Vertebral Column Flashcards
Radiographic Procedure and Image Critique
What SID should be set for the lateral projection of the cervical spine?
72 inch/ 180 cm
Where should the CR enter for the lateral projection of the cervical spine?
Perpendicular to C4 - halfway between EAM and jugular notch
What breathing instructions should be given to the patient for the lateral projection of the cervical spine?
Suspend on full expiration to depress the shoulders
How should the patient be positioned for the lateral cervicothoracic swimmer’s projection
Elevate arm closest to IR; opposite arm depressed against patient’s side
Center IR to level of C7-T1 interspace
Midcoronal plane perpendicular to IR
Midsagittal plane parallel to IR
What plane should be aligned perpendicular to the IR for the AP open mouth and AP axial projections of the cervical spine?
Occlusal plane - edge of upper incisors to base of skull
How should the CR be directed for the AP axial projection of the cervical spine?
15-20 degrees cephalad, entering C4
How should the patient be positioned for an AP projection of the thoracic spine?
AP supine
Midcoronal plane parallel with IR
Flexed knees/hips
Center IR to MSP and halfway between jugular notch and xiphoid process (T7)
Top of IR 1 1/2 to 2 inches above shoulders
How should the patient be positioned for a lateral projection of the thoracic spine?
LEFT lateral recumbent (to avoid magnification of the heart and its superimposition on the spine)
Align thoracic vertebral column parallel to IR
Midcoronal plane perpendicular to IR
Center to posterior half of thorax, at level of T7
Upper border of IR 1 1/2 to 2 inches above shoulders
What breathing technique can be used for the lateral thoracic spine?
Suspend on expiration
OR
Breathing technique - use long exposure time (3-4 seconds and decrease mA)
What breathing instructions should be given to the patient for both the thoracic and lumbar spines?
Suspend on full expiration
What is the CR for the AP lumbar spine?
Perpendicular to the IR at 1-1.5 inch (2.5-4 cm) above iliac crests (L3)
What can be done if the spine is not horizontal/parallel to the IR for the lateral projection of the lumbar spine?
Place a radiolucent sponge under lower thorax
What is the CR for the lateral projection of the lumbar spine?
1.5 inches (4 cm) above iliac crest (L3); halfway between elevated ASIS and posterior aspect of pelvic ala
What is the CR for the lateral L5-S1 projection of the lumbar spine?
On the coronal plane, 2 inches (5cm) posterior to ASIS + 1.5 inches (4 cm) inferior to iliac crests
What can be done if spine is not horizontal for the lateral L5-S1 projection of the lumbar spine?
Angle CR caudad: 5 degrees (males); 8 degrees (females) on average
OR
Align CR parallel to interiliac plane
What should be part of the preparation of the patient when imaging the sacrum and coccyx?
Ask them to use the rest room before the procedure to empty their bowels and bladder if possible
What is the CR for the AP axial projection of the sacrum?
15 degrees cephalad to enter 2 inches (5 cm) superior to the pubic symphysis
What is the CR for the AP axial projection of the coccyx?
10 degrees caudad to enter 2 inches (5 cm) superior to the pubic symphysis
Where should the IR/CR be centered for the lateral projection of the sacrum?
3-4 inches (7.5-10 cm) posterior to the elevated ASIS
Where should the IR/CR be centered for the lateral projection of the coccyx?
3.5 inches (9cm) posterior and 2 inches (5 cm) inferior to the elevated ASIS
What artifacts must be removed when imaging the cervical spine?
All jewelry from the neck up
Bra and shirts with metal artifacts
Dental appliances
What image analysis guideline of the cervical spine indicates the lateral projection was positioned with no rotation?
Superimposed anterior and posterior aspects of the R and L zygapophyseal joints/articular pillars
What image analysis guideline of the cervical spine indicates the lateral projection was positioned with no tilt toward or away from the IR?
Superimposed superior and inferior aspects of the L and R zygapophyseal joints/articular pillars
Open intervertebral disk spaces
What positioning error occurred on a lateral projection of the cervical spine if C1 and C2 are superimposed by the mandibular rami?
AML was not parallel to the floor; chin was not elevated enough