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Donny RAD POS ll > Ch 8 Cervical + Thoracic > Flashcards

Ch 8 Cervical + Thoracic Flashcards

exam review

1
Q

Where do you inject for a Myelogram (cervical)?
What is this called?

A

C1-C2
Subarachnoid space
Cisternal puncture

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2
Q

What is Lordosis?

A

increased concavity (lumbar)
exaggerated lumbar curvature
(swayback)

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3
Q

What is Scoliosis?

A

exaggerated lateral curvature of the spine

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4
Q

What is Kyphosis?

A

increased (exaggerated) convexity in the thoracic area
(humpback)

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5
Q

What is Halatosis? **

A
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6
Q

what is concave?

A

rounded inward
or
depressed surface like a cave

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7
Q

what is convex?

A

rounded outward
or
elevated surface

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8
Q

Cervical is what type of curve?

A

first compensatory curve
concave

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9
Q

Thoracic is what type of curve?

A

first primary curve
convex

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10
Q

lumbar is what type of curve?

A

second compensatory curve
concave

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11
Q

sacrum (sacral) is what type of curve?

A

second primary curve
convex

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12
Q

What makes up the zygapophyseal joint?

A

superior and inferior articular processes**

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13
Q

compensatory curve=

A

concave (lordotic)
(1st cervical) (2nd lumbar)

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14
Q

Primary curve=
What are the 2 primary curves?

A

convex
(1st thoracic) (2nd sacrum)

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15
Q

What are primary curves?

A

convex curves
1st primary curve: thoracic
2nd primary curve: sacral

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16
Q

What are compensatory curves?

A

Concave curves
1st compensatory curve: cervical
2nd compensatory curve: lumbar

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17
Q

Where is the pedicle located? *****
What does it connect?

A

posterior to the body of the vertebrae
attaches body to vertebral arch
(terminate in the area of the transverse process)

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18
Q

Where are the laminae located? *****
What does it connect?

A

connects the transverse process to the spinous process
(posterior to transverse anterior to spinous)

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19
Q

In a cervical exam when would we see the zygapophyseal joints? (C2-C7)

A

true lateral
90 degrees to the midsagittal plane

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20
Q

When do we see the C1 & C2 Z joints?

A

In an AP open mouth

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21
Q

In a cervical exam when would we see the foramen?

A

45 degree oblique

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22
Q

When would we best see the intervertebral disk space best?

A

AP

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23
Q

When the positioning of the patient changes from AP to PA what happens to the angle?

A

AP to PA would change the angle from being cephalic to caudad and vice versa

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24
Q

How do we position for an open mouth?

A

upper incisors and base of skull lined up

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25
Q

When taking the Judd and Fuchs what are we looking for and what does it look like?

A

J: Dens sticking out in the hole of skull (foramen magna)
Book: Den’s and surrounding bony structures of the C1 ring

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26
Q

What is the name of the joint that articulates/connects the skull and the atlas?

A

Atlantooccipital joint

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27
Q

What is the purpose of the transverse foramen in the cervical spine?

A

For the nerve roots to connect to the brain **

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28
Q

How many zygapophyseal joints do we see in a lateral (cervical)?

A

5 Z joints
(C1 & C2 are seen in AP open mouth)

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29
Q

(t/f)
During trauma we are doing a cross table lateral for a cervical spine we don’t see the anatomy demonstrated we would use a sand bag.

A

false
Sandbags would cause more harm then good

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30
Q

how we position for a flexion cervical?

A

true lateral
depress chin until it touches chest

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31
Q

How would we position for extension cervical?

A

true lateral
raise chin and tilt head back as far as possible

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32
Q

What skull line would we use to position for Judd and Fuchs?

A

MML
(Mentomeatal line)

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33
Q

What is the space called that we inject myelograms?
What level of the spine is this?

A

Subarachnoid space
Cervical: C1-C2
Lumbar: L3-L4

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34
Q

Which foramen is seen in PA cervical oblique? (RAO/LAO)

A

downside (closest to IR)
(marker is on side down)

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35
Q

Which foramen is seen in AP cervical oblique?

