EXAM #3 (T-SPINE, SWIMMERS) Flashcards by Casey Myles Jones

[Anatomy: Cervical Vertebrae ]

?x in number

Occupy the _____ region

Unique features:

_____ _____ located on transverse processes

_____ _____ processes

[Anatomy: Cervical Vertebrae]

Seven in number

Occupy the neck region

Unique features:

Transverse foramina located on transverse processes

Bifid spinous processes

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[Anatomy: Cervical Vertebrae ]

First two are atypical to join with skull

_____ or _____

_____ is also atypical to join with T-spine

[Anatomy: Cervical Vertebrae]

First two are atypical to join with skull

C1 or atlas

C2 or axis

C7 is also atypical to join with T-spine

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[Anatomy: C1 (Atlas) ]

Consists of:
?

C1 has no _____ _____

_____ _____ _____ receive the condyles of the occipital bone

[Anatomy: C1 (Atlas)]

Consists of:
Anterior arch
Posterior arch
Two lateral masses
Two transverse processes

C1 has no vertebral body

Superior articular processes receive the condyles of the occipital bone

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[Anatomy: C2 (Axis) ]

Has a conical process, called the _____ or _____, on upper, anterior of body

_____ is received into _____ ring of C1

[Anatomy: C2 (Axis)]

Has a conical process, called the dens or odontoid, on upper, anterior of body

Odontoid is received into anterior ring of C1

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[Anatomy: C7]

Also called the _____ _____ because of its long, prominent spinous process

Easily _____

[Anatomy: C7]

Also called the vertebra prominens because of its long, prominent spinous process

Easily palpated

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[Lateral Cervicothoracic Swimmer’s ]

Note: This projection is needed when _____ is not well demonstrated on _____ _____ projection and to better visualize _____ on _____ _____ projection.

[Lateral Cervicothoracic Swimmer’s]

Note: This projection is needed when C7 is not well demonstrated on lateral C-spine projection and to better visualize T1-T3 on lateral T-Spine projection.

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[Lateral Cervicothoracic Swimmer’s]

Patient position:

Upright, seated or standing, in true lateral position

Recumbent true lateral position with _____ resting on arm or other firm support

Note: Can also be done _____ (pt. supine - dorsal decubitus)

[Lateral Cervicothoracic Swimmer’s]

Patient position:

Upright, seated or standing, in true lateral position

Recumbent true lateral position with head resting on arm or other firm support

Note: Can also be done cross-table (pt. supine - dorsal decubitus)

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[Lateral Cervicothoracic Swimmer’s ]

Part position:

_____ centered to midline of grid

Extend arm closer to IR above head and rotate _____ _____ anteriorly

If upright, flex _____ and rest _____ on head

Depress _____ further from IR, if possible

Head and body in true lateral position

_____ interspace in center

[Lateral Cervicothoracic Swimmer’s]

Part position:

MCP centered to midline of grid

Extend arm closer to IR above head and rotate humeral head anteriorly

If upright, flex elbow and rest forearm on head

Depress shoulder further from IR, if possible

Head and body in true lateral position

C7-T1 interspace in center

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[Lateral Cervicothoracic Swimmer’s ]

CR:

Perpendicular to _____ interspace if shoulder away from IR is depressed

If shoulder cannot be depressed, angle __ to __ degrees caudad

Collimated field:

Includes lower cervical and upper thoracic vertebrae

[Lateral Cervicothoracic Swimmer’s]

CR:

Perpendicular to C7-T1 interspace if shoulder away from IR is depressed

If shoulder cannot be depressed, angle 3 to 5 degrees caudad

Collimated field:

Includes lower cervical and upper thoracic vertebrae

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[Image Evaluation of the Lateral Cervicothoracic Swimmer’s Projection ]

Evidence of proper collimation

Adequate x-ray penetration through the shoulder region demonstrating the lower cervical and upper thoracic vertebra, not appreciably rotated from lateral position

Humeral heads _____ _____ on vertebral column

Soft tissue and bony trabecular detail

[Image Evaluation of the Lateral Cervicothoracic Swimmer’s Projection]

Evidence of proper collimation

Adequate x-ray penetration through the shoulder region demonstrating the lower cervical and upper thoracic vertebra, not appreciably rotated from lateral position

Humeral heads minimally superimposed on vertebral column

Soft tissue and bony trabecular detail

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[Anatomy: Thoracic Vertebrae ]

?x in number

Occupy the _____ _____

Unique features:

_____ _____ on posterior, lateral sides of bodies for articulation with head of ribs

_____ on transverse processes for articulation with tubercle of _____ (except for __ and __)

[Anatomy: Thoracic Vertebrae]

12 in number

Occupy the posterior thorax

Unique features:

Costal facets on posterior, lateral sides of bodies for articulation with head of ribs

Facets on transverse processes for articulation with tubercle of ribs (except for T11 and T12)

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[General Patient Position ]

Ambulatory patients:

Upright or recumbent (we will do recumbent)

