Nrad Exam 1 Cervical Spine +

Front 1

what is the anomaly?

Back 1

accessory articulation of the Spinous process of C1-C2

Front 2

what is the anomaly in which C1 is fused to the occiput?

Back 2

Occipitalization or Assimilation of C1

Front 3

which anomaly has an extra bony process which extends downwards from the jugular process of the occiput to the TVP of C1

Back 3

Paracondylar process

Front 4

which anomaly may have an extra bony protuberance from the tvp of C1 which extends upward toward the jugular process of the skull base

Back 4

epitransverse process

Front 5

which anomaly may have a articulation of occiput to cervical anterior tubericle

Back 5

third condyle

Front 6

which anomaly would you see an absence of the bony posterior neural arch of C1

Back 6

agenesis of the posterior arch

Front 7

you may find megaspinous with what other types of anomalies

Back 7

Spina bifida occulta
complete agenesis of the posterior arch

Front 8

what are the 2 hypoplasias of the posterior arch? and what would you see with them?

Back 8

thin posterior arch- posterior arch is thin and attenuating
short posterior arch- may shorten the diameter of the spinal canal

Front 9

which anomaly has calcification extending posteriorly from lateral masses to the posterior arch

Back 9

Posterior ponticle

Front 10

what are some controversies about adjusting posterior ponticles?

Back 10

some say that the ponticle can compromise the vertebral artery
however some say clinical significance is a matter of debate

Front 11

which anomaly arises from the superior lateral aspect of the lateral mass of C1 and forms a complete bony arch over to the tvp enclosing the vertebral artery?

Back 11

lateral ponticle

Front 12

failure of fusion of the apical secondary ossification center at the odontoid tip is what anomaly?

Back 12

Os Terminale of Bergman

Front 13

if you look at a APOM view and see a small, diamond-shaped osseous density separated from the remainder of the dens by a corresponding "V" shape you are looking at which anomaly

Back 13

Os Terminale of Bergman as long as your patient is over the age of 12-13

Front 14

which anomaly is seen with a mid-line defect (cleft) within the posterior neural arch?

Back 14

Spina Bifida Occulta

Front 15

according to Yochum and Rowe a spina bifida occulta located at C1 is called What?

Back 15

Spondyloschisis
the defect is bridged by a fibrous tissue (not cartilage) and therefore, has potential to become clinically significant

Front 16

failure of two or more segments to separate during development is which anomaly

Back 16

congenital block vertebra

Front 17

the presence of 2 or more blocked vertebrae in the cervical or thoracic spine is an indication of which anomaly

Back 17

Klipple-feil syndrome
usually associated with sprengles deformity and omovertebral bone

Front 18

the classic clinical triad associated with klipple feil syndrome is

Back 18

1. low posterior hairline
2. short webbed neck
3. decreased cervical range of motion

Front 19

which Systems are commonly involved with Klipple-feil syndrome

Back 19

1. genital urinary system
2. cardiopulmonary system
3. nervous system

Front 20

which anomaly presents with a small rotated scapula so that the glenoid process faces inferiorly and inferior angle rests above the level of T7

Back 20

Sprengels deformity

Front 21

an isolated ossification within the anterior annular fibers of a cervical intervertebral disc is what anomaly

Back 21

intercalary bone

Front 22

what anomaly would you find ossification within the nuchal ligament

Back 22

Nuchal bone (ossicle)

Front 23

what anomaly would you find calcification of the nuchal ligament where it attaches to the occiput?

Back 23

enlarged EOP
Occipital spur
known to fracture with direct fracture

Front 24

calcification of the ligament/membrane extending from the posterior aspect of the petrous portion of the temporal bone to the posterior aspect of the posterior clinoid of the sella turcica is what anomaly

Back 24

Petroclinoid Ligament calcification

Front 25

calcification of the ligament/membrane extending from the anterior to the posterior clinoid processes is which anomaly

Back 25

interclinoid ligament calcification

Front 26

what is the cardinal rule in radiology?

Back 26

at least two views taken at right angles (90 degrees) to each other.
supplemental views may be required to visualize certain areas and abnormalities
to be content with a single view is to miss potentially important abnormalities

Front 27

these markers stand for what:
RPO-
RAO-
LPO-
LAO-

Back 27

RPO- right posterior oblique
RAO- right anterior oblique
LPO- left posterior oblique
LAO- left anterior oblique

Front 28

in radiography of the cervical spine there are 3 different series what are these and how many views are in each?

