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RAD 372 - Anatomy > TEST 2 (spine) > Flashcards

TEST 2 (spine) Flashcards

1
Q

From a posterior view, C & L spine have ____ curves

A

concave

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2
Q

From a posterior view, T & sacrum have ____ curves

A

convex

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3
Q

Which spinal curves are primary

A

T & sacrum

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4
Q

Which spinal curves develop soon after birth

A

T & Sacrum

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5
Q

Which spinal curves are compensatory

A

C & L spine

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6
Q

3 common terms to describe abnormality in spinal curve

A

lordosis
kyphosis
scoliosis

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7
Q

What is Lordosis

A

Exaggerated concavity (Swayback)

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8
Q

What is Kyphosis

A

Exaggerated convexity (Humpback)

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9
Q

What is Scoliosis

A

Exaggerated lateral curvature

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10
Q

Abnormal anterior concavity of lumbar spine is ____

A

Lordosis

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11
Q

Abnormal increased convexity of thoracic spine is ___

A

Kyphosis

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12
Q

Abnormal lateral curvature of spine is ____

A

Scoliosis

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13
Q

3 parts of vertebral

A

body
vertebral arch
vertebral foramen

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14
Q

Which structure attach superiorly and inferiorly to vertebral body

A

intervertebral disk

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15
Q

Which structure extend posteriorly from vertebral body

A

vertebral arch

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16
Q

Posterior surface of body & arch form _____

A

vertebral foramen

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17
Q

Vertebral foramen contains _____

A

spinal cord

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18
Q

Location of Pedicle

A

extend posteriorly from both side of vertebral body

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19
Q

Which structure extend directly posterior off of the vertebral body

A

pedicle

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20
Q

Which structure extend posteriorly from each pedicle and unite in the midline

A

Lamina

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21
Q

The spinous process of cervical extends ____

A

posteriorly where 2 laminae unite

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22
Q

What are components of the vertebral arch (4)

A

pedicle
lamina
transverse process
spinous process

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23
Q

Lamina converge at ___

A

spinous process

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24
Q

Pedicle continue mid line at the ____

A

laminae

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25
Q

Which structure join 2 vertebrae together

A

S/I articular process

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26
Q

Which joint is formed between S/I articular process of 2 vertebra

A

zygapophyseal joint

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27
Q

Other names for zygapophyseal joint

A

Apophyseal
Facet

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28
Q

What structure is formed between S/I vertebral notch

A

intervertebral foramen

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29
Q

Zygapophyseal joint is formed between ____

A

S/I articular process

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30
Q

Intervertebral foramen of L-spine is formed between _____
A. S/I articular process
B. S/I vertebral notch

A

S/I vertebral notch

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31
Q

Spinal nerves and blood vessels pass through ____

A

intervertebral foramen

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32
Q

spinal cord pass through ____

A

vertebral foramen

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33
Q

Intervertebral disk acts as a ____

A

shock absorber

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34
Q

2 parts of intervertebral disk (outer to inner)

A

annulus fibrosis - nucleus fibrosis

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35
Q

Herniated disk is caused by _____

A

nucleus fibrosis protrudes thru annulus fibrosis and press on the spinal cord —> pain & numbness that radiate into upper & lower limbs

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36
Q

Which position would we best see cervical zygapophyseal joint

A

lateral

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37
Q

in C-spine, Zygapophyseal joint is ___ degree from AP. for which vertebra?

A

90
C2-7

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38
Q

in C-spine, Intervertebral foramen are seen:
___ degree from midsagittal
___ degree inferior angle

A

45
15

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39
Q

Which position would we see intervertebral foramen for c-spine?

A

Obliques

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40
Q

Is the tube angle needed to see intervertebral foramen?

A

YES

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41
Q

Tube angle to see intervertebral foramen

A

15 cephalad

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42
Q

The atlas is ____
The axis is ____

A

C1
C2

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43
Q

The transverse process arise from ___ & ____

A

pedicle & body

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44
Q

What are the 3 foramina of the cervical vertebra

A

2 transverse foramen
1 vertebral foramen

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45
Q

vertebral veins & arteries pass thru _____

A

transverse foramen

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46
Q

Bifid spinous processes are found on ___ through ___

A

C2 - C6

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47
Q

3 parts of C-spine?

