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Cervical - Thoracic Flashcards

1
Q

OML 15deg from Horizontal

A
  1. AP Axial Cervical Vertebrae
    2.
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2
Q

RP: C4

A
  1. AP Axial Cervical Vertebrae
  2. Lateral Cervical Vertebrae (Grandy Method)
  3. Lateral Cervical Vertebrae (Hyperflexion and Hyperextension)
  4. AP Oblique Cervical Intervertebral Foramina (Hyperflexion and Hyperextension- Boylston Method)
  5. AP Cervical Vertebrae (Ottonello Method)
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3
Q

CR 15-20deg cranial - 36-40” - MSP - level - C4

A

AP Axial Cervical Vertebrae

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4
Q

Demo lower 5 cervical bodies (C3-C7) and upper 2-3 thoracic vertebraes

A

AP Axial Cervical Vertebrae

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5
Q

To show presence/ absence of cervical ribs

A

AP Axial Cervical Vertebrae

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6
Q

Pt -pull rung if stool if seated

A

AP Axial Cervical Vertebrae

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7
Q

Shoulders rotated according to natural kyphosis of the back

A

Lateral Cervical Vertebrae (Grandy Method)

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8
Q

CR (H) - 60-70” - CP of neck passing through mastoid tips - level - C4

A
  1. Lateral Cervical Vertebrae (Grandy Method)
  2. Lateral Cervical Vertebrae (Hyperflexion and Hyperextension)
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9
Q

Demo lat view of cervical bodies (C1-C7), spinous process, 5 zygapophyseal jts (C3-C7), and interspaces

A

Lateral Cervical Vertebrae (Grandy Method)

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10
Q

Conventional respiration in suspended expiration to
obtain maximum depression of shoulders.

A

Lateral Cervical Vertebrae (Grandy Method)

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11
Q

Demonstrates motility of cervical spine, including intervertebral disks and zygapophyseal joints

A

Lateral Cervical Vertebrae (Hyperflexion and Hyperextension)

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12
Q

Shows anteroposterior movement

A

Lateral Cervical Vertebrae (Hyperflexion and Hyperextension)

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13
Q

Oblique projections for demonstrating the cervical intervertebral foramina were first described by (1) and (2). Both sides are exami ned for comparison.

A
  1. Barsony
  2. Koppenstein
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14
Q

Body and head adjusted 45° from cassette

A
  1. AP Axial Oblique Cervical Intervertebral Foramina
  2. PA Axial Oblique Cervical Intervertebral Foramina
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15
Q

Establish 1” above the prominent point of TC to coincide with MP of cassette (to compensate for cephalic angulation).

A
  1. AP Axial Oblique Cervical Intervertebral Foramina
  2. PA Axial Oblique Cervical Intervertebral Foramina
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16
Q

 Avoid head/chin rotation to prevent superior vertebrae rotation
 Chin is protruded to prevent superimposition with the spine

A
  1. AP Axial Oblique Cervical Intervertebral Foramina
  2. PA Axial Oblique Cervical Intervertebral Foramina
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17
Q

 15°-20° Cranial (36”-40”)
 Coronal plane passing through the mastoid tips - level of C4

A

AP Axial Oblique Cervical Intervertebral Foramina

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18
Q

Demo intervertebral foramina and pedicles farthest from the IR, including an oblique image of cervical vertebrae

A

AP Axial Oblique Cervical Intervertebral Foramina

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19
Q

Functional studies of cervical vertebrae

A

APO

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20
Q

Head rotated maximally to one side, then neck flexed for first exposure and extended for second exposure

A

AP Oblique Cervical Intervertebral Foramina (Hyperflexion and Hyperextension- Boylston Method)

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21
Q

Demo fractures of articular processes/facets and obscure
dislocations/subluxations

Nb. Performed by a physician

A

AP Oblique Cervical Intervertebral Foramina (Hyperflexion and Hyperextension- Boylston Method)

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22
Q

Demo the intervertebral foramina and pedicles closest from the IR, including an oblique image of cervical vertebrae

A

PA Axial Oblique Cervical Intervertebral Foramina

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23
Q

 15°-20° Caudal (36”-40”)
 Coronal plane passing through the mastoid tips - level of C4

A

PA Axial Oblique Cervical Intervertebral Foramina

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24
Q

Patient to open/close mouth without striking teeth together (to blur the mandible)

A

AP Cervical Vertebrae (Ottonello Method)

