T-Spine Test

Question 1

Explain how the anode heel effect is used when imaging the AP T-Spine.

Answer 1

The thicker part of the body can be placed under the cathode side of the tube and the thinner part of the body can be placed under the anode side of the tube for optimal exposure and density across the whole image.

Question 2

If the patient is positioned correctly for an AP thoracic spine, which of the following should be seen on the image:
1.) spinous process
2.) transverse process
3.) intervetebral foramina
4.) posterior ribs
5.) pedicle

a.) 3, 4 and 5
b.) 3 and 4
c.) 1, 2 and 3
d.) 1, 2 and 4

Answer 2

d.) 1, 2 and 4

Question 3

Intervetebral foramina are best seen on:

a.) lateral
b.) AP
c.) swimmers

Answer 3

a.) lateral

Question 4

For an AP thoracic projection, the
1.) should and the ASISs are positioned at equal distances from the IR
2.) hips and knees are flexed until the lower back is pressed against the imaging table
3.) central ray is centered to the fifth thoracic vertebra
4.) transversely collimated field is open to an 8 inch field size

a.) 1, 2 and 4
b.) 1 and 2
c.) 3 and 4
d.) 1, 2, 3 and 4

Answer 4

a.) 1, 2 and 4

Question 5

No rotation on an AP thoracic spine is indicated by:

a.) SC joints are equidistant from the spine
b.) posterior ribs are superimposed
c.) zygapophyseal joints are closed
d.) intervetebral foramina are closed

Answer 5

a.) SC joints are equidistant from the spine

Question 6

The CR for an AP T spine should be:
1.) angled cephalically
2.) angled caudally
3.) angled perpendicuallary
4.) centered to T7
5.) centered to T8
6.) centered 2 inches below jugular notch

a.) 1 and 5
b.) 1 and 4
c.) 3 and 4
d.) 2 and 6

Answer 6

c.) 3 and 4

Question 7

Even with good collimation on a lateral thoracic spine, the scatter radiation reaching the image receptor obscures the spinous processes. What can the technologist do to improve the visibility of the posterior elements of the spine?

a.) place a lead strip on the table posterior to the patient
b.) increase the KV, lower the MAS
c.) use higher speed screens and film
d.) use a higher grid ratio

Answer 7

a.) place a lead strip on the table posterior to the patient

Question 8

Which structures form the zygapophyseal joints?

1.) lamina
2.) superior artucular process
3.) pedicle
4.) transverse process
5.) inferior articular process

a.) 2 and 5
b.) 3, 4 and 5
c.) 1, 2 and 5
d.) 1 and 2

Answer 8

a.) 2 and 5

Question 9

T2-T3 disk space is found at the level of the:

a.) sternal angle
b.) jugular notch
c.) xiphoid process
d.) 2 inches below the jugular notch

Answer 9

b.) jugular notch

Question 10

Where is the IR centered for the lateral projection of the cervicothoracic region (swimmers technique)?

a.) sixth cervical vertebra
b.) first thoracic vertebra
c.) at the c7-T1 interspace
d.) seventh cervical vertebra

Answer 10

c.) at the c7-T1 interspace

Question 11

What structures are not visualized well on a lateral t spine?

a.) T1 to T3
b.) intervetebral disk spaces
c.) intervetebral foramina
d.) T1 to T5

Answer 11

a.) T1 to T3

Question 12

An AP thoracic projection obtained with the patient rotated toward the left side demonstrates:

1.) the spinous processes positioned closer to the right side
2.) a greater distance from the right pedicle to the spinous process than from the left pedicle to the spinous process
3.) the right SC joint superimposed over the vertebral column
4.) closed intervetebral disk spaces

a.) 2 and 3
b.) 1 and 3
c.) 1, 2, 3 and 4
d.) 4 only

Answer 12

b.) 1 and 3

Question 13

The zygopophyseal joints for the thoracic spine lie at an angle of _________ in rotation to the midsagital plane.

a.) 70 to 75 degrees
b.) 45 degrees
c.) 60 degrees
d.) 90 degrees

Answer 13

a.) 70 to 75 degrees

Question 14

The posterior cervical oblique projections demonstrate the intervetebral foramina and pedicles on the side fartherest from the image receptor.

a.) true
b.) false

Answer 14

a.) true

Question 15

How many bones make up the adult vertebral column?

a.) 28
b.) 31
c.) 33
d.) 26

Answer 15

d.) 26

Question 16

Which two vertebral curves are kyphotic curves?

a.) cervical and thoracic
b.) cervical and lumbar
c.) throracic and sacral
d.) thoracic and lumbar

Answer 16

c.) thoracic and sacral

Question 17

A patient enters the emergency department (ED) because of a motor vehicle accident. The patient is on a backboard and wearing a cervical collar. The technologist is concerned about the artifacts that the collar will project on the spine during the horizontal beam lateral projection. What should the technologist do in this situation ?

