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C Spine/thoracic Flashcards

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

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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
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2
Q

The _______ and ______ curves are primary curves present at birth

A

Thoracic and sacral

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3
Q

The _________ curve is a secondary curve that develops when a baby begins to lift his head

A

Cervical

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4
Q

________is an abnormal exaggerated thoracic curve or “humpback”. It is a (convex/concave) forward curve.

A

Kyphosis / convex

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5
Q

__________ is an abnormal exaggerated lumbar curve or “sway back”. It is a (convex/concave) forward curve.

A

Lordosis/ concave

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6
Q

_________ is an abnormal lateral curvature of the spine.

A

Scoliosis

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7
Q

The ______ process is the process extending posteriorly from the vertebral arch.

A

Spinous

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8
Q

The two ________ processes extend laterally from the vertebral arch

A

Transverse

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9
Q

The vertebral body is located on the (anterior/posterior) aspect of the verteba

A

Anterior

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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

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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

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12
Q

The upper surface of the pedicle is the _______.

A

Superior vertebral notch

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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

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14
Q

What passes through the intervertebral foramen?

A

Spinal nerves and blood vessels

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15
Q

What are found between the vertebral bodies of the articulated vertebral column

A

Intervertebral disks

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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

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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)

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18
Q

What is the structural classification, mobility, and movement type between the vertebral bodies

A 
Mobility= amphiathrodial
Structural= cartilaginous
Movement = n/a
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19
Q

What is the structural classification, mobility, and movement type of the zygapophyseal joints

A

Mobility=diarthrodial
Structural=synovial
Movement=plane/gliding

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20
Q

What is the structural classification, mobility, and movement type of the atlantooccipital joint

A 
Mobility = diarthrodial
Structural = synovial
Movement = ellipsis
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21
Q

What is the structural classification, mobility, and movement type of the atlantoaxial joint

A 
Mobility = diarthrodial 
Structural = synovial
Movement = trochoid/pivot
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22
Q

Which joint allows the movement of the head when you say “no”

A

Atlantoaxial / C1-C2

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23
Q

Which joint allows the movement of the head when you say “yes”

A

Atlantooccipital

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24
Q

Another name for C1

A

Atlas

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25
Q

Another name for C2

A

Axis

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26
Q

Which cervical vertebrae has many features of a thoracic vertebrae, including a long spinous process.

A

C7

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27
Q

Describe how the transverse foramina of cervical vertebrae are unique

A

Only the C spine has 3 foramen

Thoracic and lumbar only have 1

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28
Q

Describe how the spinous processes of the cervical vertebrae are unique

A

They are shorter and have bifid tips

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29
Q

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 ______

A

Articular pillar

Inferior articular process and superior articular process

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30
Q

Which cervical vertebrae lacks both a vertebral body and a spinous process

A

Atlas /C1

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31
Q

The atlas is a ring made of the _______ anteriorly and _________posteriorly and two lateral masses

A

Anterior arch

Posterior arch

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32
Q

What is the distinctive feature of C2 that is a process of bone projecting superiorly from the body

A

Dens / odontoid

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33
Q

The spinous process of C7 is located at the level of the body of

A

T1

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34
Q

Which vertebrae is located at the level of the mastoid tip

A

C1

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35
Q

The palpable landmark that lies at the level of C3 is the

A

Gonion / angle of mandible

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36
Q

Which vertebrae is located at the level of the thyroid cartilage

A

C4-C5

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37
Q

What anatomy is demonstrated in a lateral c-spine (joints/foramina)

A

Zygapophyseal joints

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38
Q

What anatomy is demonstrated in RAO c-spine (joint/foramina)

A

Right intervertebral foramina

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39
Q

What anatomy is demonstrated in LAO c-spine (joint/foramina)

A

Left intervertebral foramina

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40
Q

What anatomy is demonstrated in RPO c-spine (joint/foramina)

A

Left intervertebral foramina

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41
Q

What anatomy is demonstrated in LPO c-spine (joint/ foramina)

A

Right intervertebral foramina

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42
Q

On a trauma patient with neck injury, which projection should be done first and why?

A

Cross table lateral, so the radiologist/dr can determine if the spinal chord is compromised

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43
Q

List the routine for a trauma c-spine

A

Lateral
Both obliques
AP
Odontoid

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44
Q

What SID is a lateral c-spine and why?

A

72”

To reduce magnification caused by OID

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45
Q

Gould the lateral c-spine be taken on inspiration or expiration and why?

