Anatomy and Procedures of the Cervical Spine Flashcards
1
Q
What forms the central axis of the skeleton?
A
Vertebral Column
2
Q
What is located in the posterior trunk?
A
Vertebral Column
3
Q
What are the functions of the Vertebral Column?
A
- encloses and protects spinal cord
- supports trunk and skull
- provides muscle attachments
4
Q
Where is the Vertebral Column centered?
A
Centered in the midsagittal plane
5
Q
Vertebral Column is composed of small irregular bones called what?
A
vertebrae
6
Q
How many vertebrae are in early life?
A
total of 33 vertebrae in early life
7
Q
How many vertebrae are considered true and movable?
A
24
8
Q
What are considered false and fixed vertebrae?
A
sacral and coccygeal vertebrae
9
Q
What is fuse in the sacrum?
A
sacral vertebrae
10
Q
What is fuse to form coccyx?
A
Coccygeal vertebrae
11
Q
What are the 5 groups in the Vertebral Column?
A
- Cervical vertebrae
- thoracic vertebrae
- lumbar vertebrae
- sacral vertebrae
- coccygeal vertebrae
11
Q
How many groups is the Vertebral Column divided into?
A
5 groups
12
Q
Has 4 curves that arch anteriorly and posteriorly from midcoronal plane?
A
Vertebral Column
13
Q
Lordotic curves are considered what anteriorly?
A
convex
14
Q
Kyphotic curves are what anteriorly?
A
concave
15
Q
Cervical is what type of curve?
A
Lordotic
16
Q
Thoracic is what type of curve?
A
Kyphotic
17
Q
Lumbar is what type of curve?
A
Lordotic
18
Q
Pelvic is what type of curve?
A
Kyphotic
19
Q
Cervical curve anteriorly is considered what?
A
Convex
20
Q
Thoracic curve anteriorly is considered what?
A
concave
21
Q
Lumbar curve anteriorly is considered what?
A
convex
22
Q
Pelvic curve is considered what anteriorly?
A
concave
23
Q
is a condition of abnormal lateral curvature of the spine
A
Scoliosis
24
is a condition of increased kyphotic curve of the thoracic spine (T- spine)
Kyphosis
25
How are curves in scolisis?
It curves right in the thorax and left in the lumbar
26
What help separates the vertebrae and is composed of fibrocartilage?
- function as cushions
intervertebral disks
27
Allow for movement of the bone
intervertebral disks
28
Disk is composed of
- annulus fibrosus
- nucleus pulposus
29
is known as outer, fibrocartilaginous disk
annulus fibrosus
30
Common area for slipped disks
L5 and S1
30
is known as central, soft mass
nucleus pulposus
31
Comes out of normal space and pushes on nerve ending
- known as "slipped disk"
Herniated Nucleus Pulposus (HNP)
32
A typical vertebrae is composed of?
- body (anterior)
- vertebral arch (posterior)
33
The two parts (body and vertebral arch) enclose a space known as
the vertebral foramen
34
What does the articulation of vertebral foramina form?
vertebral canal
35
Vertebral arch is formed by:
- 2 pedicles
- 2 laminae
- the above supports four articular processes, two transverse processes, and one spinous process
36
what projects from posterior part of the body
pedicles
37
bottom is concave to form what?
vertebral notches
38
articulation of vertebral notches form what?
intervertebral foramina
39
What is projected posteriorly and medially from pedicles
laminae
40
laminae is join together to create what?
posterior arch
41
Most posterior part of the vertebrae is
the spinous process
42
What is project laterally and a little posteriorly from junction of laminae and pedicles
transverse process
43
What projects posteriorly and inferiorly from junction of both laminae
spinous process
44
is congenital (born with it) in which the laminae fail to fuse. Laminae didn't fully join together
Spina bifida
45
How many articular process arise from junction of pedicles and laminae?
4
- 2 superior
- 2 inferior
46
articulation form between superior and inferior
zygapophyseal joints
47
articulate with vertebrae above and below to form what?
zygapophyseal joints
48
What is another name for zygapophyseal joints
interarticular facet joints
49
How many Cervical vertebrae are there?
7
50
What occupy the neck region
Cervical vertebrae
51
area in which the superior and inferior articulation of 1 vertebrae to the other vertebrae articulate creating the joint space
zygapophyseal joints
52
For the Cervical vertebrae only where is the transverse foramina located?
Transverse foramina located on transverse processes
53
What kind of spinous process does Cervical vertebrae have?
bifid spinous process
54
What Cervical vertebrae does not have a spinous process?
C1
55
Body of the Cervical vertebrae is considered more what compared to the others
more squared
56
First two Cervical vertebrae are considered what because they join with the skull?
atypical
56
C1 is also known as
atlas
57
C2 is also known as
axis
57
articulates with back of the skull and occipital bone
- where head and neck attach
- only vertebrae that does not have a body
C1 atlas
57
Turns around on the dens (odontoid)
- makes it possible for our heads to spin around
C2 axis
58
C7 is also considered what since it joins with T- spine
atypical
59
What does C1 (Atlas) consist of:
- anterior arch
- posterior arch
- 2 lateral masses
- 2 transverse process
60
The superior articular process of C1 receives what?
the condyles of the occipital bone
61
What two things makes up where odontoid comes through?