Nonambulatory patients:

Alter positioning to maximize patient comfort

Trauma patients:

Move IR and CR to obtain images to maximize patient safety (see Chapter 13, p. 30)

[General Patient Position]

Ambulatory patients:

Upright or recumbent (we will do recumbent)

Nonambulatory patients:

Alter positioning to maximize patient comfort

Trauma patients:

Move IR and CR to obtain images to maximize patient safety (see Chapter 13, p. 30)

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[IR/Collimated Field Size ]

A 14” x 17” IR is used in the radiography of the adult Thoracic Spine (lengthwise/portrait)

A 10” x 12” IR may be used for children/infants

[IR/Collimated Field Size]

A 14” x 17” IR is used in the radiography of the adult Thoracic Spine (lengthwise/portrait)

A 10” x 12” IR may be used for children/infants

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SID?

40”

60” for scoliosis

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[Patient Instructions ]

Explain positions, procedures, and breathing instructions

Respiration is _____ at the end of _____ for most middle to lower vertebral column projections

_____ _____ spine procedures can use breathing technique to blur lung and rib anatomy

[Patient Instructions]

Explain positions, procedures, and breathing instructions

Respiration is suspended at the end of expiration for most middle to lower vertebral column projections

Lateral Thoracic spine procedures can use breathing technique to blur lung and rib anatomy

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[AP T-Spine ]

Patient position:

Supine or upright

_____ in same horizontal plane

_____ by side

[AP T-Spine]

Patient position:

Supine or upright

Shoulders in same horizontal plane

Arms by side

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[AP T-Spine ]

Part position:

_____ in center

If supine, reduce kyphosis by _____ _____ and _____ to place thighs vertical

If upright, weight should be equally distributed on both _____

IR placed __ to __ inches above shoulders to place __ in center

[AP T-Spine]

Part position:

MSP in center

If supine, reduce kyphosis by flexing hips and knees to place thighs vertical

If upright, weight should be equally distributed on both feet

IR placed 1½ to 2 inches (3.8 to 5 cm) above shoulders to place T7 in center

[AP T-Spine ]

CR:

Enters patient halfway between _____ _____ and _____ _____

Collimated field:
7 x 17 inches (18 x 43 cm)

[AP T-Spine]

CR:

Enters patient halfway between jugular notch and xiphoid process

Collimated field:
7 x 17 inches (18 x 43 cm)

[Lateral T-Spine ]

Note: T-spine _____ _____ is demonstrated on lateral projection .

Also: _____ _____ are shown on oblique (__°), which is not an essential projection for T-spine. This will be important for you to know for written exam (pg. 410-412).

[Lateral T-Spine]

Note: T-spine intervertebral foramina is demonstrated on lateral projection.

Also: Zygapophyseal joints are shown on oblique (70°), which is not an essential projection for T-spine. This will be important for you to know for written exam (pg. 410-412).

[Lateral T-Spine ]

Patient position

Recumbent or upright

Left lateral minimizes _____ _____ and overlapping of _____ on spine

[Lateral T-Spine]

Patient position

Recumbent or upright

Left lateral minimizes heart magnification and overlapping of heart on spine

[Lateral T-Spine ]

Part position:

Long axis of _____ _____ aligned horizontal

Firm support for head and lower portion, if needed

If recumbent, flex _____ and _____ for comfort

Superimpose _____ and _____ for true lateral position

Adjust _____ to right angle from body

[Lateral T-Spine]

Part position:

Long axis of vertebral column aligned horizontal

Firm support for head and lower portion, if needed

If recumbent, flex hips and knees for comfort

Superimpose hips and knees for true lateral position

Adjust arms to right angle from body

[Lateral T-Spine ]

CR:

Directed perpendicular to the IR, if spine is horizontal

If not, angle CR __ to __ degrees cephalad/caudad?

Enters patient at __ (ABOUT inferior angles of scapulae)

TOP OF THE IR AT THE _____

[Lateral T-Spine]

CR:

Directed perpendicular to the IR, if spine is horizontal

If not, angle CR 10 to 15 degrees cephalad

Enters patient at T7 (ABOUT inferior angles of scapulae)

TOP OF THE IR AT THE SHOULDERS

[Scoliosis Radiography ]

Typical scoliosis examination may include:

PA (or AP) upright

PA (or AP) upright with lateral bending

Lateral upright (with or without bending)

PA (or AP) recumbent

[Scoliosis Radiography]

Typical scoliosis examination may include:

PA (or AP) upright

PA (or AP) upright with lateral bending

Lateral upright (with or without bending)

PA (or AP) recumbent

[Scoliosis Radiography]

Demonstrates amount/degree of curvature that occurs with force of gravity acting on body

Also used to evaluate fixation devices, such as _____ rods

Bending studies used to differentiate between _____ and _____ curves

[Scoliosis Radiography]

Demonstrates amount/degree of curvature that occurs with force of gravity acting on body