A

transverse foramen
bifid spinous process
articular pillars

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48
Q

Articular pillars formed by ____

A

S/I articular processes

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49
Q

Articular pillars are called ____ ____ when refer to C1

A

lateral mass

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50
Q

Zygapophyseal joint for C1-C2 are seen in which position?

A

AP open mouth

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51
Q

Zygapophyseal joint for C3-C7 are seen in which position

A

lateral

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52
Q

To open & demonstrate cervical intervertebral foramen radiographically, what must be done?

A

rotate patient 45 oblique
15-20 cephalad tube angle

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53
Q

3 anatomical parts of C1

A

superior facets
anterior arch
posterior arch

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54
Q

What structure C1 lack but other Cervical spines have?

A

body & spinous process

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55
Q

[C1] instead of the body, what structure is present anteriorly?

A

anterior arch

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56
Q

[C1} instead of the spinous process, what structure is present posteriorly

A

posterior arch

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57
Q

anterior and posterior arch of C1 terminates at ___

A

tubercle

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58
Q

Which structure of C1 join with the skull

A

superior facets

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59
Q

(spine) Superior facet is a surface located on ____

A

superior articular process

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60
Q

Function of lateral mass of C1

A

support weight of head & assist in head rotation

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61
Q

What is the distinctive feature of C2

A

odontoid process (dens)

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62
Q

Location of odontoid process

A

posterior to anterior arch of C1

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63
Q

On the oblique positions for cspine, which structure we are looking for

A

intervertebral foramina

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64
Q

On a posterior oblique, which side will have the intervertebral foramina open

A

upside (side farthest away from IR)

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65
Q

On anterior oblique, which side will have the intervertebral foramina open

A

the downside (side closest to IR)

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66
Q

[C-spine] Tube angle for
anterior oblique: ____
posterior oblique: ____

A

15-20 caudad
15-20 cephalad

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67
Q

[C] in LPO which intervertebral foramina is opened

A

RIGHT

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68
Q

Routine for C-spine

A

AP
AP open mouth
LT Lateral
RPO
LPO

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69
Q

Positioning parameter for AP C-spine
Positioning?
CR?
SID?

A

supine or erect
slightly extend chin
15-20 cephalad tube angle
CR: mid-sagittal
SID: 40”

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70
Q

Tube angle for AP C-Spine

A

15-20 Cephalad

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71
Q

CR for AP C-spine

A

C4 (level of thyroid cartilage)

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72
Q

Why do we need tube angle for AP C-spine

A

direct beam between overlapping cervical vertebral bodies to see intervertebral disk better

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73
Q

[AP C-spine] CR angle:
supine: ___
erect: ____

A

15 cephalad
20 cephalad

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74
Q

Kyphotic patient will need an angle of ____ for AP C-spine

A

more than 20

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75
Q

AP Open mouth is best for which cervical spine

A

C1-C2

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76
Q

Position patient for AP Open mouth

A

mouth open
lower margin of top incisors is in line (perpendicular) with base of skull

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77
Q

What indicate no rotation of head during AP Open Mouth

A

equal distances from lateral mass of C1 to condyle of mandible

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78
Q

Which joint do we need to see for AP Open mouth

A

atlantoaxial joint (C1-C2)

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79
Q

What anatomy are demonstrated through AP open mouth (4)

A

dens
vertebral body of C2
lateral mass & transverse process of C1
atlantoaxial joint between C1-C2

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80
Q

Positioning parameter for RPO/LPO C-spine

A

the patient can be sitting or standing, rotates 45 degrees, with the arms placed at side

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81
Q

CR & Tube angle for RPO/LPO C-spine

A

CR: C4
Tube: 15-20 cephalad

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82
Q

Oblique positions for C-spine show which structure?