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25
Chin is raised to place the occlusal surface of upper incisors and mastoid tips in vertical position.
AP Cervical Vertebrae (Ottonello Method)
26
Demonstrates entire frontal view of cervical vertebrae with obliterated mandibular shadow.
AP Cervical Vertebrae (Ottonello Method)
27
Albers-Schonberg 1910 / George 1919
AP Atlas and Axis (Open Mouth)
28
Occlusal Plane (Lower Edge of Upper Incisor and Mastoid Tip) perpendicular to RT
AP Atlas and Axis (Open Mouth)
29
Patient to keep mouth open and phonate "AH" during exposure to affix tongue to the floor of the mouth (prevents tongue superimposition with Atlas and Axis and movement of the mandible)
AP Atlas and Axis (Open Mouth)
30
Demonstrate Atlas and Axis within the open mouth
AP Atlas and Axis (Open Mouth)
31
AP Atlas and Axis (Open Mouth) If pt can't open the mouth, this is done
Tomography
32
Support placed under the head to place RP to coincide with MP - Cassette
Lateral (Cross-Table Lat) Atlas and Axis
33
RP: Establish 1" distal to the tip of the mastoid process (Atlantoaxial Articulation)
Lateral (Cross-Table Lat) Atlas and Axis
34
Demonstrate lateral view of Atlas and Axis, Atlantoaxial Articulation
Lateral (Cross-Table Lat) Atlas and Axis
35
 Slight head rotation to prevent superimposition of laminae of Atlas  Slight horizontal tilt to demonstrate arches of Atlas
Pancoast, Pendergrass, Schaeffer Recommendation (Lateral Atlas and Axis)
36
OML at 37° from RT
PA Atlas and Dens (Judd Method)
37
RP: Upper margin of TC
PA Atlas and Dens (Judd Method)
38
Demonstrate Atlas and Dens projected within the foramen magnum
PA Atlas and Dens (Judd Method)
39
Contraindications: Unhealed/suspected cervical fracture/degenerative disease
PA Atlas and Dens (Judd Method)
40
 Head rotated (MSP) 40°-45° away from the side of interest  IOML straight and crossing the LA of RT
AP Axial Oblique Dens (Kasaback Method - R/L Head Rotations)
41
RP: Bn EAM and OCE
AP Axial Oblique Dens (Kasaback Method - R/L Head Rotations)
42
10-15° Caudal (36"-40") - RP - Exit - MP - CXT
AP Axial Oblique Dens (Kasaback Method - R/L Head Rotations)
43
Demonstrate axial oblique view of Dens
AP Axial Oblique Dens (Kasaback Method - R/L Head Rotations)
44
CR (V) - 36"-40" - Midway bn mastoid processes - Level - Atlanto-Occipital Joint
Hermann and Stender Recommendation (Dens)
45
CR - (V) - 36"-40" - MSP - Level - a point distal to the tip of the chin - Exit - MP - CXT
AP Dens (Fuchs Method)
46
Demo Dens lying within the circular foramen magnum
AP Dens (Fuchs Method)
47
Contraindications: Patients with cervical fracture
AP Dens (Fuchs Method)
48
Recommended When: Upper half of Dens is not clearly demonstrated in the open mouth
AP Dens (Fuchs Method)
49
Demo laminae and articular facets of the upper cervical vertebrae
Smith and Abel Recommendation (Dens)
50
o Slight extension of neck o Mouth open wide o Head rotated 10° to the side to prevent mandibular superimposition o CR caudal 35° - C3
Smith and Abel Recommendation (Dens)
51
 MSP coincides with MLART  Forehead and nose resting on RT  OML perpendicular to RT
PA Atlanto-Occipital Articulations
52
RP: Infra orbital margin
PA Atlanto-Occipital Articulations
53
Demo bilateral frontal view of atlanto-occipital joints projected through maxillary sinuses
PA Atlanto-Occipital Articulations
54
 Head rotated (MSP) 45°-60° away from the side of interest  IOML straight and crossing LA of RT
APO Atlanto-Occipital Articulations (R/L Head Rotns)
55
RP: 1" anterior to EAM
APO Atlanto-Occipital Articulations (R/L Head Rotns)
56
Demo oblique image of atlanto-occipital joint including the dens
APO Atlanto-Occipital Articulations (R/L Head Rotns)
57
 Head turned 45°-50° away from the side of interest  Modification: Mouth open and chin drawn down  CRD: (V) - 36"-40" at dependent mastoid tip
Buetti Recommendation (APO Atlanto-Occipital articulations)
58
 MSP coincides with MLART  Head hyperextended
AP Axial Vertebral Arch (Pillars)
59
20-30deg caudal - 36-40" - MSP - level - TC
AP Axial Vertebral Arch (Pillars)
60
Decmo cervical vertebral pillars, posterior part of cervical vertebrae, upper part of thoracic vertebrae, articular and spinous process
AP Axial Vertebral Arch (Pillars)
61
Head (MSP) rotated 40°-50° from the side of interest to demonstrate articular process of C2-C7
AP Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
62
Head (MSP) rotated 60°-70° to demonstrate articular process of C6-T1-T4
AP Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
63
RP: Spinous process of C7 (exit point of CR)
AP Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
64
 Caudal 35° (36"-40")  Mastoid tip exit at spinous process of C7 *Technique: Top edge of cassette at level of mastoid tip
