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Merrills Ch 8 pt 2

Vertebral Column- pt 2

QuestionAnswer
AP projection of dens is also known as what? Fuchs method
IR for AP Fuchs 8 x 10" (18 x 24 cm) ↔
Patient position for AP Fuchs supine w/ chin extended (MML near ⊥ to tabletop)
Location of IR for AP Fuchs Center IR @ tips of mastoid processes
CR for AP Fuchs ⊥ to IR just distal to chin tip
Area of interest for AP Fuchs Dens w/in foramen magnum
PA projection of dens is also known as what? Judd method
Patient position for PA Judd prone w/ chin extended (MML near ⊥ to tabletop)
IR for PA Judd 8 x 10" (18 x 24 cm) ↔
Location of IR for PA Judd ⊥ to MML @ inferior tip of mandible
CR for PA Judd ‖ to MML 1" (2.5 cm) inferoposterior to mastoid tips & ∠s of mandible; ∠ as needed
Area of interest for PA Judd Dens w/in foramen magnum
Respiration for AP Fuchs Suspend
Respiration for PA Judd Suspend
AP projection of atlas & axis is also known as what? Open mouth technique
IR for AP open mouth 8 x 10" (18 x 24 cm)
Patient position for AP open mouth supine
Location of IR for AP open mouth IR CTR @ C2; occlusal plane ⊥ to IR
CR for AP open mouth ⊥ @ midpoint of open mouth
Respiration for AP open mouth Phonate "ah" upon exposure
Area of interest for AP open mouth C1 & C2 through open mouth
IR for AP axial C-spine 8 x 10" (18 x 24 cm) ↕
Patient position for AP axial C-spine supine or upright
Location of IR for AP axial C-spine CTR IR @ C4 w/ occlusal plane ⊥ to IR
CR for AP axial C-spine 15-20° cephalad @ C4
Respiration for AP axial C-spine Suspend
Area of interest for AP axial C-spine C3- T2/3; ? C-ribs
SID for AP open mouth 30" (76 cm) to ↑ view of odontoid area
True or false? AP Fuchs should not be attempted if fx or degenerative disease of upper cervical region is suspected. True
Lateral projection of C-spine is also known as what? Grandy method
IR for lateral C-spine, Grandy method 8 x 10" (18 x 24 cm) ↕
SID for lateral C-spine, Grandy method 60- 72" SID due to ↑ OID; helps show C7
Patient position for lateral C-spine, Grandy method seated or standing, midsagittal plane ‖ to IR; Ⓡ or Ⓛ position
Location of IR for lateral C-spine, Grandy method CTR coronal plane that passes thru mastoid tips to IR midline
CR for lateral C-spine, Grandy method ⊥ @ C4; shoulder FARTHEST from IR proj ↓ lower c-spine
Area of interest for lateral C-spine, Grandy method C3-C7 Zygapophyseal joints
Respiration for lateral C-spine, Grandy method Suspend @ expiration ∴ ↓ shoulders
True or false? Sandbags can be attached to each of patient's wrists in lateral C-spine, Grandy method? True
True or false? Lateral C-spine, hyperflexion or hyperextension can be performed as long as patient as sufficient support. False; only attempt once C-spine pathology or fx has been r/o.