A

intervertebral foramen

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83
Q

RPO/LPO shows intervertebral foramina ____ IR

A

farthest from

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84
Q

RAO/LAO shows intervertebral foramina ____ IR

A

closest to

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85
Q

What way to prevent mandible from superimpose vertebrae

A

protract chin

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86
Q

what will cause the superimposition of base of skull over the posterior arch of C1

A

excessive skull and neck extension

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87
Q

CR & Tube anlge for RAO/LAO of C spine

A

CR: C4
tube: 15-20 caudad

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88
Q

RPO C-spine looks for ____ intervertebral foramen

A

LEFT

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89
Q

RAO C-spine looks for ____ intervertebral foramen

A

RIGHT

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90
Q

SID for Lateral C-spine

A

60-72”

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91
Q

Position patient for Lateral C-spine

A

erect or x-table
depress shoulders with patient straight
slightly extend chin

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92
Q

CR for lateral c-spine

A

C4

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93
Q

Lateral C-spine looks for ____

A

C7-T1 (top)

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94
Q

Why do we INcreased SID from Ap to Lateral C-spine

A

To decrease OID due to the patient shoulder

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95
Q

CR for Xtable C-spine

A

C4 (top IR: 1-2” above EAM)

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96
Q

If we cant see C7-T1 on lateral, what other position we do ?

A

Swimmer

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97
Q

Positioning parameter for C-spine Swimmer

A

raise arm closest to IR
depress arm farthest from IR

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98
Q

For Swimmer C-spine, a 3-5 caudad tube angle can do what

A

separate 2 shoulders farthest from IR

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99
Q

For C-spine flexion & extension, patient is placed in ____ position

A

lateral

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100
Q

Position parameter for C-spine flexion

A

depress chin until it touches the chest

101
Q

Position parameter for C-spine extension

A

elevate chin & tilt head back as much as possible

102
Q

which T-spine are cervical like

A

T1-4

103
Q

which T-spine are thoracic like

A

T5-8

104
Q

which T-spine are lumbar like

A

T9-12

105
Q

T-spine has _____ spinous process

A

inferior projecting

106
Q

Key distinguish feature of thoracic spine

A

facets for rib articulations

107
Q

facets of thoracic vertebra accept the ____ of a rib to form ____

A

head
costovertebral joint

108
Q

to form costovertebral, the facets for rib articulation located on ____

A

body vertebra

109
Q

facets of thoracic vertebra articulate with tubercle of rib 1 - 10 to form _____

A

costotransverse joints

110
Q

Rib 11 - 12 articulate at ____

A

costovertebral joint

111
Q

to form costotransverse joint in T-spine, the facets for rib articulation located on ____

A

transverse process

112
Q

In T-spine, zygapophyseal joint is ____ degree from AP

A

70-75

113
Q

In T-spine, intervertebral foramen is ____ degree from AP

A

90

114
Q

Position parameter for AP T-spine, include CR & breathing technique

A

supine
knee flexed
suspend respiration on expiration
CR: T7

115
Q

Mastoid tip is at ____

A

C1

116
Q

Jugular notch is at ___

A

T2/3

117
Q

Sternal angle is at ___

A

T4/5

118
Q

1” inferior to EAM is ____

A

C1

119
Q

Gonion is at ____

A

C3

120
Q

2 topographic landmarks for C-spine

A

mastoid tip (C1)
gonion (C3)

121
Q

3 topographic landmarks for T-spine

A

jugular notch (T2/3)
sternal angle (T4/5)
Xiphoid tip (T9/10)

122
Q

For AP T-spine collimate to ____

A

4-5”

123
Q

position parameter for Lateral T-spine, include CR

A

lateral recumbent
knee flexed
CR: T7 & 3” anterior from spinous process

124
Q

why do we suspend respiration on expiration for AP T-spine

A

decrease lung volume

125
Q

Breathing technique for Lateral T-spine helps ___

A

blur ribs & pulmonary marking

126
Q

If T1-3 not well visualized, which position should be done to obtain the images

A

Swimmers

127
Q

Position parameter for swimmer T-spine, include CR

A

pt in lateral
arm closest to IR raise above head
arm farthest from IR depress
CR: 1” above jugular notch