AP Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
65
Demo axial oblique of vertebral pillars
AP Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
66
 Head turned from the side of interest  Cheek resting on RT to place MSP 45° from RT  Spinous process of C7 coincides with MLART
PA Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
67
 8x10 BD  Longitudinal  Lower edge - level - spinous process of C7
PA Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
68
30°-40° Cranial - 36"-40" spinous process of C7 - exit - level of symphysis menti
PA Axial Oblique Vertebral Arch (Pillars) - R/L Head Rotations
69
T2/ between C7-T1/ shaft of clavicle
AP (Rec) Cervicothoracic Region
70
Demonstrates frontal view of cervico-thoracic region (C5-T4)
AP (Rec) Cervicothoracic Region
71
Opposite shoulderdepressed, moved posteriorly to prevent humeral head superimposition with vertebrae
Lat Cervicothoracic Region (Twinnign Method - R/L Position)
72
RP: Bn C7-T1
1. Lat Cervicothoracic Region (Twinnign Method - R/L Position) 2. Lat Cervicothoracic Region (Pawlow Method and Modified Pawlow Method - R/L Posn Rec)
73
(H) or 5deg caudal - 36-40" - CP - level - C7-T1
Lat Cervicothoracic Region (Twinnign Method - R/L Position)
74
Demo cervico-thoracic region in lateral view projected through shadows of shoulders, lower cervical, and upper thoracic vertebrae (C5-T4)
Lat Cervicothoracic Region (Twinnign Method - R/L Position)
75
 Dependent UE extended upward, head resting on it  Opposite UE extended alongside body, grasping thigh  Both LE flexed, knees for support
Lat Cervicothoracic Region (Pawlow Method and Modified Pawlow Method - R/L Posn Rec)
76
Body in true lateral position (avoid rotation)
1. Lat Cervicothoracic Region (Pawlow Method and Modified Pawlow Method - R/L Posn Rec) 2. Lat Thoracic vertebrae
77
3°-5° caudal (36"-40") - MCP - level of C7-T1
Lat Cervicothoracic Region (Pawlow Method and Modified Pawlow Method - R/L Posn Rec)
78
Demonstrates lateral view of cervico-thoracic region from C5-T4
Lat Cervicothoracic Region (Pawlow Method and Modified Pawlow Method - R/L Posn Rec)
79
5°-15° cranial angulation to reduce scatter radiation and improve contrast
Monday Recommendation (Cervicothoracic Region)
80
Purpose of flexing both LE on knees when in supine?
To reduce kyphosis; makes back in contact with RT
81
RP: T7 ( Upper edge of CXT - 1 1/2" - 2" from shoulder level)
1. AP Thoracic vertebrae 2. APO Zygapophyseal Joints 3. PAOZygapophyseal Joints
82
Demo frontal view of thoracic vertebrae
AP Thoracic vertebrae
83
Exposure preferably in shallow breathing
AP Thoracic Vertebrae
84
Both UE flexed at elbow, forearm placed along sides of head OR abducted at right angle to the long axis of the body
Lat Thoracic Vertebrae
85
Support: Lead rubber/ radiolucent support placed under lower thorax to maintain vertebral column in horizontal position
Lat Thoracic vertebrae
86
RP: T7
1. AP Thoracic vertebrae 2. Lat Thoracic Vertebrae
87
Upper border - CXT - 1 1/2" - 2 from shouler level
Lat Thoracic vertebrae
88
CR (V) or Cranial : 36” -40”  Vertical: MCP/Posterior half of thorax, Level of RP  Cranial: - Female: 100 deg - Male: 150 deg  (36” - 40”) MCP/ Posterior half of thorax-T7-Exit MP-CXT
Lat Thoracic vertebrae
89
Demo lateral view of thoracic vertebrae
Lat Thoracic vertebrae
90
Procedure can be done in upright (orthostatic position) - left side dependent
Oppenheimer Recommendation (Thoracic vertebrae )
91
Demonstrates: Zygapophyseal joints closest to IR
PAO Thoracic vertebrae (Oppenheimer Recommendation)
92
Demonstrates: Zygapophyseal joints farthest from IR
APO Thoracic vertebrae (Fuchs Recommendation)
93
 Dependent UE flexed, palm of hand/FA placed against head  Opp UE drawn posteriorly  Both LE in a comfortable position
APO Zygapophyseal Joints
94
 Body Rotation: Slightly posterior to place MCP at 70° from recumbent table  Vertebral Column: MSP coincides with midline of the table (MLART)
APO Zygapophyseal Joints
95
Demo oblique view of thoracic vertebrae, zygapophyseal joint farthest from IR
APO Zygapophyseal joint
96
Conventional, exposure at the end of expiration
1. APO Zygapophyseal joint 2. PAO Zygapophyseal joint
97
 Elevated UE abducted at right angle to long axis of body  Dep UE abducted and extended behind the back (posteriorly) along the long axis of the body  Both LE in a comfortable position
PAO Zygapophyseal joint
98
 Body Rotation: Slightly anterior to place MCP at 70° from recumbent table  Vertebral Column: MSP coincides with midline of the table (MLART)
PAO Zygapophyseal joint
99
Demonstrate the oblique view of thoracic vertebrae, zygapophyseal joint nearest to IR
PAO Zygapophyseal joint

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