3 RadReview Spine and Pelvis

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1

Which of the following statements is (are) true with respect to the differences between the male and female bony pelvis?

  1. The female pelvic outlet is wider
  2. The pubic angle is 90 degrees or less in the male
  3. The male pelvis is more shallow

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

1 and 2 only

2

The intertrochanteric crest is located on the

A proximal posterior femur.

B proximal anterior femur.

C distal posterior femur.

D distal anterior femur.

A proximal posterior femur.

3
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Which of the following anatomic structures is indicated by the number 1 in Figure 2–24?

Courtesy of Stamford Hospital, Department of Radiology.

A Body of L3

B Body of L4

C Spinous process

D Transverse process

Spinous process

4

The innominate bone is located in the

A middle cranial fossa.

B posterior cranial fossa.

C foot.

D pelvis.

D pelvis.

5

The short, thick processes that project posteriorly from the vertebral body are the

A transverse processes.

B vertebral arches.

C laminae.

D pedicles.

D pedicles.

6

AP erect left and right bending images of the thoracic and lumbar vertebrae, to include 1 inch of the iliac crest, are performed to demonstrate

A spondylolisthesis.

B subluxation.

C scoliosis.

D arthritis.

<ul> <li>C scoliosis.</li> </ul> <br>

7

Which of the following may be used as landmark(s) for an AP projection of the hip?

  1. 2 in. medial to the ASIS
  2. Prominence of the greater trochanter
  3. Midway between the iliac crest and the pubic symphysis

A 1 only

B 1 and 2 only

C 1 and 3 only

D 1, 2, and 3

B 1 and 2 only

8

Which of the following positions would demonstrate the right lumbar apophyseal articulations closest to the IR?

A LAO

B RAO

C LPO

D RPO

D RPO

9

Which of the following is (are) demonstrated in the lateral projection of the thoracic spine?

  1. Intervertebral spaces
  2. Apophyseal joints
  3. Intervertebral foramina

A 1 only

B 2 only

C 1 and 3 only

D 1, 2, and 3

  • C 1 and 3 only
10

The RPO position of the cervical spine requires which of the following combinations of tube angle and direction?

A 15 to 20 degrees caudad

B 15 to 20 degrees cephalad

C 25 to 30 degrees caudad

D 25 to 30 degrees cephalad

B 15 to 20 degrees cephalad

11

Which of the following positions would best demonstrate the lumbar intervertebral joints and foramina?

A LPO

B RPO

C Lateral

D PA

C Lateral

12

Which of the following is (are) well demonstrated in the oblique position of the cervical vertebrae?

  1. Intervertebral foramina
  2. Disk spaces
  3. Apophyseal joints

A 1 only

B 1 and 2 only

C 1 and 3 only

D 1, 2, and 3

A 1 only

13

Which of the following will best demonstrate the lumbosacral junction in the AP position?

A CR perpendicular to L3

B CR perpendicular to L5–S1

C CR caudad 30–35 degrees

D CR cephalad 30–35 degrees

D CR cephalad 30–35 degrees

14

An accurately positioned oblique projection of the first through fourth lumbar vertebrae will demonstrate the classic “Scotty dog.” What bony structure does the Scotty dog's neck represent?

A Superior articular process

B Pedicle

C Transverse process

D Pars interarticularis

D Pars interarticularis

15

The femoral neck can be located

A parallel to the femoral shaft.

B perpendicular to the femoral shaft.

C perpendicular to a line drawn from the ASIS to the pubic symphysis.

D perpendicular to a line from the iliac crest to the pubic symphysis.

C perpendicular to a line drawn from the ASIS to the pubic symphysis.

16

Which of the following statements is (are) true regarding the lateral projection of the lumbar spine?

  1. The MSP is parallel to the tabletop.
  2. The vertebral foramina are well visualized.
  3. The pedicles are well visualized.

A 1 only

B 1 and 2 only

C 1 and 3 only

D 1, 2, and 3

C 1 and 3 only

17
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What is the anatomic structure indicated by number 3 in the radiograph in Figure 6–21?

Courtesy of Stamford Hospital, Department of Radiology.

A Superior articular process

B Inferior articular process

C Pedicle

D Lamina

D Lamina

18
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What is the anatomic structure indicated by number 1 in the radiograph shown in Figure 6–21?

Courtesy of Stamford Hospital, Department of Radiology.

