Projections, CRs, positioning for C-spine, T-spine, and L-Spine

Question 1

AP “Open Mouth” C1-C2: C-Spine (CR, pt positioning, anatomy)

Answer 1

*CR: center of open mouth
*position: pt erect
*anatomy: 2/3 dens, body of C2, lateral masses and transverse processes of C1, atlantoaxial joints

Question 2

AP (Fuchs method): C-Spine (CR, pt positioning, anatomy)

Answer 2

*CR: 1” inferoposterior to mastoid tips
*position: pt erect w/ chin slightly raised
*anatomy: dens within foramen magnum

Question 3

AP Axial: C -Spine (CR, pt positioning, anatomy)

Answer 3

*CR: angle 15-20° cephalad at C4
*position: pt erect w/ chin slightly raised as needed
*anatomy: int. disk spaces, C3-T2 vertebral bodies, trachea, spinous processes

Question 4

Oblique: C-Spine (CR, pt positioning, anatomy)

Answer 4

*CR: angle 15-20° cephalad (posterior) 15-20° caudad (anterior) at C4
*position: pt erect and rotated 45° w/ chin raised slightly looking straight ahead
*anatomy: open int. foramina and pedicles (LPO/RPO demonstrates upside, RAO/LAO demonstrates downside)

Question 5

Lateral: C-spine (CR, pt positioning, anatomy)

Answer 5

*CR: C4
*position: pt erect in lateral position and position w/ shoulders depressed
*anatomy: **Z joints, spinous processes, C1-C7 intervertebral disk spaces, articular pillars

Question 6

AP: T-Spine (CR, pt positioning, anatomy)

Answer 6

*CR: T7
*position: supine no rotation
*anatomy: disk spaces, spinous processes, pedicles

Question 7

Oblique: T-Spine (CR, pt positioning, anatomy)

Answer 7

*CR: T7
*position: recumbent and rotated 20° to create 70° oblique
*anatomy: Z joints

Question 8

Lateral: T-Spine (CR, pt positioning, anatomy)

Answer 8

*CR: T7
*position: recumbent lateral w/ knees and elbows flexed and arms raised
*anatomy: int. foramina, disk spaces, posterior ribs

Question 9

AP: L-Spine (CR, pt positioning, anatomy)

Answer 9

*CR: L4 (iliac)
*position: recumbent w/ knees and hips flexed
*anatomy: disk spaces, spinous processes, transverse processes

Question 10

Oblique (scottie dog): L-Spine (CR, pt positioning, anatomy)

Answer 10

*CR: L3
*position: recumbent w/ body at 45°
*anatomy: sup. and inf. art. processes, pedicles, **Z joints, transverse processes

Question 11

Lateral: L-Spine (CR, pt positioning, anatomy)

Answer 11

*CR: L4
*position: lateral recumbent w/ knees and hips flexed and spine parallel
*anatomy: int. foramina, spinous processes, disk spaces

Question 12

L5-S1 (“Spot”): L-Spine (CR, pt positioning, anatomy)

Answer 12

*CR: 1.5” inferior to iliac crest and 2” posterior to ASIS
*position: lateral recumbent w/ knees and hips flexed
*anatomy: disk spaces, open int. foramina

5-8° caudad for women (hips)