Area of interest for lateral C-spine, hyperflexion & hyperextension Motility of C-spine; includes intervertebral disks & zygapophyseal joints
Location of spinous processes in lateral C-spine, hyperflexion elevated & widely separated
Location of spinous processes in lateral C-spine, hyperextension depressed in close appoximation
IR for lateral C-spine, hyperflexion & hyperextension 24 x 30 cm ↕
Patient position for lateral C-spine, hyperflexion & hyperextension seated or standing; chin dropped or chin extended; Ⓡ or Ⓛ position
CR for lateral C-spine, hyperflexion & hyperextension ⊥ @ C4
Location of IR for lateral C-spine, hyperflexion & hyperextension IR CTR @ C4 & top 2" (5 cm) ↑ EAM
Respiration for lateral C-spine, hyperflexion & hyperextension Suspend
SID for lateral C-spine, hyperflexion & hyperextension 60- 72" SID due to ↑ OID; helps show C7
EAM External acoustic meatus
MML Mentomeatal line
Occlusal plane line from the lower edge of the upper incisors to the tip of the mastoid process
SID for AP axial oblique C-spine, RPO & LPO 60- 72" SID due to ↑ OID
Area of interest for AP axial oblique C-spine, RPO & LPO Cervical intervertebral foramina; C2/C3- C7/T1
IR for AP axial oblique C-spine, RPO & LPO 8 x 10" (18 x 24 cm) ↕
Patient position for AP axial oblique C-spine, RPO & LPO supine or upright* (seated or standing); elevate/protrude chin
Body rotation for AP axial oblique C-spine, RPO & LPO 45° ∠
Location of IR for AP axial oblique C-spine, RPO & LPO IR CTR to body of C3
1" (2.5 cm) ↑ to the most prominent point of the thyroid cartilage C3
CR for AP axial oblique C-spine, RPO & LPO 15- 20° cephalad @ C4; w/ ∠ of foramina
Respiration for AP axial oblique C-spine, RPO & LPO Suspend
Side of interest for AP axial oblique C-spine, RPO & LPO side FARTHEST from IR
True or false? Hyperflexion & hyperextension of AP oblique C-spine is performed to demonstrate fx, obscure dislocations & subluxations of the articular processes. True
IR for PA axial oblique C-spine, RAO & LAO 8 x 10" (18 x 24 cm) ↕
SID for PA axial oblique C-spine, RAO & LAO 60- 72" SID due to ↑ OID
Patient position for PA axial oblique C-spine, RAO & LAO prone or upright* (seated or standing); chin elevated & protruded
Location of IR for PA axial oblique C-spine, RAO & LAO CTR IR @ C5
Body rotation for PA axial oblique C-spine, RAO & LAO 45° ∠ ∴ foramina openings ‖ w/ IR
Respiration for PA axial oblique C-spine, RAO & LAO Suspend
CR for PA axial oblique C-spine, RAO & LAO 15- 20° caudal @ C4; w/ ∠ of foramina
Side of interest for PA axial oblique C-spine, RAO & LAO side CLOSEST to IR
Area of interest for PA axial oblique C-spine, RAO & LAO Intervertebral foramina & pedicles
What is the Lateral projection of the cervicothoracic region also known as? "Swimmer's" technique
IR for Lateral Swimmer's 24 x 30 cm ↕
Patient position for Lateral Swimmer's recumbent or upright
Area of interest for Lateral Swimmer's cervicothoracic vertebrae between shoulders
Location of IR for Lateral Swimmer's CTR IR @ C7-T1, 2" (5 cm) ↑ jugular notch
CR for Lateral Swimmer's ⊥ to C7-T1 or 3-5° caudal when unable to ↓ shoulder
Respiration for Lateral Swimmer's Suspend; breathing tech if pt able & can be immobilized
2" (5 cm) ↑ jugular notch C7-T1 interspace
IR for AP T-spine 35 x 43 cm (14" x 17") or 18 x 43 cm ↕
Location of IR for AP T-spine Top of IR 1½- 2" (3.8- 5 cm) ↑ shoulders ∴ T7 in CTR of image
Position of patient for AP T-spine supine or upright
CR for AP T-spine ⊥ to IR @ ½ btwn jugular notch & xiphoid process
Respiration for AP T-spine Shallow breaths; or suspend @ expiration
Area of interest for AP T-spine T1-T12 w/ uniform density
IR for Lateral T-spine, Ⓡ or Ⓛ 35 x 43 cm (14" x 17") or 18 x 43 cm ↕