- transverse Atlanta ligamnet
- anterior arch
62
Most common fracture of C1
(ex. falling right on head - swimming, football players)
Jefferson fractures
62
Contains a body
- has a conical process, called the dens or odontoid, on upper, anterior of body
-Odontoid receives into the anterior ring of C1
C2 (axis)
63
C7 is also called what because of its long, prominent spinous process
- easily palpated
vertebra prominens
64
What cervical vertebrae has the longest spinous process
- no longer has bifid tips
C7
64
For cervical spine where are zygapophyseal joints seen?
Seen on lateral view
- they sit on a 90 degree angle
65
For cervical spine where are the intervertebral foramen seen?
Seen on obliques
- 45 degree angle
66
What unique anatomic feature is found in the typical cervical vertebrae?
Presence of transverse foramina in transverse processes
67
The dens is located on:
C2
68
What is the recommended SID for cervical projections except open mouth and ap axial?
60 to 72 inches
69
what is the SID for open mouth and ap axial?
40 inches
69
Which side do we mark down for cervical obliques projection?
mark side down
70
What is the breathing technique for lateral cervical spine (grandy)?
suspension after full expiration (expiration)
71
What do you tell the patient to do for AP open mouth?
tell patient to phonates "ah" to depress tongue to floor of mouth
72
What is the breathing technique for swimmer's method?
shallow breathing to blur lung anatomy
72
What are the essential projections of cervical spine?
- AP (Fuchs) for dens
- AP open mouth position for C1 and C2
- AP axial
- Lateral (Grandy)
- Lateral (Hyperflexion) (Hyperextension)
- Lateral Swimmer's tecnique (Cervicothoracic Region)
- AP axial oblique (RPO) (LPO)
- PA axial oblique (LAO) (RAO)
73
What is your part position for AP open mouth?
Align edge of upper incisors and mastoid tip perpendicular to IR
74
How is the CR for AP open mouth?
perpendicular
75
What must you make sure when doing an open mouth?
make sure mouth is open as wide as possible and tilt head back a little bit
75
What is the SID for open mouth?
40 inches
75
The alignment of mastoid tip with the upper incisors is considered what type of plane?
occlusal plane
76
Why is the open mouth done?
To see C1 and C2
77
What is the other name for AP Dens (Fuchs) ?
Tip shot
78
Why is the AP (Fuchs) done?
so you are able to see the dens of the odontoid if you are not able to see it on the open mouth
79
What is the patient position for AP Fuchs?
supine
80
What is the SID for AP Fuchs method
40 inches
81
What is the part position for AP Fuchs?
- extend chin until tip is vertical
- midsagittal plane of head perpendicular to IR
82
What is not seen in the AP Fuchs?
the lateral masses- and C1 are not seen because we are only looking at the tip
82
When doing the AP Fuchs what happens to the dens?
It places the dens in the center of foramen magnum
83
How does the centray ray enter for AP Fuchs?
Perpendicular enters patient on MSP just distal to tip of chin
84
What should be equal for the open mouth?
area between lateral masses and dens should be equal
85
When lateral masses and dens are not equal what does that demonstrate?
most likely there is a fracture and make sure you stop what you are doing
86
What is the patient position for AP axial C- spine?
upright or supine
87
What is the part position for AP axial C-spine?
- shoulders in same plane
- MSP aligned with long long axis of IR
- MSP of head perpendicular
- extend chin to place occlusal plane perpendicular to tabletop
- Extend chin until line
from upper occlusal
plane to mastoid tip
in perpendicular MSP
perpendicular
88
How many degrees is the CR directed for AP axial C-spine?
15 to 20 degrees cephalic
88
Where do we center for the AP axial C-spine?
C4
89
What does the AP axial C-spine do?
Opens up intervertebral disks spaces
90
what is the breathing technique for Ap axial C-spine?
suspended breathing (hold your breath)
90
What is the SID for Ap axial C-spine?
40 inches
91
What do you not see in AP axial C-spine?
C1 and C2
91
What do you see in AP axial C-spine?
C3 through C7 so 5 in total
92
What does the Lateral C-spine (Grandy) method demonstrate?
Lateral projection demonstrates zygapophyseal joints of cervical spine
93
What is the patient position for Lateral C-spine (Grandy)?
Upright, seated or standing
94
What is the SID for Lateral C-spine (Grandy) method?
60 to 72 inches
mostly 72 inches
95
What is the breathing technique for Lateral C-spine (Grandy)?
expiration to depress shoulders
96
Where do you center for Lateral C-spine (Grandy)?
C4
97
What is the part position for Lateral C-spine (Grandy)?
-MCP perpendicular to IR
- MSP parallel to IR
-Shoulders in same horizontal plane, relaxed down
- chin elevated and mandible protruded
98
Lateral C-spine (Grandy) is done to see what two joint space?
C7 and T1
99
what should be ruled out befoe attempting Lateral C-spine Hyperflexion and Hyperextension?
