Deck 8: Image Analysis of the Cervical and Thoracic Vertebrae

Question 1

For PA axial oblique cervical projection,
1)the midcoronal plane is aligned at a 45-degree angle with the IR.
2)the central ray is angled 15 degrees caudally.
3)the head's midsagittal plane is aligned perpendicular to the IR.
4)an increased caudal angle is needed to demonstrate the lower vertebrae on a severely kyphotic patient.

A) 1 and 2 only
B) 1 and 3 only
C) 2 and 3 only
D) 1, 2, and 4 only

Answer 1

1, 2, and 4 only

Question 2

An AP axial cervical projection demonstrates the third cervical vertebra superimposed by the lower jaw. How should the positioning setup be adjusted for an optimal projection to be obtained?
1)Decrease the degree of central ray angulation.
2)Rotate the patient toward the left side.
3)Elevate the chin.
4)Align the acanthiomeatal line perpendicular to the IR.

A) 1 and 2 only
B) 3 only
C) 3 and 4 only
D) 1, 3, and 4 only

Answer 2

3 and 4 only

Question 3

For a lateral cervical projection obtained in maximum flexion, the
1)patient's chin is tucked into the chest as far as possible.
2)intervertebral disk spaces between the cervical bodies are narrowed.
3)patient's chin is extended up and backward as far as possible.
4)intervertebral disk spaces between the cervical bodies are widened.

A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Answer 3

1 and 2 only

Question 4

For an AP axial cervical projection, the
1)mandibular angles, mastoid tips, and shoulders are positioned at equal distances from the IR.
2)central ray is angled 15 to 20 degrees cephalically.
3)OML is aligned perpendicular to the IR.
4)long axis of the cervical vertebra is aligned with the short axis of the collimated field.

A) 1 and 2 only
B) 1, 2, and 3 only
C) 2 and 3 only
D) 3 and 4 only

Question 5

For an AP atlas and axis projection,
1)the mandibular angles and the shoulders are positioned at equal distances from the IR.
2)the acanthiomeatal line is aligned parallel with the IR.
3)a 5-degree cephalad angulation is used.
4)an imaginary line connecting the upper occlusal plane and posterior occiput's inferior edge is aligned perpendicular to the IR.

A) 1 and 4 only
B) 1 and 3 only
C) 2 and 3 only
D) 1, 3, and 4 only

Question 6

An AP atlas and axis projection with poor positioning demonstrates the dens superimposed over the posterior occiput. The upper incisors are demonstrated about 3 inches (7.5 cm) superior to the posterior occiput's inferior edge. How could the positioning setup be adjusted for an optimal projection to be obtained?
1)Adjust the central ray 15 degrees caudally.
2)Tuck the patient's chin 1.5 inches (3.75 cm).
3)Align the acanthiomeatal line perpendicular to the imaging table.
4)Move the central ray and IR 3 inches (7.5 cm) inferiorly.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 3 and 4 only

Question 7

An AP atlas and axis projection with accurate positioning demonstrates
1)the axis's spinous process aligned with its body midline.
2)an open atlantoaxial joint.
3)the upper incisors and posterior occiput superior to the dens.
4)the first through fourth cervical vertebrae.

A) 1 and 3 only
B) 2 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 8

The vertebral body of C7 is not demonstrated on a lateral cervical projection. To demonstrate this cervical vertebra
1)take the image on expiration.
2)have the patient hold weights on each arm to depress the shoulders.
3)take a lateral cervicothoracic (swimmer's) image.
4)angle the central ray 10 degrees cephalically.

A) 1 and 2 only
B) 1 and 3 only
C) 1, 2, and 3 only
D) 3 and 4 only

Question 9

The prevertebral fat stripe is
1)located anterior to the cervical vertebrae.
2)demonstrated on cervical images with excessive image density.
3)used to detect fractures, masses, and inflammation within and around the cervical vertebrae.
4)demonstrated on a lateral cervical projection.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

Question 10

An AP atlas and axis projection with poor positioning demonstrates the upper incisors about 1 inch (2.5 cm) inferior to the posterior occiput, obscuring the dens and atlantoaxial joint. How was the positioning setup mispositioned for such a projection to be obtained?
1)The patient's face was rotated toward the left side.
2)The acanthiomeatal line was perpendicular to the IR, and the central ray was perpendicular.
3)The patient's chin was tucked more than needed.
4)An imaginary line connecting the occlusal plane and posterior occiput's inferior edge was not aligned perpendicular to the imaging table.

