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181

Section IIISection III

CROSS-SECTIONALANATOMY

CROSS-SECTIONALANATOMY

CHAPTER 15 • Neuro Anatomy

CHAPTER 16 • Thoracic Anatomy

CHAPTER 17 • Abdominopelvic Anatomy

CHAPTER 18 • Musculoskeletal Anatomy

INTRODUCTIONA radiologic technologist practicing in any fi eld of radiology must understand basic human anatomy and physiology in order to perform his or her duties. Those working in CT or MRI must also be able to identify normal anatomic struc-tures on cross-sectional images. This requires an adaptation in thinking; special attention must be paid to the relation-ships among structures. There are many excellent resources available that provide comprehensive images from the entire head and body, allowing readers to learn, identify, and recall anatomic structures in cross section. Some of these resources are listed here.The aim of this section is to provide an introduc-tion to cross-sectional anatomy by presenting just a few representative slices from some of the most common examinations performed in the CT department. Each cross-sectional image is accompanied by a drawing, in shades of gray, to help identify structures. All the drawings have been done according to the same gray scale. Re-gardless of where they are found in the body, air is depicted as black; bone is white. Within these extremes, shading varies for tissues, organs, and abnormalities. Each cross-sectional image is also accompanied by a reference image to help the reader imagine its location in the body.

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182 Computed Tomography for Technologists: A Comprehensive Text

Because only representative slices are included, the slices displayed are not adjacent. Compared with an actual CT examination that includes contiguous slices, the reader is at a considerable disadvantage in accurately identifying specifi c structures from a single image. (Note: questions contained in the certifi cation examination for CT asking the examinee to identify ana-tomic structures most often provide only a single cross-sectional image. Therefore, this format, although not refl ecting actual practice,

does mirror that commonly used for the CT examination.) In actual practice, whenever there is doubt the viewer should analyze adja-cent superior and inferior images and compare the structures in question.Resources:Madden ME. Introduction to Sectional Anatomy. Phila-delphia: Lippincott Williams & Wilkins, 2001.Kelley LL, Peterson C. Sectional Imaging for Imaging Professionals. St. Louis: Mosby/Elsevier, 2006.Dean D, Herbener TE. Cross-Sectional Human Anatomy. Philadelphia: Lippincott Williams & Wilkins, 2000.

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Neurologic Imaging Procedures 183

Chapter 15

NEURO ANATOMY

1. Nasal bones 7. Occipital bone

2. Eye, lens 8. Vertebral artery

3. Maxillary sinus 9. Mastoid air cells

4. Vomer 10. Zygoma

5. Sphenoid bone 11. Eye, globe

6. Medulla oblongata 12. Ethmoid sinus

HEAD BrainRoutine scans of the brain usually begin at the base of the skull and continue superiorly. Depending on the clinical indication, the scans may be done without IV contrast enhancement, with IV contrast enhancement, or without and with IV contrast enhancement. The images included below include IV contrast enhancement.

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1. Medial rectus m.2. Globe of eye3. Optic n.4. Sphenoid bone, greater wing of5. Mandibular condyle6. Mastoid air cells in left temporal bone7. Sigmoid sinus

8. Pons9. Cerebellum10. Internal auditory canal11. Auricle12. External auditory meatus13. Lateral rectus m.14. Zygoma

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1. Medial rectus m. 7. Sigmoid sinus

2. Globe of eye 8. Pons

3. Optic n. 9. Cerebellum

4. Sphenoid bone, 10. Internal auditory canal

greater wing of 11. Auricle

5. Mandibular condyle 12. External auditory meatus

6. Mastoid air cells 13. Lateral rectus m.

in left temporal bone 14. Zygoma

Chap15.indd 184 10/9/2009 2:36:30 PM


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1. Frontal sinus2. Pituitary3. Sphenoid bone4. Middle cerebral a.5. Temporal lobe6. Mastoid air cells in left temporal bone7. Sigmoid sinus8. Occipital bone

9. Cerebellar peduncles10. Cerebellum11. Right lamboid suture 12. Fourth ventricle13. Basilar a.14. Sella tursica15. Temporalis m.16. Frontal bone, orbital roof

1. Frontal sinus 9. Cerebellar peduncles

2. Pituitary 10. Cerebellum

3. Sphenoid bone 11. Right lamboid suture

4. Middle cerebral a. 12. Fourth ventricle

5. Temporal lobe 13. Basilar a.

6. Mastoid air cells 14. Sella tursicain left temporal bone 15. Temporalis m.

7. Sigmoid sinus 16. Frontal bone, orbital roof

8. Occipital bone

Chap15.indd 185 10/9/2009 2:36:31 PM


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1. Frontal bone2. Falx cerebri3. Anterior cerebral a.4. Middle cerebral a.5. Lateral ventricle, temporal horn6. Parietal bone

