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C-Spine
Image Analysis
| Question | Answer |
|---|---|
| What type of curvature is the Pelvic Spine? | Kyphotic; convex |
| What type of curvature is the Cervical Spine? | Lordotic; concave |
| What type of curvature is the Lumbar Spine? | Lordotic; concave |
| What type of curvature is the Thoracic Spine? | Kyphotic; convex |
| Most surgeons refer to the Spine _______ as that is how they view it when operating. | posteriorly |
| Primary curvatures of the Spine? | Thoracic and Sacral |
| Secondary curvatures of the Spine? | Cervical and Lumbar |
| abnormal exaggerated curvature of the Spine with increased convexity (humpback) | Kyphosis |
| abnormal exaggerated Lumbar curvature of the Spine with increased concavity (swayback) | Lordosis |
| abnormal lateral curvature of the Spine (more pronounced in the lower vertebral column) | Scoliosis |
| What type of bones are the vertebrae? | Irregular |
| The two main parts to the vertebrae of the Spine? | Body and Arch |
| Vertebrae are considered true because they are what? | moveable |
| Vertebrae are considered false because they are what? | fused or fixed; immoveable |
| Which bones of the vertebral column are considered false vertebrae? | Sacrum and Coccyx |
| How many cervical vertebrae are there? | 7 |
| How many Vertebral bones are there? | 24 |
| A typical vertebrae is from ______ to ______? | C3-C6 |
| The anatomy of the Typical Cervical Vertebrae is distinguished by what? | Transverse foramen in the transverse processes and Bifid Spinous Processes |
| Projects laterally from the junction of the Lamina and the Pedicles on each side of the Vertebrae? | Transverse Process |
| What forms the Transverse Processes? | Lamina and Pedicle |
| Short and Wide, projects laterally and posterior on the Cervical Vertebrae? | Pedicles |
| What are the 3 Vertebral Foramen that all Cervical Vertebra contain? | Right and Left Transverse Foramen and Vertebral Foramen |
| Unique feature to the Spinous Processes of the Cervical Spine from vertebral level ______ to _______ | Bifid Tips; C2-C6 |
| In order to visualize the Intervertebral Foramen on an Oblique Cervical Spine Position, what is the degree of angle for positioning and Central Ray angle? | 45 degree oblique position and a 15 degree CR angle |
| The intervertebral Foramen of the Cervical Spine are formed by what? | Vertebral Notches of the Pedicles |
| A short thick column of bone that makes the cervical vertebrae stronger and more supportive, located between the Superior and Inferior Articular Processes and behind the Transverse Processes? | Articular Pillar |
| What joins to form the Spinous Processes of the C2-C6 Cervical Vertebra? | Lamina |
| What is best demonstrated on the Lateral Projection of the Cervical Spine? | Apophyseal Joints |
| What separates the Anterior and Posterior Arches of the C1 Vertebrae? | Transverse Atlantal Ligament |
| What vertebrae least resembles the typical cervical vertebrae? | C1 |
| The Apophyseal Joints of C2-C7 lie at what degree angle to the Midsagittal Plane? | 90 Degrees |
| What receives the Odontoid Process (Dens) of C2? | Anterior Arch of C1 |
| The Posterior Arch of C1 transmits what? | The Spinal Cord |
| The most solid part of the C1 Vertebrae, located on either side of the Anterior Arch, two solid masses of bone that support the weight of the Head? | Lateral Masses |
| Located on the Superior aspect of the Lateral Masses of C1 | Condyles of the Occipital Bone |
| The Occipitoatlantal Joint is formed by what? | Superior Articular Process of C1 and the Condyles of the Occipital Bone of the Skull |
| Unique distinguishing features of the C2 Vertebrae (Axis)? | Dens or Odontoid Lamina broader and thicker No Transverse Processes |
| Another name for the C2 Vertebrae? | Axis |
| Unique distinguishing features of the C1 Vertebrae (Atlas)? | 1. Ring-like bone 2. No body or Spinous Process 3. Lateral Masses that support the weight of the Head |
| Unique distinguishing features of the C7 Vertebrae? | Vertebral Prominens and Palpable |
| Encloses and protects the Spinal Cord? | Vertebral Canal |
| What is a "Cervical Rib"? | Extra Rib |
| What forms the Vertebral Arch? | Two Pedicles and Two Lamina |
| What forms the Vertebral Foramen? | Body of the Vertebrae and the Vertebral Arch |
| During fetal development, what is formed by the body of C1 fusing to C2, allowing the head to rotate from side to side? | Odontoid Process or Dens |
| Separates the Vertebral Bodies with the exception of C1 and C2? | Intervertebral Disks |
| The function of the Intervertebral Disks of the Spine? | 1.Absorbs shock during movement of the Spine 2. Provides cushion between the Vertebrae |
| Central Mass of soft, pulpy, semigelatinous material that helps form the intervertebral disks? | Nucleus Pulposis |
| Forms the outer fibrocartilaginous portion of the Intervertebral Disk? | Annulus Fibrosis |
