form each other is the location of the non- union

Question 16

OS ODONTOIDEUM

Answer 16

Non-union will be at the base of the end of the vertebral body

Question 17

OSSICULUMTERMINALE PERSISTENS

Answer 17

Non-union is at the superior tip of the odontoid process.

Question 18

AP OM view

Answer 18

Taken A-P 
• Read P-A 
• Nameplate in upper 
left/lower right 
• demonstrates Atlas, 
Axis, Atlanto-occipital joint, Atlanto-Axial 
jointtext

Question 19

Lateral sacrum

Answer 19

CR: left to right or right to left
• Patient Position: the patient’s coronal planeis perpendicular to the bucky
• Tube tilt: none
• Demonstrates: sacrum, lumbosacral joint,
coccyx

Question 20

Anterioposterior sacrum

Answer 20

CR: anterior to posterior
• Patient Position: the patient’s coronal plane is parallel to the bucky and their midsagittalplane is aligned with the midline
• Tube tilt: 15 degrees cephalad
(perpendicular to the sacrum)
• Demonstrates: sacrum, S-I joints, coccyx,
lumbosacral joint

Question 21

Anterioposterior pelvis

Answer 21

CR: anterior to posterior
• Patient Position: the patient’s coronal planeis parallel to the bucky with their
midsagittal plane aligned with the midline
• Tube tilt: none
• Demonstrates: both inominates, sacrum,
proximal femur heads, coccyx, soft tissue

Question 22

Lumbar obliques

Answer 22

CR: obliquely anterior to posterior for
posterior obliques
• CR: obliquely posterior to anterior for
anterior obliques
• Patient position: coronal plane angled 45degrees
• Tube tilt: none
• Demonstrates: Scotty dog to observe
10/16/2014 integrity of the pars interarticularis

Question 23

Lateral lumbrosacral

Answer 23

CR: right to left, left to right 
• Patient Position: the patient’s coronal planeis perpendicular to the bucky 
• Tube tilt: None 
• Demonstrates: lumbar spine, sacrum, 
coccyx, soft tissue

Question 24

Anterioposterior lumbar

Answer 24

CR: anterior to posterior
• Patient Positioning: the patient’s coronal
plane is parallel to the bucky with their
midsagittal plane aligned with the midline • Tube Tilt: none
• Demonstrates: lumbar, pelvis, soft
abdominal tissues, sacrum, hips

Question 25

Swimmer view

Answer 25

Tube tilt: caudal 5 degrees • Demonstrates: lower cervical spine, upper thoracic spine • only taken when these items are not visible on routine lateral cervical view

Question 26

Lateral cervicothoracic

Answer 26

AKA SWIMMER’S VIEW • CR: obliquely left to right or obliquely right to left • Patient position: the patient’s coronal plane is rotated 10-20 degrees off of perpendicular to the bucky with the arm next to the bucky flexed and the arm next tothe tube extended

Question 27

Lateral thoracic

Answer 27

CR: left to right, or right to left • Patient position: the patient’s coronal planeis perpendicular to the bucky • Tube tilt: None • Demonstrates: thoracic spine, ribs, lung fields, heart shadow

Question 28

Anterioposterior thoracic

Answer 28

CR: anterior to posterior • Patient position: the patient is upright with their coronal plane parallel to the bucky (thepatient will be x-rayed supine if they are extremely obese) • Tube tilt: None • Demonstrates: thoracic spine, ribs, lung fields, sternum

Question 29

Cervical obliques

Answer 29

CR: anterior to posterior for posterior obliques • CR: posterior to anterior for anterior obliques • Patient position: the patient’s coronal planeis angled 45 degrees to the bucky • Tube tilt: cephalad for post., caudal for ant. • Demonstrates: IVF’s

Question 30

Flexion/extension views

Answer 30

CR: left to right or right to left • PATIENT POSITION: the patient’s coronal plane is perpendicular to the bucky with full flexion or full extension of the head • TUBE TILT: none • DEMONSTRATES: ADI (should not deviatemore than 1 mm from neutral lateral view), 10/16/2014 cervical curve, mobility of cervical spine

Question 31

AP OM view

Answer 31

Tube tilt: parallel to the floor if head is extended, 15 degrees cephalad if the head isparallel to the floor • Demonstrates: atlas, axis, atlanto-occipital joint, atlanto-axial joint

Question 32

AP OM view

Answer 32

CR: anterior to posterior • PATIENT POSITION: the patient’s coronalplane is parallel to the bucky with the patient’s midsagittal plane aligned with the vertical midline of the bucky. The patient’s mouth is open and the head is extended 15 degrees (with CR parallel to the floor) or hard palate is parallel to the floor (with CR 10/16/2014 cephalad 15 degrees).

Question 33

Anteroposterior cervical view

Answer 33

TUBE TILT: 15 degrees cephalad • DEMONSTRATES: Joints of Luschka,bony structures, soft tissue (trachea in the midline), air space (apex of the lungs)

Question 34

Anteroposterior cervical view

Answer 34

``` aka Lower Cervical View • CR: anterior to posterior • PATIENT POSITION: patient’s coronal plane is parallel to the bucky with midsagittal plane aligned with the verticalmidline of the bucky ```

Question 35

Lateral cervical view

Answer 35

``` DEMONSTRATES: body heights and widths, • disc height, • cervical curve, • ADI (less than 3 mm for adults, less than 5mm for children), ```

Question 36

Lateral cervical view demonstrates

Answer 36

``` sella turcica (AP normal range 5-16mm, average 11 mm) (SI normal range 4-12 mm, average 8 mm) • prevertebral soft tissue (Retropharyngeal Interspace at C1-3 levels) (Retrolaryngeal Interspace at C4-5 levels) (Retrotracheal Interspace at C6-7 levels), • airways (Pharynx C1-3) (Larynx C4-5) 10/16/2014 (Trachea C6-7) ```

Question 37

Lateral cervical view

Answer 37

CR: left to right or right to left (doctor’s choice except for scoliosis) • PATIENT POSITION: patient’s coronal plane is perpendicular to the bucky • TUBE TILT: none (some techniques will betaken with a tube tilt for chiropractic purposes