Imagine Upper Quarter Flashcards
Routine radiographs on the cervical spine are done where?
- AP open-mouth
- AP lower cervical spine
- Lateral
What is the less common radiograph in the cervical spine?
Oblique
What is the AP open mouth radiograph best at showing?
Best at demonstrating the AA joint
When taking an AP x-ray of the lower cervical spine, what will you see?
Demonstrates lower cervical vertebrae, upper thoracic, associated ribs, and clavicles
When looking at an AP x-ray of the lower cervical spine, what exactly does the vertebral column look like?
- Vertically aligned vertebral bodies
- Midline spinous processes
- Lateral column has overlapping articular pillars and Z joints and one smooth bony column lateral to the bodies
What is difficult to see with an AP lower cervical spine x-ray?
- TPs difficult to discern
- Uncovertebral joints
What color is the air filled trachea on an x-ray?
Dark gray, almost black
What does a lateral x-ray show in the upper extremity?
Demonstrates alignment of all cervical vertebrae
Normal vertebral alignment on a lateral x-ray can be seen by 3 parallel lines, what are these borders?
- Anterior vertebral borders
- Posterior vertebral borders
- Spinolaminar line
What is the spinolaminar line?
- Spinous process and laminae junction
- Represent posterior extent of central spinal canal
The normal vertebral alignment in a lateral x-ray should remain constant whether the neck is …
In neutral, flexed, or extended aka stress views when investigating mechanical instability
What do you notice about intervertebral and interspinous spacing in flexion compared to extension?
Vertebral bodies in x-rays are what shape with what kind of edges?
Boxed, with smooth edges
What x-ray position gives the best view of the disc spaces?
Lateral
What x-ray position gives the best view of the Z joint spaces?
Lateral
What is the normal space between the anterior dens and atlas that is kept by the transverse ligament?
- 2.5 mm for adults
- 4.5 mm for children
- greater than or equal to 3.5 is a concern for instability in adults
Oblique x-rays in the upper extremities are best used for what?
Best view for single side intervertebral foramen
What is the standard imaging in the ER following head and neck trauma?
CT
Cervical spine imaging is indicated in trauma patients unless they meet what criteria?
- No posterior midline cervical spine tenderness
- No evidence of intoxication
- A normal level of alertness
- No focal neurologic deficit
- No painful distracting injuries
What are the routine radiographs for the shoulder?
- AP in external rotation
- AP in internal rotation
AP radiographs in external rotation of the shoulder are best used for?
Profile of greater tubercle and glenohumeral joint space
AP radiographs in internal rotation of the shoulder are best used for?
Profile of the lesser tubercle
Scapular Y lateral view of the shoulder is most frequently used in assessment of what?
Fractures or dislocations of the proximal humerus
The axillary view radiograph is most frequently used for?
To assess dislocations
What is the most commonly missed fracture in the hand?
Scaphoid Fracture
After trauma if clinical signs and symptoms indicate a fracture what should you do?
Immobilize and refer for imaging
Following a gradual onset, if clinical signs and symptoms indicate a fracture what should you do?
Realize early radiographs may be negative for a stress fracture because density changes take time to occur, and the fracture may not show for 1-2 weeks
