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Ch. 9 Part B-3
Positioning of the Cervical and Thoracic Spine
| Question | Answer |
|---|---|
| In addition to the gonads, which 3 other radiosensitive organs are of greatest concern during cervical and thoracic spine radiography | Thyroid gland, para thyroid glands, and female breasts. |
| Two advantages of using higher kV exposure factors for spine radiography, especially on an AP thoracic spine radiograph | Increase in exposure latitude and decrease in patient dose. |
| T/F When using digital imaging for spine radiography, it is important to use close collimation, grids, and lead masking. | True- it is important to use close collimation, grids, and lead masking. |
| T/F If close collimation is used during conventional radiography of the spine, the use of lead masking is generally not required. | False- Lead masking should be used even if close collimation is used. |
| T/F To a certain degree, MRI and CT are replacing myelography as the imaging modalities of choice for the diagnosis of a ruptured intervertebral disk. | True- These modalities are replacing myelography. |
| T/F Nuclear Medicine is often performed to diagnose bone tumors of the spine. | True. Nuclear Medicine is used to diagnose bone tumors of the spine. |
| To ensure that the intervertebral joint spaces are open for lateral thoracic spine projections, it is important to : | Keep the vertebral column parallel to the image receptor. |
| For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail by : | Using a small focal spot and increasing the source to image receptor distance (SID). |
| What are the major differences between spondylosis and spondylitis? | Spondylitis is an inflammatory process of the vertebrae. Spondylosis is a condition of the spine characterized by rigidity of a vertebral joint. |
| What is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space? | Myelography |
| Which imaging modality is ideal for detecting early signs of osteomyelitis? | Nuclear Medicine |
| T/F Many geriatric patients have a fear of falling off the radiographic table. | True. |
| Which two landmarks must be aligned for an AP "open mouth" projection. | The lower margin of upper incisors and the base of the skull. |
| What is the purpose of the 15 to 20 degree angle for the AP axial projection of the cervical spine? | To open the intervertebral disk space. |
| For an AP axial of the cervical spine, a plane through the tip of the mandible and _______ should be parallel to the angled central ray. | Base of skull |
| What are two important benefits of an SID longer than 40-44 inches for the lateral cervical spine projections? | Less divergence of x-ray beam to reduce shoulder superimposition of C7, and compensates for increased OID; reducing magnification. |
| What central ray angulation must be used with a posterior oblique projection of the cervical spine? | 15 degree cephalad angle. |
| Which foramina are demonstrated with a left posterior oblique (LPO) position of the cervical spine? | The right intervertebral foramina or upside. |
| Which foramina are demonstrated witha a left anterior oblique (LAO) position of the cervical spine? | The left intervertebral foramina or downside. |
| In addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the upper cervical vertebrae for the oblique projections? | Rotate the skull into a near lateral position. |
| What is the recommended SID for a lateral projection of the cervical spine? | 60" - 72" |
| The lateral projection of the cervical spine should be taken during _________. | Expiration. To maximize shoulder depression. |
| Which specific projection must be taken first if trauma to the cervical spine is suspected and the patient is in a supine position on a backboard? | Lateral, horizontal beam projection. |
| The proper name of the method for performing the cervicothoracic (swimmer's lateral) projection is the________. | Twining method. |
| Where should the central ray be placed for a cervicothoracic (swimmer's lateral) projection? | At T1 1 inch above jugular notch, or at the vertebral prominence (C7) |
| Which region of the spine must be demonstrated with a cervicothoracic (swimmer's lateral) projection? | C4 to T3 |
| Which one of the following projections is considered a "functional study" of the cervical spine. AP wagging jaw projection, AP open mouth position, Fuchs or Judd method, Hyperextension and flexion lateral positions. | Hyperextension and flexion lateral positions. |
| When should the Judd or Fuchs method be performed? | If unable to demonstrate the upper portion of the dens with the AP open mouth projection. |
| Which AP projection of the cervical spine demonstrates the entire upper cervical spine with one single projection? | Scoliosis series. |
| Which two things can be done to produce equal density along the entire thoracic spine for the AP projection (especially for a patient with a thick chest)? | correct use of anode-heel effect; use of compensating (wedge) filter. |
| What is the purpose for using a brething technique for a lateral projection of the thoracic spine? | To blur out rib and lung markings that obscure detail of thoracic vertebrae. |
| Which zygopophyseal joints are demonstrated in a right anterior oblique (RAO) projection of the thoracic spine? | The right downside. |
| Which one of the following projections delivers the greatest skin dose to the patient? AP thoracic spine projection, Lateral cervical spine projection, Swimmer's lateral projection, Fuchs or Judd method. | Swimmer's Lateral |
| Which of the following results in the lowest midline and skin doses for the patient? AP T-Spine projection at 90kV@7 mAs, AP T-spine at 80kV @12 mAs, Lateral T-spine at 80kV@50 mAs, Oblique T-spine at 80kV@20 mAs | AP Thoracic spine at 90kV@7mAs |
| T/F The thyroid dose used during a posterior oblique cervical spine projection is more than 10 times greater than the dose used for an anterior oblique projection of the cervical spine. | True (anterior oblique <5 mrad; posterior oblique <69 mrad) |
| Which one of the following structures is best demonstrated with an AP axial vertebral arch projection? Spinous processes-lumbar spine, Articular pillar-(lateral mass)-cervical spine, Zygopophyseal joints-thoracic spine, Cervicothoracic spine region. | Articular pillar (lateral masses) of cervical spine. |
| What central ray angle must be used with the AP axial-vertebral arch projection? | 20-30 degree caudal angle |
| What ancillary device should be placed behind the patient on the table top for a recumbent lateral projection of the thoracic spine when using computed radiography? | lead mat or masking |
| Which skull positioning line is aligned perpendicular to the IR for a PA (Judd) projection for the odontoid process? | Mentomeatal line (MML) |
| Which zygopophyseal joints are best demonstrated with a LPO position of the thoracic spine? | right (upside) |
| How much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position? | 20 degrees from lateral |
Created by:
Mr. Massive
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