Spine Positioning Flashcards
Anteroposterior for lower cervical
PP: supine, arms by side; chin extended to place a line from the occlusal plane to the mastoid tip in same vertical plane
direction of tube: 15 to 20 degrees cephalad (CR to run line from tip of mandible to base of skull)
Central ray: the ray is centered at the midpoint of cervical spine about c-4 (thyroid cartilage)
IR size 10x12
Bucky
IR position lengthwise
SID: 40”
bony markings: lower 5 cervical bodies, intervertebral spaces; spinous process should be equidistant from the pedicles. The bodies of c-3 to T-1 should be clearly seen on radiograph image.
AP projection of c-1 and c-2 (open mouth, odontoid process)
PP: supine; with the patient’s mouth wide open adjust head to place an imaginary line from the mastoid tip to the incisors (upper teeth), perpendicular to table; mouth opened as wide as possible. be sure head not rotated.
Direction of tube: perpendicular
Central Ray: The ray is centered at the mid point of open mouth
IR size: 10x12
bucky
lengthwise
SID: 40”
bony markings: atlas (C1) and axis (C2), showing relationships of the lateral masses of the atlas to the dens and the articulations between the upper two cervical vertebrae. there should be no rotation of the head.
(respiration is suspended during exposure.
Oblique projection of cervical spine (ap/pa oblique)
upright or recumbent; oblique at 45 degree angle
direction fo tube: for AP angle the tube 15 to 20 degrees cephalad/ for PA angle the tube 15 to 20 degrees caudad
central ray:the ray is centered to the fourth cervical vertebra (c-4)
IR: size 10x12
Bucky
IR positon: lengthwise
SID: 40/ 72
bony markings: oblique view of cervical, spine, demonstrating all intervertebral foramina and pedicles;
If PA projection is used foramina and pedals demonstrated are the ones closer to IR
if AP projection is used foramina & pedicles demonstrated are the ones farthest from the IR
lateral projection of cervical spine
PP: upright; shoulders should be lowered by weights held in hands; elevated mandible into neutral position ( do not attempt if fracture is present or subluxation is suspected; cross-table lateral or trama views.
Direction of tube: perpendicular
central ray: the ray is centered at C-4 at level of mastoid tip. (@ atoms apple)
IR size: 10x12
Bucky
IR: lengthwise (top of IR should be about 2” about EAM)
SID: 72”
bony markings: entier cervical spine c-1- c-7
t-1 should be included)
zygapophyseal joint of lower 6 vertebrae are clearly demonstrated; this view also demonstrates the intervertebral joints (spaces) very well.
AP of thoracic spin (dorsal spin)
PP: supine; arms resting along side; hips and knees flexed direction of tube: perpendicular
central ray: ray is centered or directed at about the 7th thoracic vertebrae. which is 3-4 inches below jugular notch
IR size: 14x17
bucky
IR: lengthwise
SID: 40”
entier thoracic spine; spinous process should be equidistant from pedicels and the intervertebral spaces should be seen without overlap.
lateral projection od thoracic spine
PP: lateral recumbent
tube D: perpendicular or angle CR towards head when spine is not horizontal to the table.
(Merrill’s rexommeds an angle of 10 for females and 15 for males
Central Ray: centered at (T7); spine must be straight in order to demonstrate the intervertebral spaces
IR size: 14x17 (top of IR should be about 2” above shoulder.
Bucky
lengthwise
SID: 40”
Bony Markings: lateral view of thoracic bodies and their spaces from T-4 down to T-12. intervertebral foramina clearly seen and superimposed.
swimmers view/twining position (lateral if upper thoracic and lower cervical spine)
PP: left Lateral.; left arm above head, right arm by side; place the shoulder remote from the IR down and slightly posterior. head has to remain in a true lateral position.
tube D: angle 5 caudad when the shoulder cannot be well depressed otherwise perpendicular
Central ray: to 2nd thoracic vertebra/ C-7 AKA vertebra prominens
10x12
bucky
lengthwise
SID:72
bony markings: lower cervical and upper thoracic vertebrae
AP if lumbosacral spine (LS-spine)
PP: supine; knees and hips are flexed, and arms by side
tube D: perpendicular
central ray: centered at the iliac crest
IR size: 14x 17
bucky
IR: lengthwise
SID: 40”
bony markings: pelvis, sacrum, entire lumbar spine, spinous process should be equidistant from pedicles, transverse processes & sacrum are demo.; SI joints should be included on AP projection.
intervertebral spaces are fairly well seen except for the lumbo-sacral intervertebral spaces.
oblique of lumbar spine
PP: supine; rotated 45 degrees (RAO/LPO) perpendicular central ray: the ray is centered 1 1/2 inches above the iliac crest; center 1 1/2 inches lateral to midline of body. (2" medial to the upside ASIS 10x12 bucky lengthwise 40" bony markings: L1 though L-5 zygapophyseal joints on the RPO & LPO are closer to the IR. (SCOTTY DOG SEEN)
lat. of the lumbosacral spine
lateral recumbent left lat.; spine has to be horizontal to the IR
perpendicular
Central ray: the ray is centered at iliac crest
IR: size : 14x17
IR: lengthwise
SID: 40”
bony markings: from T12 through L5; intervertebral Foramina well demo. All intervertebral disk space should be clearly seen. All spinous process should be included
lateral of L-5 (spot)
PP: lateral
Tube D: angle 5-8 degrees toward feet, when spine is not adjusted in the horizontal position.
central ray: center 1 1/2” below the crest (the CR is directed midway between the iliac crest and the ASIS
IR size: 10x12
bucky
IR: lengthwise
40”
bony markings: lateral view of L5; lumosacral intervertebral space should be clearly seen
AP sacroiliac joints (si joints) RPO/LPO
PP: in the supine position; patient oblique 25- 30 degrees; arm closer to the table resting along PT’s side; opposite arm is placed across the patient’s chest knees slightly flexed
tube D: perpendicular to IR
Central ray: to the elevated scar-iliac joint; at the level of the ASIS and about 1” medial to the elevated ASIS
IR size: 10x12
bucky
IR positon: lengthwise
SID: 40”
bony markings: sacra-iliac joint remote from the IR respiration is suspended durning the exposure.
LPO will show right joint
RPO will show left joint
AP of sacrum
Supine 15 degrees cephalad central ray: mid-way between public symphysis and anterior superior iliac spine. 2" above symphysis pubis IR size: 10x12 Bucky lengthwise SID: 40" bony markings entire sacrum without superimposition
AP of Coccyx
recumbent (supine) tube D: 10 degrees caudad central ray: 2" above pubic symphysis IR size 10x12 Bucky IR position: lengthwise SID: 40" bony markings: entire coccyx is seen without superimposition.
lateral sacrum
left lateral perpendicular CR: 2" anterior to posterior sacral surface at level of ASIS IR size: 10x12 Bucky IR: lengthwise SID: 40" bony markings: sacrum and coccyx should be demo. in profile