A) 1 only
B) 2 only
C) 2 and 3 only
D) 2, 3, and 4 only

Question 11

The upper incisors are superimposed over the dens and the posterior occiput's inferior edge is demonstrated about 1 inch (2.5 cm) superior to the dens on an AP atlas and axis projection. How could the positioning setup be adjusted for an optimal projection to be obtained?
1)Align the acanthiomeatal line perpendicular to the IR.
2)Elevate the patient's chin 0.5 inch (2 cm).
3)Adjust the central ray 5 degrees caudally.
4)Move the central ray and IR 1 inch (2.5 cm) superiorly.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 4 only

Question 12

An AP axial cervical projection with poor positioning demonstrates obscured intervertebral disk spaces and each vertebra's spinous process within its vertebral body. How was the positioning setup mispositioned for such a projection to be obtained?

A) The patient was rotated toward the right side.
B) The central ray was angled too caudally.
C) The patient's head was tilted.
D) The central ray was angled too cephalically.

Question 13

A lateral cervical projection with poor positioning demonstrates the articular pillars and zygapophyseal joints of one side on the patient situated anterior to those of the opposite side. How was the patient mispositioned for such a projection to be obtained?
1)The patient was rotated.
2)The midcoronal plane was not positioned perpendicular to the IR.
3)The head was tilted toward the IR.
4)The central ray was angled cephalically.

A) 1 only
B) 1 and 2 only
C) 2 and 3 only
D) 4 only

Question 14

A lateral cervical projection with accurate positioning demonstrates
1)C1 and C2 without cranial or mandibular superimposition.
2)open intervertebral disk spaces.
3)superimposed right and left articular pillars and zygapophyseal joints.
4)the spinous process in profile.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 15

An AP atlas and axis projection obtained with the patient's face rotated toward the left side demonstrates
1)a narrower distance from the atlas's lateral mass to the dens on the right side than on the left side.
2)the upper incisors obscuring the dens and atlantoaxial joint.
3)the patient's jaw shifted toward the left side.
4)the atlas's spinous process shifted toward the left side.

A) 1 and 3 only
B) 2 only
C) 3 and 4 only
D) 1, 3, and 4 only

Question 16

For a lateral cervical projection,
1)the midcoronal plane is positioned parallel with the IR.
2)the IPL is aligned perpendicular to the IR.
3)the long axis of the cervical vertebral column is aligned with the short axis of the collimated field.
4)a 72-inch (183-cm) SID is used.

A) 1 and 3 only
B) 2 and 4 only
C) 1, 2, and 3 only
D) 2 and 3 only

Question 17

An AP axial cervical projection obtained with the patient rotated toward the right side demonstrates
1)the spinous processes positioned closer to the left side of the vertebral bodies.
2)closed intervertebral joint spaces.
3)elongation of the uncinate processes.
4)the left SC superimposed over the vertebral column.

A) 1 only
B) 2 and 3 only
C) 3 and 4 only
D) 1 and 4 only

Question 18

A lateral cervical projection obtained with the patient's head tilted toward the IR demonstrates
1)the inferior cortices of the mandible without superimposition.
2)the articular pillars and zygapophyseal joints with superoinferior separation.
3)the vertebral foramen of C1.
4)superimposed inferior cranial cortices.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 19

An AP axial cervical projection obtained using too much cephalic central ray angulation demonstrates
1)elongated uncinate processes.
2)obscured intervertebral disk spaces.
3)each vertebra's spinous process within the inferior adjoining vertebral body.
4)undistorted vertebral bodies.

A) 1 and 2 only
B) 3 and 4 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 20

An AP axial cervical projection with accurate positioning demonstrates
1)each vertebra's spinous processes within the inferior adjoining vertebral body.
2)open intervertebral disk spaces.
3)the spinous processes aligned with the midline of the cervical bodies.
4)the second cervical vertebra in its entirety.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 21

A lateral thoracic projection with accurate positioning demonstrates
1)the intervertebral foramina.
2)about 0.5 inch (1 cm) of space between the posterior ribs.
3)open intervertebral disk spaces.
4)the pedicles in profile.

A) 1 and 3 only
B) 2 and 4 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 22

A less than optimal AP axial cervical vertebrae projection demonstrating closed intervertebral disk spaces and each vertebra's spinous process within its vertebral body

A) was obtained with the central ray angled too cephalically.
B) was obtained with the central ray angled too caudally.
C) was obtained because the patient was kyphotic and the central ray angle was not decreased over the routinely used angulation.
D) will also demonstrate elongated uncinate processes.

Question 23

A PA axial oblique cervical projection (LAO position) obtained with the patient overrotated demonstrates the
1)right pedicles in the midlines of the vertebral bodies.
2)right pedicles in profile.
3)left zygapophyseal joints.
4)vertebral column superimposed over the right SC joint and medial clavicle.