7. Cerebellum, tentorium8. Internal occipital protuberance9. Fourth ventricle10. Posterior cerebral a.11. Basilar a.12. Temporal bone

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1. Frontal bone 7. Cerebellum, tentorium

2. Falx cerebri 8. Internal occipital

3. Anterior cerebral a. protuberance

4. Middle cerebral a. 9. Fourth ventricle

5. Lateral ventricle, 10. Posterior cerebral a.

temporal horn 11. Basilar a.

6. Parietal bone 12. Temporal bone

Chap15.indd 186 10/9/2009 2:36:33 PM


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1. Superior sagittal sinus2. Frontal bone3. Lateral ventricle, anterior horn4. Caudate nucleus, head5. Putamen/Globus pallidus6. Third ventricle7. Choroid plexus

8. Parietal bone9. Internal occipital protuberence10. Cerebellar vermis11. Pineal body12. Thalamus13. Internal capsule14. Temporal bone

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1. Superior sagittal sinus 8. Parietal bone

2. Frontal bone 9. Internal occipital

3. Lateral ventricle, protuberence

anterior horn 10. Cerebellar vermis

4. Caudate nucleus, head 11. Pineal body

5. Putamen/Globus pallidus 12. Thalamus

6. Third ventricle 13. Internal capsule

7. Choroid plexus 14. Temporal bone

Chap15.indd 187 10/9/2009 2:36:34 PM


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1. Falx cerebri2. Frontal bone3. Corpous callosum4. Caudate nucleus, body5. Parietal bone

6. Superior sagittal sinus 7. Occipital lobe8. Choroid plexus9. Lateral ventricle, body10. Temporal bone11. Corona radiata12. Straight sinus

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1. Falx cerebri 7. Occipital lobe

2. Frontal bone 8. Choroid plexus

3. Corpous callosum 9. Lateral ventricle, body

4. Caudate nucleus, body 10. Temporal bone

5. Parietal bone 11. Corona radiata

6. Confl uence of sinuses (torcula) 12. Straight sinus

Chap15.indd 188 10/9/2009 2:36:36 PM


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1. Frontal lobe2. Superior sagittal sinus 3. Precentral gyrus4. Central suicus5. Falx cerebri6. Parietal lobe

7. Parietal bone8. Temporal bone9. Scalp10. Frontal bone

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1. Frontal lobe 6. Parietal lobe

2. Superior sagittal sinus 7. Parietal bone

3. Precentral gyrus 8. Temporal bone

4. Central suicus 9. Scalp

5. Falx cerebri 10. Frontal bone

Chap15.indd 189 10/9/2009 2:36:37 PM


SinusesSinus screening is intended as an inexpensive, accurate, and low radiation dose method for confirming the pres-ence of inflammatory sinonasal disease. If confirmed and the patient will then have endoscopic sinus surgery, the coronal images provide a “roadmap” for the surgeon. When the clinical indication is recurrent or chronic sinus-itis, the study is done without IV contrast enhancement and scanning is done in the coronal plane. Other clinical indications may require the administration of IV contrast or additional scans in the axial plane.

Sinuses (Coronal)

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1.Sphenoid bone2. Sphenoid sinus3. Sella tursica, floor 4. Zygoma5. Medial pterygoid m.6. Masseter m.7. Mandible

8. Aryepiglottic fold9. Pharynx10. Hyoid bone11. Lateral pterygoid m.12. Pharyngeal constrictor

1. Sphenoid bone 7. Mandible

2. Sphenoid sinus 8. Aryepiglottic fold

3. Sella tursica, fl oor 9. Pharynx

4. Zygoma 10. Hyoid bone

5. Medial pterygoid m. 11. Lateral pterygoid m.

6. Masseter m. 12. Pharyngeal constrictor

Chap15.indd 190 10/9/2009 2:36:39 PM


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1. Frontal lobe2. Medial rectus m.3. Superior rectus m.4. Infraorbital fissure5. Nasal conchae6. Maxillary sinus7. Zygoma 8. Maxillary bone9. Hard palate

10. Mandible11. Tooth12. Nasal bone (nasal septum)13. Inferior rectus m.14. Lateral rectus15. Optic nerve/ canal16. Sphenoid sinus17. Tongue18. Oral vestibule19. Masseter m.