A Superior articular process

B Inferior articular process

C Transverse process

D Lamina

A Superior articular process

19

With the patient supine, the left side of the pelvis elevated 25 degrees, and the CR entering 1 in. medial to the left anterosuperior iliac spine (ASIS), which of the following is demonstrated?

A Left sacroiliac joint

B Left ilium

C Right sacroiliac joint

D Right ilium

A Left sacroiliac joint

20

Which of the following is (are) demonstrated in the lateral projection of the cervical spine?

  1. Intervertebral joints
  2. Apophyseal joints
  3. Intervertebral foramina

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

21

Which of the following is a functional study used to demonstrate the degree of AP motion present in the cervical spine?

A Moving mandible position

B AP open-mouth projection

C Flexion and extension laterals

D AP right and left bending

C Flexion and extension laterals

22
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What is the anatomic structure indicated by the number 3 in the radiograph in Figure 6–12?

Courtesy of Stamford Hospital, Department of Radiology.

A Spinous process

B Transverse process

C Pedicle

D Intervertebral foramen

B Transverse process

23
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The radiograph in Figure 6–12 could be improved in which of the following ways?

Courtesy of Stamford Hospital, Department of Radiology.

A The MSP should be 45 degrees to the plane of the IR.

B The MSP should be 90 degrees to the plane of the cassette.

C The chin should be elevated slightly.

D The head should be flexed slightly.

C The chin should be elevated slightly.

24

The relationship between the ends of fractured long bones is referred to as

A angulation

B apposition

C luxation

D sprain

B apposition

25

Which of the following is demonstrated in a 25-degree RPO position with the CR entering 1 inch medial to the elevated ASIS?

A Left sacroiliac joint

B Right sacroiliac joint

C Left ilium

D Right ilium

A Left sacroiliac joint

26
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The number 2 in Figure 2–40 represents which of the following structures?

A Body

B Pedicle

C Inferior articular process

D Superior articular process

C Inferior articular process

27

The innominate bone is located in the

A middle cranial fossa

B posterior cranial fossa

C foot

D pelvis.

D pelvis.

28

Which of the following structures is located at the level of the interspace between the second and third thoracic vertebrae?

A Manubrium

B Jugular notch

C Sternal angle

D Xiphoid process

B Jugular notch

29

Which of the following positions will best demonstrate the right apophyseal articulations of the lumbar vertebrae?

A PA

B Left lateral

C RPO

D LPO

C RPO

30

Which of the following is (are) demonstrated in a lateral projection of the cervical spine?

  1. Intervertebral foramina
  2. Apophyseal joints
  3. Intervertebral joints

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

C 2 and 3 only

31

Which of the following is a functional study used to demonstrate the degree of AP motion present in the cervical spine?

A Open-mouth projection

B Moving-mandible AP

C Flexion and extension laterals

D Right and left bending AP

C Flexion and extension laterals

32

In the anterior oblique position of the cervical spine, the CR should be directed

A parallel to C4

B perpendicular to C4

C 15 degrees cephalad to C4

D 15 degrees caudad to C4.

D 15 degrees caudad to C4.

33

All the following are palpable bony landmarks used in radiography of the pelvis except

A the femoral neck

B the pubic symphysis

C the greater trochanter

D the iliac crest

A the femoral neck

34
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Which of the following is (are) well demonstrated in the lumbar spine shown in Figure 2–35?

  1. Apophyseal articulations
  2. Intervertebral foramina
  3. Inferior articular processes

Courtesy of Stamford Hospital, Department of Radiology.

A 1 only

B 1 and 2 only

C 1 and 3 only

D 1, 2, and 3

C 1 and 3 only

35

Standard radiographic protocols may be reduced to include two views, at right angles to each other, in which of the following situations?

A Barium examinations

B Spine radiography

C Skull radiography

D Emergency and trauma radiography

D Emergency and trauma radiography

36

To visualize or “open” the right sacroiliac joint, the patient is positioned

A 30 to 40 degrees LPO

B 30 to 40 degrees RPO

C 25 to 30 degrees LPO

D 25 to 30 degrees RPO.

C 25 to 30 degrees LPO

37

Which of the following is (are) effective in reducing exposure to sensitive tissues for frontal views during scoliosis examinations?

  1. Use of PA position
  2. Use of breast shields
  3. Use of compensating filtration

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

D 1, 2, and 3

38

Which of the following precautions should be observed when radiographing a patient who has sustained a traumatic injury to the hip?

