Positioning Chapter 8 Flashcards
Compression FX
fx of spine produced by compression
wedge shaped appearance of vertebral body
Scoliosis
abnormal lateral curvature of the spine
Degenerative Disk Disease
gradual degenerative changes to spine associated with aging
Lordosis “swayback”
the lumbar curvature is exaggerated
may be caused by pregnancy, extreme obesity, poor posture, rickets, or tuberculosis of the spine
increased concavity
Kyphosis “humpback”
abnormal thoracic curvature
increased convexity
caused by poor posture, rickets, or tuberculosis of the spine
Hangman’s Fracture
result of acute hyperextension of the head on the neck
appears as a fracture of the arch of C2 anterior to the inferior facet and is usually associated with anterior subluxation of C2 on C3
Typical vertebral anatomy
Two main parts:
Body- weight bearing part of the vertebrae
Vertebral Arch- half ring of bone and helps make the vertebral foramen. All of the vertebral foramen make up the vertebral canal which the spinal cords fit through.
Pedicle, Laminae, a Spinous Process, and Transverse Processes are on the arch.
Intervertebral Joints of typical vertebrae
Allow for flexibility and movement in the spine.
these joints lie between the vertebral bodies.
Zygapophyseal Joints of typical vertebrae
made up by 4 articular processes.
Costovertebral Joints
connect ribs to vertebrae
found only on Thoracic spine
Intervertebral foramina of typical vertebrae
made by the superior and inferior margins of adjoining pedicles
Spinal nerves and blood vessels pass through these foramina
Intervetebral disk
Fibrocartiliginous disks between thebodies of vertebrae except between C1 and C2
Consists of an outer fibrous portion called the annulus fibrosus, and the soft jelly like part called the nucleus pulposus.
HNP (herniated nucleus pulposus)
When soft part protrudes through the fibrous layer, it presses on the spinal cord causing pain and discomfort. It is sometimes called a slipped disk or HNP.
Vertebral Column:
Spinal Canal
Spinal Cord
Intervetebral Disks
Spinal Canal
starts at the base of the skull and extends into the sacrum
follows the curves of the spinal vertebrae
contains the spinal cord and is filled with cerebral fluid
Spinal Cord
enclosed and protected by the spinal canal
starts at the Medulla Oblongata in the brain
moves through all of the vertebrae all the way till about the 1st lumbar vertebrae
from the 1st lumbar vertebrae it tapers off into the Conus Medulliarus
Intervertebral Disks
these are really tough disks which separate the vertebrae and provide cushion spacing, movement, and stability
Annulus fibrosus is the outer fibrous portion
Nucleus pulposus is the soft inner part
Vertebrae Sections of the neck- Cervical Spine (c-spine)
C1-C7
show little resemblance to other vertebrae
gets larger as they move downwards to the t-spine
C-Spine Characteristics
Bifid Spinous Process tips
Overlapping (lipping) vertebral bodies
Transverse Foramina
C1
Atlas
has no vertebral body
has a thick arch called Anterior Arch on which includes the anterior tubercle
Atlas
has a transverse atlantal ligament which holds the ondontoid (dens) in place (the dens is actually part of C2) fits like a ring on a finger
has two superior articular processes which articulate with the occipital condyles of the skull
called the atlantooccipital articulation
segments of bone between the superior and inferior articular processes are called lateral masses on C1 only
C1 supports weight of the head
Incorrect positioning of C1 can cause the radiologist to think there is damage or injury to the spine
Axis
C2
this is where rotation of the head occurs
whiplash injuries can cause the dens to break and cause possible damage to the spinal cord
C2 often hides behind the jaw and teeth on open mouth projections, but parts of it should still be seen.
Zygapophyseal Joint Spaces of the cspine
are only seen on an AP Open mouth projection for C1 and C2
C3-C6
have typical cervical vertebrae
The Transverse processes arise from the pedicle and body and include transverse foramen
Transverse foramen of cspine
nerves, arteries, and veins pass the transverse foramen of cspine
Typical Cervical vertebrae
have 3 vertebral foramina
Each vertebrae has a bifid tip.
Zygapophyseal joint spaces for C1-C7
are ONLY seen on the Lateral Projection of the c spine
Intervertebral Foramina for cspine
are ONY seen at a 45 degree angle to the MidSagital Plane (MSP) and at a 15 degree inferior angle.
15-20 degrees caudal tube angle for AP Oblique
15 degree cephalic angle for PA Oblique
C7
resembles more of a t-spine vertebrae and is called the vertebral prominens which is a bony landmark.
on Laterals and AP’s always count from C7 up
Thoracic spine (T1-T12)
sometimes called the Dorsal spine. Wrong because the entire spine is on the dorsal side of the body
T1-T4
share features of cervical vertebrae
T5-T8
are typical t-spine vertebrae
T9-T12
are larger and share characteristics of lumbar vertebrae
Facets
Each t-spine has either a full or demi facet and accepts a head of a rib to form a costovertebral joint (rib to vertebrae)
T1-T10
have costotransverse joints (rib to transverse process) which articulatethe transverse processes and a rib.
T11& T12
ONLY have a rib articulation at the vertebrae (costovertebral)
T-spine characteristics
elongated spinous process which is located very inferior
Zygapophyseal joint space
inferior articular process faces forward to meet the superior articular processes of the vertebrae below.
Zygapophyseal joint space of T-spine
can only be seen on an oblique 70 degree projection (which is rarely done)
Intervertebral foramina of T-spine
can only be seen on a 90 degree lateral. T-spine intervertebral foramina are made by superior and inferior margins of pedicles.
C1
Occipitoatlantal Joint
Synovial
Diarthrodial
Ellipsoid/Condyloid
C1-C2
R and L lateral atlantoaxial Joint
Synovial
Diarthrodial
Plane/gliding
C1-C2
Medial atlantoaxial Joint
Synovial
Diarthrodial
Trochoid/pivot
C2-T12
Intervertebral Joint
Cartilaginous (symphysis)
Amphiarthrodial (slightly movable)
C2-T12
Zygapophyseal joint
Synovial
Diarthrodial
Plane/gliding
T1-T12
Costovertebral joint
Synovial
Diarthrodial
Plane/gliding
T1-T10
Costotransverse joint
Synovial
Diarthrodial
Plane/gliding
Lateral Mass/Articular pillar
Short column(pillar) of bone that is more supportive on the Cervical vertebrae sometimes called the lateral mass when referring to C1
