Midterm Review: Non Routine Positions

Question 1

Hospital C-Spine routine:

Answer 1

• Lateral
• Swimmer’s (depending on patient anatomy)
• 15° AP axial
• AP odontoid

Question 2

Clinic C-Spine Routine

Answer 2

• Lateral
• Swimmer’s (depending on patient anatomy)
• 15° AP axial
• AP odontoid
• AP 15° axial obliques (both sides)

Question 3

Standard Fuch’s: Why ?? What is??

Answer 3

if you are unable to demonstrate the odontoid this is another option on a NON-TRAUMA patient.

Question 4

Modified Fuch’s : wat.

Answer 4

as a replacement for odontoid view, can be done supine with the patient in a c-spine collar

Question 5

What routine is very similar to c-spine for query foreign body, tissue swelling such as epiglottitis?

Answer 5

soft tissue neck :

• 15° AP axial
• Lateral

Question 6

Lateral Soft Tissue neck:

Answer 6

Similar to a lateral C-spine but:

• Demonstrates nasopharynx to lung apices
• Collimate to exclude eyes
• Decreased technique to better visualize soft tissue
• Taken on modified Valsalva manouever to demonstrate air in the pharynx and trachea

Question 7

Soft Tissue Neck AP:

Answer 7

AP projection is similar to C-spine AP

Chin is extended higher than for c-spine AP

Collimate from lower level of nasal bones to sternal angle

Taken on modified Valsalva maneuver to demonstrate air in the pharynx and trachea

Question 8

Special Request Laterals:

Answer 8

Hyperflexion Lateral and Hyperextension Lateral

• Functional study
• Rule out fracture first!

Question 9

Evaluation Criteria: Lateral - Hyperflexion and Hyperextension

Answer 9

• C1-C7 visualized
• No rotation
• Hyperflexion–Spinous processes well separated
• Hyperextension–Spinous processes in close proximity
• Optimal exposure factors