spine (c-spine, t-spine) Flashcards
5 general regions of spine
cervical, thoracic, lumbar, sacrum, coccyx
primary curves are __________; located in the _____________ regions
concave (curves posteriorly, “C” towards front); thoracic and sacral
compensatory curves are ____________; located in the __________ regions
convex (curves anteriorly “C” towards back), cervical and lumbar
exaggerated lateral curvature of the spine
scoliosis
abnormal anterior concavity of the lumbar spine
lordosis
abnormal convexity of the thoracic spine
kyphosis
a typical vertebra consists of two main parts ______________________
vertebral arch (neural arch); body
vertebrae are ____________ bones
irregular
spongy bone is also known as ____________; honey-comb like
trabecular
cortical bone is also known ____________
compact bone
typical joints of the spine
intervertebral, zygapophyseal, costal (t-spine only)
Each vertebral disc is a _______________ joint (a _______); lie between adjacent vertebral bodies in the vertebral column
fibrocartilaginous, symphysis
intervertebral discs act as a ______________________ and ________________
ligament to hold the vertebrae together; absorb shock
what does the “EAM” stand for?
external auditory meatus
zygapophyseal joint are made from the __________________________________
articulating surfaces of 2 vertebral bodies
SID for AP Axial C-Spine
40 inches
CR angle for AP Axial C-Spine
15-20 degree cephalad
CR entrance for AP Axial C-Spine
level of upper margin of thyroid cartilage to pass through C4
respiration on AP Axial C-Spine
suspend respiration
positioning for AP Axial C-Spine
Adjust the head so that a line drawn for the upper incisors to the base of the skull is perpendicular to the IR
AND
a line drawn from the tip of the mandible to the base of the skull is parallel to the CR angle
Eval criteria AP Axial C-Spine
-______________ vertebral bodies
-______________ equal distance from pedicles
-(open/closed) intervertebral disk spaces
-_____________________ should be superimposed
-No rotation
-C3 through T2
-Spinous Processes
-Open
-Mandible and base of the skull
with an AP Axial C-spine exam, the spinous processes move towards the side positioned _________ the IR
farther from
Lateral C-Spine is also called ___________
Grandy Method
SID for Lateral C-Spine
72 inches
CR entrance for Lateral C-Spine
C4
CR angle for Lateral C-Spine
perpendicular to IR
respiration for Lateral C-Spine
full expiration
why full expiration for Lateral C-Spine?
depresses shoulders down
with a Lateral C-Spine, elevate chin to place _______________
AML parallel with the floor
what does AML stand for?
acanthiomeatal line
Evaluation criteria for Lateral C-Spine
-__through ___
-Superimposed __________
-(Open/closed) intervertebral joint spaces
-(Overlap/no overlap) of skull/mandible over spine
-C1 through T1
-articular pillars
-open
-no overlap
AP Open Mouth SID
40 inches
AP Open Mouth positioning
Adjust the head so that, with an open mouth, a line drawn from the ____________________ to the_____________ is perpendicular to the IR
lower margin of the upper incisors, base of the skull
CR angle for AP Open Mouth
perpendicular to IR
CR entrance for AP Open Mouth
through center of open mouth
For an AP Open Mouth, ensure no rotation – ___________________ are equidistant to the IR
mandibular angles and mastoid tips
respiration for AP Open Mouth
suspended respiration
When the patient opens their mouth, have them keep their tongue in the ______. Why?
lower jaw; to prevent the tongue shadow from superimposing over the atlas and axis
Evaluation criteria for AP Open Mouth
-Demonstrate __________
-Symmetrical _____________
-Open joint space
-Occlusal plane and base of skull superimposed
-C1 and C2
-lateral masses
-Occlusal plane and base of skull
AP Open Mouth rotation: side that demonstrates the greater distance is the side _____________________
toward which the face was rotated
For AP Open Mouth, if the teeth are superimposed on the upper dens, reposition by slight _____________ of the neck ______________________
hyperextension, (neck flexed too much; chin too far down)
For AP Open Mouth, if the base of the skull is superimposed on the upper dens, reposition by slight ____________ of the neck ________________________
hyperflexion, (neck extended too much; chin too far up)
AP Fuchs SID
40 inches
AP Fuchs positioning
MML perpendicular to IR
CR entrance for AP Fuchs
parallel to MML directed to inferior tip of the mandible
respiration for AP Fuchs
suspend respiration
SID for Judd method
40 inches
positioning for Judd method
MML perpendicular to IR
CR angle for Judd method
parallel to MML through occipital bone 1 inch inferior to mastoid tip and angles of mandible
respiration for Judd method
suspend respiration
Evaluation criteria for Fuchs/Judd method
Dens is demonstrated through foramen magnum
Evaluation criteria for Fuchs/Judd method: Dens is demonstrated through ____________-
foramen magnum
PA Oblique C-Spine CR angle
15-20 degrees cephalic to C4
AP Oblique C-Spine CR angle**
15-20 degrees caudad to C4
MSP plane angle for oblique c-spine**
45 degrees
Evaluation criteria for oblique c-spines
___ through ___
(Open/closed) intervertebral foramina
No overlap of skull or mandible on spine
C1 through t1
Open
No overlap of skull or mandible on spine
SID for C-spine obliques
40-72 inches
Hyperflexion/Hyperextension SID
60-72 inches
CR entrance for hyperflexion/hyperextension
C4
respiration for hyperflexion/hyperextension
full expiration
CR angle for Swimmer’s Lateral
perpendicular to IR
CR entrance for Swimmer’s Lateral
roughly 1 inch above level of jugular notch at T1
respiration for Swimmer’s Lateral
full expiration
Evaluation Criteria for Swimmer’s Lateral
adequate penetration to visualize C7 to T3
positioning for Swimmer’s Lateral
IR arm = up and resting on head
Tube arm = slightly down and posterior (to replace remote humeral head posterior to vertebrae)
CR angle for AP Axial C-Spine with…
low lordotic curvature
more lordotic curvature
15 = low lordotic curvature
20 = more lordotic curvature
T1-T4 resemble _____________
cervical vertebrae
T5-T8 resemble _________
typical thoracic vertebrae
T9-T12 resemble ________
lumbar vertebrae
T1-T10 have _______ for _________________
facets, costotransverse joints
T10-T12 have a ____________
single costal facet
T11-T12 have __________ for costotransverse joints
no facets
AP T-spine SID
40 inches
positioning for AP T Spine
supine (preferred) or standing erect
CR angle AP T-Spine
perpendicular to IR
CR entrance for AP T-spine
directed to T7; 3-4 inches below jugular notch
respiration for AP T-Spine; why?