a.) for liability reasons, ask the patient to remove the collar
b.) remove the collar carefully and do not move the patients head
c.) have the nurse remove the collar and hold the patients head while you make the exposure
d.) leave the collar on

Answer 17

d.) leave the collar on

Question 18

Which position/projection of the cervical spine will best demonstrate the zygopophyseal joint spaces between c1 and c2?

a.) AP open mouth
b.) lateral
c.) AP axial
d.) 45 degree obliques

Answer 18

a.) AP open mouth

Question 19

Why is the intervetebral foramina important?

a.) allows each vertebra to articulate with the one below and one above it
b.) spinal cord runs through it
c.) it allows for movement and flexibility
d.) cushions the vertebral body

Answer 19

b.) spinal cord runs through it

Question 20

The thoracic spine normally has a concave curvature.

a.) true
b.) false

Answer 20

b.) false

Question 21

Scoliosis is defined as abnormal or exaggerated:

a.) swayback lumbar curvature
b.) concave curvature
c.) convex curvature
d.) lateral curvature

Answer 21

d.) lateral curvature

Question 22

Where should the CR be positioned for both AP and lateral views of the T Spine?

a.) T7
b.) 3 inches below the jugular notch
c.) xiphoid
d.) T5

Answer 22

a.) T7

Question 23

The inner portion of an intervetebral disk is called:

a.) annulus fibrosis
b.) the core
c.) nucleus pulposis
d.) body

Answer 23

c.) nucleus pulposis

Question 24

For an AP t spine the image should be performed:

a.) on suspension of breathing
b.) with a breathing technique
c.) on expiration
d.) on inspiration

Answer 24

c.) on expiration

Question 25

Which of the following factors will enhance the visibility of the vertebral bodies during a lateral projection of the thoracic spine?

a.) use a breathing technique
b.) increase SID
c.) use a high kv
d.) flex the spine

Answer 25

a.) use a breathing technique

Question 26

The bony structures connected directly to the vertebral body are the:

a.) pedicles
b.) laminae
c.) transverse process
d.) articular processes

Answer 26

a.) pedicles

Question 27

Sway back is also known as:

a.) kyphosis
b.) scolisosis
c.) osteoporosis
d.) lordosis

Answer 27

d.) lordosis

Question 28

The semi gelatanious material within an intervetebral disk is called:

a.) cauda equina
b.) nucleus pulposis
c.) annulus fibrosis
d.) conus medullaris

Answer 28

b.) nucleus pulposis

Question 29

A radiograph of an AP open mouth projection reveals that the base of the skull is superimposed over the dens. What positioning error led to this radiographic outcome?

a.) excessive extension of the skull
b.) excessive CR angulation
c.) excessice flexion of the skull
d.) rotation of the skull

Answer 29

a.) excessive extension of the skull

Question 30

The xiphoid tip corresponds to the level of:

a.) t8-t9
b.) t7-8
c.) t10-11
d.) t12

Answer 30

c.) t10-11

Question 31

T9 and T10 are located at the level of the:

a.) jugular notch
b.) xiphoid process
c.) sternal angle
d.) vertebra prominens

Answer 31

b.) xiphoid process

Question 32

Which factor is most important to open up the intervetebral joint spaces for a lateral thoracic spine projection?

a.) keep vertebral column parallel to tabletop
b.) angle the CR 5 degrees to 10 degrees caudad
c.) use sufficiently high kv
d.) collimate the spine region to reduce scatter

Answer 32

a.) keep vertebral column parallel to tabletop

Question 33

Why are the anterior obliques (RAO/LAO) positions preferred over the posterior oblique position sof the cervical spine?

a.) prevent overlap of the mandible over the spine
b.) place the zygopophyseal joints closer to the image receptor
c.) less thyroid and breast dose
d.) more comfortable for the patient

Answer 33

c.) less thyroid and breast dose

Question 34

The ________ of the rib articulates with the vertebral body.

a.) costal groove
b.) neck
c.) head
d.) tubercle

Answer 34

c.) head

Question 35

If there is no rotation on a lateral t spine then

a.) the SC joints will be equidistant form the spine
b.) there will be less than 1/2’’ between posterior ribs
c.) there will be less than 1 inch between the posterior ribs
d.) the entire thoracic spine will be seen from T1- T12

Answer 35

b.) there will be less than 1/2’’ between posterior ribs

Question 36

A patient comes to radiology for a thoracic spine routine. The patient has a history of artiritis of the spine. The radiologist requests that additional projections to be taken to demonstrate the zygopophyseal joints. What positions/projections would be ideal to demonstrate these structures?

a.) spot AP and lateral projections of interest region
b.) swimmer lateral projection
c.) pillar view projection of interest region
d.) 70 degree oblique projectionsd

Answer 36

d.) 70 degree oblique projections