Also used to evaluate fixation devices, such as Harrington rods

Bending studies used to differentiate between primary and compensatory curves

[Scoliosis Radiography] Long IRs (36 inches) and __ inches SID used to demonstrate entire spine with one exposure

[Scoliosis Radiography] Long IRs (36 inches) and 60 inches SID used to demonstrate entire spine with one exposure

[Scoliosis: PA Thoracolumbar ] Patient position: Upright, facing vertical Bucky Part position: Ensure _____ parallel to Bucky _____ abducted and not in field CR: _____ to Bucky

[Scoliosis: PA Thoracolumbar] Patient position: Upright, facing vertical Bucky Part position: Ensure MCP parallel to Bucky Arms abducted and not in field CR: Perpendicular to Bucky

[Scoliosis: Lateral Thoracolumbar ] Patient position: Upright, lateral Part position: _____ perpendicular to Bucky _____ at right angle to body CR: _____ to Bucky

[Scoliosis: Lateral Thoracolumbar] Patient position: Upright, lateral Part position: MCP perpendicular to Bucky Arms at right angle to body CR: Perpendicular to Bucky

[Scoliosis: PA Thoracolumbar (Ferguson) ] First radiograph taken in same manner as previously described PA Second PA radiograph taken with patient’s _____ side elevated __ to __ inches Ferguson specified that elevation must be sufficient to require patient to expend effort to maintain position

[Scoliosis: PA Thoracolumbar (Ferguson)] First radiograph taken in same manner as previously described PA Second PA radiograph taken with patient’s convex side elevated 3 to 4 inches (7.6 to 10.2 cm) Ferguson specified that elevation must be sufficient to require patient to expend effort to maintain position

[AP T-Spine ] Evidence of proper collimation All ?x thoracic vertebrae All vertebrae shown with uniform _____ and _____ (or two radiographs taken for the upper and lower vertebrae) No _____ as demonstrated by spinous processes at the midline of the vertebral bodies

[AP T-Spine] Evidence of proper collimation All 12 thoracic vertebrae All vertebrae shown with uniform brightness and contrast (or two radiographs taken for the upper and lower vertebrae) No rotation as demonstrated by spinous processes at the midline of the vertebral bodies

[AP T-Spine] Vertebral column aligned to the middle of the radiograph Soft tissue and bony trabecular detail Ribs, shoulders, lungs, and diaphragm if a full field projection is made To take advantage of heel effect: _____ over abdomen, _____ over shoulders

[Lateral T-Spine] Evidence of proper collimation and posterior field shielding, to reduce scatter radiation to posterior structures of the spine Vertebrae clearly seen through _____ and _____ shadows

[Lateral T-Spine] Evidence of proper collimation and posterior field shielding, to reduce scatter radiation to posterior structures of the spine Vertebrae clearly seen through rib and lung shadows

[Lateral T-Spine] ?x thoracic vertebrae centered on the IR. Superimposition of the _____ on the upper vertebrae may cause underexposure in this area. The number of vertebrae visualized depends on the size and shape of the patient. __ to __ are not well seen.

[Lateral T-Spine] Twelve thoracic vertebrae centered on the IR. Superimposition of the shoulders on the upper vertebrae may cause underexposure in this area. The number of vertebrae visualized depends on the size and shape of the patient. T1 to T3 are not well seen.

[Lateral T-Spine] _____ superimposed posteriorly to indicate that the patient was not rotated Open _____ _____ spaces Soft tissue and bony trabecular detail

[Lateral T-Spine] Ribs superimposed posteriorly to indicate that the patient was not rotated Open intervertebral disk spaces Soft tissue and bony trabecular detail

[Scoliosis Radiography ] Thoracic and lumbar vertebrae to include about __ inch of the iliac crests Vertebral column aligned down the center of the radiograph Soft tissue and bony trabecular detail

[Scoliosis Radiography] Thoracic and lumbar vertebrae to include about 1 inch of the iliac crests Vertebral column aligned down the center of the radiograph Soft tissue and bony trabecular detail

[Scoliosis Radiography ] Always include crests with patient standing straight with weight evenly distributed because that’s where the _____ come from

[Scoliosis Radiography] Always include crests with patient standing straight with weight evenly distributed because that’s where the measurements come from

Which position did we cover in PP should use a compensating filter?

AP T-Spine

Book talks about placing lead on the table for lateral projection, gives reason why

Reduces scatter improving image

What are the specifics of the intervertebral foramina of the thoracic spine?

45° angle anterior from MSP 15° angle inferior to horizontal plane

What are the typical cervical vertebrae?

C3-C6

Which vertebrae are not well seen in the lateral T-spine projection?

T1-T3

[Lateral (swimmer’s technique)] Pawlow: ? Twining: ? Fletcher, Monda: CR angles?

[Lateral (swimmer’s technique)] Pawlow: recumbent Twining: upright Fletcher: 3-5° caudad Monda: 5-15° cephalad

How many parts are in the typical vertebra (which are the typical parts)

two main parts: body + arch