Podcast
Questions and Answers
Which anatomical landmark corresponds to the level of T7 when the arms are positioned at the sides?
Which anatomical landmark corresponds to the level of T7 when the arms are positioned at the sides?
What is the primary purpose of the central ray (CR) in radiographic positioning?
What is the primary purpose of the central ray (CR) in radiographic positioning?
Which of these vertebrae should the radiographic image include?
Which of these vertebrae should the radiographic image include?
What common fault might occur if the image receptor and beam are centered too low?
What common fault might occur if the image receptor and beam are centered too low?
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Where is the vertical collimated beam centered when capturing thoracic vertebrae?
Where is the vertical collimated beam centered when capturing thoracic vertebrae?
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Which vertebra is identifiable by the absence of an attached rib?
Which vertebra is identifiable by the absence of an attached rib?
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What is a likely result of using high radiographic contrast in images of the thoracic vertebrae?
What is a likely result of using high radiographic contrast in images of the thoracic vertebrae?
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In which position is the patient typically placed for a lateral decubitus thoracic vertebra examination?
In which position is the patient typically placed for a lateral decubitus thoracic vertebra examination?
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What anatomical structure indicates the level of T9?
What anatomical structure indicates the level of T9?
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At what anatomical landmark does T4 correspond?
At what anatomical landmark does T4 correspond?
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What level is indicated by a line joining the most superior parts of the iliac crests?
What level is indicated by a line joining the most superior parts of the iliac crests?
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What is the correct position for the upper edge of the CR cassette during imaging?
What is the correct position for the upper edge of the CR cassette during imaging?
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What aspect is crucial for achieving essential image characteristics?
What aspect is crucial for achieving essential image characteristics?
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What common fault may result from poor centering of the image receptor?
What common fault may result from poor centering of the image receptor?
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In which scenario is the patient typically positioned supine on the X-ray table?
In which scenario is the patient typically positioned supine on the X-ray table?
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What does high radiographic contrast generally cause in imaging?
What does high radiographic contrast generally cause in imaging?
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Study Notes
Radiographic Techniques - Thoracic Vertebrae
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Landmarks:
- The inferior angle of the scapula marks the level of T7 (when arms are at sides).
- The sternal notch is at the junction of T2 and T3.
- The sternal angle indicates T4, while T9 corresponds to the xiphisternal junction. Xiphisternal joint is variable in size.
- The lower costal margin identifies L3, an easily recognizable landmark for spinal radiography positioning.
- A line through the superior iliac crests indicates L4.
- The tubercle of the iliac crest locates L5.
- Anterior and posterior iliac spines are at the level of the second sacral vertebra.
- Cricoid cartilage is at the level of the sixth cervical vertebra.
Anteroposterior Radiography (Basic)
- Patient Position: Patient supine on the X-ray table, with the median sagittal plane perpendicular to the table and centered with the Bucky.
- Cassette Positioning: The upper edge of the cassette should be just below the thyroid cartilage prominence to include upper thoracic vertebrae.
- Beam Direction: The collimated beam is centered at right angles to the image receptor and 2.5 cm below the sternal angle, aimed precisely at the spine.
Lateral Radiography (Basic)
- Patient Position: Commonly taken in lateral decubitus, but can also be erect.
- Image Receptor Alignment: The median sagittal plane should be parallel to the image receptor and the midline of the axilla, coincident with the table or Bucky midline.
- Arm Positioning: Arms should be raised well above the patient's head.
- Head Support: The head can be supported with a pillow.
- Cassette Positioning: The upper edge of the cassette should be 3-4 cm above the spinous process of C7.
- Beam Direction: The collimated vertical beam should be at a right angle to the long axis of the thoracic vertebrae; this may require caudal angulation.
- Beam Centering: Beam is usually centered just below the inferior angle of the scapula (easily palpable), assuming arms are raised.
Essential Image Characteristics (General)
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Vertebrae Range: The image should include vertebrae from C7 to L1.
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Image Density: Adequate density for clear visualization of bony details of upper and lower thoracic vertebrae is crucial.
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Shoulder Superimposition: Upper two or three vertebrae may be obscured by shoulder superimposition.
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Rib on L1: Absence of a rib on L1 at the lower border of the image confirms proper inclusion of T12 in the field.
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Patient Rotation: Superimposed posterior ribs indicate the patient was not rotated too far forward or backward.
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Image Density for Diagnosis: Sufficient image density is necessary for accurate diagnosis.
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Common Faults and Solutions:
- Inadequate upper thoracic vertebrae on the image: Image receptor and beam may be centered too low, omitting these vertebrae from the image.
- Missing lower vertebrae: Lower vertebrae (especially L1) may be excluded from the image. L1 is easily identified due to typically not having a rib attached.
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Radiographic Contrast: High radiographic contrast may cause high density over the vertebrae. Lower contrast produces acceptable density for both upper and lower vertebrae (see Fig. 6.17c and 6.17d).
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Description
This quiz covers essential landmarks and positioning techniques for thoracic vertebrae in radiographic imaging. It details important anatomical reference points and patient positioning for optimal X-ray imaging. Test your knowledge on proper techniques and anatomical landmarks relevant to thoracic radiography.