Area of interest for Lateral T-spine, Ⓡ or Ⓛ thoracic vertebral bodies & intervertebral foramina
Location of IR for Lateral T-spine Ⓡ or Ⓛ Top of IR 1½- 2" (3.8- 5 cm) ↑ shoulders ∴ T7 in CTR of image
inferior ∠ of scapulae T7
Patient position for Lateral T-spine, Ⓡ or Ⓛ lateral recumbent (Ⓡ or Ⓛ* position), upright
CR for Lateral T-spine, Ⓡ or Ⓛ ⊥ @ T7; 10 cephalad for ♀ & 15 cephalad for ♂ to T7 if vertebral column not elevated
Respiration for Lateral T-spine, Ⓡ or Ⓛ Normal breathing or suspend @ expiration
Area of interest for AP/PA (opt) L-spine Lumbar vertebrae: bodies, IV disk spaces, laminae, spinous & transverse processes. w/larger IR also shows abd viscera & air/gas patterns
SID for AP/PA L-spine 48" (122 cm); ↓ distortion, opens intervertebral joint spaces ↑, & and ↑ quality of exam
IR for AP/PA L-spine 35 x 43 cm (14 x 17") for lumbosacral spine; or 30 x 35 cm (12 x 14") for L-spine only
Patient position for AP/PA L-spine recumbent or upright
Location of IR for AP/PA L-spine L-spine & sacrum: CTR IR @ L4; L-spine only: 1½" (3.8 cm) ↑ iliac crest @ L3
CR of IR for AP/PA L-spine For L-S exam: ⊥ @ L4; For Lumbar exam: ⊥ & 1½" (3.8 cm) ↑ L3
Respiration for AP/PA L-spine Suspend @ expiration
Level of iliac crests L4
IR for Lateral Lumbar & Lumbosacral vertebrae 35 x 43 cm (14 x 17") for lumbosacral spine; or 30 x 35 cm (12 x 14") for L-spine only
Patient position for lateral lumbar & lumbosacral vertebrae upright or recumbent (same as AP/PA), lying ON AFFECTED side
Location of IR for Lateral Lumbar & Lumbosacral vertebrae L-spine & sacrum: CTR IR @ L4; L-spine only: 1½" (3.8 cm) ↑ iliac crest @ L3
CR for Lateral Lumbar & Lumbosacral vertebrae For L-S exam: ⊥ @ L4; For Lumbar exam: ⊥ & 1½" (3.8 cm) ↑ L3
Respiration for Lateral Lumbar & Lumbosacral vertebrae Suspend @ expiration
Area of interest for Lateral Lumbar & Lumbosacral vertebrae L-vertebrae; intervertebral foramina of L1-L4
IR for Lateral L5-S1 8 x 10" (18 x 24 cm)
Location of IR for Lateral L5-S1 CTR on coronal plane 2" (5 cm) posterior to ASIS & 1½" (3.8 cm) ↓ to the iliac crest
Patient position for Lateral L5-S1 lateral recumbent
CR for Lateral L5-S1 ‖ w/ interiliac line; or if spine not horizontal 5° caudal for ♂ & 8° caudal for ♀
Respiration for Lateral L5-S1 Suspend
provides a standardized & accurate reference point from which to CTR the L5-S1 junction ASIS
Area of interest for Lateral L5-S1 Lateral lumbosacral junction; L4- L5, and upper sacrum
imaginary line between both iliac crests interiliac plane
What are AP or PA axial projection of L-S jct & SI joints also known as? Ferguson method
IR for AP/PA axial L5-S1/SI joints 8 x 10" (18 x 24 cm) or 24 x 30 cm ↕
Location of IR for AP/PA axial L5-S1/SI joints IR ctr to CR
Patient position for AP/PA axial L5-S1/SI joints supine (PA axial, prone)
CR for AP/PA axial L5-S1/SI joints 30° cephalad ♂ & 35° ♀; 1½" (3.8 cm) ↑ to pubic symphysis (30-35° caudal @ L4 for PA axial)
Respiration for AP/PA axial L5-S1/SI joints Suspend
Area of interest for AP/PA axial L5-S1/SI joints Lumbosacral joint & both SI joints
CR Variation for PA axial L5-S1/SI joints (Meese) ⊥ & CTR to ASIS @ 2" (5 cm) distal to spinous process of L5
IR for AP oblique Zygapophyseal joints, RPO & LPO 35 x 43 cm (14 x 17") or 30 x 35 cm ↕; 8 x 10" (18 x 24") for the last zygapophyseal joint
Location of IR for AP oblique Zygapophyseal joints, RPO & LPO IR ctr to CR
Patient position for AP oblique Zygapophyseal joints, RPO & LPO recumbent or upright; affected side closest to IR
Respiration for AP oblique Zygapophyseal joints, RPO & LPO Suspend @ expiration
CR for AP oblique Zygapophyseal joints, RPO & LPO For lumbar region, 2" (5 cm) medial to ↑ ASIS & 1½" (3.8 cm) ↑ iliac crest @ L3; For 5th Z-joint, 2" (5 cm) medial to ↑ ASIS & ½way btwn ASIS and iliac crest.