  1. When a fracture is suspected, manipulation of the affected extremity should be performed by a physician.
  2. The axiolateral projection should be avoided.
  3. To evaluate the entire region, the pelvis typically is included in the initial examination.

A 1 only

B 1 and 3 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 3 only

39

The AP axial projection, or “frog leg” position, of the femoral neck places the patient in a supine position with the affected thigh

A adducted 25 degrees from the horizontal

B abducted 25 degrees from the vertical

C adducted 40 degrees from the horizontal

D abducted 40 degrees from the vertical

D abducted 40 degrees from the vertical

40

Which of the following positions will demonstrate the lumbosacral apophyseal articulation?

A AP

B Lateral

C 30-degree RPO

D 45-degree LPO

C 30-degree RPO

41

The AP projection of the coccyx requires that the CR be directed

  1. 15 degrees cephalad
  2. 2 inches superior to the pubic symphysis
  3. to a level midway between the ASIS and pubic symphysis

A 1 only

B 2 only

C 1 and 2 only

D 1 and 3 only

B 2 only

42

Which of the following bones participate(s) in the formation of the obturator foramen?

  1. Ilium
  2. Ischium
  3. Pubis

A 1 and 2 only

B 1 and 3 only

C 2 and 3 only

D 1, 2, and 3

C 2 and 3 only

43

The axiolateral, or horizontal beam, projection of the hip requires the IR to be placed

  1. parallel to the central ray (CR)
  2. parallel to the long axis of the femoral neck
  3. in contact with the lateral surface of the body

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

C 2 and 3 only

44
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The structure labeled 4 in Figure 2–32 is the

Courtesy of Stamford Hospital, Department of Radiology.

A body of C1

B body of C2

C odontoid process

D anterior arch of C1

C odontoid process

45
card image

The structure labeled 5 in Figure 2–32 is the

Courtesy of Stamford Hospital, Department of Radiology.

A body of C1

B body of C2

C odontoid process

D anterior arch of C1

D anterior arch of C1

46

Which of the following is (are) appropriate technique(s) for imaging a patient with a possible traumatic spine injury?

  1. Instruct the patient to turn slowly and stop if anything hurts.
  2. Maneuver the x-ray tube instead of moving the patient.
  3. Call for help and use the log-rolling method to turn the patient.

A 1 and 2 only

B 1 and 3 only

C 2 and 3 only

D 1, 2, and 3

C 2 and 3 only

47

To demonstrate the first two cervical vertebrae in the AP projection, the patient is positioned so that

A the glabellomeatal line is vertical.

B the acanthiomeatal line is vertical.

C a line between the mentum and the mastoid tip is vertical.

D a line between the maxillary occlusal plane and the mastoid tip is vertical.

D a line between the maxillary occlusal plane and the mastoid tip is vertical.

48

Which of the following is (are) demonstrated in an AP projection of the cervical spine?

  1. Intervertebral disk spaces
  2. C3–7 cervical bodies
  3. Apophyseal joints

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

49

In the anterior oblique position of the cervical spine, the structures best seen are the

A intervertebral foramina nearest the IR

B intervertebral foramina furthest from the IR

C interarticular joints

D intervertebral joints

A intervertebral foramina nearest the IR

50
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The position illustrated in the radiograph in Figure 2–28 may be obtained with the patient

  1. supine and the CR angled 30 degrees caudad.
  2. supine and the CR angled 30 degrees cephalad.
  3. prone and the CR angled 30 degrees cephalad.

Courtesy of Stamford Hospital, Department of Radiology.

A 1 only

B 2 only

C 1 and 3 only

D 2 and 3 only

B 2 only

51
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In Figure 2–27, the structure indicated as number 7 is which of the following?

A Neck of rib

B Tubercle of rib

C Transverse process

D Head of rib

D Head of rib

52

A kyphotic curve is formed by which of the following?

  1. Sacral vertebrae
  2. Thoracic vertebrae
  3. Lumbar vertebrae

A 1 only

B 1 and 2 only

C 3 only

D 1 and 3 only

B 1 and 2 only

53

Which of the following positions will provide an AP projection of the L5-S1 interspace?

A Patient AP with 30- to 35-degree angle cephalad

B Patient AP with 30- to 35-degree angle caudad

C Patient AP with 0-degree angle

D Patient lateral, coned to L5

A Patient AP with 30- to 35-degree angle cephalad

54

Which of the following should be performed to rule out subluxation or fracture of the cervical spine?