Back 28

1. standard series (3 views)
2. extended series (5 views)
3. Davis series (7 views)

Front 29

in the Standard series what are the views you would find

Back 29

Lateral cervical nuetral (LCN)
AP lower cervical (APLC)
AP open mouth (APOM)

Front 30

in the extended series what are the views you would find?

Back 30

Lateral cervical nuetral (LCN)
AP lower cervical (APLC)
AP open mouth (APOM)
Right Obliques
Left Obliques

Front 31

in the Davis series what are the views you might find

Back 31

Lateral cervical nuetral (LCN)
AP lower cervical (APLC)
AP open mouth (APOM)
Right Obliques
Left Obliques
Lateral cervical flexion
lateral cervical extension

Front 32

at the level of C2 what space,which can be no more than 5-7mm, might you find on an x-ray?

Back 32

Retroharyngeal soft tissue space

Front 33

at the level of C6 the soft tissue space, which can be no more than 20-22mm in adults or 14mm in children, might you find on an x-ray?

Back 33

Retrotracheal soft tissue space

Front 34

distance between lateral dens and medial aspect of the lateral mass superior border close to equal on either side, with no greater than 2mm difference is what space?

Back 34

Paraodontoid space

Front 35

put these densities in order from most film density to the least film density:
Bone
Water/soft tissue
Metal
Fat
Air/gas

Back 35

1. Air/gas
2. Fat
3. water/soft tissue
4. Bone
5. metal

Front 36

what 7 items must be included with every radiograph?

Back 36

1. clinic name or doctors name
2. name and location at which the film was taken (if the same as 1 does not need to be repeated)
3. patient name
4. patients DOB or age
5. gender
6. date of film
7. ID number (not required in all states)

Front 37

what line of mensuration is there a line extending A to P from the anterior clinoid process to the dorsum sella representing the upper most portion of the sella

Back 37

Sella turcica size
normal- 16mm maximum horizontal 12mm maximum vertical

Front 38

which line of mensuration has 2 lines: 1st line from the nasion to center of sella turcica.
2nd line from the center of sella turcica to anterior foramen magnum

Back 38

Martins basilar angle
no larger than 152 degrees
no smaller than 123 degrees

Front 39

martins basilar angle may be seen with which views

Back 39

lateral skull; often difficult to assess on lateral cervical due to collimation of orbits

Front 40

which view would you be able to assess the sella turcica size?

Back 40

lateral skull, lateral cervical

Front 41

Posteriosuperior hard palate to the most inferior surface of the occipital bone is which line of mensuration

Back 41

McGregor's line
the tip of the odontoid should not extend greater than 8mm above this line. under the age of 18 these values diminish with decreasing chronological age

Front 42

what views would you find the McGregor's line

Back 42

Lateral skull, Lateral cervical

Front 43

if the tip of the odontoid extends more than 8mm above McGregor's line this may be indicative of what?

Back 43

Basilar impression

Front 44

increased angle of Martin's Basilar angle (greater than 152degrees) may mean what?

Back 44

Platybasia- flatting of the skull base

Front 45

posterior hard palate to the posterior foramen magnum is which line of mensuration?

Back 45

Chamberlain's line
odontoid tip should not extend more than 5 mm above the reference line

Front 46

if the tip of the odontoid extends more than 5mm above chamberlain's line this may be indicative of what?

Back 46

Basilar impression

Front 47

which views would you be able to see chamberlain's line?

Back 47

lateral skull
Lateral cervical

Front 48

a line connecting the anterior (Basion) and posterior (opisthion) margins of the foramen magnum is which line of mensuration

Back 48

McRae's Line
1. the inferior margin of the occipital bone should lie at or below this line
2. perpendicular line from the odontoid apex should intersect the reference line in the anterior quarter

Front 49

which views would you see McRae's line?

Back 49

lateral skull
lateral cervical

Front 50

if the inferior margin of the occipital is above McRae's line this is indicative of what?

Back 50

Basilar impression

Front 51

line joining the diagastric grooves medial to the mastoid processes is which line of mensuration?

Back 51

Diagastric Line
1. the odontoid- diagastric distance, measured from the tip of the odontoid to the reference line can range from 1-21mm
2. the atlanto-occipital joint digastric measurement can range from 4 to 20mm

Front 52

which views would you find the Digastric line?

Back 52

APOM

Front 53

in the diagastric line superior position is indicative of what?

Back 53

Basilar impression

Front 54

measurement between the posterior anterior tubercle to the anterior surface of the odontoid is which line of mensuration?

Back 54

Atlantodental interspace
child- no greater than 5mm
adult- no greater than 3mm

Front 55

increased dimension of the atlantodental interspace could represent what

Back 55

rupture or laxity of the transverse ligament, resulting in narrowing of the spinal canal

Front 56

narrowing of the atlantodental interspace could be indicative of what?

