Exam 1 Flashcards
1
Q
of bones in child sacrum
A
5
2
Q
of bones in child coccyx
A
4
3
Q
post. obl C-spine, you view which side? What CR angle?
A
Upside; 15 degrees cephalad
4
Q
ant. obl C-spine, which side is viewed? What CR angle?
A
Downside; 15 degree caudad
5
Q
post. obl T-spine demonstrates what?
A
upside zygapophyseal joints
6
Q
ant. obl T-spine demonstrates what?
A
downside zygapophyseal joints
7
Q
1” below level of EAM
A
C1
8
Q
T1 is about ______________ to the level of the jugular notch
A
1.5” superior
9
Q
examinations of the c-spine generally are made with the patient ______ to demonstrate alignment and ligament stability
A
erect
10
Q
T-spines are usually radiographed with the pt ________, except for ________ exams
A
recumbent; scoliosis
11
Q
what reduces chance of motion
A
short exposure T w optimal kV and mA settings
12
Q
what do you do to exposure factors when pt has osteoporosis?
A
the kV and/or mAs may need to be reduced
13
Q
Myelography
A
inject contrast into spinal canal at L3-4, to check for lesions that appear as filling defects
14
Q
Clay shoveler’s fracture results from what?
A
hyper flexion of neck
15
Q
Clay shoveler’s fracture is best seen on what XR?
A
lat C-spine
16
Q
Which XR’s best demonstrate a Jefferson’s fracture?
A
AP open mouth and lat C-spine (splintered or crushed fracture from axial load)
17
Q
HNP best demonstrated by?
A
MRI of spine
18
Q
Angle CR 15 degrees cephalad for AP C-spine when pt is?
A
supine
19
Q
angle CR 20 degrees cephalad for AP C-spine when pt is?
A
erect, or more lordotic curvature is evident
20
Q
erect or recumbent pos preferred for C-spine
A
erect
21
Q
structure demonstrated on AP C-spine?
A
body of C3-T2, spinous processes, shadow of mandible and occipital bone
22
Q
an XR of AP “wagging jaw” (Ottonello method) was taken at 75 kV, 20 mAs, and 0.5 sec shows that part of the mandible is still visible and obscuring the upper C-spine. What needs to be modified?
A
- mAs, and + exposure time to produce + blurring of mandible
23
Q
AP T-spine XR shows upper T-spine is overexposed but lower vertebra are well visualized. head of pt was placed at anode end. what can be done on repeat?
A
wedge filter w thicker part over upper T-spine to equalize density
24
Q
swimmer’s lat shows superimposition of humeral heads over upper T-spine. pt arthritic and can not rotate shoulders farther apart. what can be done on repeat?
A
angle CR 3-5 degrees caudad
25
after basic C-spine XR's rule out subluxation after motor vehicle accident (MVA), what should be done to evaluate whiplash injury?
hyperextension/hyperflexion lat pos's
26
If C-spone XR only shows C1-6, what can be done to see C7-T1?
Simmer's lat
27
pt eneters ER w possible C-spine fracture, but initial XRs don't show any gross fracture/subluxation. ER Dr suspects either a congenital defect or fracture of the articular pillars of C4, what best show's this area of C4?
AP axial-vertebral arch (pillar) projection
28
pt comes to ER w possible Jefferson fracture, other than lat or CT, what best shows the type fracture?
AP open mouth - carefully w/o moving C-spine
29
pt comes in w clinical history of Scheuermann disease. What procedures often performed for this condition?
Scoliosis series
30
which vertebral level does the solid spinal cord terminate?
L1/L2
31
L-spine has a concave _______ spinal curvature
anterior
32
abnormal/exaggerated T-spine w + convexity
Kyphosis
33
which foramina are created by the sup. and inf. vertebral notches?
intervertebral foramina
34
which joints are found in btw the sup. & inf. articular processes?
zygapophyseal joints (facets)
35
what makes up inner aspect of intervertebral disk?`
nucleus pulposus
36
what passes through the cervical transverse foramina?
vertebral artery, veins, & certain nerves
37
Which vertebra have a bifid spinous process?
C-spine
38
intervertebral foramina of C-spine lie at ____ degree angle to MSP
45
39
which ligament holds the dens against the ant. arch of C!?
transverse atlantal ligament
40
large joint space btw C1 & C2 is called
R/L atlantoaxial joints
41
2 partial facets found on the T-vertebrae
demifacets
42
which T-vertebrae do not posses a facet for costotransverse joint?
T11-12
43
2 distinct feat.'s of all C-veterberae?
BIFID SPINAL PROCESS TIPS & TRANSVERSE FORAMINA
44
one distinct feat of all T-vertebrae?
rib articulations
45
which T-spine pos best demonstrates the intervertebral foramina?
lat XR
46
which C-spine XR best shows zygapophyseal joints btw C3-C7?
R lat
47
which specific joint spaces are visualized w LAO T-spine?