128
Q

For Swimmer T-spine, an angle of ___ can be used if needed

A

3-5 caudal

129
Q

3 characteristics of L-spine

A

Smaller transverse process
Bulkier spinous process
pars interarticularis

130
Q

Zygapophyseal joint for L-spine can be seen in which position

A

Oblique

131
Q

[L-spine] ____ degree from MSP you will see zygapophyseal joint

A

30-50

132
Q

Intervertebral foramen of L-spine can be seen in which position

A

Lateral

133
Q

[Scotty dog]
the nose is ___

A

transverse process

134
Q

[Scotty dog]
the eye is ___

A

pedicle

135
Q

[Scotty dog]
the ear is ___

A

superior articulating process

136
Q

[Scotty dog]
the leg is ___

A

inferior articulating process

137
Q

[Scotty dog]
the neck is ___

A

pars interarticularis

138
Q

[Scotty dog]
the part between ear & leg is ___

A

zygapophyseal joint

139
Q

fracture of the scotty dog’s neck results = fracture in ___

A

pars interarticularis

140
Q

SID & kVp for L-spine

A

40”
75-90

141
Q

Position patient for AP L-spine, include CR & breathing instruction

A

Pt supine
Knee bent

CR: L3 or L4
suspend on expiration

142
Q

L3 is ____
L4 is ____

A

1.5” above crest
at crest

143
Q

CR for Lateral L-spine

A

L3 to L4 based on IR
3” anterior to spinous process

144
Q

L-spine is ___ anterior to ____

A

3” spinous process

145
Q

Position parameter for posterior oblique L-spine, include CR

A

45 posterior
CR: L3 & 2” medial to upside ASIS
collimate

146
Q

RPO of L-spine shows _____
A. Left intervertebral foramen
B. Right intervertebral foramen
C. Right zygapophyseal joint
D. Left zygapophyseal joint

A

C. RIGHT zygapophyseal joint

147
Q

For which spine and position, if done correctly, would we see scotty dog

A

L-spine
Obliques

148
Q

CR for L5/S1 spot

A

CR: 1 1/2” below crest & 2” posterior to ASIS
5-8 caudal tube angle
(parallel with interiliac line)

149
Q

Why would we do a lateral L5/S1 spot ?

A

because superimposition of bilateral ilium –> high contrast

150
Q

Which position can be used in Scoliosis series

A

Erect & recumbent

151
Q

If patient has scoliosis, the ___ should be stationary and used as a ___

A

pelvis
fulcrum

152
Q

for Lateral Bending, which position patient is in?
AP: ____
PA: ____

A

recumbent
erect

153
Q

What do you need to ensure for lateral bending

A

Ensure no rotation - patient bend laterally

154
Q

Flexion have pt bend _____
Extension have pt bend ____

A

forward
backward

155
Q

[ L-spine] what is CR for Scoliosis

A

L4 or higher

156
Q

which vertebra is the strongest

A

lumbar

157
Q

the intervertebral foramina of L-spine is formed by ____

A

superior/inferior vertebral notch

158
Q

the lamina between superior and inferior articular process formed ____

A

pars interarticularis

159
Q

Pars interarticularis is best seen on which position

A

oblique

160
Q

AP of L-spine demonstrated ____

A

spinous process superimpose vertebral bodies

161
Q

which structure protrude laterally of the vertebral body

A

transverse process

162
Q

front leg of scottie dog above and ear of scottie below will form____

A

zygapophyseal joint

163
Q

WHat is the purpose of flexing the knee for L-spine

A

reduce lumbar curvature

164
Q

why L-spine is not taken in PA?

A

increased magnification unsharpness

165
Q

[L-spine] with bigger IR size, CR is directed to ____

A

iliac crest

166
Q

[L-spine] with smaller IR size, CR is directed to ____

A

L3 (1.5” above crest)

167
Q

[L-spine] If patient has a wider pelvis & narrow thorax, what is the CR?

A

CR: crest with a 5-8 degree caudal tube angle

168
Q

[L-spine] if patient has scoliosis, which position should the patient be in?

A

lateral - which places the convexity down

169
Q

[L-spine] which structure can indicate if there is rotation when in lateral?

