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Toggle Recoil > Chapter IV: X-rays and Listing System > Flashcards

Chapter IV: X-rays and Listing System Flashcards

0
Q

When analyzing films for toggle recoil, what do you compare the segment of interest to?

A

The foramen magnum

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1
Q

Characteristics of X-ray Accuracy

A

Proper X-ray equipment
Properly installed
Proper alignment
Proper pt placement

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2
Q

How many different listings are there for the atlas?

A

12

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3
Q

Describe what film each part of the atlas listing comes from and what information it describes in the listing.

A

1st letter: A for Atlas; no misalignment value
2nd letter: from lat film; sup/inf of the atlas; S or I to listing
3rd letter: from nasium film; laterality of atlas; R or L to listing
4th letter: from BP film; ant/post rotation of atlas on the side of laterality; A or P of listing

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4
Q

How many atlas listings have no rotation or laterality? What are they?

A

Four

ASR, ASL, AIR, AIL

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5
Q

How many Axis listings are there? How are they classified?

A

8

Simple or compound

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6
Q

How many axis listings have no rotation?

A

2

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7
Q

Out of all of the axis and atlas listings, how many total have no rotation/laterality?

A

2 axis + 4 atlas = 6 total

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8
Q

What are the four required films for toggle recoil?

A

Lateral/longitudinal
Nasium/horizontal
Base posterior/vertical
A-P Open Mouth/vertico-horizontal

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9
Q

What is the alternative name for the lateral film?

A

Longitudinal

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10
Q

What is the alternative name of the nasium film?

A

Horizontal

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11
Q

What is the alternative name of the base posterior film?

A

Vertical

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12
Q

What is the alternative name of the APOM film?

A

Vertico-horizontal

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13
Q

What are the primary and secondary analytical purposes of taking a lateral (longitudinal) film?

A

Primary: to obtain the second letter of the atlas listing (AS/AI)
Secondary: to evaluate the C1/C2 relationship, check for cervical anomalies, and evaluate the cervical curve (normal = lordotic)

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14
Q

Before analyzing a lateral (longitudinal) film, what do you need to check?

A
  1. Flexion/extension malposition by comparing the hard palate to the top of the film (should be parallel to each other)
  2. Rotational malposition - the posterior lines of the mandible should be superimposed on one another
  3. Typical smooth lordotic cervical curve
  4. Visual impression of a listing of AS or AI before constructing lines
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15
Q

What 3 lines are constructed in analyzing the lateral (longitudinal) film?

A

Occipital condylar line (OCL)
Atlas plane line (APL)
Listing line (LL)

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16
Q

Which lines should be parallel on the lateral (longitudinal) film?

A

The OCL and the LL

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17
Q

The APL in a normal configuration is projected _______ degrees above the LL. This normal finding would be described as an ______.

A

Four

AS0

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18
Q

Any measurement above the 4* APL-LL angle would be an _____ listing by that many degrees. Any measurement below the 4* APL-LL angle would be an _____ listing by that many degrees.

A

AS

AI

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19
Q

What is the primary analytical purpose for taking the nasium (horizontal) film? What does this tell you?

A

To determine the third letter of the atlas listing.

This finding will calculate atlas laterality (right/left)

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20
Q

What is the secondary purpose of taking the nasium (horizontal) film?

A

To determine if there is any condyle malformation

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21
Q

What is the FFD for a nasium (horizontal) film?

A

40”

22
Q

What is the FFD for the lateral (longitudinal) film?

A

72”

23
Q

What are the four lines constructed when analyzing the nasium (horizontal) film?

A

Ocular orbit line (OCL)
Superior basic line (SBL)
Inferior basic line (IBL)
Vertical median line (VML)

24
Q

Which lines on the nasium (horizontal) film are parallel?

A

The Ocular Orbit Line (OOL) and the Superior Basic Line (SBL)

25
Q

How is atlas laterality determined on the nasium (horizontal) film?

A

By measuring the distance from the lateral-inferior tips of the lateral mass to the VML on each side. The side that shows the greatest distance is the side of laterality.

26
Q

After construction of the lines on the nasium (horizontal) film, assuming no orbital malposition, if the OOL is not parallel to the top of the film what does this indicate?

A

Lateral head tilt

27
Q

How would you check for possible head rotation on the nasium (horizontal) film?