L zygapophyseal
48
vertebra prominens @...
C7-T1
49
jugular notch @...
T2-3
50
3-4" below jugular notch is @...
T7
51
gonion @...
C3
52
sternal angle @...
T4-5
53
thyroid cartilage @...
C4-6
54
which modality is not performed to rule out HNP
nuclear med
55
avulsion fracture of spinous processes of C6-T1 is
clay shoveler's fracture
56
Scheuermann disease is a form of
scoliosis/kyphosis
57
HNP usually develops at what vertebral level?
L4-L5
58
what C-spine XR shows the L intervertebral foramen?
LAO/RPO
59
pt w possible Jefferson fracture enters ER. Which XR best demonstrates this fracture?
AP open mouth & lat C-spine
60
pt comes in for f/u for clay shoveler's fracture. which XR best shows this?
lat & AP C-spine
61
which modality is recommended for a "teardrop burst" fracture
CT
62
portion of the lamina located btw the sup. and inf. articular processes
pars interarticularis
63
sup. & inf. vertebral notches join together to form
intervertebral foramina
64
what angle is better for viewing upper Lumbar zygapophyseal joints
50 degrees to MSP
65
what angle is better for viewing lower lumbar zygapophyseal joints
30 degrees to MSP
66
small foramina found in the sacrum
pelvic sacral foramina
67
the ant. & sup. aspect of the sacrum that forms the post. wall of the pelvic inlet is called the
promontory
68
sacral horns aka
cornua
69
SI joints lie at an obl angle of ____ degrees to coronal plane
30
70
name for the sup. broad aspect of the coccyx
base
71
leg of scotty dog
inf. articular process
72
neck of scotty dogs
pars interarticularis
73
eye of scotty dog
pedicle
74
nose of scotty dog
transverse process
75
ear of scotty dog
sup. articular process
76
LPO of L-spine shows...
L zygapophyseal joints
77
RAO of L-spine shows what?
L zygapophyseal joints
78
Lat L-spine shows what?
intervertebral foramina
79
RPO of L-spine shows what?
R zygapophyseal joints
80
LAO of L-spine shows what?
R zygapophyseal
81
degree of obliquity required for obl XR at the T12-L1 level is approximately _____ degrees, where as the L5-S1 level spine requires ______degrees. Therefore a _____ degrees obl performed for general L-spine
50;
30;
45
82
ASIS @...
S1-S2
83
Xiphoid process @...
T9-10
84
lower costal margin @...
L2-L3
85
iliac crest @...
L4-L5
86
symphysis pubis @...
tip of coccyx
87
does AP or PA XR of L-spine opens the intervertebral joint spaces better?
PA
88
increased SID of 44-46" does what to spine anatomy?
reduces distortion
89
lat curvature of vertebral column indicates?
scoliosis
90
fracture of the vertebral body caused by hyperflexion force
chance fracture
91
congenital defect in which the post. elements of the vertebrae fail to unite
spina bifida
92
most common at L4-5 level and may result in sciatica
HNP
93
forward displacement of 1 vertebra onto another vertebra
spondylolisthesis
94
inflammatory condition most common in males in their 30s
ankylosing spondylitis
95
dissolution/separation of the pars interarticularis
spondylolysis
96
fracture type that rarely causes neurological deficits
compression fracture
97
w a 14 x 17" IR, the CR is centered at the level of the ____________ for AP & lat L-spine XRs
iliac crest
98
what 2 structures can be evaluated to determine whether rotation is present on an XR of an AP projection of L-spine
SI joints are equidistant from spine;
| spinous process should be midline to vertebral column (transverse processes are equal length)
99
how much rotation is needed to properly see the zygapophyseal joints at L5-S1 level?
30 degrees
100
which specific set of zygapophyseal joints is demonstrated w an LAO pos of L-spine?
R upside
101
the pedicle (or eye of snoopy) should be where on a correctly obliqued L-spine
near center of the vertebral body
102
what pos error was committed if pedicles are too far post w a 45 degree obl L-spine?
excessive rotation
103
what L-spine XR best demonstrates a possible compression fracture
lat
104
pt w a wide pelvis and narrow thorax may require CR angle of _____ degrees ________ for a lat L-spine
5-8; caudad
105
how should the spine of a pt w scoliosis be positioned for a lat L-spine?
w the sag or convexity of spine closest to IR
106
female ovarian dose used for PA L-spine is approximately ___% less than the dose for AP
30
107
where is CR centered for a lat L5-S1 XR of L-spine
1.5" below iliac crest & 2" post. to ASIS
108
what CR is needed for an AP axial L5-S1 XR on male pt?
30 degrees cephalad
109
which following techniques/devices produces a more uniform density along the vertebral column for an AP/PA scoliosis XR?
