Cervical Spine Flashcards
Why are cervical spine precautions so important
Patients are at a high risk of paralysis, shock, and death
Who can perform manipulation of a patient’s head when they are in c-spine precautions
The attending physician
What are the four projections usually taken in a trauma c-spine
1)AP Axial
2)Odontoid
3)X-Table Lateral
4)Swimmers
What projection is usually done first
X-Table Lateral
When is a swimmers necessary
When the articulation between C7 and T1 is not clearly seen
When a patient arrives in a C spine collar can we assume the paramedics have removed artifacts
No, we still need to look for artifacts
What are some commonly missed artifacts when performing C-spine
Necklaces, earrings, BOBBY PINS, dental retainers
What is the CR for X-table lateral for cervical spine
Perpendicular to IR, at level of C4
What is a method of locating C4 on a patient
Halfway between EAM and Jugular notch
What should you bear in mind when finding the mid coronal plane of a patient in a c-spine collar
The collar adds a lot of space posteriorly and especially anteriorly. Follow the EAM to find the midline
What is the preferred SID for X-table lateral of the cervical spine
180cm
Do we need a grid for X-table lateral of C-spine in a collar
No, the air ga technique compensates for lack of grid
What anatomy needs to be included on a X-table lateral C-spine
Sella turcica to T1(in its entirety). Soft tisue and retropharyngeal tissue as well.
What is anatomy we DO NOT want to include on X-table lateral C-spine
Orbits, Nose, Skull, Shoulder below C7/T1
What are the three “lines” that radiologists will use to evaluate C-spine
1) Anterior contour line
2)Posterior contour line
3)Spinolaminar contour line
What is a Hangman’s Fracture
A hyperextension injury that fractures the anterior arch of C2. Often this also causes subluxation of C2 and C3
What commonly causes Hangman’s Fractures (especially in trauma)
Whiplash. Also from, as the name implies, Hanging injuries
What is a compression fracture of C-spine
A Hyperflexion injury resulting in an anterior compression of a vertebral body. This causes compaction of the bone.
What is a teardrop extension fracture
Hyperextension causing a traingular fragment of the vertebra to be avulsed off the body and leave a “teardrop” fragment
What is the most common site for a teardrop fracture
C2
What is the most common site of a spinous process fracture
C6 or C7
What is the cause of a spinous process fracture
flexion as the body or neck rotates
What is the CR for a swimmers
Perpendicular to IR at C7/T1
What are some indicators that an Odontoid is positioned correctly
Base of the skull is aligned with upper teeth, Symmetrical periodontoid space, Entirety of the C2 lateral masses can be seen, We cn see the transverse processes of C1
If a patient cannot line up their EAM with the occlusal plane what do we do
Angle the tube
What is the Mach Effect
When artifacts or the upper incisors/occipital bone/soft tissue overlay the peg and mimics a fracture
What is a Burst/Jefferson Fracture
A Communited fracture of C1 caused by axial compression
What will you visually see on an odontoid image that may indicate a burst fracture
Unilateral widening of the peg joint space on C1 or C2
What is the Fuchs method
A method to obtain an odontoid image without the patient opening their mouth. Angle the CR cephalad through the Mentum and Mastoid processes towards C1/C2
