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C-Spine, T-Spine
| Question | Answer |
|---|---|
| Functions of vertebral column | - encloses and protects spinal cord - supports trunk and skull - provides muscle attachments |
| number of bones in vertebral column | - 26 - 24 are true, movable vertebrae - sacral and coccygeal segments are false, fixed vertebrae - sacral vertebrae fuse to form sacrum - coccygeal vertebrae fuse to form coccyx |
| two main parts of vertebrae | - body (anterior) - vertebral arch (posterior) |
| vertebral arch formed by what? | - 2 pedicles and 2 laminae |
| what do pedicles form? | the posterior aspect of vertebral body - bottom is concave to form vertebral notches - articulation of vertebral notches form intervertebral foramina |
| where do laminae project? | posteriorly and medially from pedicles |
| transverse processes project from where? | laterally and from junction of laminae and pedicles |
| how many articular processes arise from the junction of pedicles and laminae? | four -- two superior and two inferior |
| what are zygapophyseal joints? | they are where articular processes articulate with vertebrae above and below |
| spinous processes project from where? | posteriorly and inferiorly from junction of both laminae |
| spina bifida is a congenital condition in which | the laminae fail to fuse |
| vertebral discs are composed of ____________ and function as __________ | fibrocartilage, cushions |
| vertebral discs composed of | annulus fibrosus - outer, fibrocartilaginous disc nucleus pulpsus - central, soft mass |
| how many curves in the vertebral column | four |
| lordotic curves | convex anteriorly |
| kyphotic curves | concave anteriorly |
| scoliosis, kyphosis | abnormal lateral curvature, increased kyphotic curve of thoracic spine |
| unique characteristics of cervical vertebrae | - applicable to C3-C6 - transverse foramina, located in transverse processes, spaces where vertebral arteries flow - Bifid, or split tips on spinous processes |
| C1 (ATLAS), re: unique exceptions | - has no vertebral body - superior articular processes articulate with condyles of the occipital bone |
| C2 (AXIS). re: unique exceptions | - has a process called the dens or odontoid - odontoid articulates with the anterior ring of C1 |
| C7, re: unique exceptions | - called vertebra prominens because of its long, prominent spinous process. Used as a bony landmark |
| number of thoracic vertebrae | 12 |
| unique features of thoracic vertebrae | - costal facets on posterior |
| where do thoracic vertebrae articulate with heads of ribs? | lateral sides of bodies |
| where do thoracic vertebrae articulate with tubercle of ribs (except for T11 and T12)? | facets on transverse processes |
| the two most superior cervical vertebrae are | - atypical, which allows for articulation with skull - C1 (called Atlas) and C2 (called Axis) |
| C7 is atypical because it joins with | T- spine |
| C4-C5 has a bony landmark called what? | the thyroid cartilage |
| When would you use a lateral swimmer's technique? | to visualize C7-T1 |
| in an AP axial c-spine, how are the occlusal plane and mastoid tips positioned? | perpendicular to IR |
| lateral projection of C-spine demonstrates what? | zygapophyseal joints |
| re: AP axial oblique C-spine, where are the intervetebral foramina? | on side farther from IR |
| re: PA axial oblique C-spine, where are the intervetebral foramina? | on side closer to IR |
| what should you do if shoulder cannot be depressed for lateral cervicothoracic (Swimmer's?) | angle 3-5 degrees caudad |
| Fuchs Method (AP Odontoid) | Chin elevated so mentomeatal line is perpendicular to chin, CR directed to tip of the chin |
| lateral cervical spine - extension -- what is it? | hyperextension -- patient relaxes head as far back as possible |
| lateral cervical spine - extension should be performed when? | - only with physician order and no trauma suspected - patient must move the neck slowly and actively -- never assisted |
| Lateral Cervical Spine — Flexion -- what is it? | Hyperflexion: Have patient put chin as close to chest as possible |
| For lateral cervical spine flexion and extension, what must be ruled out before attempting? | fracture and/or pathology |
| ottonello method (AP cervical projection), aka "wagging jaw" | - mandibular shadow is blurred or obliterated by having the patient perform an even chewing motion during exposure - patient's head must be rigidly immobilized -l ong exposure time |
| For what shot do you use the breathing technique (low mA, long time)? | lateral thoracic spine |
| a lateral projection of the thoracic spine demonstrates what? | T spine intervertebral foramina |
| PA obliques (RAO/LAO) best demonstrate what? | zygapophyseal joints closest to IR |
| "strings of pearls" visualized in what view? | oblique c- spine |
| erect lateral T spine vs. recumbent lateral T spine | erect - evaluate kyphosis, shows natural curvature under gravity recumbent - trauma, pain, or inability to stand, spine appears less kyphotic due to lack of weightbearing |
| tissue thickness of upper T-spine (T1-T4) | thicker (shoulders, upper chest) |
| tissue thickness of lower T-spine (T8-T12) | thinner |
| anode heel effect | - higher intensity radiation at the cathode - lower intensity radiation at the anode - most prominent at shorter SID, like 40" |
| C-Spine AP obliques show what structures? | LPO shows right intervertebral foramina (side up) RPO shows left intervertebral foramina (side up) - 15-20 cephalad |
| C-Spine PA obliques show what structures? | LAO shows left intervertebral foramina (side down) RAO shows right intervertebral foramina (side down) 15 - 20 caudad |
| T Spine obliques show what structures at what position and degrees? | LPO - 70 - right zygapophyseal joints (side up) RPO - 70 - left zygapophyseal joints (side up) LAO - 70 - left zygapophyseal joints (side down) RAO - 70 right zygapophyseal joints (side down) |
| what structure is best demonstrated in T-Spine oblique? | zygapophyseal joints (side closest to IR) |
| what structure is best demonstrated in AP T spine? | vertebral bodies, pedicles, spinous processes |
| what structure is best demonstrated in lateral T spine? | vertebral bodies in profile, disc spaces |
| what structure is best demonstrated in swimmer's lateral? | C7-T3 junction |
| jefferson fracture | - burst fracture of C1 - open mouth (odontoid) projection is best - testing clue - lateral mass displacement / axial load injury |
| hangman's fracture | - bilateral pars fracture of C2 - Lateral C spine projection is best - htesting clue - yperextension injury, MVC |
| compression fracture | - vertebral body collapse - lateral C spine projection is best - testing clue - anterior wedging |
| if you see intervetebral foramina, think about... | C-spine obliques |
| if you see foraminal side specified, think about... | AP oblique - side closest to IR PA oblique - side furthest from IR |
| if you see "correct cervical lordosis," think about... | AP axial C-spine, 15-20 degrees cephalad |
| if you see "CERVICAL zygapophyseal joints," think about... | lateral C spine, joints are nearly horizontal |
| if you see "zygapophyseal joints," think about... | T-spine obliques, 70-75 degree body rotation |
| if you see "zygapophyseal joint side specific," think about.. | closest side to IR |
| if you see "rib/lung markrings obscure spine," think about... | lateral T spine with breathing technique |
Created by:
user-1998695