Cervical Spine Flashcards
For radiation protection, what are some precautions?
- Pregnancy checks
- Observe ALARA
- Minimise repeats
- Recognise thyroid is radiosensitive
What is the name of the collar used for cervical injuries?
Philadephia collar
A patient suffers from a cervical injury, how are you going to approach this patient for an x-ray?
Never remove collar/move neck without clearance by med team, check if patient has tucked their chin into collar - encourage them to not to do so and stay still, consider table/beam angulation for their positions
Why do some patients tuck their chins into their neck brace?
Comfort or freedom to do so - not able to flex or extend their necks
For an AP cervical spine, what are the surface anatomical positions?
Sternal notch (inferior point) ; centring at the C4 (inf margin of thyroid cartilage)
What are the surface anatomical landmarks for lateral cervical x-ray?
Ext auditory meatus, vertebra prominens, and mental symphysis
MML = meatomental line
Why do Philadephia collars open on the left side?
To palpate soft tissue structures near the collar - such as occipital projections
What is the neurological loss?
Suspicision of nerve damage - obliques because they show the structures of vertebral & cervical foramina to maximally display any neurological impingement
What are the structural pathologies associated with the spine?
Kyphosis - exag. thoracic
Lordosis - exag. lumbar
Scoliosis - abnormal curvature
What are the main regions of the spine?
Three regions- cervical, thoracic, lumbar
What are the 3 points of vertebral articulations
Intervertebral discs (soft tissue gel cushion); & 2 facet joints = zygapophyseal joints
What is the kVp & mAs for Lateral cervical?
75 kVp and 14mAs
What is the FFD & centring ray for lateral
180cm & level of thyroid cartilage at the level of c4, mid of soft tissues
What are the instructions of the lateral cervical spine?
“Relax the shoulders, as if you are touching your toes” & suspended expiration - helps lower shoulders
supine/erect - raise chin gently
What are the criteria points for lateral
base of skull - T1 seen in entirety
no rotation
rami of mandible - not over C1/C2
Side marker in place if required by department
What is the FDD, kVp & mAs for AP Axial?
75kVp, & 10mAs & 100cm FFD
What is the centring for AP axial?
15 degrees cephalad on the thyroid cartilage, mid sagittal plane
“stay still”
What are the criteria points for Ap Axial?
C3-T1 seen
no rotation
intervertebral disc spaces open
base of skull superimposes C1 & C2
What is the FDD, kVp & mAs for the PEG/AP Open Mouth?
75kVp, 16mAs, 100cm
What is the centring for AP open mouth
Middle of open mouth
instruction: “drop your jaw”
What do not say for AP Open mouth
Do not say open the mouth as wide as you can, but rather drop your jaw
What is the criteria for the Peg Proj?
C1, C2, zygopophyseal joints of both seen; upper incisors & base of skull superimposed, no rotation, C1-C2 windowed
What is the FDD, kVp & mAs for the Oblique cervical spine?
100cm, 75kVp, 14mAs
What is the centring of the posterior oblique? Anterior oblique
CR: level of thyroid cartilage, mid soft tissues
15 deg cephalad (post); 15 caudad (ant)
