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Positioning Spring 2015 > C Spine And T Spine > Flashcards

C Spine And T Spine Flashcards

0
Q

Total bones in vertebral column

A

Children 33

Adult 26

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1
Q

What are the 5 divisions of the vertebral column

A 
Cervical vertebrae 
Thoracic vertebrae 
Lumbar vertebrae 
Sacrum 
Coccyx
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2
Q

When stacked what forms the spinal canal

A

The vertebral foramina

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3
Q

Spinal canal

A

Begins at the base of the skull and extends to the sacrum

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4
Q

What does the spinal canal contain

A

Contains spinal cord and is filled with cerebrospinal fluid

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5
Q

Spinal chord

A

Enclosed and protected by the spinal canal

Begins with medulla oblongata

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6
Q

The spinal chord passes through what

A

The foramen magnum of the 1st cervical vertebra and ends at the lower level of L-1

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7
Q

Where does the spinal chord terminate

A

The conus medullaris

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8
Q

In some people the conus medullaris may extend to as low as

A

The body of L-2

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9
Q

To avoid striking the spinal chord what is a common site for lumbar puncture

A

L-3 L-4

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10
Q

Intervertebral disks

A

Fibrocartilage disks that separate adult vertebrae

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11
Q

Where are there no intervertebral disks?

A

C1 and C 2

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12
Q

Function of intervertebral disks

A

Act as a cushion

Allow for flexibility and movement of vertebral column

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14
Q

The intervertebral disks account for how much length of the vertebral column

A

One quarter the length

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15
Q

what is the inner portion of the intervertebral disks

A

nucleus pulposus

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16
Q

what is the outer portion of the intervertebral disks

A

annulus fibrosus

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17
Q

nucleus pulposus

A

central core of disk

pulpy and gelatinous

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18
Q

annulus fibrosis

A

fibrocartilage disk
surrounds nucleus pulposus
keeps nucleus material in the center

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19
Q

herniated nucleus pulposus (HNP)

A

when the nucleus pulposus ruptures and protrudes into the vertebral canal and impinges on a spinal nerve
AKA slipped disk

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20
Q

where does an HNP most commonly occur?

A

the lumbar region

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21
Q

cervical vertebrae

A

the most superior 7 vertebrae

occupy the region of the neck

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22
Q

thoracic vertebrae (dorsal)

A

next 12 bones after the cervical spine
forms the midback region
articulates with the ribs

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23
Q

lumbar vertebrae

A

next 5 vertebrae after the thoracic
form the lower back
largest and strongest vertebrae
the load of the body weight increases toward the inferior end of the column which are common sites of injury

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24
Q

sacrum

A

the 5th lumbar vertebrae articulates with the sacrum

articulates with the coccyx inferiorly

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25
Q

coccyx

A

the sacrum and coccyx develop as multiple separate bones and fuse into two distinct bones

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26
Q

vertebral curvatures

A

when viewed from the side the vertebral column has 4 curves

they are either concave or convex

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27
Q

concave curve

A

a rounded inward or depressed surface

like a cave

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28
Q

convex curve

A

rounded outward or elevated surface

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29
Q

cervical and lumbar regions have what curvatures

A

concave curvatures

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30
Q

thoracic and sacral regions have what curvatures

A

convex curvatures

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31
Q

primary curves

A

soon after birth the thoracic and sacral curves begin to develop
they’re called primary curves

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32
Q

secondary/compensatory curves

A

cervical and lumbar curves because they develop after birth

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33
Q

when does the cervical curve develop

A

when the child begins to hold the head up at about 3-4 months

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34
Q

when does the lumbar curve develop

A

when the child begins to walk

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35
Q

what is the purpose of the vertebral curvatures

A

increase strength of vertebral column

maintain balance in upright position

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36
Q

which curves are usually more pronounced in women

A

lumbar and sacral curves

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37
Q

3 abnormal distortions of the normal spinal curvature

A
  1. lordosis
  2. kyphosis
  3. scoliosis
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38
Q

lordosis

A

bent backward “swayback”
any abnormal increase in the posterior concavity of the lumbar or cervical region
also can be a normal concavity

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39
Q

what can lordosis be caused by

A

pregnancy, obesity, poor posture, rickets, or tuberculosis of the spine

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40
Q

kyphosis

A

humpback
any abnormal increase in the posterior convexity of the thoracic curve
results in stooped posture/ reduced height

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41
Q

what can kyphosis be caused by

A

compression fractures, poor posture, rickets, or other spinal diseases

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42
Q

in the frontal view the vertebral column is

A

near straight with a little lateral curvature

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43
Q

True or false:

a slight lateral curvature is sometimes present in the upper thoracic region

A

TRUE

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44
Q

True or False:

the slight lateral curve is to the right in right handed pts. and to the left in left handed pts.