A) 1 and 4 only
B) 1 and 3 only
C) 1, 2, and 3 only
D) 3 and 4 only

Question 24

For an AP thoracic projection, the
1)shoulders and the ASISs are positioned at equal distances from the imaging table.
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 (20-cm) field size.

A) 1 and 2 only
B) 3 and 4 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 25

To achieve uniform density throughout the entire thoracic vertebrae on an AP thoracic projection,
1)position a wedge-type compensating filter over the upper thoracic vertebrae.
2)use a high-ratio grid.
3)position the patient's feet toward the cathode end of the tube.
4)use a low kVp technique.

A) 1 only
B) 2 and 4 only
C) 1 and 3 only
D) 3 only

Question 26

For a lateral thoracic projection,
1)the shoulders are positioned at equal distances from the imaging table.
2)the arms are abducted to a 90-degree angle.
3)a breathing technique is used.
4)a radiolucent sponge is positioned between the patient's lateral body surface and imaging table at a level just inferior to the iliac crest.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 2, 3, and 4 only

Question 27

An optimal AP axial cervical vertebrae projection demonstrates all of the following except

A) the spinous processes aligned with the midline of the cervical bodies.
B) open intervertebral disk spaces.
C) each vertebra's spinous process visualized at the level of its superior intervertebral disk space.
D) the third cervical vertebra inferior to the posterior occiput and mandibular mentum.

Question 28

A lateral cervicothoracic projection (Twining method) demonstrates closed intervertebral disk spaces and distorted vertebral bodies. How was the patient mispositioned for such a projection to be obtained?

A) The midcoronal plane was not aligned parallel with the IR.
B) The arm situated farther from the IR was not depressed.
C) The patient was rotated anteriorly.
D) The midsagittal plane was not aligned parallel with the IR.

Question 29

A lateral cervicothoracic projection (Twining method) with poor positioning demonstrates the humerus with the greater degree of magnification rotated posteriorly. How was the patient mispositioned for such a projection to be obtained?

A) The arm situated farther from the IR was rotated posteriorly.
B) The midcoronal plane was not aligned parallel with the IR.
C) The arm situated closer to the IR was rotated posteriorly.
D) The arm situated closer to the IR was not elevated.

Question 30

A lateral thoracic projection with poor positioning demonstrates more than 0.5 inch (1 cm) of space between the posterior ribs. How should the patient be positioned for an optimal projection to be obtained?
1)Rotate the patient's elevated side anteriorly.
2)Position the midsagittal plane perpendicular to the imaging table.
3)Center the central ray and IR superiorly.
4)Align the shoulders, posterior ribs, and posterior wings perpendicular to the imaging table.

A) 1 only
B) 1 and 4 only
C) 2 only
D) 2 and 3 only

Question 31

A PA axial oblique cervical projection demonstrates closed intervertebral disk spaces and distorted vertebral bodies when the

A) central ray angulation is inaccurate.
B) patient is overrotated.
C) patient's head is not in a lateral position.
D) patient is underrotated.

Question 32

An AP thoracic projection with accurate positioning demonstrates
1)distorted vertebral bodies.
2)the long axis of the thoracic vertebrae aligned with the long axis of the collimated field.
3)spinous processes aligned with the midline of the vertebral bodies.
4)open intervertebral joint spaces.

A) 1 and 4 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

Question 33

An AP axial cervical vertebrae projection demonstrates a portion of the third cervical vertebra superimposed over the posterior occipital bone. How should the positioning setup be adjusted to obtain an optimal projection?

A) Center the central ray more inferiorly.
B) Increase the degree of cephalic central ray angulation.
C) Decrease the degree of chin tuck.
D) Increase the degree of chin tuck.

Question 34

For a lateral cervicothoracic projection (Twining method), the
1)patient is placed in a lateral projection.
2)arm placed adjacent to the imaging table is elevated.
3)arm placed farther from the imaging table is positioned at a 90-degree angle with the body.
4)midsagittal plane is aligned parallel with the IR.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 35

An AP thoracic projection with poor positioning demonstrates closed eighth through twelfth intervertebral disk spaces. How was the patient mispositioned for such a projection to be obtained?

A) The patient was rotated toward the left side.
B) The patient's knees and hips were extended.
C) The long axis of the vertebral column was laterally tilted.
D) The patient's head was on a thick pillow.

Question 36

A lateral thoracic projection with poor positioning demonstrates closed eighth through twelfth intervertebral disk spaces. How was the patient mispositioned for such a projection to be obtained?
1)The central ray was not aligned perpendicular to the thoracic vertebrae.
2)The vertebral column was not aligned parallel with the imaging table.
3)A radiolucent sponge was not accurately positioned between the lateral surface of the patient and the imaging table.
4)The hips and knees were extended.