A

foramen farthest from IR (upside)
(marker on side up)
(RPO/LPO)

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36
Q

Which foramen is seen on LAO cervical oblique?
how is the projection?
how are the markers?

A

left foramen (downside)
PA projection
Mark side down, left side (cause that foramen is best demonstrated)

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37
Q

Which foramen is seen on RPO cervical oblique?
how is the projection?
how are the markers?

A

left foramen (upside so opposite)
AP projection
Marker on side up, left-side (bc that foramen is best shown)

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38
Q

Which foramen is seen on LPO cervical oblique?
how is the projection?
how are the markers?

A

Right foramen (upside)
AP projection
Marker on side up, right-side (bc that foramen is best shown)

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39
Q

Which foramen is seen on RAO cervical oblique?
how is the projection?
how are the markers?

A

right side (downside)
PA projection
Marker is side down, right-side (bc that foramen is best demonstrated)

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40
Q

What level is the vertebral prominens at?

A

C7

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41
Q

What level is the jugular notch located at?

A

T2-T3

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42
Q

What level is the xiphoid tip located at?

A

T9-T10

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43
Q

What level is the thyroid cartilage located at?

A

C5
(varies between C4-C6)

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44
Q

What level is the sternal angle located at?

A

T4-T5

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45
Q

Where is mid thorax located?
How do we find this?

A

T7
by going 3-4 inches inferior to
jugular notch for AP
or 7-8 inches below vertebral promenins for PA

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46
Q

What is another way to find mid-thorax in an PA projection?

A

7-8 inches below vertebra prominens
(7 for women 8 for men)

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47
Q

What level is the EAM located at?

A

1 inch above C1 (mastoid tip)

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48
Q

At what level is the mastiod tip located?

A

C1
(one inch inferior to EAM)

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49
Q

What is the jeffersons fx?

A

fx of C1 Ant & Post arches
from landing on feet/head abruptly
(AP open mouth best demonstrates this)

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50
Q

What is the clay shoveler’s fx?

A

avulsion fx of C6 to T1 from hyperextending neck
(best demonstrated in a lateral C spine)

51
Q

What is a compression wedge fx?

A

collapse of T/L vertebral bodies from flexion
vertebral shapes like a wedge instead of a block

52
Q

Scoliosis can be caused by:

A

Neuromuscular disorder
congenital (happens from birth)
idiopathic (just cause)

53
Q

looking from the posterior aspect the cervical spine appears to be concave or convex?

A

concave

54
Q

When do you see the zygapophyseal joints in a thoracic spine?

A

70-75 degree oblique from the midsagittal plane

55
Q

When do you see the foramen in the thoracic spine?

A

90 degrees to the midsagittal plane
(true lateral)

56
Q

Where is the facet located?

A
57
Q

Where is the spinous process located?

A

Posterior to vertebral body

58
Q

Where are the zygapophyseal located?

A

in between inferior/superior articular processes

59
Q

Where is the thoracic process located?

A
60
Q

Where is superior articular process located?

A
61
Q

what helps form the intervertebral foramen?

A

inferior vertebral notch
&
superior vertebral notch

62
Q

(t/f)
If the patient has a traumatic injury to their spine, its best to manipulate the tube rather than move the patient

A

true
Moving the patient in trauma situations can lead to more damage

63
Q

What do you see in a PA cervical oblique?
AO or PO?
how is the positioning?

A

anterior oblique (AO)
15 degrees caudad
pedicles and foramina closest to IR
Mark side down

64
Q

what do you see in an AP cervical oblique?
AO or PO?
how is the positioning?

A

posterior oblique (PO)
15 degrees cephalic
pedicles and foramina farthest from IR
Mark side up?

65
Q
A
66
Q

General:
Why is there a 15 degree cephalic angle for AP/oblique cervical spine?

A

shape and overlapping of the C-spine vertebrae

67
Q

Exam:
What do you seen in the lateral cervical spine?

A

zygapophyseal joints

intervertebral disc space (joint spaces) (not best displayed but general idea)

68
Q

What do you seen in a lateral thoracic spine?

A

intervertebral foramen

69
Q

What do you see in a thoracic oblique spine?