A

sciatic notch of ileum

170
Q

CR angle for L5/S1 spot must ____

A

parallel to iliac spine

171
Q

Sacrum has how many fused vertebrae

A

5

172
Q

Sacrum has 4 sets of _____

A

sacral foramen

173
Q

On S1, the prominent anterior portion is ___

A

promontory

174
Q

Sacral canal is a continuation of ____

A

vertebral foramen

175
Q

the _____ is where L5 ends

A

sacral canal

176
Q

what is considered as the vertebral foramen for sacrum

A

sacral canal

177
Q

If the segment of _____ still separated, it will be the spinous processes of sacrum

A

median sacral crest

178
Q

SI joint is the articulation between

A

iliac and auricular surface of sacrum

179
Q

what structure of sacrum synonymous to inferior articular processes

A

sacral horn

180
Q

More of pelvis muscles & tendons attach themselves to ____

A

coccyx

181
Q

how many segments for coccyx

A

3-5 fused segments

182
Q

Coccyx has transverse process ___

A

posteriorly

183
Q

Coccyx has ____ & ___ that similar to patella

A

apex
head

184
Q

Routine for Sacrum/Coccyx

A

AP & Lateral

185
Q

kVp for Coccyx

A

80

186
Q

Position parameter for AP sacrum, include CR

A

pt supine
CR: MSP & 2” superior to symphysis pubis OR 2” below ASIS
tube angle: 15 cephalad

187
Q

Why do we need cephalad tube angle for AP Sacrum

A

flatten out normal concavity of sacrum

188
Q

how do we intentionally distort sacrum for AP

A

15 cephalad tube angle

189
Q

why sacrum & coccyx are ordered together

A

superimposition of coccyx over sacrum

190
Q

To determine rotation for AP Sacrum, ____ should be in line with ____& ____

A

median sacral crest
coccyx - symphysis pubis

191
Q

CR for Lateral Sacrum

A

at ASIS & 3-4” posterior

192
Q

No rotation on lateral sacrum is determined by _____

A

greater sciatic notch superimposed

193
Q

CR for AP Coccyx

A

2” superior to symphysis pubis
or
2” below ASIS
tube angle: 10 caudal

194
Q

Why caudal tube angle for Coccyx

A

project pubis away to see unobstructed view of coccyx

195
Q

Why can the sacrum get fractured?

A

its role with the articulation of the lower appendicular skeleton to the axial

196
Q

Which structure of sacrum are lateral to first sacral segment

A

Alae

197
Q

Articular process of sacrum located

A

superiorly

198
Q

Zygapophyseal joint between L5/S1 is formed by_____

A

superior articular process of sacrum & inferior articular process of L5

199
Q

Anterior sacrum dominate ___ curve
Lateral sacrum dominate ____ curve

A

concave
convex

200
Q

Promontory is best seen on ____

A

lateral

201
Q

greater curvature of coccyx requires ___ CR angle

A

greater

202
Q

LPO = ___ SI joint

A

RIGHT

203
Q

What is myelography

A

study of spinal cord and nerve root branches with contrast used

204
Q

where is contrast injected into for myelography

A

subarachnoid space of spinal canal

205
Q

Why myelography is performed

A

when lesions are detected in the spinal canal OR may protrude into the canal
Cord impingement

206
Q

5 contraindications to myelography

A
  1. Sensitive to iodine
  2. recent LP
  3. blood in CSF
  4. arachnoiditis
  5. increased intracranial pressure
207
Q

how long ago was the recent LP must be considered to perform a myelogram

A

2 weeks

208
Q

Why myelogram cannot be performed on patient with recent LP

A

extravasation of contrast medium outside subarachnoid space thru the hole by puncture

209
Q

what is the tissue encase the spinal cord called

A

menenges

210
Q

what are the 3 tissue layers of spinal menenges ? (outer to inner)

A

dura matter
arachnoid
pia matter

211
Q

where does CSF flow?