Use 14x36" IR, lower kV, higher mAs, compensating filter
compensating filter
110
which side of spine should be elevated for the 2nd exposure for yje AP/PA XR (Ferguson method) scoliosis series (by having the pt stand on a block w 1 foot)
convex side of spine
111
during the AP (PA) R/L bending XRs of L-spine, the ______ must remain stationary during positioning
pelvis
112
how much CR angle is required for an AP XR of sacrum for typical male?
15 degrees cephalad
113
if pt cannot lie on back for AP sacrum, what alt XR can be done?
PA (prone) w CR 15 degrees caudad
114
where is CR centered for an AP XR of coccyx
2" sup. to symphysis pubis
115
pt's should be asked to empty their bladder before performing which projections of vertebral column?
AP of sacrum & coccyx
116
which SI joint is shown w an RPO pos
Left
117
how much body rotation is required for obl pos's of SI joints?
25-30 degrees
118
AP L-spine shows that the spinous processes are not midline to the vertebral column & distortion of the vertebral bodies is present. which specific pos error is present?
spine rotation
119
an LPO of L-spine shows that the downside pedicles and zygapophyseal joints are projected over the ant. portion of the vertebral bodies. which pos error is present?
insufficient spinal rotation (pedicle should be to midvertebral bodies)
120
a lat L-spine on female shows that the mid- to lower intervertebral joint spaces are not open. the tech supported the midsection of the spine w sponges to straighten the spine. what else can be done to open joint spaces?
if pt has wide pelvis, can angle CR 5-8 degrees caudad
121
XR of lat L5-S1 shows that the joint spaces are not open. the tech did support the mid-aspect of spine w a sponge. what else can be done to open up joint spaces?
put more support beneath spine, or use 5-8 degree caudal angle
122
AP axial coccyx shows that the distal tip is superimposed over the pubic symphysis. what must tech do to eliminate this problem on repeat?
increase CR angle to separate coccyx from pubic symphysis
123
XR of an obl pos of L-spine shows that the downside pedicle and zygapophyseal joint are post. in relation to vertebral body. what modification of the pos must be made during repeat?
less rotation of body/spine
124
pt comes in for lumbar series. has clinical history of adv spondylolysis. what XRs best show this condition?
post. or ant. obl pos's best demonstrates adv signs of spondylolysis
125
pt comes in for a lumbar series. she has clinical history of severe kyphosis. how should routine be modified for this pt?
should be performed erect
126
what 3 things can be done to scoliosis series to minimize dose to pt's breasts
+ kVp technique
PA (rather than AP)
use of breast shields
127
pt w a clinical history of spondylolisthesis at the L5-S1 level comes in, which specific pos would best show extent of this condition?
lat L5-S1 pos would show degree of forward displacement of L5 onto S1
128
compared w the spinous processes of C-/T-spine, the L-spinous processes are...
larger and more blunt
129
the ant./sup. ridge of the upper sacrum is called
the promontory
130
the angle of the midlumbar spine zygapophyseal joints in relation to the MSP is _____degrees
30-50
131
where is the pars interarticularis found?
btw the sup. and inf. articular processes
132
3 characteristics of vertebra that identify it as a lumbar over thoracic?
larger bodies; fairly small transverse processes; bulky/blunt spinous processes
133
the ear and front leg of scotty dog make up the
zygapophyseal joint
134
what landmark corresponds to the L2-L3 level?
lower costal margin
135
anterior wedging and loss of vertebral body height are characteristic of:
compression fracture
136
which condition is often diagnosed by prenatal U/S?
spina bifida
137
where is CR centered for AP L-spine w 11x14" IR
level of L3 (palpate lower costal margin)
138
CR angle/centering for AP sacrum
CR 15 degrees cephalic to 2" sup. to pubic symphysis
139
CR angle/centering for AP coccyx
CR 10 degrees cephalad to 2" sup to pubic symphysis
140
CR angle/centering for lat sacrum/coccyx
CR perpendicular to 3-4" post. to ASIS
141
CR/angle/centering for lat coccyx
CR perpendicular to 3-4" post. and 2" distal to ASIS
142
pedicle shown posteriorly on vertebral bodies indicates
over-rotation
143
pedicle shown anteriorly on vertebral bodies indicates
under-rotation
144
how much spinal rotation is needed to show the zygapophyseal joints btw L1-L2?
50 degrees from table top
145
what CR angle should be used for lat L5-S1 XR if waist is not supported
5-8 degrees caudad
146
where is CR angled/centered for AP L5-S1?
CR 30 degrees (male), 35 degrees (female) cephalic to level of ASIS
147
which projection/method is designed to show the degree of scoliosis deformity btw the primary and compensatory curves as part of a scoliosis series
PA(AP) projection: scoliosis series - Ferguson method
148
1/2 the mAs is the same as decreasing kVp by
10
149
lat L-spine should include what?
T12 and sacrum
150
If C7-T1 cannot be shown on Swimmer's, pt should be sent where?
to CT
151
In AP open mouth, CR should be parallel to...?
MML
152
Which is more practical for trauma? Fuchs or Judd?
Fuchs (bc AP)
