Cervical Spine Flashcards
Identify
C1- atlas
C2 - axis + dens
C3 - bifid tip
C4 - Adam’s apple/thryoid cartilage
C5 - bifid tip
C6 - bifid tip
C7 - vertebra prominens - palpable at posterior base of neck
The cervical spine has ___ vertebras and a ___ curve.
The first two cervical vertebra are atypical in that they are structurally modified to join the ___ and the seventh vertebra is slightly modified to join the ___ spine.
The ___, the first cervical vertebra (C1), is a ___-like structure with no body and a very short spinous process. The ___ portion of the ring recieves the dens of the ___.
The ___, the second cervical vertebra (C2), has a strong conical process arising from the upper surface of its body called the dens or ___. It is recieved by the atlantal ring to acts as the ___ or body for the atlas.
The seventh vertebra (C7), termed the ___, is easily ___ at the posterior base of the ___.
The ___ is where the vertebral artery and vein pass through. It has a prominent ___.
C__-C__ are your typical vertebraes. They have ___.
All cervical vertebrae contain three foramina: the ___ and ___ transverse foramina and the ___ foramina.
The ___, is where the spinal cord passes through.
The ___ are what articulate with the vertebraes above it and the ___ articulate with the vertebraes below.
The joint spaces between the SAP of one vertebra and ISP of another vertebra are called the ___ joint.
In between two vertebraes is the ___.
The cervical spine has 7 vertebras and a lordotic curve.
The first two cervical vertebra are atypical in that they are structurally modified to join the skull and the seventh vertebra is slightly modified to join the thoracic spine.
The atlas, the first cervical vertebra (C1), is a ring-like structure with no body and a very short spinous process. The anterior portion of the ring recieves the dens of the axis.
The axis, the second cervical vertebra (C2), has a strong conical process arising from the upper surface of its body called the dens or odontoid process. It is recieved by the atlantal ring to acts as the pivot or body for the atlas (rotation of skull).
The seventh vertebra (C7), termed the vertebra prominens, is easily palpable at the posterior base of the neck.
The transverse foramen is where the vertebral artery and vein pass through. It has a very prominent spinous process.
C3-C6 are your typical vertebraes. They have bifid tips.
All cervical vertebrae contain three foramina: the right and left transverse foramina and the vertebral foramina.
The vertebral foramen, is where spinal cord passes through.
The superior articular processes are what articulate with the vertebraes above it and the inferior articular processes articulate with the vertebraes below.
The joint spaces between the SAP of one vertebra and IAP of another vertebra are called the zygapophyseal joint.
In between two vertebraes is the intervertebral foramina.
What are the routine projections, SID, and kVp of cervical spine films?
Routine Projections =
SID =
kVp =
What are the routine projections, SID, and kVp of cervical spine films?
Routine Projections = AP axial, AP odontoid/open mouth, Lateral
SID = 48” for AP axial and AP odontoid —- 72” lateral
kVp = 80
AP Axial
- Patient is positioned either ___ or ___.
- Extend the chin to prevent superimposition of the ___ on the cervical spine.
- Angle the tube ___° ___
- Direct CR at level of ___ so that the CR will enter at most prominent point of the ___ (Adam’s apple)
- This projection demonstrates the ___ ___(#) cervical vertibrae. The ___ should be equidistant to the ___.
AP Axial
- Patient is positioned either supine or upright.
- Extend the chin to prevent superimposition of the mandible on the cervical spine.
- Angle the tube 15° cephalad
- Direct CR at level of C4 so that the CR will enter at most prominent point of the thyroid cartilage (Adam’s apple)
- This projection demonstrates the lower 5 cervical vertibrae. The spinous processes should be equidistant to the pedicles.
AP Odontoid / Open /Mouth
- The patient is positioned the same way as for the AP axial projection
- Have the patient open the mouth as ___ as possible and adjust the head so that a line from the ___ edge of the ___ to the tip of the ___ is ___ to the IR.
- CR ___ to the mouth
- This projection demonstrates an AP projection of the ___ and ___ through the open mouth
AP Odontoid / Open /Mouth
- The patient is positioned the same way as for the AP axial projection
- Have the patient open the mouth as wide as possible and adjust the head so that a line from the lower edge of the upper incisors to the tip of the mastoid process is perpendicular to the IR.
- CR perpendicular to the mouth
- This projection demonstrates an AP projection of the atlas and axis through the open mouth
AP Lateral
- Place the patient in an upright ___ lateral position before vertical grid.
- A ___ SID is used because of the increased ___ and to ___.
- Adjust the height of the IR so that it remain centered at the level of ___. The ___ edge of the IR will be just above the ___.
- Elevate the ___ and depress the ___ as much as possible.
- Direct CR to midpoint of film.
- Respiration is ___ at the end of full ___ to obtain maximum depression of the ___.
- All ___ cervical vertebrae and part of ___ must be demonstrated on the routine lateral. Otherwise, a separate radiograph of the ___ region is needed.
AP Lateral
- Place the patient in an upright left lateral position before vertical grid.
- A 72” SID is used because of the increased OID and to minimize magnification.