A Oblique cervical spine, seated

B AP cervical spine, recumbent

C Horizontal beam lateral

D Laterals in flexion and extension

C Horizontal beam lateral

55
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Which of the following statements is (are) correct with respect to the images shown in Figure 2–23?

  1. Image A was made with cephalad angulation.
  2. Image B was made with cephalad angulation.
  3. Images A and B were made with CR directed 15 degrees cephalad.

Courtesy of Stamford Hospital, Department of Radiology.

A 1 only

B 2 only

C 2 and 3 only

D 1, 2, and 3

A 1 only

56

The long, flat structures that project posteromedially from the pedicles are the

A transverse processes

B vertebral arches

C laminae

D pedicles

C laminae

57

The thoracic apophyseal joints are demonstrated with the

A coronal plane 90 degrees to the IR

B midsagittal plane 90 degrees to the IR

C coronal plane 20 degrees to the IR

D midsagittal plane 20 degrees to the IR.

D midsagittal plane 20 degrees to the IR.

58

Structures comprising the neural, or vertebral, arch include

  1. pedicles
  2. laminae
  3. body

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

59

The lumbar lamina is represented by what part of the “Scotty dog” seen in a correctly positioned oblique lumbar spine view?

A Eye

B Nose

C Body

D Neck

C Body

60

The articular facets of L5-S1 are best demonstrated in a(n)

A AP projection

B 30-degree oblique

C 75-degree oblique

D AP axial

B 30-degree oblique

61

What structure can be located midway between the anterosuperior iliac spine (ASIS) and pubic symphysis?

A Dome of the acetabulum

B Femoral neck

C Greater trochanter

D Iliac crest

A Dome of the acetabulum

62

The lumbar transverse process is represented by what part of the “Scotty dog” seen in a correctly positioned oblique lumbar spine?

A Eye

B Nose

C Body

D Ear

B Nose

63

To reduce the amount of scattered radiation reaching the IR in CR/DR imaging of the lumbosacral region, in the lateral projection, which of the following is (are) recommended?

  1. Close collimation
  2. Lead mat on table posterior to the patient
  3. Decreased SID

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

64

A radiolucent sponge can be placed under the patient's waist for a lateral projection of the lumbosacral spine to

  1. make the vertebral column parallel with the IR
  2. place the intervertebral disk spaces perpendicular to the IR
  3. decrease the amount of SR reaching the IR

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

65

Which of the following bony landmarks is in the same transverse plane as the symphysis pubis?

A Ischial tuberosity

B Prominence of the greater trochanter

C Anterosuperior iliac spine

D Anteroinferior iliac spine

B Prominence of the greater trochanter

66

Which of the following projections can be used to supplement the traditional “open-mouth” projection when the upper portion of the odontoid process cannot be well demonstrated?

A AP or PA through the foramen magnum

B AP oblique with right and left head rotation

C Horizontal beam lateral

D AP axial

AP or PA through the foramen magnum

67
card image

Which of the following is (are) well demonstrated in the lumbar spine pictured in Figure 2–8?

  1. Apophyseal articulations
  2. Intervertebral foramina
  3. Pedicles

Courtesy of Stamford Hospital, Department of Radiology.

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

C 2 and 3 only

68

What is the name of the condition that results in the forward slipping of one vertebra on the one below it?

A Spondylitis

B Spondylolysis

C Spondylolisthesis

D Spondylosis

C Spondylolisthesis

69

The right posterior oblique position (Judet method) of the right acetabulum will demonstrate the

  1. anterior rim of the right acetabulum
  2. right iliac wing
  3. right anterior iliopubic column

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

70

The male bony pelvis differs from the female bony pelvis in which of the following way(s)?

  1. The male pelvis has a larger pelvic inlet.
  2. The female pubic arch is greater than 90 degrees.
  3. The male ilium is more vertical.

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

C 2 and 3 only

71
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Critique the lateral cervical spine seen in Figure 2–1 and select the most correct statement below.

Courtesy of Stamford Hospital, Department of Radiology.

A The chin has been depressed too much.

B The chin needs to be extended more.

C The head is tilted.

D The shoulders are not depressed enough.

D The shoulders are not depressed enough.

72

The right posterior oblique (RPO) position of the left acetabulum will demonstrate the

1. posterior rim of the left acetabulum.

2. left anterior iliopubic column.

3. left iliac wing.

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

B 1 and 2 only

73

With which of the following does the femoral head articulate?

1. Ilium

2. Ischium

3. Pubis

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

D 1, 2, and 3

74

The lateral aspect of the obturator foramen is formed by the

A ilium.