A

Expiration

To relax the shoulders down

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46
Q

The most inferior interspace that should be visualized on the x-table lateral c-spine is

A

C7-T1

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47
Q

If the interspace between c7-T1 cannot be visualized with a lateral c-spine, which position should you do?

A

Swimmers

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48
Q

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

A

Lower margin of the base of the incisors to the mastoid tips

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49
Q

List the routine projections for the routine c-spine

A

Lateral
Both obliques
AP
+/- odontoid

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50
Q

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 _________

A

< 15-20

C4

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51
Q

How do you determine the patient was in a true AP with no rotation on the AP axial C-spine image?

A

Spinous process and SC joints equidistant

Mandible and base of skull superimposed over C1-C2

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52
Q

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

A

45
15-20
Caudad

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53
Q

How do you determine that the patient properly extended their chin on the RAO c-spine image?

A

The jaw line does not superimpose on the vertebrae

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54
Q

When performing the erect lateral c-spine, the top of the IR should be placed at the level of the

A

Ear attachment

55
Q

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

A

C4 thyroid cartilage

56
Q

How do you determine the patient was in the true lateral position with no rotation or tilt on the erect lateral c-spine image

A

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
Q

Why do you have to angle c-spine AP an oblique

A

Because the vertebral bodies overlap

58
Q

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

A

Clay shovelers fx

59
Q

Wedge shaped vertebral body from lateral perspective; irregular spacing from AP perspective

A

Compression fx

60
Q

Fx of the anterior C2 arch, usually also with anterior subluxation (partial dislocation) of C2 on C3

A

Hangmans fx

61
Q

Bilateral offset or spreading of the lateral masses of C1 relative to dens

A

Jeffersons fx

62
Q

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

A

Herniated nucleus pulposus (HNP)

63
Q

Abnormal or exaggerated convex thoracic curvature

A

Kyphosis

64
Q

Abnormal or exaggerated lateral curvature of spine

A

Scoliosis

65
Q

Degeneration of cartilage and formation of osteophytes (bony outgrowths)

A

Osteoarthritis

66
Q

Most common radiographic examination for clay shoveler’s fx

A

Lateral and AP c-spine

CT

67
Q

Most common radiographic examination for compression fx

A

Lateral and AP of affected spine

CT

68
Q

Most common radiographic examination for hangman’s fx

A

Lateral c-spine

CT

69
Q

Most common radiographic examination for jefferson’s fx

A

AP open mouth (odontoid) of C1-C2
Lateral x table
CT

70
Q

Most common radiographic examination for herniated nucleus pulposus (HNP)

A

AP and lateral of affected spine

MRI

71
Q

Most common radiographic examination for kyphosis

A

Lateral t-spine

Scoliosis series, including lateral bending

72
Q

Most common radiographic examination for osteoarthritis

A

AP and lateral C and/or T spine

73
Q

Most common radiographic examination for osteoporosis

A

DXA bone density exam of AP L-spine and lateral hip

74
Q

The two main parts of a typical vertebra are the

A

Body and vertebral arch

75
Q

The ________ are two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline

A

Lamina

76
Q

The ______ foramina are created by two small notches on the superior and inferior aspects of the Pedicles.

A

Intervertebral

77
Q

The opening or passageway for the spinal cord is the

A

Vertebral spinal canal

78
Q

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 ________

A

Medula oblongata
Lower boarder of L1
Conus medullaris

79
Q

What is found between the superior and inferior articular processes

A

Zygapophyseal joints

80
Q

T/F the zygapophyseal joints of all vertebrae are visualized only in a true lateral position

A

False

C1-C2 is visible with AP or frontal projection

81
Q

A short column of bone found between the superior and articular processes in a typical cervical vertebra is called

A

Articular pillar

82
Q

What I the term for the articular pillar for the C1 vertebra

A

Lateral masses

83
Q

The zygapophyseal joints for the second through the seventh cervical vertebrae are at ________ degree angle to the midsagittal plane

A

90

84
Q

The thoracic vertebrae are at a _______ degree angle to the midsagittal plane

A

70-75

85
Q

What is the name of the joint found between the superior articular processes of c1 and the occipital condyles of the skull

A

Occipitoatlantal articulation

86
Q

The modified body of C2 is called the

A

Dens or odontoid process

87
Q

A lack of symmetry of the zygapophyseal joints between C1 and C2 may be caused by injury or may be associated with