A

zygapophyseal joints
(70-75 degree oblique)

70
Q

What is demonstrated in an AP open mouth (cervical)?

A

C1 & C2 zygapophyseal joints
(AP open mouth)

71
Q

What are the two main parts of the spine vertebrae?

A

body
vertebral arch

72
Q

When do we see the Zygopophyseal joints in Cervical?
And Thoracic?

A

C spine: lateral L or R
T-spine: 70-75 degree oblique PO or AO

73
Q

When do we see the intervertebral foramina in a cervical?
And thoracic?

A

C-spine: 45 degree oblique PO (upside) or AO (downside)
T-spine: lateral L or R

74
Q

What is demonstrated in an oblique Cervical?

A

intervertebral foramina
(45 degrees)

75
Q

What is best demonstrated in a lateral C spine?

A

Zygapophyseal joints

76
Q

What is demonstrated in an AP thoracic spine?

A

intervertebral disc space

77
Q

What would be some reasons to shoot a scoliosis x-ray PA instead of AP?

A

radiation safety to:
gonads
eyes
thyroid cartilage
breasts
(Mainly Thyroid)

78
Q

What can lower the amount of radiation to the patient when shooting a scoliosis x-ray?

A

a filter (thick to thin)
shielding (brick shield**)

79
Q

Exam:
What would we do for a functionality test of the spine?

A

flexion and extension

80
Q

when would we do a cross table spine?

A

Trauma **

81
Q

What is the nucleus pulposus?
(gusher)

A

inner layer of disk
(soft semi-gelatinous)

82
Q

What is the annulus fibrosis?
(gusher)

A

outer layer of disk

83
Q

Exam:
What projection would require the most amount of dose/penetration?
What is the kvp?

A

swimmers/ transthoracic cervical
80-90 kvp ***

84
Q

General:
how many bones in the vertebral column for a child?
how many for an adult?

A

33 child
26 adult

85
Q

General:
Where do the first 10 thoracic vertebrae articulate with the ribs?

A

costotransverse joints
&
costovertebral joints

86
Q

General:
What is the anterior facet called?
What is the posterior?

A

Costovertebral joints (anterior facets)
Costotransverse joints (posterior facets)

87
Q

General:
Where do the 11th and 12th thoracic vertebrae articulate with the ribs?

A

single costovertebral joints
(because 11/12 are false ribs)

88
Q

General:
what part of the spine contains the spinal cord?

A

Vertebral foramen

89
Q

General:
What does spine vertebrae consist of?

A

2 pedicles
2 lamina
2 transverse process (lateral)
1 spinous process (posteriorly)
1 large body (anteriorly)
4 articular processes (2 inferior 2 superior)

90
Q

General:

what forms the zygapophyseal joints?

A

2 inferior articular processes
2 superior articular processes
(forms left and right Z joints)

91
Q

General:

what is the space in between the vertebrae called?

A

intervertebral disc space

92
Q

General:

what are the “anterior” facets called?

A

costovertebral joints
(for the head of the rib)

93
Q

General:

what are the “posterior” facets called?

A

costotransverse joints
(for the tubercle rib)

94
Q

General:

What are T1-T4 similar too?
What are T5-T8 referred as?
What are T9-T12 similar to?

A

cervical vertebrae (small)
typical thoracic vertebrae (medium)
lumbar vertebrae (large)

95
Q

General:

what is the joint between C1 and the skull?
What type of joint is this?

A

Atlantooccipital joint
synovial, diarthrodial, ellipsoid (condyloid)

96
Q

General:

What is the name of the joints between C1 and C2?
What type of joints are these?

A

R and L lateral atlantoaxial joints
synovial, diarthrodial, plane or gliding

97
Q

General:

what type of joints are the medial atlantooccipital joints?

A

synovial, diarthrodial, pivot (trochoid)

98
Q

General:

What kind of joints are the intervertebral joints? (C2-T12)

A

amphiarthrodial (slightly moveable)
cartilaginous (symphysis)

99
Q

General:

What kind of joints are the zygapophyseal joints?

A

plane or gliding
synovial
diarthrodial

100
Q

General:

What type of joints are the costotransverse (T1-T10) and the costovertebral (T1-T12) joints?