| What type of Joint is the Occipitoatlantal Joint and what movements does it allow? | Condyloid Joint - allows the head to rock back and forth |
| What forms the Atlantoaxial Joint? | Anterior Arch of C1 (Atlas) and the front of Odontoid Process |
| What type of Joint is the Atlantoaxial Joint and what movements does it allow? | Pivot Joint - allows head to turn from side to side |
| What type of Joints are the Joints of Lushka and what movements do they allow? | Diarthroidal - flexion and extension |
| Where are the Joints of Lushka located? | Between the posterolateral margins of the lower 5 Cervical Vertebrae |
| What forms the Apophyseal Joints? | Superior Articular Processes below and Inferior Articular Processes above |
| What type of Joint are the Apophyseal Joints and what movements do they allow? | Gliding Joints - flexion and extension |
| Location of the Intervertebral Joints, what type of joint and what movements do they allow? | Between the vertebral bodies - Amphiarthroidal Joints - slight movement |
| Where is a Compression Fracture found and what causes it? | In the body of the Vertebra - caused by forceful flexion of the Vertebral Column causing the inferior and superior surfaces of the vertebral bodies to compress |
| What is a Hangman's Fracture? | A fracture of the Pedicles of C2 without displacement of C2 or C3 |
| What is Burst or Jefferson Fracture? | Fracture of the 1st Cervical Vertebrae caused by a direct blow to the Head (such as diving), causing the C1 ring of bone to break apart |
| A separation of normally joined parts (ex; symphysis pubis)? | Diastasis |
| A partial loss of continuity between two articular surfaces with some part remaining intact? | Subluxation |
| What is Arthritis? | Inflammation of a Joint |
| What is Rheumatoid Arthritis? | Immune response to Joint inflammation |
| What is a Herniated Nucleus Pulposis (HNP)? | The inner nucleus pulposis protrudes into the vertebral canal and presses on the Spinal Cord |
| Clinical Indications for Routine Cervical Spine Projections? | Pain or Neuropathy |
| Clinical Indication for Lateral Soft Tissue Neck Projections? | Foreign Body Localization |
| Clinical Indications for Trauma Cervical Spine Projections? | Injury or suspected fractures |
| Trauma C-Spine Projections: | 1. X-Table Lateral 2. AP Axial 3. AP - Open Mouth Odontoid 4. X-Table Lateral Swimmers when necessary |
| Routine C-Spine Projections: | 1. AP Axial 2. AP Open Mouth Odontoid 3. Lateral 4. Bilateral Obliques |
| Bony Landmark location for the Mastoid Tip? | C1 |
| Bony Landmark location for the Gonion or Angle of the Mandible? | C2-C3 |
| Bony Landmark location for the Hyoid Bone? | C4 |
| Bony Landmark location for the Thyroid Cartilage? | C5 |
| Bony Landmark location for the Cricoid Cartilage? | C6 |
| Bony Landmark location for the Vertebral Prominens? | C7-T1 |
| SID for Lateral Cervical Spine Projections? | 72 inch SID |
| What is the Air Gap Technique and why is it applied in the Lateral Projection of the C-Spine? | Technique used to decrease scatter and magnification (OID increased between neck and IR) by increasing SID to 72 inches for the Lateral Projection of the Cervical Spine |
| Top of the IR placement for the AP Axial C-Spine? | 1-2 inches above the EAM |
| Breathing instruction for the AP Axial C-Spine? | Expiration |
| Image Receptor orientation for the Lateral C-Spine? | Crosswise |
| Image Receptor orientation for the AP Axial C-Spine? | Lengthwise |
| Top of the IR placement for the Lateral C-Spine? | 1-2 inches below the level of TEA |
| Where is the CR centered for the Routine C-Spine Projections? | at the level of Thyroid Cartilage C5 |
| Purpose for having the patient hold their breath on expiration for most C-Spine Projections? | To bring the Shoulders down |
| What type of Projections are the Flexion and Extension series for the Cervical Spine? | Functional Study |
| What are the soft tissue structures of the Neck? | Pharynx and Larynx |
| Purpose for preforming Bilateral Oblique positions of the Cervical Spine? | To visualize the Intervertebral Foramen for bone spurring or stenosis of the foramen |
| Which Oblique Projection will reduce dose to the Thyroid Gland? | PA |
| SID for the Oblique Positions of the Cervical Spine? | 40-72 inch SID |
| CR angle for the AP Oblique Position of the Cervical Spine? | 15 degrees Cephalad to the level of Thyroid Cartilage |
| Top of IR placement for the AP Oblique Position of the Cervical Spine? | 1 inch above TEA |
| CR angle for the PA Oblique Position of the Cervical Spine? | 15 degrees Caudad 1 inch inferior to the Thyroid Cartilage C5 |
| Top of IR placement for the PA Oblique Position of the Cervical Spine? | 1 inch below the TEA |
| Most important projection of the Trauma C-Spine Routine and Why? | X-Table Lateral - determines spinal cord injury due to fracture |