- Adjust the height of the IR so that it remain centered at the level of C4 The upper edge of the IR will be just above the ear.
- Elevate the chin and depress the shoulders as much as possible.
- Direct CR to midpoint of film.
- Respiration is suspended at the end of full expiration to obtain maximum depression of the shoulders.
- All seven cervical vertebrae and part of T1 must be demonstrated on the routine lateral. Otherwise, a separate radiograph of the cervicothoracic region is needed.
Swimmer’s Lateral
- SID =
- kVp =
- Upright = ___ method Recumbent = ___ method
- Place patient in a ___ position, either upright or recumbent
- Extend ___ arm to a vertical postion and depress ___ shoulder to prevent superimposition of the ___ on the vertebrae
- Direct CR with ___° ___ angel at the level of ___-___
- The swimmer’s lateral projection demonstrates the ___ region
Swimmer’s Lateral
- SID = 48”
- kVp = 85
- Upright = twining method Recumbent = pawlow method
- Place patient in a left lateral position, either upright or recumbent
- Extend left arm to a vertical postion and depress right shoulder to prevent superimposition of the humeral heads on the vertebrae
- Direct CR with 5° caudal angel at the level of C7-T1
- The swimmer’s lateral projection demonstrates the cervicothoracic region
Soft Tissue Neck / Upper Airway
Examinations of the upper airway are performed to evaluate the soft tissue of the neck for ___, pathologies of the ___, and ___ infections.
- Routine Projections =
- SID =
- kVp =
AP Axial
- Patient in same position as AP axial, upright with ___ extended
- Angle tube ___° ___
- CR ___ to level of ___
- Expose on ___ to ___ airway
Lateral
- Place patient in upright ___ position before vertical grid as for routine lateral projection.
- CR at level of ___
- Elevate ___ and depress ___ as much as possible
- Expose on ___ to ___ airway
Soft Tissue Neck / Upper Airway
Examinations of the upper airway are performed to evaluate the soft tissue of the neck for foreign bodies, pathologies of the pharynx, and upper airway infections.
- Routine Projections = AP axial and Lateral
- SID = 72”
- kVp = 70
AP Axial
- Patient in same position as AP axial, upright with chin extended
- Angle tube 15° cephalad
- CR perpendicular to level of C4
- Expose on inspiration to fill airway
Lateral
- Place patient in upright left lateral position before vertical grid as for routine lateral projection.
- CR at level of C4
- Elevate chin and depress shoulders as much as possible
- Expose on inspiration to fill airway
Special Request Positions
- SID =
- Can be done AP or PA
- ___ projections of the cervical spine will demonstrate the cervical ___, which are formed for the transmission of the ___ and ___.
For a PA oblique position,
- patient is upright facing vertical grid
- rotate patient’s entire body ___° to position the ___ parallel with IR
- Elevate the patient’s chin to prevent superimposition of the ___ with the ___
- Direct CR with a ___° ___ angle at the level of ___
Both side are always examined for comparison. The ___ must be open and well demonstrated.
The PA oblique position will demonstrate the ___ ___ to the IR (side down is side demonstrated).
Patient position: RAO demonstrates RIGHT ___. LAO demonstrates LEFT ___.
For an AP projection, use a ___° ___ tube angle to demonstrate ___ ___ from the IR (side up is side demonstrated).
Patient position: RPO demonstrates ___ foramina. LPO demonstrates ___ foramina.
Special Request Positions
- SID = 72”
- Can be done AP or PA
- Oblique projections of the cervical spine will demonstrate the cervical intervertebral foramina, which are formed for the transmission of the spinal nerves and blood vessels.
For a PA oblique position,
- patient is upright facing vertical grid
- rotate patient’s entire body 45° to position the intervertebral foramina parallel with IR
- Elevate the patient’s chin to prevent superimposition of the mandible with the spine
- Direct CR with a 15° caudal angle at the level of C4
Both side are always examined for comparison. The intervertebral foramina must be open and well demonstrated.
The PA oblique position will demonstrate the foramina closest to the IR (side down is side demonstrated).
Patient position: RAO demonstrates RIGHT foramina. LAO demonstrates LEFT foramina.
For an AP projection, use a 15° cephalad tube angle to demonstrate foramina farthest from the IR (side up is side demonstrated).
Patient position: RPO demonstrates LEFT foramina. LPO demonstrates RIGHT foramina.
Flexion and Extension Projections
SID =
These views demonstrate the ___ movement or an ___ of movement from trauma or disease.
- Position the patient for a routine ___ cervical projection
- Flexion: Ask the patient to drop head ___ and then draw chin to ___. The ___ of all 7 vertebrae are shown and will be widely ___.
- Extension: Ask the patient to elevate the ___ as much as possible. The ___ will be in ___ approximation.
Flexion and Extension Projections
SID = 72”
These views demonstrate the normal movement or an absence of movement from trauma or disease.
- Position the patient for a routine lateral cervical projection
- Flexion: Ask the patient to drop head forward and then draw chin to chest. The spinous processes of all 7 vertebrae are shown and will be widely separated.
- Extension: Ask the patient to elevate the chin as much as possible. The spinous processes will be in close approximation.