A

plane or gliding
synovial
Diarthrodial

101
Q

General:

How do we see the C-spine intervertebral foramina in an PA projection?

A

45 degree oblique LAO/RAO
15 degrees caudad
LAO shows left foramina
RAO shows right foramina
(AO shows the same side foramina)
(downside visualized)

102
Q

General:

How do we see the C-spine intervertebral foramina in an AP projection?

A

45 degree oblique LPO/RPO
15 degrees cephalic
LPO shows right foramina
RPO shows left foramina
(PO shows the opposite side foramina)
(upside visualized)

103
Q

General:

C spine AO key differences

A

15 degrees caudad
LAO/RAO
AO shows downside (same side) foramina
(ex: LAO shows left foramina)

104
Q

General:

C spine PO key differences

A

15 degrees cephalic
LPO/RPO
PO shows upside (opposite side) foramina
(ex: LPO shows right foramina)

105
Q

General:

when do you see the vertebral foramina in a T-spine x-ray?

A

R or L lateral

106
Q

General:

When do you see the Zygapophyseal joints in a Thoracic spine?

A

70 degree oblique
LPO/RPO = upside (PO shows opposite side)
LAO/RAO =Downside (AO shows same side)

107
Q

General:

what does wagging jaw best show?

A
108
Q

General:

What are the cervical landmarks?

A

mastoid tip (C1)
gonion (C3)
thyroid cartilage (C5) (Adam’s apple)
vertebral Prominens (C7) last cervical spinous process

109
Q

General:

what are the thoracic landmarks?

A

jugular notch (T2-T3)
sternal angle (T4-T5)
mid-thorax (T7) (3-4 inches below jugular notch or 7-8 inches below prominens)
xiphoid tip (T9-T10)

110
Q

General:

What is the CR for AP open mouth?
What is best shown?

A

Upper incisors & base of skull lined up
CR is mid-mouth
Odontoid process (Dens) & C1 and C2

111
Q

General:
What is the CR for a AP axial cervical?
What is best shown?

A

15 (supine) - 20 (erect) cephalic
CR is C4
disk space from C3-T2

112
Q

General:

What is the CR for Oblique?
What is best shown?

A

RAO/LAO is 15 caudad
RPO/LPO is 15 cephalic
CR is C4
Foramen and pedicles best shown

113
Q

General:
What is the CR for Lateral Cervical?

A

true lateral
CR is C4
expose on second expiration (to drop shoulders)

114
Q

General:

What is the CR for Swimmers lateral cervical spine?

A

left arm raised, right arm dropped
3-5 caudad
CR is T1
(1 inch above jugular notch)
expose of second full expiration

115
Q

General:

What is the CR for flexion cervical?

A

CR is C4
expose on 2nd expiration
head depressed to chin

116
Q

General:

What is the CR for extension cervical?

A

CR is C4
expose of 2nd expiration
tilt head back as far as possible

117
Q

General:

What is CR for Fuch’s method?
What does it best show?

A

AP projection
CR is parallel to MML
Dens and bony structures of C1

118
Q

General:

What is the CR for Judd’s method?
What is best shown?

A

PA projection
CR is parallel to the MML
Dens/ Bony C1 is best shown

119
Q

General:

What is the CR for AP Cervical wagging Jaw?
What is it also known as?
What is best shown?

A

CR is C4
mandible in continuous motion
OTTONELLO method
C1-C7 vertebral bodies w/ blurred mandible

120
Q

General:

What is the CR for AP Axial projection vertebral arch (pillars)?
What is best shown?

A

20 to 30 caudad
CR is C5
Zygapophyseal joints in AP

121
Q

General:

What is the CR for AP thoracic spine?
Best shown?

A

CR is T7
expose of expiration
intervertebral disk space

122
Q

General:

What is the CR for lateral Thoracic spine?

A

CR is T7
intervertebral disk space and foramen

123
Q

General:

What is the CR for Oblique thoracic spine?
what is best shown?

A

70 degree oblique
2nd full expiration
CR is T7

124
Q
A

Donny RAD POS ll (8 decks)

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