Cervical Trauma Routine Flashcards
Lateral neutral position
Align mid-coronal plane to CR and midline of table.
Patient lateral.
Relax shoulders down.
Lift chin up
Lateral neutral CR
CR perpendicular to C4-5. Book: 1” distal to mastoid tip.
Lateral neutral structures
Cervical bodies. Intervertebral joint spaces. Articular pillar. Spinous processes. Zygapophyseal joints. C1-T1 or C1-7. Rami of mandible not superimposed over C1
Lateral extension position
Align mid-coronal plane to CR and midline of table.
Patient lateral.
Relax shoulders down.
Extend chin up and head and neck back.
Lateral extension CR
CR perpendicular to level of C4
Lateral extension structures
Cervical bodies. Intervertebral joint spaces. Articular pillar. Spinous processes. Zygapophyseal joints Plus functional anatomy
SFMC routine
Lateral extension Lateral neutral 45 degree LAO 15-20* caudally 45 degree RAO 15-20* caudally AP axial 15-20* cephalic AP odontoid
45 degree LAO and RAO 15-20* caudally
Positioning
PA oblique.
Patient PA.
Rotate body and head 45*
Chin extended and elevated to prevent mandible superimposition over vertebra.
CR for 45* LAO and RAO 15-20* caudally
CR directed 15-20* caudal to level of C4
Structures 45* LAO 15-20* caudally
Left Intervertebral Foramina and pedicle of C3-7
Mandible and occipital bone are not overlapping C1-2
Structures 45* RAO 15-20* caudally
Right intervertebral Foramina and pedicle of C3-7
AP axial 15-20* cephalic position
MSP to midline of table or vertical Bucky. Center IR at the level of C4.
Raise chin.
AP axial 15-20* cephalic CR
CR angled 15-20* cephalic @ level of C-4. Inferior to upper margin of thyroid cartilage.
AP axial 15-20* cephalic structures
C3-T2 vertebral bodies and intervertebral disk spaces.
AP odontoid position
MSP to midline of table or vertical Bucky. Center the IR at the level of the axis
Lower margin of upper incisors and mastoid tip are perpendicular to IR.
Then open mouth, without moving head.
Pt must remove dentures, piercings, hair pins, jewelry.
AP odontoid CR
CR perpendicular to open mouth
AP odontoid structures
Odontoid process.
Vertebral bodies of C2. lateral masses of C1.
Zygapophyseal joints between C1 and C2.
No teeth in way.
What are the optional obliques?
45* RPO and LPO 15-20* cephalic position
Position for 45* RPO and LPO 15-20* cephalic position
Patient AP oblique 45*.
Chin extended to prevent mandible superimposition over vertebrae.
CR 45* RPO and LPO 15-20* cephalic position
CR directed 15-20* cephalic to level of C4
Structures 45* RPO and LPO 15-20* cephalic position
See the intervertebral Foramina furtherest from IR.
RPO- left intervertebral Foramina and pedicle.
LPO- right intervertebral Foramina and pedicle.
Technical factors for cervical spine trauma
72” SID.
Small focal spot.
KVp 80
Breathing.
Non trauma cervical routine, exclude?
AP odontoid and Lateral extension
Functional studies of the lateral cervical vertebrae show?
Normal AP movement or absence of movement. The spinous processes are elevated and widely separated in hyperflexion and depressed closely in hyperextension.
