RAD-143 CERVICAL SPINE ROUTINE w/ANATOMY

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what are the unique characteristics of the cervical vertebrae

transverse foramina, bifid spinous process tips and overlapping vertebral bodies
what is the hole in the transverse process called

transverse foramina
how can you visualize the apophyseal joints in c2-c7

with the neck at a lateral position or 90 deg angle to the MSP
how are the apophyseal joints seen on c1 and c2

on an ap open mouth projection
the intervertebral formina are best seen how
and how is the foramina made
- they are created by the roofs of the pedicles
- and are seen when the c spine is rotated 45 deg with 15 deg cephalad angle
what is the first cervical vertebrae known as

the atlas
the dens or odontoid process is part of what vertebrae

c2 or axis
what are the lateral masses on c1

they are areas of the bone between the superior and inferior articular processes the support the weight of the head and asiist in rotation
what type of trauma can cause severe fracture of the dens/odontoid process

whiplash from a car accident forced flexion-hyperextension
what joint makes up the articulation of c1 and c2

atlantoaxial joint
the lpo position of the cervical spine shows what structure and on what side
- intervertebral foramina
- foramina on the right side
the side _____ from the IR in the obliques of the c spine show the foramina
lpo?
rpo?
whats the angle
- farthest
- lpo = means it visualizes the right upside foramina
- rpo = visualizes the left upside foramina
- 15 cephalad
if you were to do an oblique anteriorly the side ______ to the IR opens what joints of the cspine
RAO and LAO
what is the tube angle
- closest
- LAO = left downside formaina
- RAO = right downside foramina
- 15 deg caudad
for trauma patients what is crucial that we do not do

do not remove the cervical collar and do not move their head or neck until authorized by a physician who has evaluated the horizontal beam lateral image
where is cr for a cervicothoracic simmers lateral position cervical spine
what is the breathing
what does this visualize
- CR at t1 1 inch above level of jugular notch
- suspend respiration on full expiration or optional breathing method
- c7 and t1
what structures must we ensure are perpendicular to the table on an ap open mouth

lower margin of upper incisors to the base of the skull(mastoid tips)
where is the cr for an open mouth
when the patient is instructed to open the mouth only _____ should move
- in the middle
- the lower jaw
if we cannot see the upper dens in the ap open mouth what is the alternative

fuchs or judd methosd
if the base of the skull is superimposed on the upper dens what sohuld you do 2 things

reposition using a bit of hyperflexion on the neck or angle the tube slightly 5 deg caudal
the ap axial projection cervical spine is used to visualize pathology of what vertbra
what structures are per and parallel to the tube on this projection
- c3-c7-12
- lower margin of upper incisors to the base of the skull (mastoid tips) perp to ir
- line from tip of mandible to base of skull is parallel to cr
what is cr angle of for an ap axial projection cervical spine
where is the cr
- 15-20 deg cephalad
- cr to enter at level of the lwoer margin of thyroid cartilage to pass thru c4
what is the breathing for an ap axial cerv spine
patient should not _____ during this breathing
- suspend respiration
- swallow
when the patient is supine and erect how much do we angle the tube for each in ap axial cerv spine
- supine 15 deg caudal or when there is less lordotic curvature
- erect 20 deg caudal or more lordotic curvature is present
why are anterior oobliques preferred over posterior obliques

anterior obliques in reltation to the neck provide less radiation dose to the thyroid
what sid is recommened for the obliques of the spine
what is the degre of obliquity in this position of the spine
- 40-72 but 72 the farther is better
- 45 deg
in the oblique positioning of the neck what can we ask the patient to do to prevent superimposition of the mandible on the vertebrae

ask patient to protract their chin forward
what is the cr angle, positions, and cr location for anterior obliques and posterior obliques of the spine
what is the breathing
- 15 deg caudal @ c4 for anterior obliques RAO and LAO
- 15 deg cephald @ c4 for posterior obliques LPO and RPO
- suspend respiration
what structures are shown in the oblique positioning of the cerv spine

intervertebral foramina of c2-c7
what is the SID for an erect lateral c spine

72 in
what is the position of the shoulders and chin in a lateral c spine
- relax and drop shoulders down and forward as much as possible
- and prtract the chin (prevents superimposition of the mandible)
where is the cr for a lateral c-spine

cr @ c4 level of adams apple or upper margin of thyroid cartilage
what is the breatihng for a lateral c spine amd why a 72 sid
what can be used to keep the shoulders down in this projection
- suspend respiration on full expiration (for maximum shoulder pression)
- long sid to compensate for increase OID
- 5-10 lb weights suspended from the wrists
what structures are visible in the lateral position of the c spine
what do you you do if you cannot see t1 and c7
- zygo joints c1-c7 -t1
- do a cervicothoracic prjection swimmers method
where is the cr for a lateral cspine horizontal beam
what structure is this cr above
what is the breathing
- cr @ c4 at leve of upper thyroid cartilage margin
- 1-2 in above EAM
- same as lateral (full expiration)
should u use a grid on a gorizontal beam lateral position of cpsin

if the patient is average size no bigger patient use a grid to compensate the air gap
in an ap axial position of the cervical spine what can we do open up the lower intervertebral spaces

angle tube 20 cephalad
on an oblique postion of the cervical spine what structure is best visualized at c1

posterior arch and tubercle of c1
how many foramina are in each c spine

3 (2 on transvers one vertebral)
what is column of bone located posterior to the transverse process at junction of pedicle and lamina on a lateral view of the c spine and is mainly between the inferior and superior articular process

articular pillar or lateral mass
the intervertebral foramina are directed at what angle because of the shape of the bone

15 deg angle
instead of the two lamina on the sides of a spinous process o na regular vertebrae what is located here and which vertebrae
- posterior archs c1
- c3-c6 have lamina
how are the occipitoatlanto joints formed

between the articulations of c1 and the occipital condyles of the skull
the gonion is at level of ____
the mastoid tip is at the level of ____
- c3
- c1
the thyroid cartilage is at the level of ____

c5
a patient with possible cervical spine injury enters the emergency room and is lying on a backboard. which projection is first to be taken

lateral crosstable xray
what projections are needed to rule out mobility of the neck due to a whiplash injury from a car accident

lateral positions hyperflexion and hyperextension
a radiograph of an rpo cervical spine reveals that the lower intervertebral foramina are not open but the upper intervertebral foramina are well visualized. what is the error located here?

the patient was not obliqued enough to a 45 degree angle the whole body must be 45 deg
a radiograph of an ap wagging or otonello method reveals that the mandible is still visible and obscuring the upper thoracic vertebrae (dens)
tech factors used:
40 sid
75 kvp
20 mas
.5 seconds

the exposure time is too short the mas needs to be lowered and use a longer exposure time to allow more blurring of the mandible to see the dens
what is the ring or arch of bone that extends posteriorly from the vertebral body

vertebral arch

Author

anatomy12

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RAD-143 CERVICAL SPINE ROUTINE w/ANATOMY

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xray

Updated

4/26/2014, 9:00:31 PM

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