Fracture or pathology
100
Used to demonstrate absence of normal movement from trauma or disease?
Lateral C-spine
> Hyperflexion and Hyperextension
100
What is known as vertebra prominens
C7
101
What is the patient position for Lateral C-spine (Hyperextension and Hyperflexion)?
Upright, seated or standing
102
What is the CR for Lateral C-spine (Grandy)?
Horizontal and perpendicular to C4
102
What is the SID for Lateral C-spine Hyperextension/Hyperflexion?
72 inches
103
What is the breathing technique for Lateral C-spine Hyperextension/Hyperflexion?
Suspended breathing
104
Where do we center for Lateral C-spine Hyperflexion/Hyperextension?
C4
105
Why is Lateral C-spine Hyperextension/Hyperflexion done?
done for mobility "how much patient can bend head"
106
For Hyperextension on lateral C-Spine what would you like the patient to do?
Have patient relax head as far back as possible
107
Hyperflexion on lateral C-Spine what would you like the patient to do?
Have patient put chin as close to chest as possible
108
What is shown on lateral C-spine Hyperextension/hyperflexion?
All seven spinous process C1 through C7
109
What is the CR for lateral C-Spine Hyperflexion/hyperextension?
horizontal and perpendicular to C4
110
What does the AP axial Oblique C-Spine show?
Intervertebral foramina on side furtherest from IR is demonstrated
111
Where do we center for AP axial Oblique C-Spine?
C4
111
What is the breathing technique for AP axial Oblique C-Spine?
Suspended respiration
111
What is the SID for AP axial Oblique C-Spine?
60 to 72 inches
112
What is the angle of the CR for AP axial Oblique C-Spine?
15 to 20 degrees cephalic
113
What is the position for AP axial Oblique C-Spine projection?
RPO and LPO
114
How many degrees of Oblique is the AP axial Oblique C-Spine?
45 degrees
115
What is the patient position for AP axial Oblique C-Spine for upright?
Upright seated or standing in 45 degrees posterior Oblique position
116
What is the patient position for AP axial Oblique C-Spine for recumbent?
Recumbent 45 degrees posterior Oblique position
117
Why do we put an angle on for the AP axial Oblique C-spine?
to open up foramen
117
What is the CR for AP axial Oblique C- Spine?
directed to C4 at 15 to 20 degrees cephalic
117
For AP axial Oblique C-Spine what side do you mark?
The side that is down
117
What is the part position for AP axial Oblique C-Spine?
- head and body at 45-degree angle from IR
- C- spine centered to IR
- IR centered to C4
- Chin elevated and protruded
118
What does the PA axial Oblique C-Spine show?
the intervertebral foramina on side that is closer is being demonstrated
119
What is one benefit of doing the PA axial Oblique C-Spine instead of the AP axial Oblique C-Spine?
less OID
119
What is the PA axial Oblique C-Spine positions?
RAO and LAO
120
What is the SID for PA axial Oblique C-Spine?
60 to 72 inches
121
Where do we center for PA axial Oblique C-Spine?
C4
122
How much do we angle the tube for PA axial Oblique C-Spine
C-Spine 15 to 20 degrees caudad
123
Patient position for upright and recumbent for PA axial Oblique C-Spine?
Upright seated, standing or recumbent in 45 degrees anterior oblique position
124
What is the part position for PA axial Oblique C-Spine?
- head and body at 45 degrees angle to IR
- C spine in center of IR
- IR at level of C4
- Chin elevated and protrudad
125
What is the CR for PA axial Oblique C- Spine?
directed to C4 at 15 to 20 degrees caudad
126
the swimmer's technique also shows what junction from just a regular lateral c-spine?
junction of C7 and T1
127
What is the SID for Lateral Cervicothoracic (Swimmer's)?
40 inches
128
What is the patient position for lateral cervicothoracicis the (Swimmer's) for upright?
Upright seated, or standing in true lateral position what
128
When lateral cervicothoracic (swimmer's) is done laying down what method is that?
Pawlow method
129
What is the breathing technique for Lateral Cervicothoracic (Swimmer's)?
shallow breathing
129
What is the part position for lateral cervicothoracic (swimmer's)?
- mcp centered to midline of grid
- extend arm closer to IR above head, and rotate humeral head anteriorly
> if upright , flex elbow, and rest forearm on head
- depress shoulder farther from IR, if possible
- head and body in true lateral position
- C7 to T1 interspace in center
129
When laying down how much should you angle tube for lateral cervicothoracic (swimmer's)
3 to 5 degrees caudad
129
What is the CR for lateral cervicothoracic (swimmer's)?
perpendicular to C7 - T1 interspace if shoulder away from IR is depressed
129
What is the patient position for lateral cervicothoracic (swimmer's) for recumbent?
Recumbent true lateral position with head resting on arm or other firm support
129
When lateral cervicothoracic (swimmer's) is done standing what method is that?
Twinning method
130
If shoulder cannot be depressed for lateral cervicothoracic (swimmer's) what do you do?
angle 3 to 5 degrees caudad
131