A

By checking the mastoid and ramus of the mandible on both sides to see if they are symmetrical, respectively

28
Q

What is the 70% finding for the nasium (horizontal) film state? What does it serve to check?

A

The superior basic line and the inferior basic line converge to the side of laterality 70% of the time. It serves to double check the measured laterality.

29
Q

What are the two lines analyzed on the base posterior (vertical) film?

A

Atlas plane line (APL)

Perpendicular skull line (PSL)

30
Q

What is the primary analytical purpose for taking the base posterior (vertical) film?

A

To determine the atlas rotation on the side of laterality

31
Q

What is the secondary purpose of taking the base posterior (vertical) film?

A

To visibly inspect the integrity of the odontoid and the ring of the atlas

32
Q

On the side of laterality (as found on the nasium/horizontal film), if the angle between the PSL and the APL is greater than 90, the rotation will be _________. If the angle is less than 90, the rotation will be _________. If the angle equals 90*, the listing ________.

A

Posterior
Anterior
Has no rotation

33
Q

Like points on the orbits should be _________ to the top of the film if the patient is fairly symmetrical and you have good patient placement.

A

Parallel

34
Q

What is the primary purpose for taking the APOM (vertico-horizontal) film?

A

To determine the complete axis listing

35
Q

What is the secondary purpose for taking the APOM (vertico-horizontal) film?

A

To determine the assumed atlas listing, which consists of the last two letters of the listing. The laterality is measured and the rotation is derived from the applicable 70% finding.

36
Q

What are the four lines used to analyze the APOM (vertico-horizontal) film?

A

Ocular orbit line (OOL)
Superior basic line (SBL)
Inferior basic line (IBL)
Vertical median line (VML)

37
Q

What two points are used to draw the superior basic line on the APOM (vertico-horizontal) film?

A

On the jugular processes. If these points are obscured by the teeth or the occiput, the dots can be placed on the radiodense area of the occiput, lateral to the condyles.

38
Q

Which line(s) on the APOM (vertico-horizontal) line are drawn the same as the Nasium (horizontal)?

A

All of them except for the superior basic line (SBL)

39
Q

To determine the spinous rotation of the axis listing, what two points do you compare?

A

The bottom dot, on the spinous process, to the top dot, at the base of the odontoid/body

40
Q

What points are used to determine the entire segment component?

A

Top dot of the axis, at the base of the odontoid/body to the vertico-median line (VML)

41
Q

How do you determine the major of a compound axis listing?

A

Compare the magnitude of the spinous misalignment relative to the base of the odontoid/body from that of the magnitude of the odontoid/body misalignment relative to the vertical median line

42
Q

How is the assumed atlas found?

A

From the APOM film, you must first measure the laterality along the inferior basic line. The rotational component is determined by applying the 70% rule.

43
Q

What is the 70% finding for the APOM (vertico-horizontal) film?

A

The SBL and IBL converge to the side of atlas anterior rotation and/or the SBL and the IBL diverge to the side of posterior rotation

44
Q

If the SBL and the IBL lines are not parallel to one another on the APOM film and there is no measured laterality, what would the finding be?

A

Describe what you see: the right side has rotated to the anterior/posterior or the left side has rotated to the anterior/posterior, depending on the side of convergence/divergence. This must be written out with no abbreviations.

45
Q

If the SBL and the IBL lines are parallel to one another on the APOM film and there is a measured laterality, what would the finding be?

A

R or L

46
Q

If the SBL and the IBL lines are not parallel to one another on the APOM film and there is a measured laterality, what would the finding be?

A

LP, LA, RP, or RA

47
Q

If the atlas listing shows no rotation and/or the axis listing is Entire Segment Right/Left, this is
A. Constant
B. Variable
C. Non-Applicable

A

C. Non-applicable

48
Q

If the atlas and axis rotate in opposite directions, this is
A. Constant
B. Variable
C. Non-Applicable

A

B. Variable

49
Q

If the atlas and the axis rotate in the same direction, this is
A. Constant
B. Variable
C. Non-Applicable

A

A. Constant

50
Q

A non-applicable should be treated as a _____

A

Constant

51
Q

If a doctor determines that a variable exists, the doctor should adjust the _______

A

Atlas

52
Q

If a doctor determines that a constant exists or one or both segments show no rotation, the doctor should _______

A

Consider the misalignment of each segment and choose the greater as the segment to be adjusted

Toggle Recoil (3 decks)

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