C-Spine Test

Question 1

A radiograph of an AP axial projection of the cervical spine reveals that the intervetebral joints are not open. The following factors were used for this projection: 5 degree cephalad angle, 40 inch SID, grid, slight extension of the skull, and the CR centered to the thyroid cartilage. Which alteration should be made for the repeat expsoure?

a.) increase the CR angulation
b.) center the CR to the gonion
c.) increase the SID to 72 inches
d.) keep the CR perpendicular to the image receptor

Answer 1

a.) increase the CR angulation

Question 2

The KVP range for an AP cervical projection on a digital system is:

a.) 90-100
b.) 60-70
c.) 50-70
d.) 75-85

Answer 2

d.) 75-85

Question 3

How are small weights applied to the arms for the lateral projection of the cervical spine?

a.) held by the fingers
b.) affixed to the elbows
c.) held in the hands
d.) affixed to the wrists

Answer 3

d.) affixed to the wrists

Question 4

Which vertebral body has two foramina, one of which the dens fits into?

a.) C4
b.) axis
c.) atlas
d.) vertebral prominens

Answer 4

c.) atlas

Question 5

Along with the upper incisors, what other bony landmark must be aligned for the AP open-mouth projection?

a.) tip of the mandible
b.) Inferior margin of lower incisors
c.) thyroid cartilage
d.) base of skull

Answer 5

d.) base of skull

Question 6

RAO and LAO is the same as ______________ obliques.

a.) anterior
b.) posterior

Answer 6

a.) anterior

Question 7

A radiograph of a lateral projection of the cervical spine reveals that the ramus of the mandible is superimposed over the spine. What could the technologist have done to prevent this?

a.) angle the CR 3 to 5 degrees caudad
b.) have the patient hold 5 to 10 pounds in each hand
c.) increase the flexion of the skull
d.) increase the extension of the skull

Answer 7

d.) increase the extension of the skull

Question 8

Why are the anterior obliques (RAO/LAO) preferred over the posterior obliques of the cervical spine?

a.) less thyroid and breast dose
b.) prevent overlap of the mandible over the spine
c.) place the zygapophyseal joints closer to the image receptor
d.) more comfortable for the patient

Answer 8

a.) less thyroid and breast dose

Question 9

Where should the CR be directed for the Fuchs method?

a.) just below the mandible
b.) 1 inch above the jugular notch
c.) C5
d.) C4

Answer 9

a.) just below the mandible

Question 10

Which two parts of the vertebra make up the zygapophyseal joints?

1.) lamina
2.) pedicle
3.) superior articular process
4.) foramina
5.) inferior articular process
6.) transverse process

a.) 3 and 5
b.) 1 and 2
c.) 4 and 5
d.) 2 and 6

Answer 10

a.) 3 and 5

Question 11

In a cross table lateral cervical position, the xray beam can project c7 into the shoulder, therefore it may be necessary to center at C1.

a.) true
b.) false

Answer 11

b.) false

Question 12

Which of the following is not a correct criterion for the AP axial C spine projection?

a.) C3 to T2 or T3 vertebral bodies should be visible
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 abovec are correct criteria

Answer 12

d.) all of the above are correct criteria

Question 13

An AP axial c spine will demonstrate no rotation if:

a.) the zygapophyseal joint spaces are not open
b.) the rrami of the mandible are superimposed
c.) the intervetebral foramina are seen in profile
d.) there is equal distance between the sc joints and the spinous processes from lateral borders of the spinal column

Answer 13

d.) there is equal distance between the sc joints and the spinous processes from lateral borders of the spinal column

Question 14

The zygapophyseal joints of the cervical spine are clearly demonstrated on which projection?

a.) AP
b.) PA Oblique
c.) lateral
d.) AP oblique

Answer 14

c.) lateral

Question 15

Where is the IR centered for a hyperflexion or hyperextension lateral projection of the cervical spine?

a.) fourth cervical vertebra
b.) second cervical vertebra
c.) third cervical vertbra
d.) sevents cervical vertebra

Answer 15

a.) fourth cervical vertebra

Question 16

The __________ is formed by the superior and inferior articulating processes.

a.) zygapophyseal joints
b.) facet
c.) lamia
d.) pedicle

Answer 16

a.) zygapophyseal joints

Question 17

The top of the IR (or collimation) for a lateral c spine should be :

a.) 1’’ above the EAM
b.) 1’’ below the EAM
c.) at the level of the mastoid tip
d.) at the EAM

