Test 3 - C and T - spine Flashcards
How many cervical
7
How many thoracic
12
How many lumbar
5
Sacrum/Coccyx - Adult
1 sacrum, 1 coccyx
Sacrum/coccyx - Newborn
5 sacral bones
3-5 coccygeal bone
Vertebral curvatures - Primary
Thoracic and cervical (convex)
Vertebral curves - Compensatory
Cervical and lumbar (concave)
- happens when growth occurs
Vertebral curvatures - abnormal
- lordosis (excessive lumbar curvature)
- kyphosis (excessive thoracic/cervical curvature)
- scoliosis
Typical vertabrae
body, pedicles, lamina, transverse + spinous process, articular process
Body - anterior, thicker
pedicles - entend posteirorly from body
lamina - extend posteriorly from pedicles
transverse process - extend laterally
spinous process - extend posteriorly
articult porcesses (4) - 2 superior and 2 inferior
Typical vertabrae joints
Intervertebral
Zygapophyseal
costal (only exists on thoracic)
WHat are intervertebral foramina
Where nerves and blood vessesl can pass thorugh
Intervertebral disk portions
Annulus fibrosis - outer portion
Nucleus pulposus - inner portion (can protrude, called slipped disk)
Cervical spine, typicala dn atypical
C1, C2, C7 - atypical
C3-6 - typical
Cervical characteristics
body, tansverse + spinous process, pillar, zygapophyseal joints, fromina
body - small, oblong
transverse process - foramen
spinous process - bifid
Pillar - short column of bone betweeb articualr processes
Zygapopphyseal joints - 90 degrees to MSP
Transverse foramen - 45 deg from MSP
C7
No bifid tip, extra long spinous process
C1
name, arch, articulation, transverse …, LAT
- atlas
- posterior arch
- Atlantooccipital articulation
- small transverse faramina
- lateral masses
C2
name, somethong on C2, rotation, transverse
- axis
- dens projects upward from body
- pivot for rotation
- transverse process and foramen
C1-C2 (JFA)
There is no intervertebral space between C1-2
- C1 had no body
Jefferson fracture
fracture to anterior and posterior arches of C1
Odontoid fracture
when you dontoid/dens is fractured
Hangman’s fracture
Associated with people who try to hand themselves. (fracture due to hyperextension)
Clay Shoveler’s fracture
fracture due to spinous processes
can happen due to an evulsion fracture
Subluxation of facets
Seperation of facet spaces
C-spine kV and how to reduce scatter
kV - 80 +/- 10
Scatter: Grids, collimation
Lateral C spine (IR, kV, CR, SID, posiion)
IR + where Top of IR is placed
24x30 (top of Ir 2.5-5cm above EAM)
80kV
CR - at level of C4
180 cm SID
Shoulders relaxed, chin extended
C spine obliqes (IR, kV, CR, SID, posiion)
24x30
80 kV
15-20 degrees cephalic, at C4 (for posterior obl - RPO/LPO)
15-20 degrees caudad, at C4 (for anterior obl - RAO/LAO)
180cm sid
Rotate body 45 degrees, extend chin
AP axial C3-C7 (IR, kV, CR, SID, posiion)
18x24
80kV
C4 - Cr travels from tip of mandible to base of skull (15-20 degrees cephalad)
100cm SID
Tip of mandible should superimpose base of skull. Line should be parallel to CR
AP open mouth (c1-2) (IR, CR, SID, posiion)
18x24
middle of open mouth
100cm sid
Lower margin of teeth lined up with base of skull
Only view that let sus see zygapophyseal joints of C1-C2?
AP open mouth
If base of the skull is over the dens (AP open mouth)
Flex forward or angle slightly caudal
If teeth ar eover the dens (AP open mouth)
Raise hea dup or angle slightly cephalic
Lateral C-spine (flexion/extension) (Why?, IR, CR, SID, posiion)
Rules out instability
24x30 portrait
Centre to C4
180cm SID
Flexion - chin to chest
Extension - chin raised as much as possible
Swimmers view (why?, IR, kV, CR, SID, posiion, breathing)
Preformed when C7-T1 articulation cannot be seen
24x30
80-90 kV
centre at T1, 3-5 deg caudal
SID - 100 or 180 cm
Arm and shoulder awya from IR is down and slightly posterior
Arm and shoulder nearest IR are raised
Suspended exp, or orthostatic
Thoraicc vertabrae
Upper, Middle, Lower
Articulations
Upper 4 are like C spine
Middle 4 are typical-looking
Lower 4 resemble lumbar spine
- they sometimes have 2 articualtions with ribs (demi-facets)
Thoracic vertabrae - costovertebral joints
articulate with head of ribs
Thoracic vertabrae - costotransverse joints
T1-T10 have facets on transverse processes to articulate with rib tubercles
Thoracic vertabrae - Zygapophyseal joints
Superior and inferior articular processes
70-75 degrees from MSP
Thoracic vertabrae - intervertebral foramina
90 degrees to MSP, seen on lateral image
AP t-spine (IR, kV, CR, SID, breathing, …)
35x43
80-90 kV
Centre to t7
sid 100cm
suspended expiration
Wedge filter or anode heel effect
T-spine Lateral (what side, IR, kV, CR, SID, posiion, breathing)
Typically done left lateral
35x43
80-90 kV
cetrre at T7, between MCP and posterior thorax
100cm SID
arms up and flexed
If pateint has scoliosis.. (LAT t spine)
If patient has scoliosis, place the side with the curve closest to IR.
left scoliosis curve
levoscoliosis
Right scoliosis curve
dextroscoliosis
Vertebral arch
ring that creates vertebral foramen
