spine Flashcards
what 4 things does the vertebral column do/ whats its function
- support
- movement
- protection of spinal cord and neural structures
- production of blood cells (bone marrow)
how many vertebra are there in adult vs child
- early development = 33
- adult = 26 (sacrum and coccyx fuse)
describe how the vertebral column forms an s-shape
- the cervix and lumbar spine are lordotic
- the throacic and sacral spine are kyphotic (hunchback)
what are the 7 parts of a typical vertebra
- vertebral body
- paired pedicles
- paired laminar
- paired transverse process
- spinous process
- superior/inferiror articular facets
find a diagram and label the typical vertebral body
what is the vertebral canal
- collectively all the vertebral foramina
what are the vertebral notches
- super and inferior indentations on pedicles
what is the intervertebral foramen
- formed by the inferior and superior vertebral notches between pedicles of adjacent vertebrae
define foramen
hold/opening allowing muscle, nerves, arteries and veins to pass through
when looking at an xray of the spine, it can look like an owl, which parts of the vertebra resemble the beak, eyes and wings
eyes - pedicles
beak - spinous process
wings - transverse process
what landmark is the external occipital protuberance found
base of skull
what spinal landmark is the thyroid cartilage found
c4
what spinal landmark is the part of the back of your neck that sticks out the most
c7
what spinal landmark is the sternal notch at
t2
what spinal landmark is the sternal angle found
t4
what spinal landmark is the xiphoid sternum found
t10
what spinal landmark is the inferior angle of scapula found
t7
what spinal landmark is the lower costal margin found
l3
what spinal landmark is the iliac crest found
l4
what spinal landmark is the asis found
s1/s2
what spinal landmark is the psis found
sacroiliac joint
what are the 2 essential projections of the cervial spine
AP
Lateral
during an AP cervical spine xray, why is it important to extend the neck
so the occipital protuberance and mandible are superimposed
what should you see on a cervial ap xray
- superimposed mandible and occiputal protuberance
- no rotation or angulation
- c7 down to t1
- soft tissue margins
how can you tell if there is rotation/angulation on a ap cervix xray
- symmetry of vertebral bodies
- equal pedicle distance from the midline
- alignment of spinous process
- equal spacing of intervertebral disc
why is it important for the patient to lower their shoulder during lateral cervix xray
to visualise c7/t1
what should you see on a lateral cervix xray
- base of skull and occipital protuberance clear of upper cervical vertebrae
- c7/t1
- soft tissue borders
- facet joints and intervertebral disc spaces open and equidistant
- temporomandibular joints superimposed
what do you call the synovial joints found in the spine
zygapophyseal joint
what should you see on an odontoid peg view
- inferior border of upper central incisors superimposed over the occipital bone
- clear joint space between c1 and c2
- no rotation (joint space is clear and even)
- spinous process central to c2
what should you see on an ap thoracic xray
- superiorly c7/t1
- inferiorly t12/l1
- laterally transverse processes
- adequate penetration to see bony structures in upper and lower thoracic spine
how can you tell if there is rotation on a thoracic ap xray
- spinous processes run centrally along midline of vertebral bodies
- pedicles equidistant from midline
how is the patient able to get their spine to be parallel to the IR for a lateral t-spine xray?
- by superimposing hips and knees
during a lateral t-spine xray, why’s it important for the patient to lay on their left side
to reduce magnification of cardiac shadow projected over spine
what should you see on a lateral t-spine xay
- superiorly t1/c7
- inferiorly t12/l1
- anteriorly vertebral bodies
- posteriorly spinous process/skin margins
- ribs superimposed
- open disc spaces
- anterior and posterior borders of the vertebrae are superimposed
why should the knees be flexed for an AP lumbar spine
- to reduce lordosis so the bottom of the back can be flat against the IR
how can the image be affected if the knees are not flexed for an AP lumbar spine xray
- the divergent beam will not pass through the disc spaces so you you will not be able to see the intervertebral disc space if the patients back is not flat on the table
what should you see on an ap lumbar spine
- superiorly t12/l1
- inferiorly sacroiliac joint
- laterally sacroiliac joint
- no rotation
how can you tell if there is rotation on ap lumbar spine
- spinous process in line along midline of vertebrae
- pedicles equidistant from spinous process
- sacroiliac joints/pelvis symmetrical
what is the ala of the sacrum
the fan-shaped, laterally located area on the base of the sacrum (it is what connects to the ileum to form the sacroiliac joint
why must a lateral lumbar xray be taken on arrested expiration
to minimise superimposition of the diaphragm on the upper part of the lumbar spine
what should be seen on a lateral lumbar spine
- superiorly t12/l1
- inferiorly l5/s1
- anteriorly vertebral bodies
- posteriorly spinous processes
- illiac crests superimposed
- open disc spaces
- anterior and posterior borders of vertebrae are superimposed
how can you assess if there is rotation on a lateral lumbar spine xray
- ’ tram lines’ (blurred/double lines on the back of the vertebrae)
- when posterior borders of vertebrae aren’t superimposed, it shows the spine isnt parallel to the ir
what is c1 and c2 also known as
- c1= atlas
- c2 = axis
what 3 main features do cervical vertebrae have different to other vertebrae
- triangular vertebral foramen
- bifid spinous process
- transverse foramina
what is the purpose of transverse foramina in cervical spine
give passage to vertebral artery vein and sympathetic nerve
find and label the diagram of a cervial spine vertebra c1/c2 and c3…
how do you check alignment on a cervical spine xray
- check the anterior and/or posterior vertebral line (found by tracing anterior or posterior border of vertebral body)
- spina-laminar line ( found by tracing the posterior aspect of the spinal canal)
- posterior spinous line ( tracing posterior border of spinous process)
where is the centering point for a AP sacrum xray
- at a level midway between ASIS and superior border of symphysis pubis in midline
what needs to be done to the tube during sacrum xray and why
5-15 degree cranial angulation of xray tube
- due to natural angulation of pelvis and lordosis of sacrum/lower lumbar
be aware that greater angulation of beam is need for xray of sacrum in females
what is the centering point for a lateral sacrum
point in the midline of the table at a level midway between the PSIS and sacro-coccygeal junction
why is a thoracic xray taken on arrested inspiration
- cause diaphragm to move over upper lumbar spine which reduced the change of a large difference in density appearing on image from superimposition of lungs on thoracic vertabrae
where must the upper border of the receptor reach during ap thoracic xray
upper edge of detector should be at a level just below prominence of thyroid cartilage to ensure upper thoracic vertabrae is included
where is the centering point for thoracic xray
2.5cm below sternal angle
where should the beam be centered for a lateral thoracic xray
5cm anterior to the axis of t7/6 spinous process (at level of inferior angle of scapula)
why might the upper 2/3 vertebrae no be seen on lateral thoracic xray
due to superimposition of shoulder (normal)
how can you tell that a patient was not over or under rotated for a lateral thoracic xray
the posterior ribs should be seen as superimposed
why would a PA thumb xray have lack of sharpness on image
due to air space between thumb and detector
why would a PA thumb be done over an AP thumb
- less painful
- maintains relationship between adjacent bones e.g radius and ulna
