4a. Cervical Spine Flashcards
what is the SID for cervical spine views
lateral views
oblique views
110cm
lateral = 150-180cm
oblique = 100-180cm
what is the kV for cervical spine views
70-85kV
what is the mAs for cervical spine views
16mAs
do you use grids for cervical spine views
yes
what is the breathing technique for cervical spine views
suspend respiration on exposure
what is the CP for the odontoid view
through the centre of the open mouth
what is the patient positioning for the AP open mouth view
3 things
supine/erect
mouth open
lower margin of upper incisor perpendicular to the base of skull and IR
what is the collimation for the AP open mouth view
top teeth to chin level
horizontal line in line with lip crease
what is the image critique for the AP odontoid view in terms of position
in terms of superimposition, no head rotation, which joint space needs to be open
3 things
upper incisors and BOS superimposed
no head rot = EAM at the same level
C1-2 atlantoaxial joint space open
what is the image critique for the AP odontoid view in terms of area of interest
in terms of C1 and C2 and dens
3 things
entire dens in foramen magnum
C2 vertebral body
C1 lateral masses and transverse processes
what is the CP for the AP axial view
15-20*cranial
midline of lower thyroid cartilage (C4)
what is the patient positioning for the AP axial view
3 things
supine/erect
no swallowing, suspend respiration
chin raised so CR angle superimposes chin over BOS
what is the collimation for AP axial view
in terms of laterally and inferiorly
C-spine laterally
T2 inferiorly
what is the image critique for the AP axial view in terms of area of interest
2 things
C3-T2 vertebral bodies and intervertebral joints
what is the image critique for the AP axial view in terms of positioning
in terms of no rotation, joints to be open, spinous processes and superimposition
4 things
no rotation = EAM equidistant
intervertebral joints open
spinous processes equidistant to midline
BOS and mandible superimpose C1-2
what is the CP for the posterior oblique view
15-20* cranially to C4
what is the CP for the anterior oblique view
15-20* caudally to C4
what is the patient positioning for the AP/PA oblique view
in terms of MSP plane, body and head rotation, skull rotation, chin position
4 things
erect
MSP perpendicular to the IR
body and head 45* oblique
skull 45-90* rotation
protract and elevate chin
why do you need to protract and elevate the chin for the AP/PA oblique views
protract = prevent mandible superimposing vertebrae
elevate = AML line parallel to the floor
what is the image critique for the AP/PA Oblique view in terms of positioning
in terms of intervertebral foramina, pedicles and superimposition
3 things
intervertebral foramina uniformly open
pedicles in profile
no C1/BOS superimposition
what is the image critique for the AP/PA Oblique view in terms of area of interest
2 things
C2-7 intervertebral foramina open
cervical pedicles demonstrated
in terms of AP/PA oblique views which is upside and which is downside
upside = Posterior oblique
downside = anterior oblique
what is the CP for the lateral view
horizontal ray
perpendicular to C4 upper thyroid cartilage
what is the patient positioning for the lateral view
in terms of what 2 things are aligned to the CR/IR, shoulders and chin
4 things
erect
C-spine and MCP aligned to the CR/IR
shoulders depressed and rolled forwards
protract and chin elevated
what is the image critique for the lateral view in terms of area of interest
2 things
C1-7 intervertebral joint spaces and vertebral bodies
what is the image critique for the lateral view in terms of positioning
in terms of what shows no rotation and what should be superimposed
2 things
no rotation = mandible not superimposed over C1/2
superimposition of zygapophyseal joints
what is the CP for the cervicothoracic/swimmers view
perpendicular to T1
2.5cm above jugular notch
what is the patient positioning for the cervicothoracic/swimmers view
in terms of arm near and furthest from IR
3 things
erect
arm near IR flexed, forearm rest on head for support
arm furthest from IR depressed and rotated posteriorly
what is the image critique for the cervicothoracic/swimmers view in terms of area of interest
3 things
C5-T3 vertebral bodies and intervertebral disk spaces
humeral heads separated vertically
what is the image critique for the cervicothoracic/swimmers view in terms of positioning
in terms of humeral heads, vertebral bodies, rotation of the body and vertebrae
4 things
separation of humeral heads from C-spine
vertebral bodies in lateral perspective
no thorax/hip/shoulder rotation
minimal vertebrae rotation
what is the CP for the lateral hyperflexion/hyperextension view
perpendicular to C4, upper thyroid cartilage
what is the patient positioning for the lateral hyperflexion/hyperextension view
in terms of body rotation, IR alignment, shoulders and chin
5 things
erect
No pelvis/shoulder/head rotation
C-spine aligned to IR midline
Depress shoulders (weights)
Chin elevated/depressed as much as possible
what is the image critique for the lateral hyperflexion/hyperextension view in terms of area of interest
C1-7
what is the image critique for the lateral hyperflexion/hyperextension view in terms of positioning
in terms of head rotation and spinous processes
3 things
No head rotation
Hyperflexion = spinous process separated
Hyperextension = spinous process in close proximity
