C-Spine Positioning

Question 1

Lordotic curves - convex anteriorly

Answer 1

C spine, L spine

Question 2

Kyphotic curves - concave anteriorly

Answer 2

T spine, sacral

Question 3

Articular processes, superior and inferior articulate

Answer 3

Zygapophyseal, interarticular facet joints

Question 4

What are the 3 unique characteristics of a typical cervical vertebrae?

Answer 4

1. Bifid spinous process
2. Articular pillar
3. Three foramina

Question 5

How are zygapophyseal joints best demonstrated?

Answer 5

True lateral position

Question 6

How are intervertebral foramen best demonstrated?

Answer 6

45 degree oblique
15 degree

Question 7

The superior and inferior articular processes of cervical vertebrae have fused on either or both sides
Columns of bone that project laterally from the junction of the lamina and pedicle

Answer 7

Articular pillars

Question 8

Hook shaped process, or bony perturbance located on lateral or posterolateral margins of superior endplates of C vertebrae
Most common C3-7

Answer 8

Uncinate processes

Question 9

Vertebra prominens

Answer 9

C7

Question 10

What kv is used for C spine projections?

Answer 10

75-85

Question 11

What kv is used for lateral swimmers?

Answer 11

80-95

Question 12

What projections use an SID of 100 cm?

Answer 12

AP, open mouth, swimmers

Question 13

What projections use a SID of 150-180cm?

Answer 13

Lateral, obliques (increased OID)

Question 14

What AEC cell is used for all projections except AP open mouth?

Answer 14

Center

AP open mouth, none

Question 15

What are the essential projections for C spine?

Answer 15

-AP axial
-AP open mouth
-Lateral
-Oblique
PA (RAO, LAO)
AP (RPO, LPO)

Question 16

1 inch distal to EAM

Answer 16

C1

Question 18

-best demonstrates zyga joints
-MCP perpendicular to IR
-center C4
-shoulders relaxed, chin elevated, mandible protruded

Answer 18

Lateral C spine

Question 19

This projection is needed when C7 and top of T1 is not well demonstrated on lateral C spine

Answer 19

Lateral cervicothoracic (swimmers)

Question 20

What should the collimated field for lat. C spine include?

Answer 20

Include 1 inch above EAM to top of T1 body

*if top 1/3 of T1 is not demonstrated, lateral of cervicothoracic is required

Question 20

-true lateral
-separate shoulders (lift arm)
-CR to T1, 1 inch above jugular notch
-shoulder further from IR depressed
-C7-T1 interspace centered

Answer 20

Lateral cervicothoracic (swimmers)

Question 21

If the shoulder can not be depressed for a lateral cervicothoracic (swimmers), what angulation can be used?

Answer 21

3-5 degree caudad

Question 22

-intervertebral foramina on side closer to IR is demonstrated
-15 degree caudad

Answer 22

PA oblique (LAO, RAO)
*down, down, down

Question 23

-intervertebral foramina on side farther from IR is demonstrated
-15 degree cephalic

Answer 23

AP oblique (LPO, RPO)
*up, up, up

Question 24

T/F
In an xray image, there is no way to tell if the oblique C spine was done AP OR PA

Answer 24

True

Question 25

Why are both obliques taken?

Answer 25

To compare sides

Question 26

What position is the patient in for a PA oblique projection?

Answer 26

Anterior oblique position

Question 27

-head and body at 45 degree angle to IR -c spine in center of IR -IR at level C4 -chin elevated and protruded

Answer 27

Oblique

Question 28

T/F The head can be rotated at 45 or 90 degrees for an oblique projection

Answer 28

True

Question 29

-MCP parallel to IR -C4 centered -MSP of head perpendicular -extend chin and place occlusal plane perpendicular to tabletop

Answer 29

AP axial c spine

Question 30

What angulation is used for an AP axial?

Answer 30

15-20 degrees cephalic -15 for supine -20 for upright

Question 31

Why is a larger angle (20) used for upright compared to supine AP axial?

Answer 31

More lordosis when upright

Question 32

What does the collimated files present for an AP axial c spine?

Answer 32

C3-T2 and surrounding soft tissue

Question 33

-align edge of upper incisors and base of skull (mastoid tips) perpendicular to IR -mouth open as wide as possible -CR enters at midpoint of open mouth

Answer 33

AP C1-2 open mouth *collimated field includes upper incisors to tip of chin C1-2 in center of field

Question 34

T/F The upper incisors and base of skull should be superimposed for open mouth projection

Answer 34

True