Cervical Lines of Mensuration (Exam 1)

Question 1

What should you look at in every lateral film?

Answer 1

ADI space

Question 2

What are the other names for atlantodental interspace (ADI space)?

Answer 2

-atlas odontoid space
-predental interspace
-atlas dens interval

Question 3

Which line assessments use lateral neutral, flexion-extension c-spine view?

Answer 3

1) ADI space
2) stress lines of the cervical spine/ Ruth Jackson’s lines
3) prevertebral soft tissues

Question 4

What are the landmarks for checking ADI space?

Answer 4

distance is measured between the posterior margin of anterior tubercle and the anterior surface of the odontoid

Question 5

What is the normal measurement range for ADI space for adults and children?

Exam 1 fill in blank q

Answer 5

shape of the interspace will change to a V in flexion and to an inverted V in extension

adults= 1-3mm

children 1-5mm

Question 6

What is the best view to see ADI space?

Answer 6

flexion because it stresses the transverse ligament of the atlas

Question 7

What is a decreased ADI associated with?

Answer 7

increasing age or DDD

Question 8

What is an increased ADI associated with?

Answer 8

decreased neural canal size due to trauma, occipitalization, down syndrome, pharyngeal infections, inflammatory arthopathies, AS, RA, psoriatic arthritis, reiter’s

Question 9

What condition is associated with increased ADI and decreased acetabular angle?

Answer 9

down syndrome

Question 10

What is the procedure for method of bull analysis?

Answer 10

-2 lines are drawn
-1st line is drawn from the posterior aspect of the hard palate to the opisthion (Chamberlain’s line)
-2nd line is drawn through the midpoints of the anterior and posterior tubercles of the atlas (atlas plane line (APL)
-the angle formed posteriorly is then measured

Question 11

Which line is drawn through the midpoints of the anterior and posterior tubercles of the atlas?

Answer 11

atlas plane line (APL)

Question 12

What is the normal measurement for method of bull assessment?

Answer 12

-posterior angle formed should be 13 degrees
-accuracy is affected in patients with neck pain due to muscle spasm

Question 13

What does it mean if method of bull angle is greater than 13 degrees?

Answer 13

odontoid is tilted posteriorly because of congenital malformations of fracture displacement

Question 14

What are the other names for George’s line?

Answer 14

posterior vertebral alignment line or posterior body line (PBL)

Question 15

What is the procedure for George’s line assessment?

Answer 15

posterior vertebral body surfaces are connected with a continuous line that traverses the IVD

note: flexion/extension lateral cervical views are useful in determining disruptions in George’s line

Question 16

What is the normal measurement for George’s line assessment?

Answer 16

smooth vertical alignment of posterior body corners

Question 17

What does it mean if there isn’t a smooth vertical alignment of posterior body corners on George’s line assessment?

Answer 17

anterolisthesis or retrolisthesis due to fracture, dislocation, ligamentous laxity, or DDD

Question 18

What is the procedure for cervical gravity line assessment?

Answer 18

a true vertical line is drawn through the apex of the odontoid process (dens)

Question 19

What is the normal measurement for cervical gravity line assessment?

Answer 19

line should pass through the body of C7

Question 20

What is the purpose of a cervical gravity line assessment?

Answer 20

assess where gravitational stresses are acting at the cervicothoracic junction

Question 21

What are the other names for cervical lordosis line assessment?

Answer 21

-angle of the cervical curve
-cervical lordotic angle

Question 22

What is the procedure for cervical lordosis line assessment?

Answer 22

-line through and parallel to the endplate of C7
-line through the midpoints of the anterior and posterior tubercles of C1 (atlas plane line)
-perpendiculars are dropped until they intersect (perpendicular to the cervical spine)
-resultant acute angle is measured

Question 23

What is the normal measurement for cervical lordosis?

Test 1 q

Answer 23

40 degrees

Question 24

What does it mean if someone has <40 degree curve?

Answer 24

hypolordosis

Question 25

What does it mean if someone has >40 degree curve?

Answer 25

hyperlordosis

Question 26

What is the other name for stress lines of the cervical spine?

test q

Answer 26

Ruth Jackson’s lines

Question 27

What is the procedure for stress lines of the cervical spine?

Test 1 q

Answer 27

-line from posterior surface of axis
-line along posterior surface of C7 until it intersects the axis line
-both lines intersect (posterior to cervical spine)

Question 28

What is the normal measurement for stress lines of the cervical spine?

Answer 28

-neutral lateral and extension: lines should intersect at the C4/C5 disc or facet joint
-flexion: lines should intersect at the C5/C6 disc or facet joint

(Intersection point represents the focus of stress when the cervical spine is placed in the respective positions. Muscle spasms, joint fixation, and DDD may alter the stress point)

Question 29

What are the 3 prevertebral soft tissues?

Answer 29

1) retropharyngeal interspace (RPI)
2) retrolaryngeal interspace (RLI)
3) retrotracheal interspace (RTI)

Question 30

What are the bony landmarks for prevertebral soft tissues?

Answer 30

-anterior arch of atlas
-the inferior corners of the axis and C3
-the superior aspect of C4
-inferior corners of C5-C7

Question 31

What soft tissue space is found from C2-C3?

Answer 31

retropharyngeal interspace

Question 32

What soft tissue space is found from C4-C5?

Answer 32

retrolaryngeal interspace

Question 33

What soft tissue space is found from C5-C7?

Answer 33

retrotracheal interspace