RAD-143 CERVICAL SPINE PATHOLOGY & SPECIAL PROJECTIONS

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anatomy12
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271232
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RAD-143 CERVICAL SPINE PATHOLOGY & SPECIAL PROJECTIONS
Updated:
2014-04-23 09:21:09
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XRAY
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XRAY
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  1. Clay shovelers fx:
    best shown in what radiograph
    • avulsion fx of the spinous process of any vertebrae c6-t1
    • lateral position of the spine
  2. compression fx:
    what is the shape of the vertebral body
    • involves a collapse of a vertebral body which results from axial loading or flexion most in thoracic and lumbar regions
    • wedge shaped vertebral body from lateral perspective; irregular spacing from ap perspective
  3. hangmans fx
    why does this cause an unstable patient
    • fx extends through the pedicles of c2 with or without subluxation of c2 on c3 usually happens during extreme hyperextension
    • the intact dens is pressed posterior against the brain stem
    • fx of the anterior c2 arch usually also with anterior subluxation of c2 on c3
  4. jefferson fx:
    • comminuted fx that occurs as a result of axial laoding such as one landing on ones head or abruptly on ones feet
    • the anterior and post arches of c1 are fxed as the skull slams into the rings
  5. odontoid fx
    what exam shows this
    • fx line thru base of dens possibly extending into lateral masses of arches of c1
    • ap open mouth
  6. teardrop burst fx:
    how does this injure happen
    what condition can arise from this
    • comminuted vertebral body fragments avulsed from anteroinferior border and fragments from posterior vertebral body displaced into the spinal canal
    • compression with hyperflexion in cerv. region
    • quadripelgia
  7. herniated nucleus pulposus
    • the soft inner part nucelus pulposus of an intervertebral disk protrudes through the fibrous cartilage outer layer (annulus fibrosus) into the spinal canal, it can press on the spinal cord or nerves that cause pain and numbing on the extremities
    • narrowing of disk space between vertebra and protrusion of disk into spinal canal on ct or mr
  8. osteoarthritis
    degeneration of cartilage and formation of osteophytes
  9. osteoporosis
    bone density mineral loss
  10. scheuermanns disease
    mild kyphosis and or scoliosis most commonly involved with the thoracic curve
  11. spondylitis ankylosing
    what does it cause or form
    • systematic illness of unknown origin that involves the spine and larger joints, cause stiffening that is caused from inflammation of the sacroiliac joints, intervertebral disks and costovertebral
    • calcification with ossification (formation of bony ridges between vertebrae creating stiffness and lack of joint mobility
  12. spondylosis
    decreased intervertebral joint space foraminal stenosis
  13. transitional vertebra
    bony projections outgrowth extended laterally from transverse process
  14. spondylitis
    inflammation of the vertebrae
  15. what projection is used to rule out whiplash type injuries
    what is the sid
    • lateral positions hyperflexion and hyperextension
    • 72 in
  16. where is the cr lateral positions hyperflexion and hyperextension
    what is the position of the shoulders in each exam
    • c4 upper margin of thyroid cartilage
    • relax and depress shoulders down as far as possible
  17. how much hyper flexion is needed for this lat position
    how much hyper etension is needed
    what is the breathing for these two exams
    • until chin touches the chest or as far as patient can go
    • raise chin and tilt head back as much as possible without moving bacakward
    • suspend respiration on full expiration
  18. what position is used to view the dens if not clearly viewed in an ap open mouth
    what is the breathing for these exams
    • ap or pa fuchs and judd method c1 and c2
    • suspend respiration
  19. in the ap fuchs method where is the cr
    what structure is perp to tabletop
    what is mml
    • cr parallel to mml directed to inferior tip of the mandible
    • elevate chin to bring the mml near perp to tabletop
    • mentomeatal line (tip of chin to the ear opening should be clost to perp to tabletop )
  20. what structure is the dens visualized in the ap or pa judd and fuchs method
    foramen magnum
  21. in the pa judd method the patient is supine or prone
    where is the cr and position of the chin
    • prone
    • cr is parallel to mml through the midoccipital bone abt 1 in inferosuperior to mastoid tip and angles of mandible
    • the chin is resting on tabletop but slightly extended to brin mml near perp to table (may adjust cr)
  22. the ap wagging jaw is also known as
    otonello method
  23. where is the cr for otonello method
    what is instructions for this
    what is the breathing
    • c4 at upper thyroid cartilage so upper incisor line is in a horizontal plane with the mastoid tips
    • after centering patient correctly the pt must move the lower mandible in a continous motion without moving the head or teeth coming into contact
    • suspend respiration
  24. what should we do to the patient before attempting the wagging jaw or otonello method
    instruct and practice with patient before exposure
  25. for an ap axial projection vertebral arch (pillars) cspine where is cr and what is the angle
    what is the breathing and position of the neck
    • cr at c5 lower margin of thyroid cartilage (a bit below the adams apple)
    • 20-30 caudad angle
    • suspend respiration neck should be hyperextended if patient condition allows
  26. facets unilateral subluxation and bilateral locks
    • happens when a zyga joint is out of alignment with unilateral sublaxation the vertebral body looks like bowtie on a lateral position of the spine
    • bilateral:
    • caused by extreme flexion and distraction both left and right zyga joints on the same level can be disrupted creating bilateral locked facets

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