A

subarachnoid space under arachnoid layer

212
Q

CSF starts off in ____ of the brain

A

lateral ventricle

213
Q

Trendelenburg is when head is _____ than feet

A

LOWER

214
Q

6 equipment required for Myelogram

A
  1. Tilted xray table with shoulder braces & foot board
  2. myelogram tray
  3. x-table cassette holder
  4. grid cassette
  5. pillow for abdomen
  6. signed informed consent
215
Q

What is ideal contrast used in myelogram

A

water soluble- nonionic due to its low osmolality

216
Q

What is the important note marked for contrast used?

A

intrathecal use!

217
Q

How long does it take for contrast to absorb after injection

A

30minutes

218
Q

Contrast is radiographically undetectable after _____

A

24hrs

219
Q

what are 2 common location for puncture sites

A

lumbar (L3-L4) through interspinous space
cervical (C1-C2)

220
Q

2 positions for myelogram

A

X-table & AP Scout

221
Q

myelogram is usually done by ___

A

radiologist

222
Q

most of the time, contrast injection is done at which puncture site? why

A

Lumbar because spinal cord branches and not solid

223
Q

what is important note for cervical stick

A

injected slowly 1-2 minutes

224
Q

Why injected contrast slowly for cervical [myelogram]

A

to avoid excessive mixing of contrast & CSF

225
Q

for lumbar puncture, patient is in ___ or ___

A

prone
left lateral with spine flexed

226
Q

flexion of the spine will _____

A

widen interspinous space

227
Q

for cervical stick, patient will be _____ or ____ with ___ flexed to open interspinous space

A

erect sitting
prone
neck/head

228
Q

to reduce risk for spinal cord trauma, CSF must be ____

A

free flow rather than drawing it out with syringe

229
Q

for lumbar injection in prone position, putting a pillow under abdomen will help ____

A

open disc spaces

230
Q

When would we do cervical injection instead of lumbar injection

A

if lumbar is contraindicated

231
Q

To prevent contrast enter the head for cervical injection, patient should _____

A

hyperextend neck

232
Q

for cervical injection, patient will first _____ neck and then ____ neck after injection

A

flex
extend

233
Q

What could happen to patient when LP is performed

A

elevated CSF (blood present)

234
Q

For LP, patient is tilted _____ & ____

A

fowler
trendelenburg

235
Q

[myelogram] If patient is prone, what is the puncture site? routine?

A

cervical - Xtable, Xtable swimmer

236
Q

[myelogram] If patient is supine, what is the puncture site? routine?

A

thoracic - lateral, xtable, AP/PA

237
Q

[myelogram] If patient is semierect, what is the puncture site? routine?

A

lumbar - xtable, xtable lateral, AP/PA, obliques

238
Q

What are the post myelogram care

A

bandage injection site
place patient semi erect 30-45 for 1-2 hours
restricted to bed

239
Q

why patient is placed in 30-45 post exam for 1-2 hours after myelogram

A

allow body to absorb contrast because it could go up spinal canal and into the brain

240
Q

What are complications to myelogram (5)

A

air into ventricles
spinal needle irritate nerves
excessive subarachnoid bleeding
contrast into ventricular areas (causes seizures)
reaction to contrast

241
Q

RAO of L-spine shows ___
A. Right intervertebral foramen
B. Left zygapophyseal joint
C. Left intervertebral foramen
S. Right zygapophyseal joint

A

B

242
Q

[AP open mouth] if teeth superimpose upper dens, what does it mean and how to fix it

A

too much flexion
fix by hyperextension or angle CR slightly cephalic

243
Q

[AP open mouth] if base of skull superimpose upper dens, what does it mean and how to fix it

A

too much extension
fixed by hyperflexion or angle CR slightly caudal

244
Q

posterior to acetabulum is ___

A

ischial spine

245
Q

superior to ischial spine is ___
inferior to ischial spine is ____

A

greater sciatic notch
lesser sciatic notch

246
Q

characteristics of female pelvis (4)

A

wide pelvis
flared ilia
rounder pelvic inlet
obtuse pubic arch angle

247
Q

characteristics of male pelvis (4)

A

narrow pelvis
less flared ilia
oval pelvis inlet
narrow pubic arch angle

248
Q
A

RAD 372 - Anatomy (6 decks)

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