C-Spine Worksheet Flashcards
AP AXIAL CERVICAL VERTEBRA PROJECTION
The ___________ are aligned with the midline of the cervical bodies, the mandibular angles and mastoid tips are at equal distances from the cervical vertebrae, the articular pillars and pedicles are symmetrically visualized __________ to the cervical bodies and the distance from the vertebral column to the medial clavicular ends are equal.
spinous processes
lateral
The intervetebral disk spaces are open, the vertebral bodies are demonstrated without distortion, and each vertebras spinous process is visualized at the level of its __________ intervetebral disk space.
inferior
The third cervical vertebra is demonstrated in its entirety and the occipital base and mandibular mentum are ___________ .
superimposed
When the patient and cervical vertebrae are rotated away from the AP projection, the vertebral bodies will move toward the side positioned ____________ (closer/farther from) the IR, and the spinous processes will move towards the side positioned ____________ (closer/ farther from) the IR.
closer
farther
Will rotation on an AP cervical projection with poor positioning always be demonstrated throughout the entire cervical column?
Explain.
No.
If the head of is rotated but the thorax is in an AP the upper vertebra will be rotated and the lower will be in AP and vice versa.
A patient wearing a collar and on a backboard is taken to the radiography department for a cervical vertebrae series. Should the collar be removed before the radiographs are taken?
The patients head is rotated. Should it be adjusted?
No.
No.
If the CR angulation is not adequately angled for an AP cervical projection, the interverrtebral disk spaces are _____________ and each vertebras spinous process is demonstrated within ___________.
closed
the vertebral bodies
Where is each vertebras spinous process demonstrated if the CR angulation is too cephalad?
within the inferior adjoining vertebral body
Which anatomic structures are demonstrated on an AP cervical projection with accurate positioning?
C2-T1 and soft tissues
AP CERVICAL ATLAS AND AXIS PROJECTION
Atlas is symmetrically seated on the _________ , with the atlas’s lateral masses at equal distances from the _________________.
axis
dens
The spinous processes of the axis are aligned with the midline of the __________ body, and the mandibular rami are visualized at equal distances from the ___________
axis
lateral masses
The upper incisors and the occipital base are seen __________ to the dens and the atlantoaxial joint.
superior
The atlantoaxial joint is ____________
Open
How is the patient positioned to obtain an AP projection of the atlas and axis without rotation?
supine/upright
shoulders equidistant from the IR
align midcoronal plane
face forward
mandibular angles and mastoid tips equal distance from the IR
How is the patient positioned for an AP projection of the atlas and axis to demonstrate the upper incisor and occipital base superior to the dens and atlantoaxial joint?
chin is tucked until incisors and tip of mastoid perpendicular to the IR and mouth opened wide
Describe how to determine the CR angulation to use for an AP atlas and axis projection on a trauma patient in a collar.
IOML aligned with CR, drop the patient lower jaw and then align the CR to incisors
How can one determine from a trauma AP atlas or axis projection that the CR angulation was too cephalic for the projection?
That the CR was too caudal for the projection?
the incisors demonstrated superiorly to the dens and superimposed over the occipital bone
the occipital base is demonstrated superior to the dens and incisors are over the dens
Situation:
The distances from the atlas’s lateral masses to the dens and from the mandibular rami to the dens are narrower on the right side of the patient than on the left side, and the axis’s spinous process is shifted from the midline.
the patients head was rotated to the left
Situation:
The upper incisors are demonstrated approximately 1 inch inferior to the occipital base, obscuring the dens and atlantoaxial joint, and the occipital base is demonstrated directly superior to the dens.
the CR needed to be angled 5 degrees cephalad but wasn’t
The upper incisors are superimposed over the dens, and the occipital base is demonstrated superior to the dens and upper incisors. A 5 degree cephalic angulation was used to obtain this projection.
Patient:
CR:
Patient: head not elevated enough
CR: needs more angle
The dens is superimposed over the occiput and the upper incisors are demonstrated approximately 2 inches superior to the occiputal base.
Patient:
CR:
Patient: the patients chin was elevated
CR: needs angle
LATERAL CERVICAL VERTEBRA PROJECTION
Contrast resolution is adequate to visualize the ____________ fat stripe.
prevertebral
The anterior and posterior aspects of the right and left articular pillars and the rigt and left zygapophyseal joints of each cervical vertebra are ____________ and the spinous processes are in _______________.
superimposed
profile
The posterior arch of C1 and spinous process of C2 are in profile without _____________ obstruction, their bodies are seen without mandibular superimposition, the mandibular rami are _____________ the superior and inferior aspects of the right and left articular pillars and the _______________ of each cervical vertebra are superimposed, and the intervetebral disk spaces are open.
occipital base
superimposed
zygopophyseal joints
How can rotation be identified on a lateral cervical projection with poor positioning?
by evaluating each vertebra for anterior and posterior pillar superimposition and zygo joint superimposition
Why are lateral flexion and extension projections for the cervical vertebra obtained?
to determine vertebral mobility
How is patient positioning adjusted from a neutral lateral position of the cervical vertbera to acheive a flexed lateral projection?
lean head forward/tuck the chin
PA/AP AXIAL OBLIQUE CERVICAL VERTEBRA PROJECTION
The second through ______________ intervetebral foramina are open, demonstrating uniform size and shape, the pedicles of interest are shown in _______________ and the opposite pedicles are aligned with the ____________ veterbral bodies.
seventh
profile
anterior
The intervetebral disk spaces are open, the cervical bodies are seen as individual structures and are uniform in shape, and the posterior arch of the atlas is seen without foreshortening, demonstrating the _________________
vertebral foramen
For the following oblique projections, state whether the right or left intervetebral foramina will be demonstrated.
Right PA axial oblique (RAO) __________________
Left AP axial oblique (LPO) ___________________
Left PA axial oblique (LAO) _________________
Right AP axial oblique (RPO) ________________
Right
RIght
Left
Left
What degree and direction of CR angulation are used for PA axial oblique cervical projections?
For AP axial oblique projections?
Why is it necessary to use an angle for oblique cervical projections?
15-20 degrees caudally
15-20 degrees cephallically
the cervical spine is curved so when you add an angle it opens the disk spaces and the foramina so they are visible on the radiograph
