Vertebral Column And Cervical Spine Flashcards

1
Q

FUNCTIONS OF THE VERTEBRAL COLUMN

A

-Gives shape to and supports the trunk.
-Protect spinal cord
-Supports skull
-Provides attachment for muscles of the back and ribs
-Transmits the weight of the trunk through the hips

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2
Q

VERTEBRAL COLUMN

A

Comprised of 33 vertebrae:
-24 remain as separate bones.
-5 are fused and form the sacrum.
-4 are incompletely formed but are fused to form the coccyx
Fibrocartilage disks between vertebrae act as cushions
-Nucleus Pulposus
-Anulus Fibrosus

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3
Q

VERTEBRAL COLUMN CURVES

A

-Curves are viewed from the lateral position.
-The spinal curvatures increase its strength.
-Help to maintain balance in upright positions.
-Increase flexibility.

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4
Q

Abnormal Vertebral Curvatures

A
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5
Q

FEATURES OF A TYPICAL VERTEBRA

A

Anterior mass
-BODY-the thick anterior portion.
Posterior ring
-VERTEBRAL ARCH-extends posteriorly from the body forming a central opening called the vertebral foramen
*When the vertebrae are stacked the vertebral foramina form the spinal canal.

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6
Q

FEATURES OF A TYPICAL VERTEBRA continued

A

-On each side, the pedicles attach the vertebral body to the lamina.
-Each pedicle is notched on its superior and inferior surfaces.

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7
Q

When the vertebrae are stacked a ____________ ____________ is formed on each side by the notches in the pedicles

A

intervertebral foramen

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8
Q

________ _________ _________ pass through the intervertebral foramina to feed the upper extremities, neck, and throat

A

Spinal nerve roots

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9
Q

Lamina(e)

A

are the flat, bony, posterior portions of the vertebral arch.

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10
Q

The laminae join together to form the

A

spinous process

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11
Q

extending posteriorly from the lamina

A

Spinous Process

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12
Q

extending laterally

A

Transverse Processes

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13
Q

extending superiorly from the junction of the pedicles & lamina, one on each side. (Left & Right)

A

Superior Articulating Processes/ Facets

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14
Q

extending inferiorly from the lamina, one on each side. (Left & Right)

A

Inferior Articulating Processes/ Facets

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15
Q

FEATURES OF A VERTEBRA

A
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16
Q

When the vertebrae are stacked, the superior and inferior articulating facets align forming the

A

zygapophyseal joints

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17
Q

Each intervertebral level has __ zygapophyseal joints

A

2(left and right)

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18
Q

The cervical and lumbar spines have a _________ curvature

A

Lordotic

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19
Q

the thoracic and sacrum/coccyx have a _______ curvature

A

Kyphotic

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20
Q

The pedicles form the

A

Intervertebral foramen

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21
Q

The transverse processes extend __________ from where the pedicle and lamina meet

A

Laterally

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22
Q

The ________ process is located in the midline

A

Spinous

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23
Q

These structures make up the zygapophyseal joints:

A

Facets of the superior and inferior articular processes

24
Q

C1-C7 The transverse processes of these vertebrae have openings called

A

transverse foramina

25
Q

The transverse foramina allow

A

vertebral arteries and veins to pass through the neck to enter the base of the skull

26
Q

Cervical Vertebra picture

A
27
Q

C1 aka ATLAS

A

-ATYPICAL VERTEBRAE
-Has no body, superior articulating or spinous processes.
-Formed by anterior and posterior arches.
-Lateral masses are where the arches unite on each side
-The atlanto-occipital joints are formed by the junction of the superior aspect of the lateral masses and the occipital condyles of the skull

*Synovial Ellipsoidal

28
Q

C2 aka AXIS

A

-ATYPICAL VERTEBRAE
-Has a body with a conical shaped process extending superiorly
-The odontoid process (dens) extends into the anterior arch of C1 forming the axio-atlantal joint.
*Synovial pivot joint
*The dens acts as a pivotal point allowing side to side rotation of the head.

29
Q

CERVICAL VERTEBRAE 3-6

A

Transverse foramina
-Vertebral artery and vein
Bifid Spinous process
Z joints are perpendicular to the MSP
-Intervertebral foramina at a 45 degree angle to MSP

30
Q

Intervertebral foramina at a ___ degree angle to MSP

A

45

31
Q

C7 aka VERTEBRAL PROMINENS

A

-ATYPICAL VERTEBRAE
-has a longer spinous process.
-A radiographic landmark that can be seen and felt a the base of the neck.

32
Q

2 TYPES OF ARTICULATIONS OF THE VERTEBRAL COLUMN

A
  1. Intervertebral joints: cartilaginous symphysis
  2. Zygapophyseal joints: synovial gliding joints

Movement:
Flexion, Extension, Lateral Flexion, Rotation

33
Q

What is the 7 series of the Cervical Spine called?