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1. Frontal lobe 11. Tooth

2. Medial rectus m. 12. Nasal bone (nasal septum)

3. Superior rectus m. 13. Inferior rectus m.

4. Infraorbital fi ssure 14. Lateral rectus m.

5. Nasal conchae 15. Optic nerve/ canal

6. Maxillary sinus 16. Sphenoid sinus

7. Zygoma 17. Tongue

8. Maxillary bone 18. Oral vestibule

9. Hard palate 19. Masseter m.

10. Mandible

Chap15.indd 191 10/9/2009 2:36:42 PM


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1. Crista galli2. Ethmoid sinus 3. Medial rectus m.4. Frontal bone5. Inferior rectus m.6. Middle nasal turbinate7. Maxillary sinus8. Inferior nasal turbinate

9. Mandible10. Maxillary bone, hard palate11. Dental filling (spray artifact)12. Lacrimal gland13. Superior rectus m.14. Superior oblique m.15. Eye, globe

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1. Crista galli 9. Mandible

2. Ethmoid sinus 10. Maxillary bone, hard

3. Medial rectus m. palate

4. Frontal bone 11. Dental fi lling (spray artifact)

5. Inferior rectus m. 12. Lacrimal gland

6. Middle nasal turbinate 13. Superior rectus m.

7. Maxillary sinus 14. Superior oblique m.

8. Inferior nasal turbinate 15. Eye, globe

Chap15.indd 192 10/9/2009 2:36:44 PM


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1. Frontal lobe2. Eye, globe3. Lacrimal gland4. Inferior rectus m.5. Maxillary sinus6. Maxillary bone7. Tooth 8. Tongue

9. Oral vestibule10. Mandible11. Inferior nasal chonchae12. Nasal bone (nasal septum)13. Middle nasal chonchae14. Ethmoid sinus

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1. Frontal lobe 8. Tongue

2. Eye, globe 9. Oral vestibule

3. Lacrimal gland 10. Mandible

4. Inferior rectus m. 11. Inferior nasal chonchae

5. Maxillary sinus 12. Nasal bone (nasal septum)

6. Maxillary bone 13. Middle nasal chonchae

7. Tooth 14. Ethmoid sinus

Chap15.indd 193 10/9/2009 2:36:45 PM


Temporal BonesThe organs of hearing and balance are located in the pe-trous ridge of the temporal bone. Because these organs are tiny, thin slices are used. Once the scan data are acquired, the two petrosal bones are reconstructed separately so that the display field of view can be reduced to ensure optimal resolution. Most protocols include scans in both the coronal and axial planes; the use of IV contrast varies according to the clinical indication.

Temporal Bones (Coronal)

1. Epitympanum

2. Malleus

3. Facial canal

4. Cochlea

5. Internal auditory canal

6. Tympanic cavity

7. Mastoid air cells

8. Temporal bone

9. Semicircular canals

10. Hypoglossal c anal

11. Occipital c ondyle

12. Jugular f ossa

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Chap15.indd 194 10/9/2009 2:36:48 PM


1. Internal auditory canal2. Superior semicircularcanal3. Lateral semicircular canal4. Epitympanum5. Incus6. External auditory canal7. Styloid process8. Tympanic cavity9. Oval window

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1. Internal auditory canal

2. Superior semicircular canal

3. Lateral semicircular canal

4. Epitympanum

5. Incus

6. External auditory canal

7. Styloid process

8. Tympanic cavity

9. Oval window

Chap15.indd 195 10/9/2009 2:36:53 PM


Temporal Bones (Axial)

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1. Mandible, condyle2. Sphenoid sinus3. Clivus4. Carotid canal5. Sigmoid sinus6. Mastoid air cells7. External auditory canal

8. Jugular foramen9. Auditory ossicle: malleus10. Auditory ossicle: incus11. Carotid canal12. Internal auditory canal13.Vestibule14. Semicircular canal15. Cochlea

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1. Mandible, condyle 9. Auditory ossicle: malleus

2. Sphenoid sinus 10. Auditory ossicle: incus

3. Clivus 11. Carotid canal

4. Carotid canal 12. Internal auditory canal

5. Sigmoid sinus 13. Vestibule

6. Mastoid air cells 14. Semicircular canal

7. External auditory canal 15. Cochlea

8. Jugular foramen

Chap15.indd 196 10/9/2009 2:36:55 PM


15-17

1. Temporal lobe2. Superior semicircular canal3. Mastoid antrum4. Posterior semicircular canal5. Sigmoid sinus6. Temporal bone7. Occipital bone

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1. Temporal lobe

2. Superior semicircular canal

3. Mastoid antrum

4. Posterior semicircular canal

5. Sigmoid sinus

6. Temporal bone

7. Occipital bone

Chap15.indd 197 10/9/2009 2:37:01 PM


NECKUnless contraindicated, CT examinations of the neck are done with the IV administration of contrast media. Ar-tifacts caused by dental work often obscure surrounding structures at some levels. Some facilities split the data ac-quisition into two groups so that the gantry can be angled to reduce artifact. However, many MDCT systems do not allow the gantry to be angled in the helical mode, so this is not always possible.

