118 - Ch 8 Cervical Thoracic Spine Flashcards
Lordosis
Kyphosis
Scoliosis
Swayback -curve in lumbar
Humpback-curve in thoracic
Lateral curvature - “S like”
The vertebral column is divided into how many sections ?
5
How many vertebrae are in each section as an adult??
7-C 12-T 5-L 1-S 1-C
= 26 Vertebrae as an adult
33 in child do to bones fusing together in the sacrum and coccyx
Concave
Convex
Rounded inward
Rounded outward
What does the vertebral foremen contain ?
The spinal cord
The posterior area of the vertebral arch formed by 2 flat layers called?
Lamina
The junction of each pedicle and lamina is called
The transverse process
Respiration could not occur without the _________
Spine
Which serves as a pivot point
There are _____ articular processes which are ?
4
Superior
Inferior articular processes
Intervertebral disks are located where?
Tightly between each vertebrae to maintain stability and movement
What needs to be seen in a lateral view of the vertebra?
Zygapophyseal joints and intervertebral foramina
The outer fibrous portion of intervertebral disks is?
Annulus fibrosis
The inner soft gelatinous part of he intevertebral disks is called?
Nucleus pulposus
C1 and C2 are also known as what names?
C7 is also known as?
C1-atlas
C2-axis
Vertebra prominens (palpable bony area at base of neck)
Th spinous process found on C2-C7 are called ?
Bifid tips
Ligament that hold dens against anterior arch of C1 ?
Large ligament between C1-C2?
Atlantoaxial joint
Transverse Atlantal ligament
To ensure that intervertebral joint spaces are open for lateral thoracic spine projects what is most important to do??
Keep the vertebral column parallel to the IR
Mild form of scoliosis and kyphosis both ??
Inflammation of the vertebrae ?
Scheuermann disease
Spondylitis
Abnormal lateral curvature of spine
Avulsion fracture of C7
Scoliosis
Clay Shovelers fracture
Fracture of the pedicles and anterior arch of C2 with forwRd displacement on C3
Hangman’s fracture
What projections do we take for an HNP??
AP and Lateral spine
What projections r required for a Jefferson fracture ??
AP open Mouth (C1-C2 projection)
During an AP open mouth projection what is required to be seen in the anatomy?
The entire Dens(odontoid) !!
The lateral projection of the cervical spine should be taken during___________ breath??
Expiration to depress the shoulders as much as possible
What region of the spine must be demonstrated for a cervicothoracic lateral position??
C5-T3
Aka Swimmers
If unable to demonstrate the Dens on an open mouth projection, what other projection can be taken ?
The Judd or Fuchs Method
What’s the purpose of orthostatic breathing during a lateral projection of the thoracic spine?
To blur our lung and rib markings
What structures are best demonstrated with an AP axial vertebral arch projection ?
Articular pillars (lateral masses) of the cervical spine
Another name for the cervicothoracic lateral position?
Swimmers Method
Where is the level of the xiphoid process ?
T9-T10
The most inferior aspect of the sternum
Xiphoid process
The spinal cord begins at ??
And ends at ?,
Medula oblangata
1st Lumbar
Which 2 fractures, require us to use the AP open mouth method (C1-C2)?
Jefferson and odontoid fractures
Which projection is required for a patient with schuermann disease ?
Scoliosis series
How much angulation is required for the routine AP axial cervical Spine ?
15-20 degrees cephalad!
Centered at thyroid cartilage (C4)
The lateral cervical spine requires an SID of ?
It is also required that the patient depress their shoulders and anatomy shown must be??
72inches
Showing C1-C7/T1
The AP or PA projection for C1-C2, is also known as which projections ?
Fuchs (AP) and Judd (PA)
Projections!
(Chin is raised high with AP and chin is placed forward on table with PA)
The mentomeatal lines during Fuchs or Judd methods should be what to the table??
MML should be perpendicular with Fuchs
MML should be Parallel with the Judd
For lateral hyperfelexion or hyper extension cervical spine positions, SID should be ??
60-72inches
Hyper extension =raise chin up
Hyperflexion= depress chin down
AP wagging Jaw projection is also known as ottonello method to demonstrate what anatomy ?
Odontoid process surrounding C1..
wagging meaning mandible continuous motion during exposure
With an AP thoracic spine, CR should be directed to?
T7 (3-4inch below jugular notch)
In A lateral thoracic, T1-T3 will not be visualized but also which breathing technique should be used ?
Othostatic breathing; which patient is in a lateral recumbent position
In a swimmers position of the cervical spine, which anatomy should be demonstarated ?
Where should CR be placed?
C5-T3.
Direct CR to T1 (1inch above jugular notch)
When should the swimmers cervical spine be used?
When C7,T1 isn’t visualized in a routine lateral spine
Where is the level of the jugular notch?
T2-T3
Which projection can benefit by using the anode heel effect??
AP Projection
Thoracic Spine
At what level do we place the CR for a thoracic spine ?
CR to T7
On a RAO position, on a oblique cervical spine, we are looking at which vertebral foramina??
Angle of tube?
The right intervertebral foramina
Caudad 15-20*
Lead requirement thickness ?
Flouro lead requirement?
.25mm
.50mm
We use a grid for tissues over 10cm bcuz the thicker the tissue the more scatter but when using a grid, what affect occurs?
Increased patient dose due to having to increase mAS
When would we use a lateral hyperflexion/hyperextention cervical spine?
To rule out whiplash
Which projection requires orthostatic breathing? And why ?
Lateral thoracic
To blur out ribs and lung markings
A wedge compensating filter may be used on?
An AP thoracic spine
In the lateral thoracic projection; what anatomy much be seen?
T1-L1
Where do we center for a cervicothoracic lateral Spine (aka swimmers) ?
T1; 1 inch above jugular notch
An avulsion fracture along any spinous process vertebra of C6-T1
Clay shovelers fracture
Fracture of the anterior C2 arch ??
Hangman’s fracture
Possible narrowing of the disk space ?
HNP
Neck stiffness
Vs
Inflammation of the vertebrae
Spondylosis
Spondylitis
What is air gap?
When OID (from neck to board) compensates to reduce scatter during lateral cervical spine.
The half moon shaped area along each pedicle on the intervertebral foramina ?
Inferior and superior vertebral notch’s
The vertebral canal protects ??
Th spinal cord
Concave structures are described as also ??
Lordotic Aka (cervical and lumbar regions of spine)
What do the facets connect to on the thoracic vertebrae?
The ribs (Costovertebral joints)
Ribs 1-10 are attached:
Ribs 11-12 are not attached!!!
What do the superior and inferior articular process connect to form?
The zygapophyseal joints
The zygapophyseal joints from the midsagittal view are at what angle and why projection used to be seen??
70-75*
Lateral thoracic views
The mastoid tip responds to the level
Gonion-
Of C1
C3
The zygapophyseal joints are best demonstrated on ?
The intervertebral foramina are best demonstrated on?
The lateral position
Th oblique cervical spine
For the thoracic position of an oblique; the body must be in
A 70 degree position
