Vertebral Column And Cervical Spine Flashcards
FUNCTIONS OF THE VERTEBRAL COLUMN
-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
VERTEBRAL COLUMN
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
VERTEBRAL COLUMN CURVES
-Curves are viewed from the lateral position.
-The spinal curvatures increase its strength.
-Help to maintain balance in upright positions.
-Increase flexibility.
Abnormal Vertebral Curvatures
FEATURES OF A TYPICAL VERTEBRA
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.
FEATURES OF A TYPICAL VERTEBRA continued
-On each side, the pedicles attach the vertebral body to the lamina.
-Each pedicle is notched on its superior and inferior surfaces.
When the vertebrae are stacked a ____________ ____________ is formed on each side by the notches in the pedicles
intervertebral foramen
________ _________ _________ pass through the intervertebral foramina to feed the upper extremities, neck, and throat
Spinal nerve roots
Lamina(e)
are the flat, bony, posterior portions of the vertebral arch.
The laminae join together to form the
spinous process
extending posteriorly from the lamina
Spinous Process
extending laterally
Transverse Processes
extending superiorly from the junction of the pedicles & lamina, one on each side. (Left & Right)
Superior Articulating Processes/ Facets
extending inferiorly from the lamina, one on each side. (Left & Right)
Inferior Articulating Processes/ Facets
FEATURES OF A VERTEBRA
When the vertebrae are stacked, the superior and inferior articulating facets align forming the
zygapophyseal joints
Each intervertebral level has __ zygapophyseal joints
2(left and right)
The cervical and lumbar spines have a _________ curvature
Lordotic
the thoracic and sacrum/coccyx have a _______ curvature
Kyphotic
The pedicles form the
Intervertebral foramen
The transverse processes extend __________ from where the pedicle and lamina meet
Laterally
The ________ process is located in the midline
Spinous
These structures make up the zygapophyseal joints:
Facets of the superior and inferior articular processes
C1-C7 The transverse processes of these vertebrae have openings called
transverse foramina
The transverse foramina allow
vertebral arteries and veins to pass through the neck to enter the base of the skull
Cervical Vertebra picture
C1 aka ATLAS
-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
C2 aka AXIS
-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.
CERVICAL VERTEBRAE 3-6
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
Intervertebral foramina at a ___ degree angle to MSP
45
C7 aka VERTEBRAL PROMINENS
-ATYPICAL VERTEBRAE
-has a longer spinous process.
-A radiographic landmark that can be seen and felt a the base of the neck.
2 TYPES OF ARTICULATIONS OF THE VERTEBRAL COLUMN
- Intervertebral joints: cartilaginous symphysis
- Zygapophyseal joints: synovial gliding joints
Movement:
Flexion, Extension, Lateral Flexion, Rotation
What is the 7 series of the Cervical Spine called?
Davis series
Routine series is usually how many series
3 or 5
AP Axial Cervical Spine Positioning Criteria
-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
AP Axial Cervical Spine Evaluation Criteria
-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
AP Axial Cervical Spine Improper Positioning
AP Open Mouth Positioning Criteria
-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”
AP Open Mouth Evaluation Criteria
-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
AP Open Mouth Improper Positioning
Lateral Grandy Method Positioning Criteria
-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
Lateral Grandy Method Evaluation Criteria
-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
Lateral Grandy Method Improper Positioning
AP Axial Oblique Cervical Spine Positioning Criteria
-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
AP Axial Oblique projection demonstrates side ________ from the IR
PA Axial Oblique projection demonstrates side ________ to the IR
Farthest; Closest
AP Oblique Cervical Spine Evaluation Criteria
-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
PA Axial Oblique Cervical Spine Positioning Criteria
-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
PA Axial Oblique Cervical Spine Evaluation Criteria
Intervertebral foramina and pedicles closest to the IR
PA Axial Oblique Cervical Spine Improper Positioning
Lateral: Hyperflexion & Hyperextension
-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
Lateral: Hyperflexion & Hyperextension Positioning Criteria
-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
Lateral: Hyperflexion & Hyperextension Evaluation Criteria
-Intersegmental alignment of the cervical spine
-Evaluation criteria for Grandy method
*Flexion: Spinous processes elevated and separated
*Extension: Spinous processes depressed and closely spaced
AP Dens Fuchs Method Positioning Criteria
-10 X 12 IR CW in TB
-SID 40”
-Patient Supine
-Arms to sides
-CR: just distal to the tip of the chin
-Extend chin until tip of chin and tip of mastoids are vertical
-MSP perpendicular to IR
-Shield
-Collimate and place side marker
-Suspend Respiration
AP Dens Fuchs Method Evaluation Criteria
-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
Cervical Spine Pathology