A

TRUE

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45
Q

scoliosis

A

any abnormal curvature of the spine

occurs when a pronounced S-shaped lateral curve exists

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46
Q

true or false:
the vertebral column develops a second or compensatory curve in the opposite direction to keep the head centered over the feet

A

TRUE

47
Q

a typical vertebrae is composed of what 2 main parts

A
  1. body

2. vertebral arch

48
Q
  1. body
A

thick, weight bearing anterior portion of the vertebra

cylindrical in shape

49
Q
  1. vertebral arch (neural arch)
A

consists of a ring or arch of bone extending posteriorly from the vertebral body

50
Q

vertebral foramen

A

where the body and the arch enclose a space

51
Q

true or false:
when the vertebrae are stacked on one another, the vertebral foramina form the vertebral canal that encloses the spinal cord

A

TRUE

52
Q

pedicle

A

extends posteriorly from the vertebral body
little feet
form the sides of the vertebral arch

53
Q

true or false:

the superior and inferior borders of the pedicles are concave

A

True

54
Q

the concave border of the upper surface of the pedicle is called?

A

superior vertebral notch

55
Q

the concave border of the lower surface of the pedicle is called?

A

inferior vertebral notch

56
Q

when the vertebrae are stacked, the inferior and superior vertebral notch line up and form the?

A

intervertebral foramina

57
Q

what runs through the intervertebral foramina

A

spinal nerves and blood vessels

58
Q

lamina

A

posterior part of vertebral arch

extend posteriorly from the pedicle to form the spinous process

59
Q

transverse process

A

project laterally from the pedicles

between lamina and pedicles

60
Q

spinous process

A

extends posteriorly from the midline

serve as points of attachment for muscles

61
Q

spina bifida

A

a congenital defect of the vertebral column when the lamina fail to unite posteriorly at the mid line

62
Q

superior and inferior articular processes

A

4 processes that arise from the junction of the pedicles and lamina to articulate with the vertebra above and below

63
Q

the articular surfaces are covered with fibrocartilage and are called

A

facets

64
Q

each superior articular process has a facet on its

A

posterior surface

65
Q

each inferior articular process has a facet on its

A

anterior surface

66
Q

zygopophyseal joints

A

the articulation of the superior articular process of one vertebra to the inferior articular process of the vertebra above

67
Q

3 joints of the vertebral column

A
  1. intervertebral joints
  2. zygopophyseal joints
  3. costal joints
68
Q

True or False

without the costal joints respiration could NOT occur

A

TRUE

69
Q
  1. intervertebral joints
A

slightly movable
between the vertebral bodies
intervertebral disks are located in these joints

70
Q
  1. costal joints
A

located in the thoracic region

articulate with the rib and the vertebra

71
Q

costovertebral joints

A

head of the rib articulates with the body of the vertebra

72
Q

costotransverse joints

A

tubercle of the rib articulates with the transverse process of the vertebra

73
Q

Atypical cervical vertebrae

A

first 2 vertebrae and the seventh vertebrae
C1 and C2 are modified to join the skull
C7 long spinous process to join the thoracic vertebrae

74
Q

typical cervical vertebrae

A

C3-C6
contain:
transverse foramina, bifid spionous process tips, overlapping vertebral bodies, 3 foramina

75
Q

transverse foramen in cervical vertebrae

A

the hole in each transverse process

vertebral artery veins and certain nerves pass through here

76
Q

pillar

A

between the superior and inferior articular process is a short column of bone

77
Q

in C1 what is the pillar called

A

lateral mass

78
Q

the superior articular process of C1 contains a facet that articulates with what

A

the occipital condyles of the skull

79
Q

atlantoocipital articulation

A

the articulation between the atlas and the occipital bone

80
Q

Jefferson fracture

A

comminuted fracture that occurs as a result of axial loading AKA landing on ones head or abruptly on ones feet
the skull slams into the ring and the anterior and posterior arches of C1 are fractured

81
Q

true or false

thoracic vertebra have facets and demifacets on them for the ribs

A

TRUE

82
Q

what is the level of the mastoid tip

A

C1

83
Q

what is the level of the gonion

A

C3

84
Q

what is the level of the thyroid cartilage

A

C4-C6

85
Q

what is the level of the vertebra prominens

A

C7 or the body of T1

86
Q

whats the level of the jugular notch

A

T2 T3

87
Q

what is the level of the sternal angle

A

T4 T5

88
Q

cervical spine routine projections

A

AP open mouth
AP axial
Obliques
Lateral

89
Q

cervical spine special projections

A 
cervicothoracic lateral, twining method, swimmers 
lateral hyperflexion hyperextension
AP fuchs
PA judd 
AP wagging jaw (ottonello method)
AP axial (pillar)
90
Q