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1. Maxillary bone

2. Oral vestibule

3. Masseter m.

4. Mandible, ramus

5. Atlas, anterior arch

6. Dens

7. Spinal cord

8. Internal jugular v.

9. Mastoid tip

10. Parotid g land

11. Retromandibular v .

12. Internal carotid a.

13. Pharynx

14. Genioglossus m. 18. Rectus/oblique capitus m.

15. Vertebral a . 19. Splenius capitus m.

16. Vertebra, spinous process 20. Pterygoid m.

17. Longus colli muscles

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1. Genioglossus m. 2. Tongue3. Mandible4. Pharynx5. Left external carotid a.6. Internal jugular v.7. Left internal carotid a.8. Vertebral body

9. Vertebral a.10. Sternocleidomastoid m.11. Submandibular gland

1. Genioglossus m. 7. Left internal carotid a.

2. Tongue 8. Vertebral body

3. Mandible 9. Right vertebral a.

4. Pharynx 10. Sternocleidomastoid m.

5. Left external carotid a. 11. Submandibular gland

6. Internal jugular vv.

Chap15.indd 199 10/9/2009 2:37:16 PM


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7. Esophagus8. Vertebral body 9. Erector spinae m.10. Trapezius m.11. Vertebral a.12. Common carotid a.13. Pharynx

1. Sternohyoid/Sternothyroid mm.2. Thyroid cartilage3. Cricoid cartilage4. Sternocleidomastoid m.5. Jugular v.6. Thyroid gland

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1. Sternohyoid/Sternothyroid mm. 8. Vertebral body

2. Thyroid cartilage 9. Erector spinae m.

3. Cricoid cartilage 10. Trapezius m.

4. Sternocleidomastoid m. 11. Right vertebral a.

5. Jugular vv. 12. Right common carotid a.

6. Thyroid gland 13. Pharynx

7. Esophagus

Chap15.indd 200 10/9/2009 2:37:23 PM


SPINECT of the spine is most often performed without IV con-trast media administration. However, scans of the spine are often obtained after intrathecal contrast material is given for a myelography study.

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1. Aorta2. Psoas m.3. Dural sac4. Pedicle5. Lumbar vertebra 26. Articular facet

7.Ligamenta flava8. L1, spinous process9. L2, transverse process10. Erector spinae m.11. Kidneys12. Jejunum/ileum

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1. Aorta 7. Ligamenta fl ava

2. Psoas m. 8. L1, spinous process

3. Dural sac 9. L2, transverse process

4. Pedicle 10. Erector spinae m.

5. Lumbar vertebra 2 11. Kidneys

6. Articular facet 12. Jejunum/ileum

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1. Inferior vena cava 2. Aorta3. L2, vertebral body4. Psoas m.5. Dural sac6. L2, lamina7. L2, spinous process

8. Multifidus m.9. Erector spinae m.10. Cauda equina (in dural sac)11. Right kidney12. Nerve root (exiting)13. Posterior longitudinal lig.

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1. Inferior vena cava 8. Multifi dus m.

2. Aorta 9. Erector spinae m.

3. L2, vertebral body 10. Cauda equina (in dural sac)

4. Psoas m. 11. Right kidney

5. Dural sac 12. Nerve root (exiting)

6. L2, lamina 13. Posterior longitudinal lig.

7. L2, spinous process

Chap15.indd 202 10/9/2009 2:37:33 PM


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1. Inferior vena cava2. Aorta3. Anulus fibrosus4. Intervertebral disk L2/L35. Articular processes6. L2, spinous process

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7. Erector spinae m.8. Psoas m.9. Right kidney10. Ligamenta flava11. Dural sac12. Quadratus lumbrum m.

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1. Inferior vena cava 7. Erector spinae m.

2. Aorta 8. Psoas m.

3. Anulus fi brosus 9. Right kidney

4. Intervertebral disk L2/L3 10. Ligamenta fl ava

5. Articular processes 11. Dural sac

6. L2, spinous process 12. Quadratus lumbrum m.

Chap15.indd 203 10/9/2009 2:37:37 PM

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