A

Rotation of the skull

88
Q

Which specific thoracic vertebrae are classified as typical thoracic vertebrae (I.e. They least resemble cervical or lumbar vertebrae)

A

T5-T8

89
Q

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

A

15 degree cephalad

90
Q

The upper portion of the sternum

A

The mandibrum

91
Q

The superior margin of the mandibrum

A

Jugular notch / suprasternal notch

92
Q

The center portion of the sternum

A

The body

93
Q

The joint between top and center portion of the sternum

A

Sternal angle

94
Q

The most inferior aspect of the sternum

A

Xiphoid process (tip)

95
Q

The gonion is at what vertebral level

A

C3

96
Q

The xiphoid process is at what vertebral level

A

T9-T10

97
Q

The thyroid cartilage is at what vertebral level

A

C4-C5

98
Q

The jugular notch is at what vertebral level

A

T2-T3

99
Q

The sternal angle is at what vertebral level

A

T4-T5

100
Q

The mastoid tip is at what vertebral level

A

C1

101
Q

The vertebral prominence is at what vertebral level

A

C7-T1

102
Q

3-4inches below the jugular notch is at what vertebral level

A

T7

103
Q

What organs are radiosensitive and of greatest concern during cervical and thoracic spine radiography

A

Gonads, thyroid, parathyroid, and breast

104
Q

Two advantages of using higher KVP exposure factors for spine radiography, especially on AP thoracic spine

A

Increased density

Decrease in pt dose

105
Q

T/F When using digital imaging for spine radiography, it is important to use close collimation, grid, and lead masking

A

True

106
Q

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

A

Keep the vertebral column parallel to the IR

107
Q

For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail by

A

Using small focal spot and increasing SID

108
Q

Differences between spondylitis an spondylosis

A

Spondylitis is an inflammatory process of the vertebrae

Spondylosis is a condition of the spine characterized by rigidity of a vertebral joint

109
Q

Most geriatric pts have a fee of falling of the table

A

True

110
Q

What is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space

A

Myelography

111
Q

Which imaging modality is ideal for detecting early signs of osteomyelitis

A

Nuclear medicine

112
Q

Which two landmarks must be aligned for an AP “open mouth” projection

A

Lower margin of upper incisors and base of skull

113
Q

What is the purpose of the 15-20 degree angle for the AP axial projection of the cervical spine

A

To open up intervertebral disk spaces

114
Q

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

A

Base of the skull

115
Q

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

A

True

116
Q

What are the two important benefits of a SID longer than 40 inches for the lateral cervical spine projection

A

Compensates for increased OID; reduces magnification

Less divergence of xray beam to reduce shoulder superimposition of C7

117
Q

Which foramina are demonstrated with a LPO position of the cervical spine

A

The right intervertebral foramen (upside)

118
Q

Which foramina are demonstrated with a LAO position of the cervical spine

A

Left intervertebral foramen (downside)

119
Q

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

A

Rotate the skull to a near lateral position

120
Q

What is the recommended SID for a lateral projection o the cervical spine

A

60-72 inches

121
Q

The lateral projection I the cervical spine should be taken on inspiration or expirariton and why

A

Expiration to bring the shoulders all the way down

122
Q

The proper name for the swimmers position is

A

Twining method

123
Q

Where should the CR be for swimmers

A

T1 1 in above the jugular notch or level of vertebral promines

124
Q

Which region of the spine must be demonstrated with the swimmers position

A

C5-T3

125
Q

Which projection is considered a “functional study” of the cervical spine

A

Hyperextention and hyper flexion lateral positions

126
Q

When should the Judd or Fuchs method be performed

A

If unable to demonstrate the upper part of the debs with the open mouth AP

127
Q

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

A

Wagging jaw

128
Q

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)

A

Correct use of anode-heel effect; use of compensating wedge filter

129
Q

Which zygapophyseal joints are demonstrated in a RAO projection of the thoracic spine

A

Right (downside)

130
Q

Which projections delivers the greatest skin dose to the Pt

A

Cervicothoracic lateral positions

131
Q

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

A

True

132
Q

Which structures are best demonstrated with an AP axial vertebral arch projection

A

Articular pillars (lateral masses)

133
Q

What CR angle must be used with the AP axial vertebral arch projection

A

20-30 degrees Caudad

134
Q

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

A

Right

135
Q

How much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position

A

20 degrees from a lateral position

spine (1 decks)

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