B ischium.

C pubis.

D sacrum.

B ischium

75

Which of the following bones participate in the formation of the acetabulum? 1. Ilium 2. Ischium 3. Pubis

A 1 and 2 only

B 1 and 3 only

C 2 and 3 only

D 1, 2, and 3

D 1, 2, and 3

76

Which of the following statements regarding the male pelvis is (are) true?

1. The angle formed by the pubic arch is less than that of the female.

2. The pelvic outlet is wider than that of the female.

3. The ischial tuberosities are further apart.

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

A 1 only

77

Which of the following vertebral groups form(s) lordotic curve(s)?

1. Cervical

2. Thoracic

3. Lumbar

A 1 only

B 2 only

C 1 and 2 only

D 1 and 3 only

D 1 and 3 only

78
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Which of the following is (are) accurate criticism(s) of the open-mouth projection of C1-2 seen in Figure A?

Figure A. Courtesy of Stamford Hospital, Department of Radiology.

1. The MSP is not centered and perpendicular to the midline of the table.

2. The neck should be flexed more.

3. The neck should be extended more.

A 1 only

B 1 and 2 only

C 3 only

D 1 and 3 only

B 1 and 2 only

79

The apophyseal articulations of the thoracic spine are demonstrated with the

A coronal plane 45° to the IR.

B midsagittal plane 45° to the IR.

C coronal plane 70° to the IR.

D midsagittal plane 70° to the IR.

C coronal plane 70° to the IR.

80
card image

Which of the positions illustrated in Figure A will best demonstrate the lumbar apophyseal joints closest to the IR?

Figure A.

A Number 1

B Number 2

C Number 3

D Number 4

A Number 1

81
card image

Which of the positions illustrated in Figure A will best demonstrate the lumbar intervertebral foramina?

Figure A.

A Number 1 B Number 2 C Number 3 D Number 4

D Number 4

82

The pedicle is represented by what part of the "scotty dog" seen in a correctly positioned oblique lumbar spine?

A Eye

B Front foot

C Body

D Neck

A Eye

83

To obtain an AP projection of the right ilium, the patient's

A left side is elevated 40°.

B right side is elevated 40°.

C left side is elevated 15°.

D right side is elevated 15°.

A left side is elevated 40°.

84

The left sacroiliac joint is positioned perpendicular to the IR when the patient is positioned in a

A left lateral position.

B 25° to 30° LAO position.

C 25° to 30° LPO position.

D 30° to 40° LPO position.

B 25° to 30° LAO position.

85

Which of the following are demonstrated in the oblique position of the cervical spine?

1. Intervertebral foramina

2. Apophyseal joints

3. Intervertebral joints

A 1 only

B 1 and 2 only

C 2 and 3 only

D 1, 2, and 3

A 1 only

86
card image

Which of the positions illustrated below would best demonstrate the cervical pedicles?

1. A.

2. B.

3. C.

A 1 only

B 2 only

C 1 and 3 only

D 2 and 3 only

C 1 and 3 only

87

Which of the following is (are) demonstrated in the AP projection of the thoracic spine?

1. Intervertebral spaces

2. Apophyseal joints

3. Intervertebral foramina

A 1 only

B 2 only

C 1 and 3

D 1, 2, and 3

A 1 only

88

Which of the following positions would best demonstrate the left apophyseal articulations of the lumbar vertebrae?

A LPO

B RPO

C Left lateral

D PA

A LPO

89

The right anterior oblique of the cervical spine requires which of the following combinations of tube angle and direction?

A 15° to 20° caudad

B 15° to 20° cephalad

C 25° to 30° caudad

D 25° to 30° cephalad

A 15° to 20° caudad

90

The AP projection of the sacrum requires the central ray to be directed

A perpendicular to the midline midway between the anterior superior iliac spine (ASIS) and the pubis.

B to the midline approximately 2 inches superior to the pubis.

C 15° cephalad to a point approximately 2 inches superior to the pubis.

D 15° caudad to a point approximately 2 inches superior to the pubis.

C 15° cephalad to a point approximately 2 inches superior to the pubis.

91

When comparing the male and female bony pelves, it is noted that the

1.male pelvis is deeper.

2.female pubic arch is greater than 90°.

3.female greater sciatic notch is wider.

  • A 1 only
  • B 1 and 2 only
  • C 2 and 3 only
  • D 1, 2, and 3

D 1, 2, and 3