expiration; reduces air volume in thorax for a more uniform brightness and density
AP T-Spine Evaluation Criteria
1. ___ through ___
2. Spinous processes equal distance from _______
3. No rotation indicated by _______ being equidistant from the spine
4. Vertebral bodies, intervertebral joint spaces, spinous and transverse processes, posterior ribs, and costovertebral articulations
- C7-L1
- pedicles
- SC Joints
in an AP T-spine, the side demonstrating a larger (bigger) distance is the side of the patient positioned (father/closer) to the IR
closer
Lateral T-Spine SID
40 inches
CR angle for Lateral T-Spine
perpendicular
CR entrance for Lateral T-Spine
T-7
positioning for lateral T-spine, patient erect
lateral with arms outstretched 90 degrees to body with elbows flexed
positioning for lateral T-spine, patient lateral recumbent
head on pillow, knees flexed, support waist with sponge to get spine lateral
lateral T-spine evaluation criteria
- ___ through __ (T-1 through T-3 may not be well visualized)
- Posterior ribs __________________ due to magnification of the posterior ribs further away from the IR
- No rotation indicated by __________ of space between posterior ribs
- ___________________ aspect of vertebral bodies superimposed
- Open _____________ and __________
- T1 through L1
- nearly superimposed, but not completely
- less than 0.5 inch
- posterior lateral
- intervertebral foramen and disk spaces
respiration for lateral T-Spine
full inspiration OR orthostatic breathing
why full inspiration for lateral T-Spine?
provide maximum uniform density of the vertebrae visualized above the diaphragm
why are posterior ribs on a lateral T-spine not completely superimposed?
due to magnification of the posterior ribs further away from IR
another name for Swimmer’s method
Twining (pronounced “twine-ing”)
Swimmer’s SID
60-72 inches
positioning for Swimmer’s method
-Raise arm _____ to IR flexing elbow and resting forearm on head for support
-Depress shoulder ______ from IR extending arm down towards the floor and rotate slightly ________ to place __________________________
-closet
-furthest, posteriorly, humeral head posterior to vertebrae
CR angle for Swimmer’s
perpendicular to IR
CR entrance for Swimmer’s
level of T-1 (1 inch above jugular notch)
Eval criteria for Swimmer’s
1. Adequate penetration to visualize _________________
2. Vertebral bodies and intervertebral disk spaces from C5-T3 are shown
3. Minimal rotation indicated by _______________________
4. Humeral heads should be __________________
- C5 through T3
- superimposition of the cervical zygapophyseal joints.
- separated vertically
cervical curve develops as children ______________; lumbar curve develops when _____________
lift their heads, begin to walk
Which projection/position(s) demonstrates the right intervertebral foramina?
RAO and LPO
Which projection/position(s) demonstrates the right intervertebral foramina?
LAO and RPO
Anterior c-spine obliques (RAO and LAO) show the intervertebral foramina and pedicles on the side _____________ the IR
closest to
Posterior c-spine obliques (LPO and RPO) show the intervertebral foramina and pedicles on the side _____________ the IR
father from
the C-spine spinous processes in an AP image are visualized in the ______________________
inferior adjoining vertebral disk space
C-spine zygapophyseal joints are visualized on what image?
C-Spine Lateral
T-spine zygapophyseal joints are visualized on what image?
T-Spine Oblique
C-spine intervertebral foramina are visualized on what image?
C-Spine Oblique
T-spine intervertebral foramina are visualized on what image?
T-Spine Lateral
L-spine intervertebral foramina are visualized on what image?
L-spine lateral
L-spine zygapophyseal joints are visualized on what image?
L-Spine obliques
what is the glabellomeatal line?
line from forehead to ear
what is the orbitometal line?
line from eye to ear
what is the infraorbitalmeatal line?
line from under the eye socket to the ear
what is the acanthiometal line?
philtrum to ear
what is the lipsmeatal line?
lips to ear
what is the mentomeatal line?
tip of mandible to ear