Back 56

associated with degenerative changes of the joint itself

Front 57

what views would you might find the atlantodental interspace

Back 57

lateral cervical
cervical flexion/extension

Front 58

line created by a series of short lines at the posterior midvertebral body represents which line of mensuration

Back 58

George's line (posterior body line)
should be smooth continuous arcing line

Front 59

which views would you see the posterior body line?

Back 59

(George's line)
Lateral cervical
can be used in thoracic and lumbar spine also

Front 60

misalignment of George's line could mean what?

Back 60

fracture, dislocation, degenerative changes, or ligamentous laxity

Front 61

line created by a series of short lines at the spinolamiar junction of each individual cervical segment is which line of mensuration

Back 61

spinolaminar (junction) line
should create a smooth continuous arcing line

Front 62

misalignment of the spinolaminar line may represent what?

Back 62

fracture, dislocation, degenerative changes, or ligamentous laxity.

Front 63

what views might you find the spinolaminar line?

Back 63

lateral cervical and can also be used in thoracic and lumbar

Front 64

the distance between the posterior border of the midvertebral body to the nearest surface of the same segmental spinolaminar junction line is which line of mensuration

Back 64

sagittal dimension of the cervical spinal canal
C1- 22mm
C7- 17mm

Front 65

what views would you measure the sagittal dimension of the cervical spinal canal

Back 65

lateral cervical (neutral, flexion, extension)

Front 66

narrowing of the sagittal dimension of the cervical spinal canal is indicative of what?

Back 66

sagittal stenosis

Front 67

widening of the sagittal dimension of the cervical spinal canal is indicative of what?

Back 67

spinal cord neoplasm

Front 68

the lateral margins of the atlas lateral masses are compared to the opposing lateral corner of the axis articular surface is which line of mensuration?

Back 68

Atlanto-axial alignment
these two land marks should be in vertical alignment

Front 69

what view would you use to check the alignment of the atlanto-axial alignment?

Back 69

APOM

Front 70

lateral offset of the lateral masses of the atlanto-axial alignment may be indicative of what?

Back 70

a burst fracture of C1
this May be normal in children <4 yrs old

Front 71

a vertical line is drawn from the apex of the odontoid this line should parallel the long axis of the film is which line of mensuration?

Back 71

cervical gravitational (weight bearing) line
this line should pass through the anterior superior margin of C7

Front 72

which views would you use in order to draw the cervical gravitational line (weight bearing line)?

Back 72

lateral cervical neutral

Front 73

when you draw the cervical gravitational line and it ends up anterior to C7 this would be indicative of what?

Back 73

anterior weight bearing, head forward carriage, or head forward posturing

Front 74

which line a mensuration does these lines make:
1. a horizontal line through the center of the anterior and posterior tubercle of atlas
2. a horizontal line across the inferior endplate of C7
3. perpendicular line (at 90 degrees) at the posterior aspects of line 1 and 2 which intersect with each other

Back 74

angle of the cervical curvature
cervical lordosis
between 30-45degrees is normal
hypolordosis <30 degrees
hyperlordosis >45 degrees

Front 75

which views would you use in order to draw the angle of the cervical curvature?

Back 75

cervical lateral neutral

Front 76

reduced or reversed cervical curve may be indicative of what?

Back 76

trauma, muscle spasm, and degenerative spondylosis

Front 77

which line of mensuration are these line:
1. line paralle to the posterior C2 body and ondontoid
2. line parallel to the posterior body of C7 to intersect line 1

Back 77

Ruth Jackson's cervical stress line
flexion - lines should intersect between C5 and C6
Extension- lines should intersect between C4 and C5

Front 78

which views would you use in order to draw Ruth Jackson's cervical stress lines?

Back 78

Lateral cervical spine in flexion and extension

Front 79

T or F retropharyngeal soft tissue space should measure no greater than 8mm

Back 79

False
no more than 7mm

Front 80

T or F in adults the retrotracheal soft tissue space should measure no more than 14mm

Back 80

False
no more than 22 mm in adults
14mm in children

Front 81

anterior inferior margin of C6 to the posterior border of the adjacent tracheal air shadow is called what

Back 81

retrotracheal soft tissue space
no more than 22mm in adults
no more that 14mm in children

Front 82

name the colored lines of mensuration

Back 82

Red = anterior body line
Brown = posterior body line (George's line)
green= spinolaminar (junction) line
blue = posterior spinous line

Front 83

what year was the Radiograph discovered?