Thoracic spine routine projections

A

AP

Lateral

91
Q

Thoracic spine special projection

A

obliques

92
Q

CERVICAL SPINE

AP open mouth shows

A

fractures involving C1 and C2

demonstrates jefferson fractures

93
Q

CERVICAL SPINE

AP open mouth SID/Central ray

A

SID = 40
8x10 IR
CR is perpendicular to the IR directed through the center of the open mouth
line from lower margin of upper incisors to mastoid tip is perpendicular to IR
taken on expiration

94
Q

If the dens cannot be seen on the AP open mouth then what do you do

A

do the fuchs or the judd method

95
Q

CERVICAL SPINE

AP axial shows

A

pathology involving C3-C7

shows clay shoveler’s fracture, compression fracture and HNP

96
Q

Clay shoveler’s fracture

A

results from hyperextension of neck and causes avulsion fracture of spinous process of C6-T1

97
Q

compression fracture

A

associated with osteoporosis

collapse of a vertebral body

98
Q

CERVICAL SPINE

AP axial SID/central ray

A 
SID = 40
8x10 ir
same alignment as AP open mouth 
CR centered at level of thyroid (C4-C5)
angle 15 degrees cephalad when supine
angle 20 degrees caudad when upright 
suspend breathing
99
Q

CERVICAL SPINE

obliques show

A

intervertebral foramina

100
Q

CERVICAL SPINE

obliques SID/central ray

A 
SID = 40-72 72 preferred 
8x10 or 10x12  
45 degree obliquity 
elevate chin 
CR 15 degrees caudad at C4 for RAO/LAO
CR 15 degrees cephalad at C4 for RPO/LPO
suspend breathing
101
Q

CERVICAL SPINE
obliques
Anterior oblique positions/PA oblique projections show

A 
downside 
RAO (right), LAO (left)  
intervertebral foramina
102
Q

CERVICAL SPINE
obliques
posterior oblique positions/AP oblique projections show

A

upside
RPO (left) LPO (right)
intervertebral foramina

103
Q

CERVICAL SPINE

lateral shows

A 
spondylosis and osteoarthritis 
C1-C7/T1
SID = 60-72
8x10 or 10x12 
CR perpendicular directed to C4
suspend on full expiration 
shows the zygopophyseal joints
104
Q

if C7/T1 is NOT shown on a lateral C-spine you must perform what

A

a swimmer’s lateral

105
Q

hangman’s fracture

A

occurs when neck is subjected to extreme hyperextension

very unstable fracture due to the dens pressing against the brain stem

106
Q

odontoid fracture

A

involves the dens and can extend into the lateral masses or arches of C1

107
Q

teardrop burst fracture

A

due to compression with hyperflexion
vertebral body comminuted with triangular fragments posterior body displaced into spinal canal
quadriplegia is a high probability

108
Q

subluxation

A

vertebral body appears to have jumped over the vertebral body immediately inferior to it

109
Q

CERVICAL SPINE
swimmer’s lateral cervicothoracic shows
(twining method)

A

SID 60-72
10x12
arm and shoulder closes to IR is elevated and rotated anteriorly
CR perpendicular to IR centered 1 inch above jugular notch
a slight caudad angle (3-5 degrees) may be necessary to help separate shoulders
suspend on expiration or use breathing technique

110
Q

CERVICAL SPINE

hyperflexion/hyperextension

A

demonstrates vertebral mobility
frequently performed to rule out whiplash injury or to follow up after spinal fusion
same positioning as lateral c spine but one pic with chin depressed one with chin pushed back

111
Q

CERVICAL SPINE

fuchs (AP) or Judd (PA)

A

Done only if you did NOT get the dens on the AP open mouth
MML needs to be perpendicular to table
adjust CR angle so it is parallel to MML
suspend breathing

112
Q

CERVICAL SPINE

ottonello method

A

mandibular shadow is blurred so you can see the C spine in its entirety

113
Q

CERVICAL SPINE

AP axial Pillars

A 
shows pillars of C4-C7
SID = 40 
supine hyperextend pts. neck 
CR angled 20-30 degrees CAUDAD to enter through C5
suspend breathing

Positioning Spring 2015 (6 decks)

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