Head
C-Spine
T-Spine
L-Spine
Pelvis
100
This has to be in profile for a lateral skull.
What is the sella turcica?
- In order for the sella turcica to be in profile, the skull has to be completely lateral. This will show that it is a true lateral skull.
100
The angle on an AP axial c-spine xray
What is 15 degrees cephalic?
- To project the intervertebral disk spaces open, the central ray should be directed perpendicular to the long axis of the vertebral column with a 15 degree angle. This angle shows the interverbebral disk spaces open.
100
Where the central ray enters for an AP t-spine projection
What is t7 at the MSP?
- By entering aroung t7 at the MSP, this allows c7-L1 to be seen on the xray.
100
This is palpated for a centering point for an AP L-spine xray.
What is the iliac crest?
- The iliac crest is a landmark that can be palpated for many centering points. This landmark helps the central ray be placed in the center of the image which would therefore include atleast t12-s1.
100
The lower limbs are rotated in this much for an AP projection of the pelvis.
What is 15-20 degrees medially (so the toes are touching)?
-By rotating the lower leg, it elongates the femoral necks and places them parallel with the IR.
200
There is this amount of angulation on a PA axial projection of the skull (caldwell).
What is 15 degrees caudad?
- There is a 15 degree caudal angle on a PA axial skull to project the pretrous ridges in the lower third of the orbit and the anterior ethmoidal air sinuses.
200
These should be superimposed and perpendicular to the IR in an AP odontoid view.
What are the upper incisors and the base of the skull?
-By these two things being superimposed, it will allow for no superimposition of the teeth over the dens or the base of the skull over the dens.
200
The T-spine is different from the C and L spine due to the fact that it has this.
What are ribs attachment sites?
- The t-spine articulates laterally at the facets with the ribs. T1-T12 articulates with a rib.
200
A common condition that flexion and extension views are done to rule out.
What is Spondyolisthesis?
-Spondyolisthesis is a condition where the vertebra slips ahead of the vertebra below it. Flexion and extension views are done to assess the instability of the L-spine.
200
DDH stands for
Developmental Displaysia of the Hip
- In many pediatric hospitals, pelvis and hip xrays are done for children with DDH or for children suspected of having it. DDH is when the femoral head does not fully connect and is loose in the socket and allows for easy dislocation.
300
The central ray enters here for a lateral projection of the facial bones.
What is the lateral surface of the zygomatic bone, halfway between the outer canthus and the EAM?
- By entering here, it will show all of the facial bones in their entirety with the zygomatic bone in the center. There will be superimposed mandibular rami, superimposed orbital roofs and the sella turcica will be shown in profile.
300
Besides the AP Cervical and the Lateral Cervical images, what are the other commonly taken images of the cervical spine?
A. Posterior Oblique
B. Anterior Oblique
C. Flexion and Extension
D. A and C
E. All of the above
What is E. All of the above?
- All of these projections are commonly taken of the c-spine. There are different protocols for each hospital. Most commonly, the protocol is AP axial, lateral and oblique.
300
Kyphosis is
What is an exaggerated posterior curvature of the thoracic spine that causes significant back pain and limited mobility?
- The t-spine is naturally kyphotic but lateral projections are assessed to check for extreme kyphosis
300
The nose of the scotty dog represents
a) transverse process
b) pedicle
c) superior articular process
d) lamina
What is A the transverse process?
300
This SI joint is being seen in a RPO position
What is the left SI joint?
- The joint that is furthest away from the image receptor is seen on oblique SI joint projections. The patient is supine and the side of interest is elevated 25-30 degrees.
400
The sinuses shown in a lateral projection are
a) maxillary
b) frontal
c) sphenoidal
d) ethmoidal
e) all of the above
e) all of the above
- all four sinus groups are seen but the sphenoidal sinus group is best demonstrated in a lateral projection. The CR enters 1/2 to 1 inch posterior to the outer canthus. This will allow all 4 sinus groups to be seen.
400
This is seen on an oblique c-spine
What is intervertebral foramina
-on a lateral projection of the c-spine, the z-joints are shown and on the obliques, the intervertebral foramina are shown.
400
oblique projections of the T-spine demonstrate this
What are Z-joints?
- obliques demonstrate z-joints while a lateral projection demonstrates the intervertebral joints.
400
The scotty dog appearance is seen in this projection
What is an oblique L-spine?
- A scotty dog is seen in an oblique l-spine projection and that is how one can tell that it is a good oblique projection.
400
The centering point for an oblique SI joint is here
1 inch medial to the elevated ASIS.
- Being one inch medial to the elevated (side of interest) ASIS will allow the SI joint to be in the middle of the image. It will also allow for all of the anatomy that is needed to be seen.
500
These 2 sinus groups are best demonstrated in the open-mouth waters projection
What are the spenoidal sinuses and maxillary sinuses?
- The sphenoidal sinuses are projected through the open mouth. The maxillary sinuses are seen more anteriorly with the petrous pyramids lying directly below them. The patients OML should form a 37 degree angle from the IR to show these sinus groups.
500
this projection is done for the c-spine if c7 is not shown
What is the swimmers projection?
-for this projection the patient will have their left arm up and right arm reaching for the floor in order to see c7 if the patient has broader shoulders.
500
Z joints are also known as this
What is an apophyseal Joint?
500
The central ray for an L5-S1 spot film enters here
The central ray should be directed approximately 1.5 inches (2–3 fingers) inferior to the iliac crest and 2 inches posterior to the anterior superior iliac spine (ASIS).
- This spot film shows the body of L5 and the upper sacrum and an open lumbosacral joint space. These are usually taken during a routine L-spine xray to sometimes check for spondylolisthesis.
500
This positioning error is present when the left obturator foramen is more open than the right on an AP pelvis projection.
What is rotation to the right?
-By the patient being rotated to the right, the patients right obturator foramen will be foreshortened which will allow the left to be more opened and elongated.