Answer 17

a.) 1’’ above the EAM

Question 18

Which of the following evaulation criteria for an AP cervical projection is accurate?

a.) all cervical and thoracic vertebra should be seen
b.) the projection should include c3-t2
c.) all seven cervical vertebra should be seen
d.) the projection should include c1-c2

Answer 18

b.) the projection should include c3-t2

Question 19

The largest and heaviest part of a cervical vertebra is the:

a.) vertebral arch
b.) pedicle
c.) body
d.) spinous process

Answer 19

c.) body

Question 20

The __________ of C1 receives the occipital condyles.

a.) inferior articular process
b.) superior articular process
c.) anterior arch
d.) transverse atlantal ligament

Answer 20

b.) superior articular process

Question 21

The thyroid cartilage generally corresponds to the level of:

a.) c6-c7
b.) c1-2
c.) c7-t1
d.) c4-c6

Answer 21

d.) c4-c6

Question 22

The posterior cervical oblique projecctions demonstrate the intervetebral foramina and pedicles on the side closest to the image receptor

a.) true
b.) false

Answer 22

b.) false

Question 23

A radiograph of an RAO of the cervical spine reveals that the lower intervetebral foramina are not open. The upper vertebral foramina are well visuaslized. Which positioning error may have lead to this radiographic outcome?

a.) insufficient rotation of the upper body
b.) excessive CR angulation
c.) insufficient CR angulation
d.) incorrect CR placement

Answer 23

a.) Insufficient rotation of the upper body

Question 24

An AP axial cervical image demonstrates the third cervical verterbra superimposed by the lower jaw. How should the positioning setup be adjusted for an optimal image to be obtained?
1.) decrease the degree of central ray angulation
2.) rotate the patient toward the left side
3.) elevate the chin
4.) align the acanthiomeatal line perpendicular to the IR

a.) 3 only
b.) 1 and 2 only
c.) 3 and 4 only
d.) 1, 3 and 4 only

Answer 24

c.) 3 and 4 only

Question 25

Which of the following factors does not apply to a lateral projection of the cervical spine?

a.) use a 72 inch SID
b.) perform horizontal beam lateral projection if trauma is suspected
c.) suspend respiration upon full inspiration
d.) center the CR to thyroid cartilage

Answer 25

c.) suspend respiration upon full inspiration

Question 26

Which intervetebral foramina are demonstrated on the PA axial oblique projection of the cervical spine?

a.) those closest to the IR
b.) the inferior side fartherst from the IR
c.) those fartherest from the IR
d.) both sides are equally demonstrated

Answer 26

a.) those closest to the IR

Question 27

Situation: A patient comes to the radiology department for a cervical spine routine. The study is ordered for nontraumatic resaons. 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?

a.) perform the fuchs or judd method
b.) increase the flexion of the skull
c.) increase the extension of the skull
d.) perform the AP chewing projection

Answer 27

a.) perform the fuchs or judd method

Question 28

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

a.) AP open mouth
b.) AP projection (fuchs)
c.) twining method
d.) None of the above

Answer 28

b.) AP projection (FUCHS)

Question 29

What type of breathing technique should the lateral c-spine be exposed on?

a.) breathing technique
b.) expiration
c.) suspend
d.) inspiration

Answer 29

b.) expiration

Question 30

Which bony landmarks must be aligned for the AP open mouth projection?
1.) tip of mandible
2.) upper incisors
3.) thyroid cartilage
4.) base of skull
5.) inferior incisors

a.) 2 and 4
b.) 3 and 4
c.) 4 and 5
d.) 1 and 2

Answer 30

a.) 2 and 4

Question 31

The gelantinous part of the intervertebral disk is called the:

a.) foramina
b.) nucleus pulposis
c.) annulus fibrosis
d.) pedicle

Answer 31

b.) nucleus pulposis

Question 32

Which will best demonstrate the zygopophyseal joint spaces between c1 and c2?

a.) lateral
b.) AP axial
c.) 45 degree obliques
d.) AP open mouth

Answer 32

d.) AP open mouth

Question 33

Failure to angle on the AP cervical projection will cause the mandible to obstruct the view of the upper cervical vertebra.

a.) true
b.) falsea

Answer 33

a.) true

Question 34

ANother name for c7 is:

a.) spinous process
b.) axis
c.) atlas
d.) vertebra prominens

Answer 34

d.) vertebra prominens

Question 35

The odontoid is located on:

a.) c2
b.) c7
c.) c4
d.) c1

Answer 35

a.) c2