| What must be included on the Lateral Projection of the C-Spine to ensure the entire cervical spine has been evaluated? | C1-C7 |
| What would be performed if C7 is not included on a X-Table Lateral Trauma C-Spine Image? | X-Table Lateral Swimmers |
| Top of IR placement for the X-Table Lateral C-Spine? | TEA |
| For the AP Axial Projection of the C-Spine, you have the patient lift their chin so what plane is perpendicular to the IR? | Occlusal Plane |
| Why is the AP Open Mouth Odontoid important when performing a Trauma Routine? | To view the Apophseal Joints between C1 and C2 and to view the Odontoid Process due to it being so easily fractured when there is Cervical Spine injury |
| If the patient is unable to open their mouth or tip the chin up or down for the AP Open Mouth Odontoid, what would you do instead? | Angle the CR 5 degrees either cephalic or caudad depending on what is superimposed over the Odontoid |
| Occlusal Plane? | Line between the Mastoid tip and the bottom ridge of teeth |
| EAM? | line from the external Auditory "meathole" to the tympanic membrane |
| The Pharynx or Throat is _____ inches long? | 5 |
| Unique characteristic of the Pharynx? | Common to both the Respiratory and Digestive System |
| Location of the Pharynx in reference to the Cervical Spine? | Anterior |
| The Pharynx extends from what to what? | Sphenoid Bone in the base of the Skull to the Disk Space between C3-C4 |
| Three parts of the Pharynx? | 1. Nasopharynx 2. Oropharynx 3. Laryngopharynx or Hypopharynx |
| The Larynx or Voice box is how long? | 1 1/2 to 2 inches long |
| The Larynx extends from what to what? | C2-C3 |
| What is the first division of the Respiratory System? | Larynx |
| The Larynx is suspended by what below the Floor of the Mouth? | Hyoid Bone |
| The Larynx consists of what? | 9 rings of Cartilage |
| The Larynx consists of what two major pieces of cartilage and their vertebral level location in the spine? | 1. Thyroid Cartilage - C5 2. Cricoid Cartilage - C6 |
| Where are Tracheotomies performed? | Just below the Cricoid Cartilage |
| Location of the Glottis and Epiglottis? | Larynx |
| Acts as a lid to prevent food and fluid from entering the Larynx, Trachea and Bronchi? | Epiglottis |
| Contains the True Vocal Cords? | Larynx |
| AP Axial of the Cervical Spine best demonstrates? | Upper Thoracic and Lower Cervical Spine - SC Joints |
| What type of Joints are the SC Joints and what movements do they allow? | Saddle Joint - flexion, extension, adduction, abduction |
| No rotation in an AP Axial C-Spine image is evident by what? | Symmetrical Vertebral Bodies and SC Joints |
| If you fail to angle your CR 15 degrees Cephalad - AP Axial Projection - the Mandible will superimpose over what Cervical Vertebrae? | C1 and C2 |
| AP Open Mouth Odontoid Demonstrates what? | C1-C2 through an open mouth |
| What other methods other than open mouth odontoid can be performed to visualize the odontoid process? | Fuchs and Judd |
| How are the Spinous Processes situated on a lateral C-Spine Flexion image? | Closer together |
| How are the Spinous Processes situated on a lateral C-Spine Extension image? | Farther apart |
| What is best demonstrated on a Lateral C-Spine Projection? | Apophyseal Joints |
| Best demonstrated on an AP Oblique Position of the Cervical Spine? RPO and LPO? | Intervertebral Foramen C3-C7 farthest from the IR RPO = Left IF LPO = Right IF |
| What is being demonstrated on PA Oblique Positions of the Cervical Spine? RAO and LAO? | Intervertebral Foramen C3-C7 closest to the IR RAO = Right IF LAO = Left IF |
| What should be included on the AP and PA Oblique Projections of the Cervical Spine to ensure all Cervical Vertebrae are included on the image? | C7 |
| What must be demonstrated on the X-Table Lateral C-Spine? | C1-C7 and Apophyseal Joints |
| Posterior Oblique Projections require what CR angle? | 15-20 degrees Cephalad |
| Anterior Oblique Projectios require what CR angle? | 15-20 degrees Caudad |
| Sufficient exposure on the C-Spine images are evident by what? | Sufficient brightness and sharp outlines of bony margins and Trabeculae |
| X-Table Lateral Swimmers best demonstrates what? | Vertebral Bodies, disk spaces from C5-T3 |
| If the Base of the Skull is superimposed over the odontoid, what adjustment would you make? | Bring the Chin down or 5 degrees Caudad |
| Head position for the AP Open Mouth Odontoid | adjust head so the lower margin of upper incisors to base of the skull is perpendicular to the IR |
| No rotation on an AP open mouth odontoid is demonstrated by what? | equal distances on either side of lateral masses and spinous process in the center |
| If the teeth are superimposed over the odontoid, what adjustment would you make? | Tip the Chin up or 5 Degrees Cephalic |
Created by:
teresachristensen
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