Back 83

1895 by Wilhelm Conrad Roentgen

Front 84

the first clinical radiograph was taken on November 8, 1895 of who and of what?

Back 84

Mrs Roentgen (his wife) an x-ray of her hand was taken

Front 85

who developed the first intensifying screen?

Back 85

Pupin

Front 86

who invented the first fluoroscope?

Back 86

Thomas Edison

Front 87

who introduced the first moving grid mechanisms?

Back 87

Potter and Buckey

Front 88

in 1935 who was the first to produce a single exposure of the full AP spine?

Back 88

Sausser a Chiropractor

Front 89

which cervical vertebrae is the strongest?

Back 89

C2, Axis

Front 90

which direction do the pedicles project?

Back 90

Posterolaterally

Front 91

which direction do the lamina project?

Back 91

posteromedially

Front 92

what do the superior articular facets of the lateral masses of C1 articulate with

Back 92

the occipital condyles

Front 93

if a patient presents with a serious cervical spinal injury what is the course of action for the cervical x-rays assuming all are negative in finding anomalies. (from 1st to last)

Back 93

Lateral cervical view
if negative
AP lower cervical
if negative
AP Open Mouth
if negative
Lateral Oblique

Front 94

if your patient presents with serious cervical spinal injury and you take your course of action with x-rays and at anytime find that there is a anomaly what is your course of action?

Back 94

Place patient in Cervical Spine Collar and get them a CT and MRI

Front 95

if your patient presents with a serious spinal injury what x-ray views should you not take due to the unnecessary strain it might place on the patient

Back 95

flexion and extension views

Front 96

what part on the patient is closest to the film and whats the angle:
RAO

Back 96

right anterior shoulder at a 45 degree angle

Front 97

what part on the patient is closest to the film and whats the angle:
LAO

Back 97

Left anterior shoulder at a 45 degree angle

Front 98

what part on the patient is closest to the film and whats the angle:
RPO

Back 98

right posterior shoulder at a 45 degree angle

Front 99

what part on the patient is closest to the film and whats the angle:
LPO

Back 99

left posterior shoulder at a 45 degree angle

Front 100

which IVF's are visible in the Left oblique views?

Back 100

Right IVF's

Front 101

which IVF's are visible in the Right Oblique views?

Back 101

Left IVF's

Front 102

what is the FFD and tube tilt for lateral cervical neutral view?

Back 102

72 inches with no tube tilt

Front 103

the central ray should be at what vertebrae in a lateral cervical neutral view?

Back 103

C4

Front 104

in a AP Lower Cervical view what is the FFD, tube tile and the location of the central ray?

Back 104

FFD= 40 inches
Tilt= 15 degrees cephalic
Central ray= thyroid cartilage, C4

Front 105

what is the direction of the TVP's of C7

Back 105

laterally and inferiorly

Front 106

what is the direction of the TVP's of T1

Back 106

laterally and superiorly

Front 107

in the APOM (AP open mouth) view what should the FFD, tube tilt, and the location of the central ray be?

Back 107

FFD= 40 inches
Tilt= none
Central ray= directly through the mouth

Front 108

T or F it is very important to collimate below the eyes.

Back 108

True

Front 109

cervical spinal oblique view what is the FFD, tube tilt, and location of the central ray?

Back 109

FFD= 72 inches
Tilt anterior= 15 degrees caudal
tilt posterior= 15 degrees cephalic
central ray= C4

Front 110

T or F anterior oblique view of the cervical spine show ipsilateral structures?

Back 110

True

Front 111

T or F posterior oblique views of the cervical spine show ipsilateral structures?

Back 111

False
Contralateral structures

Front 112

what three structures would be superimposed on a LPO view?

Back 112

Right pedicle, Right TVP, and left lamina

Front 113

what three structures would be superimposed on a RAO?

Back 113

Left lamina, Right pedicle, Right TVP

Front 114

in the cervical spine flexion extension views what is the FFD, Tilt, and location of the central ray?

Back 114

FFD= 72 inches
Tilt= none
Central Ray= C4

Front 115

flattening of the angle between the clivus and body of the sphenoid is called What?

Back 115

Platybasia

Front 116

what is a upward displacement of the upper cervical spine relative to the skull base?

Back 116

Basilar impression

Front 117

how many vertebral segments are there?
cervical=
thoracic=
lumbar=
sacral=
coccygeal=

Back 117

33 in all
cervical =7
thoracic= 12
lumbar= 5
sacral= 5
coccygeal= 4 but could vary

Front 118

because there is no vertebral body of C1 where is the first superior IVD found?

Back 118

between C2 and C3