A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 4 only

Question 37

A lateral cervicothoracic projection (Twining method) with accurate positioning demonstrates
1)distorted vertebral bodies.
2)superimposed right and left articular pillars.
3)open intervertebral disk spaces.
4)the fifth through seventh cervical and first through third thoracic vertebrae.

A) 1 and 4 only
B) 2 and 3 only
C) 3 and 4 only
D) 2, 3, and 4 only

Question 38

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 intervertebral disk spaces.

A) 1 and 3 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 4 only

Question 39

A PA axial oblique cervical projection with accurate positioning demonstrates
1)the zygapophyseal joints.
2)the intervertebral foramina.
3)open intervertebral disk spaces.
4)the inferior cortical outlines of the mandible without superimposition.

A) 1 only
B) 2 and 4 only
C) 2 and 3 only
D) 2, 3, and 4 only

Question 40

Which of the following projections or positions demonstrates the right intervertebral foramina?
1)Lateral
2)LPO
3)LAO
4)RAO

A) 1 only
B) 2 only
C) 2 and 3 only
D) 2 and 4 only

Question 41

An optimally positioned lateral cervical vertebrae projection demonstrates all of the following except

A) no more than 0.25 inch (0.63 cm) of separation between the right and left zygapophyseal joints.
B) superimposition of the anterior and posterior aspects of the right and left articular pillars.
C) the posterior arch of C1 and the spinous process of C2 in profile without posterior occiput superimposition.
D) open intervertebral disk spaces.

Question 42

Which of the following is not demonstrated as open on PA axial oblique cervical vertebrae?

A) Intervertebral foramina
B) Intervertebral disk spaces
C) Vertebral foramen of C1
D) Zygapophyseal joints

Question 43

An optimal lateral thoracic vertebrae projection demonstrates all of the following except

A) clearly demonstrated intervertebral foramina.
B) the pedicles in profile.
C) open intervertebral disk spaces.
D) no more than 0.5 inch (1.25 cm) of space between the posterior surfaces of each vertebral body.

Question 44

To obtain open intervertebral disk spaces for AP axial cervical vertebrae projections when imaging the upright and kyphotic patient, the central ray

A) should remain horizontal.
B) angulation needs to be decreased over that used on the supine patient.
C) angulation needs to be increased over that used on the supine patient.
D) should be angled caudally.

Question 45

A lateral cervical vertebral projection demonstrating the right and left articular pillars and zygapophyseal joints with superoinferior separation, the inferior cortices of the cranium and mandible without superimposition, and the vertebral foramen of C1 was obtained with the

A) torso and cervical vertebrae rotated from a lateral position.
B) head and upper cervical vertebrae tilted toward the IR.
C) head and upper cervical vertebrae tilted away from the IR.
D) chin elevated.

Question 46

A PA axial oblique cervical vertebrae projection demonstrating the pedicles on one side aligned with the midline of the vertebral bodies and open zygapophyseal joints was obtained with the

A) patient rotated less than 45 degrees.
B) patient rotated more than 45 degrees.
C) central ray angled too caudally.
D) central ray angled too cephalically.

Question 47

A left lateral thoracic vertebrae projection demonstrating more than 0.5 inch (1.25 cm) of space between the posterior ribs

A) was obtained with the patient's right side rotated posteriorly.
B) will require the patient's right side to be rotated posteriorly to obtain an optimal projection.
C) will require the vertebral column to be positioned parallel with the IR to obtain an optimal projection.
D) was obtained with the midsagittal plane aligned perpendicular to the IR.

Question 48

A left lateral cervicothoracic projection (Twining method) demonstrates the right and left articular pillars and zygapophyseal joints without superimposition. The humerus demonstrating the least amount of magnification is situated anterior to the vertebral column. How should the positioning setup be adjusted to obtain an optimal projection?

A) Increase the degree of right shoulder depression.
B) Position the vertebral column parallel with the IR.
C) Rotate the right side of the patient anteriorly.
D) Rotate the right side of the patient posteriorly.

Question 49

An AP thoracic vertebrae projection demonstrating obscured lower thoracic intervertebral disk spaces and distorted vertebral bodies

A) was obtained with the patient's torso rotated.
B) was obtained with the patient's legs extended.
C) is considered to be optimal for this projection.
D) will also demonstrate closed upper thoracic intervertebral disk spaces.

Question 50

A less than optimal lateral cervical vertebrae projection demonstrates the articular pillars of one side of the patient situated anterior to the opposite articular pillars. How was the patient mispositioned?

A) The midsagittal plane was not aligned perpendicular to the IR.
B) The acanthiomeatal line was not parallel with the floor.
C) The midcoronal plane was not aligned perpendicular to the IR.
D) The interpupillary line was not perpendicular to the IR.