Ch. 8 Cervical and Thoracic Spine Flashcards
two main parts of a vertebra
body and vertebral arch
weight bearing part of the vertebrae
body
half ring of bone and helps make the vertebral foramen
vertebral arch
all of the vertebral foramen make up this which the spinal cord runs through
vertebral (spinal) canal
what is all on the arch of a vertebra
pedicles, laminae, a spinous process, and transverse processes
joints between the vertebral bodies
intervertebral joints
joints made up by the 4 articular processes
zygapophyseal joints
these joints are only in the tspine
costovertebral joints
these are made by the superior and inferior margins of adjoining pedicles
intervertebral foramina
spinal nerves and blood vessels pass through these
intervertebral foramina
fibrocartilaginous disks between the bodies of vertebrae except between C1 and C2
intervertebral disks
intervertebral disks contain an outer fibrous portion called what
annulus fibrosus
soft jelly line part of intervertebral disks
nucleus pulposus
when the nucleus pulposus protrudes through the fibrous layer of the intervertebral disks it presses on the spinal cord causing pain and discomfort, this condition is called
slipped disk; herniated nucleus pulposus (HNP)
the spinal canal contains the spinal cord and is filled with this
cerebrospinal fluid
enclosed and protected by the spinal canal
spinal cord
the spinal cord starts at this in the brain
medulla oblongata
the spinal cord runs all the way down to about this level
first lumbar vertebra
at the first lumbar vertebra, the spinal cord tapers off into this
conus medullaris
these are really tough disks which separate the vertebrae and provide cushion, spacing, movement, and stability
intervertebral disks
proper name for C1
atlas
the atlas has no vertebral body but what instead
anterior arch with an anterior tubercle
on the atlas is this which holds the odontoid (dens) in place
transverse atlantal ligament
the atlas has two superior articular processes which articulate with what
occipital condyles of the skull
what is the articulation between the skull and first vertebra called
atlantoocciptial joints
segment of bone between the superior and inferior articular processes of C1
lateral masses
this supports the weight of the head
C1
proper name for C2
axis
this is where rotation of the head occurts
axis - C2
zygapophyseal joint spaces of C1 adn C2 are only seen on this projection
AP open mouth projection
what do the transverse processes arise from on cervical vertebrae
pedicle and body
a typical cervical vertebrae has how many vertical formina
3
zygapophyseal joint spaces for C1-C7 are seen on this projection
lateral projection of c-spine
intervertebral foramina of C1-C7 are seen on this type of projection
45 degree oblique angle to the midsagittal plane and 15 degree cephalic tube angle
what is C7 called
vertebra prominens
how do you count vertebra on an AP projection
from C7 up
how do you count vertebrae on a lateral projection
from C1 down
which are typical t-spine vertebrae
T5-T8
each t-spine vertebrae have this for rib articulation
facet - full or demi-facets
each t-spine vertebrae accept a head of a rib to form this joint
costovertebral joint
these have costotransverse joints which articulate the transverse processes and a rib
T1-T10
which way do the inferior articular processes face on a t-spine vertebrae
forward
which way do the superior articular processes face on a the t-spine vertebrae
backwards
what is the meeting of the superior and inferior articular processes of vertebrae called
zygapophyseal joint spaces
zygapophyseal joint spaces of T1-T12 are seen on this type of projection
70 degree oblique position
intervertebral foramina of t-spine are seen on this type of projection
lateral projection of t-spine
what are the intervertebral foramina made from
superior and inferior margins of the pedicles
these have more dominant articular pillars
cervical vertebrae
instead of a spinous process, what does the atlas have
posterior tubercle with bifid tip
these contain demifacets for rib articulation
T1-T9
these contain single facets for rib articulation
T10-T12
what position will you see the zygapophyseal joints of the cervical spine
true lateral
what position will you see the intervertebral foramina of the cervical spine
45 degree oblique position with a 15-20 cephalad tube angle if your PO and you’ll see the upside, if your AO it would be 15-20 degree caudad tube angle and you’ll see the downside
what position will you see the intervertebral foramina of the thoracic spine
true lateral
what position will you see the zygapophyseal joints of the thoracic spine
70 degree oblique position, PO will see the upside and AO will see the downside
what level is the mastoid tip on
C1
what is at the level of C1
mastoid tip
C1 is where in accordance to the external auditory meatus (EAM)
1’’ below
what is at the level of C3
gonion
what level is the gonion
C3
the angle of the mandible is called
gonion
most prominent part of the thyroid cartilage is at what level
C5 (C4-C6)
what is at the level of C5
thyroid cartilage
what level is vertebra prominens
C7 (body of T1)
what is at the level C7/body of T1
vertebra prominens
what is at the level of T2-T3
jugular notch
what level is the jugular notch at
T2-T3
where is T1 in accordance to the jugular notch
1.5” superior
upper section of the sternum
manubrium
central portion of the sternum
body
this is where the manubrium and body of the sternum meet
sternal angle
where is the sternal angle in accordance to the manubrial notch
2” inferior
what level is the sternal angle
T4-T5
what is at the level of T4-T5
sternal angle (articulation of 2nd rib anteriorly into sternum)
where is T7 in accordance to the jugular notch
3-4” inferior (between jugular notch and xiphoid process)