A

Davis series

34
Q

Routine series is usually how many series

A

3 or 5

35
Q

AP Axial Cervical Spine Positioning Criteria

A

-10 X 12 IR LW in WB/TB
-SID 40”
-Patient supine or upright
-Shoulders in same plane
-Extend chin so occlusal plane is perpendicular to IR
-MSP straight
-CR angled 15-20 degrees cephalic centered to MSP and 4th Cervical Vertebra(thyroid cartilage)
-Collimate
-Shield
-Suspend respiration

36
Q

AP Axial Cervical Spine Evaluation Criteria

A

-Lower 5 cervical bodies and upper two or three thoracic bodies
-Interpediculate spaces
-Open Intervertebral disc spaces
-Cervical ribs, if present
-Spinous processes equidistant to the pedicles and aligned with the midline of the cervical bodies
-Mandibular angles and mastoid processes equidistant to the vertebrae

37
Q

AP Axial Cervical Spine Improper Positioning

A
38
Q

AP Open Mouth Positioning Criteria

A

-10 X 12 IR LW in TB/WB
-SID 40” (May employ 30” to increase the FOV)
-Patient supine or upright
-Shoulders in same plane
-MSP perpendicular
-Open mouth wide
-Adjust chin so that a line drawn through the lower occlusal surface of the top teeth and the mastoid processes is perpendicular to the IR
-CR perpendicular through the open mouth
-Collimate
-Shield
-Phonate “AHHHHHH”

39
Q

AP Open Mouth Evaluation Criteria

A

-Occlusal plane of the upper incisors superimposed on the base of the skull
-Dens, atlas, axis, and articulations between the first and second cervical vertebrae
-No rotation
-Mandibular rami equidistant from dens

40
Q

AP Open Mouth Improper Positioning

A
41
Q

Lateral Grandy Method Positioning Criteria

A

-NON-Trauma
-SID 72”
-10 X 12 LW IR in WB
-Patient upright
-Patient in true lateral: Left side against IR
-Top of IR 1 inch above EAM
-Stand up straight with shoulders back
-Shoulders in same plane
-Elevate chin slightly
-Wrap sandbags around wrists and instruct the patient to relax shoulders down
-CR perpendicular to MCP at the level of C4
-Collimate
-Shield
-Suspend respiration at end of full expiration

42
Q

Lateral Grandy Method Evaluation Criteria

A

-Cervical bodies, disk spaces, and Z joints, spinous processes
-All 7 cervical vertebra and top 1/3 of T1
-If shoulders are superimposed on T1/T2, you MUST do an additional view (Swimmer’s)
-Z joints superimposed
-Open disk spaces
-Superimposed mandibular rami
-Spinous processes in profile

43
Q

Lateral Grandy Method Improper Positioning

A
44
Q

AP Axial Oblique Cervical Spine Positioning Criteria

A

-Oblique projections of the cervical spine will show the cervical intervertebral foramina
-10 X 12 IR LW in WB
-SID 60-72”
-Shield
-Collimate and place a side marker SIDE DOWN
-CR angled 15 to 20 degrees cephalic to C4, halfway between the MSP and the MCP
-Suspend respiration
-Patient upright with back against grid device
-Adjust the body to a 45 degree oblique position, resting adjacent shoulder on the IR
-Elevate and protrude chin, keeping head aligned with spine
-AP Oblique projection demonstrates side FARTHEST from the IR
-PA Oblique projection demonstrates side CLOSEST to the IR
-Both sides are done for comparison when ordered

45
Q

AP Axial Oblique projection demonstrates side ________ from the IR
PA Axial Oblique projection demonstrates side ________ to the IR

A

Farthest; Closest

46
Q

AP Oblique Cervical Spine Evaluation Criteria

A

-Intervertebral foramina and pedicles FARTHEST from the IR
-All seven cervical vertebrae and T1
-Open intervertebral foramina farthest from the IR from C2-C3, C7-T1
-Open intervertebral disc spaces

47
Q

PA Axial Oblique Cervical Spine Positioning Criteria

A

-Patient Facing IR: May have to have the patient seated on a stool
-Rotate 45 degrees
-Elevate and protrude chin
-SID: 60-72 inches
-CR 15 to 20 degrees caudal centered to the cervical spine and exiting C4
-Suspend respiration
-Shield
-Collimate and place a marker in the light side DOWN

48
Q

PA Axial Oblique Cervical Spine Evaluation Criteria

A

Intervertebral foramina and pedicles closest to the IR

49
Q

PA Axial Oblique Cervical Spine Improper Positioning

A
50
Q

Lateral: Hyperflexion & Hyperextension

A

-These are considered functional studies
-Show the degree of change in the vertebral bodies and disc spaces as a patient flexes and extends the neck
-Done on trauma patients after the cervical spine has been cleared by a radiologist or post operative fusion procedures
-Always done together as a pair

51
Q

Lateral: Hyperflexion & Hyperextension Positioning Criteria

A

-10 X 12 IR LW in WB
-SID: 60-72 inches
-Prepare patient and equipment for Grandy method
*Flexion: Patient drops head forward and tucks chin to chest
*Extension: Patient elevates chin as much as possible
-Give patient something to hold on to
-Shield
-Collimate and place side marker
-Suspend respiration

52
Q

Lateral: Hyperflexion & Hyperextension Evaluation Criteria

A

-Intersegmental alignment of the cervical spine
-Evaluation criteria for Grandy method
*Flexion: Spinous processes elevated and separated
*Extension: Spinous processes depressed and closely spaced

53
Q

AP Dens Fuchs Method Positioning Criteria

A

-10 X 12 IR CW in TB
-SID 40”
-Patient Supine
-Arms to sides
-Extend chin until tip of chin and tip of mastoids are vertical
-MSP perpendicular to IR
-Shield
-Collimate and place side marker
-Suspend Respiration

54
Q

AP Dens Fuchs Method Evaluation Criteria

A

-AP projection of the dens within the foramen magnum of the skull
-Proper collimation with side marker
-No rotation:
Symmetry of mandible, cranium, and vertebrae

55
Q

Cervical Spine Pathology

A