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Cervical Vert
Radiagraphy Cerv Vert
Question | Answer |
---|---|
Lateral Projection-Swimmers Technique | Twining and Pawlow Methods |
Twining Method PT part | upright lateral position |
Pawlow Method PT part | recumbent lateral position w/head elevated on PT's arm |
IR for Swimmers Technnique | centered at level of C7-T1 interspace; 2" above jugular notch |
Swimmers Technique position part | arm closest to IR above head; humeral head can be moved anteriorly |
Respiration for Swimmers Technique | suspend or if PT can a breathing technique can be used to blur the lung anatomy |
CR for Swimmers Technique | Directed at C7-T1 if shoulder away from IR is depressed or at an anlge of 3-5 caudal wen should cannot be depressed |
Eval for Swimmers Technique | Lower cervical and upper thoracic not rotated; humeral heads min SI on vert column |
Position for PA Axial Oblique Projection | RAO or LAO position |
SID for PA Axial Oblique | 60"-72" because of increased OID |
Position PT for PA Axial Oblique | upright w/ PT back toward x-ray tube |
Position part for PA Axial Oblique | Upright or semisupine; rotate PR 45 to place foramina = w/ IR |
IR centered for PA Axial Oblique | centered at level of C5 which allows for caudal angualtion |
Why elevate and protrude chine in PA Axial Oblique | prevents SI of mandible w/ upper cervical |
CR for Pa Axial Oblique | C4 at an anlge of 15-20 caudad which will coincide w/ angle of foramina |
Structures shown for PA Axial Oblique | intervertebral foramina and pedicles closest to IR |
Evaluation criteria for PA Axial Oblique | open intervert foramina closest to IR; C1-T1; open intervert disk space; occipital bone not overlapping axis; mandible not overlapping C1-C2 |
Position for AP Axial Oblique Projection | RPO and LPR position |
SID for AP Axial Oblique | 60"-72" because of increased OID |
PT position for AP Axial Oblique | supine for upright facing the x-ray tube |
Position of part AP Axial Oblique | rotate body 45 and center cervical spine to midline of IR |
IR position for AP Axial Oblique | Center the IR to the 3rd cervical body, superior to the most prominent point of thyroid cartilage |
CR for AP Axial Oblique | Directed at C4 at a cephald angle of 15-20 so the CR coincides w/ angle of foramina |
Structures shown for AP Axial Oblique | intervertebral foramina and pedicles farthest from IR |
Evaluation criteria for AP Axial Oblique | open intervert foramina farthest from IR from C2-T1; open intervert disk space; elevated chin that doesn't overlap atlas/axis; occipital bone not overlapping axis |
What is the method for the Lateral Projection | Grandy Method |
SID for Grandy Method | 60"-72" SID for increased OID, the longer distance helps demo C7 |
PT position for Grandy Method | true lateral, upright standing or sitting |
IR for Grandy Method | Height or IR centered at level of C4, top of IR will be about 1" above EAM |
Position part for Grandy Method | center coronal plane through mastoid process tips to midline of IR |
Which directions to rotate shoulders for Grandy Method | anteriorly or posteriorly according to PT natural kyphosis and depress shoulders as much as possible |
Chin for Grandy Method | elevate slightly, to prevent SI of mandibular rami and spine |
Respiration for Grandy Method | suspend at end of full expiration to obtain maximal depression of shoulders |
CR for Grandy Method | Horizontal and perpendiculat to C4; magnified shoulder farthest from IR is projected below the lower cerv vert |
Structures shown for Grandy Method | later projection of cerv vert bodies, their interspaces, articular pillars, lower 5 zyga jts; spinous processes; good lat will include C7 |
Evaluation criteria for Grandy Method | all 7 cerv vert and 1/3 of T1; neck extended fo mandibular rami are not overlapping C1/C2; SI rami of mandible; C4 in center of radiograph; no rotation or tilt of cerv spine indicated by SI open zyga jts adn intervert disk space |
PT position for AP Axial | supine ro upright; shoulders lie in same plane |
Part position for AP Axial | extend chin do occlusal plane is perpendicular to tbl |
Why extend chin for AP Axial | prevents SI of mandible and midcervical vert |
IR position for AP Axial | centered at level of C4 |
Cr for AP Axial | though C4 at an anlge of 15-20 cephalad; enters slightly inferior to most prominent point of thyroid cart |
Structures shown for AP Axial | lower 5 cerv bodies and upper 2 thoracid bodies; SI transverse adn articular processes; intervert disk space |
Evaluation criteria for AP Axial | superior C3-T2; shadows of mandible and occiput SI over C1/C2; open intervert disk space; spinous process equidistant to pedicles and aligned w/ midling of cerv bodies; mandibular angles and mastoid process equidistant to the vert |
What is the method for Dens AP Projection | Fuchs Method |
PT position for Fuchs Method | supine, center midsagittal plane of the body to midline of grid |
Part position for Fuchs Method | extend chin until tip of chin and tip of mastiod process are vertical |
IR for Fuchs Method | perpendicular to midpoint of IR; enters the neck on midsagittal plane just distal to tip of chin |
Structures shown for Fuchs Method | AP projection of the dens lying w/in circular foramen magnum |
Evaluation criteria for Fuchs Method | entire dens w/in foramen magnum; symmetry of mandible, crandium, and vert, indicating no rotation of head or neck |
Atlas and Axis AP Projection | Open Mouth |
SID for Open Mouth | 30" to increase the field of view of the odontoid area |
PT position for Open Mouth | Supine; center midsag to midline fo grid |
Position part for Open Mouth | open mouth as wide as possible; adjust head so that a line form the lower edge of upper incisors to tip of mastoid process is perpendicular to IR |
IR position for Open Mouth | centered at level of axis |
Respiration for Open Mouth | keep mouth open and phonate "ah" to place tongue in the floor of mouth so tongue is not projected on C1/C2 |
CR for Open Mouth | perpendicular to center of IR entering at midpoint of open mouth |
Structures shown for Open Mouth | AP of axis/atlas through open mouth |
Evaluation criteria for Open Mouth | dens, atlas, axis, and articulations between the 1st and 2nd cerv vert; entire articular surfaces of atlas/axis; SI occlusal plane of the upper central incissors and the base of the skull |