where is T7 in accordance to the vertebra prominens
7-8” inferior
approximate centering for thoracic spine
T7
most inferior end of the sternum
xiphoid process; xiphoid tip; ensiform process
what level is the xiphoid tip at
T9-T10
what is at the level of T9-T10
xiphoid tip
exaggerated lumbar curvature - increased concavity
lordosis
exaggerated thoracic curvature - increased convexity
kyphosis
from an AP position how is the cervical spine curved
convex
from a PA position how is the cervical spine curved
concave
from an AP position how is the thoracic spine curved
concave
from a PA position how is the thoracic spine curved
convex
from an AP position how is the lumbar spine curved
convex
from a PA position how is the lumbar spine curved
concave
first compensatory curve
cervical spine
first primary curve
thoracic spine
second compensatory curve
lumbar spine
what curves begin right after birth
thoracic and sacral
this curve develops once kids start to lift their head and sit up
cervical
this curve develops last as children begin to walk
lumbar
in addition to gonads, what other radiosensitive organs are of greatest concern during cervical and thoracic spine radiographs
thyroid, parathyroid and breasts
two advantages of using higher kVp factors for spine radiography on an AP thoracic spine
less dose, and increases the exposure latitiude
this is often used to diagnose bone tumors of the spine
nuclear medicine
for lateral and oblique projection of the cervical spine, it is important to minimize magnification and maximize detail, how can this be done
use small focal spot, increase SID
fracture through the pedicles and anterior arch of C2 with forward displacement on C3
Hangman’s fracture
inflammation of the vertebrae
spondylitis
abnormal or exaggerated convex curvature of thoracic spine
kyphosis
comminuted fracture of the vertebral body with posterior fragments displaced into the spinal canal
teardrop burst fracture
avulsion fracture of the spinous process of C7
Clay Shoveler’s fracture
abnormal lateral curvature of the spine
scoliosis
a form of rheumatoid arthritis
ankylosing spondylitis
impact fracture from axial loading of the anterior and posterior arch of C1
Jefferson fracture
mild form of scoliosis and kyphosis developing during adolsecense
Scheuermann disease
produces the “bowtie” sign
unilateral suluxation
projections for scoliosis
erect AP/PA and lateral including bending laterals
projections for teardrop burst fracture
lateral cervical
projections for Jefferson fracture
AP open mouth for C1-C2
projections for Scheuermann disease
scoliosis series
projections for unilateral subluxation of cervical spine
lateral cervical spine
projections for herniated nucleus pulposus (HNP)
AP and lateral of affected spine
what is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space
myelography
what imaging modality is ideal for detecting early signs of osteomyelitis
nuclear medicine
what two landmarks must be aligned for an AP open mouth projection
lower margin of upper incisors and base of skull
what is the purpose of 15-20 degree cephalad angle for the AP axial projection of the cervical spine
open intervertebral disk spaces
for an AP axial of the cervical spine, a plane through the tip of the mandible and this should be parallel to the angled CR
base of skull (inion)
important benefits of using 60-72” SID for the lateral cervical spine projection
less beam divergence and compensates for OID
CR angulation for posterior oblique projection of the cervical spine
15 degrees cephalad
which foramina are demonstrated with a LPO position of the cervical spine
right side
which foramina are demonstrated with a LAO position of the cervical spine
left side
in addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the upper cervical vertebrae for oblique projections
rotate skull into near lateral position
what is recommended SID for the cervicothoracic position of the cervical spine
60-72”
what lateral projection of the cervical spine should be taken during what
expiration for max shoulder depression
what specific projection must be taken first if trauma to the cervical spine is suspected and the patient is in a supine position on a backboard
lateral horizontal beam
common name of the method for the cervicothoracic lateral position
swimmers method
where is CR for a cervicothoracic lateral position
T1, 1” above jugular notch, about level of vertebra prominins
which region of the spine must be demonstrated with a cervicothoracic lateral position
C5-T3
what projection is considered a functional study
AP wagging jaw projection
what two things can be done to produce equal density along the entire thoracic spine for an AP projection
compensating filter (wedge) or use of the anode heel affect
what is the purpose of using an orthostatic technique for a lateral projection of the thoracic spine
blur out the ribs and lung markings
which zygapophyseal joints are demonstrated in a RAO projection of the thoracic spine
right
what projections delivers the greatest skin dose to the patient
cervicothoracic lateral position
which of the following structures is best demonstrated with an AP axial vertebral arch projections
articular pillars (lateral masses) of the cervical spine
what CR angle must be used with the AP axial-vertebral arch (pillars) projection
20-30 degrees caudad
what ancillary device should be placed behind the patient on the tabletop for a recumbent lateral projection of the thoracic spine
lead mat or masking
which skull positioning line is aligned perp to the IR for a PA redundant (Judd) projection for the odontoid process
mentomeatal line (MML)
which zygapophyseal joints are best demonstrated with an LPO position of the thoracic spine
right
how much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position
20 degree from lateral (70 from AP)