Area of interest for AP oblique Zygapophyseal joints, RPO & LPO Zygapophyseal joints & articular processes of side closes to IR
plane of the zygapophyseal joints 30-60° to the MS plane in most patients; varies
Side of interest for AP oblique Zygapophyseal joints, RPO & LPO side closest to IR
Body rotation for AP oblique Zygapophyseal joints, RPO & LPO 45°, but can be up to 60° to show L5-S1 Z-joint
Show when pt properly positioned or AP oblique of L-spine/ Z-joints "Scottie dogs"
IR for PA oblique Z-joint projection, RAO & LAO 35 x 43 cm (14 x 17") or 30 x 35 cm ↕; 8 x 10" (18 x 24") for the last zygapophyseal joint
Location of IR for PA oblique Z-joint projection, RAO & LAO IR ctr @ L3
Patient position for PA oblique Z-joint projection, RAO & LAO upright or recumbent prone*; also semisupine
CR for PA oblique Z-joint projection, RAO & LAO ⊥ to L3, 2" (5cm) lateral to palpable spinous process
Respiration for PA oblique Z-joint projection, RAO & LAO Suspend @ expiration
Area of interest for PA oblique Z-joint projection, RAO & LAO Zygapophyseal joints (esp 5th) & articular processes of side farthest from IR
Side of interest for PA oblique Z-joint projection, RAO & LAO joints FARTHEST from IR
Body rotation for PA oblique Z-joint projection, RAO & LAO 45°, but can be up to 60° to show L5-S1 Z-joint
IR for PA projection, lumbar intervertebral disks, weight bearing method, Ⓡ or Ⓛ bending 35 x 43 cm (14" x 17") ↕
What is PA projection, lumbar intervertebral disks, also known as? Weight-bearing method; Ⓡ or Ⓛ bending
Patient position for PA projection, lumbar intervertebral disks, weight-bearing method, Ⓡ or Ⓛ bending standing
CR for PA projection, lumbar intervertebral disks, weight-bearing method, Ⓡ or Ⓛ bending ⊥ to L3; 15-20° caudad or thru L4/L5 or L5-S1 if area of interest
Respiration for PA projection, lumbar intervertebral disks, weight-bearing method, Ⓡ or Ⓛ bending Suspend
Location of IR for PA projection, lumbar intervertebral disks, weight-bearing method, Ⓡ or Ⓛ bending IR CTR @ L3
Area of interest for PA projection, lumbar intervertebral disks, weight-bearing method, Ⓡ or Ⓛ bending mobility of intervertebral joints; localize to site of lesion in pts w/ disk protrusion
True or false? AP L-spine bending is preferred over PA L-spine bending for comfort of patient. False; PA pref'd due to ↓ pt rad
IR for AP projection, L-spine Ⓡ or Ⓛ bending 24 x 30 cm (10 x 12") or 35 x 43 cm (14" x 17") ↕
Patient position for AP projection, L-spine Ⓡ or Ⓛ bending supine
Location of IR for AP projection, L-spine Ⓡ or Ⓛ bending IR CTR to CR
Respiration for AP projection, L-spine Ⓡ or Ⓛ bending Suspend
CR for AP projection, L-spine Ⓡ or Ⓛ bending ⊥ to L3
Area of interest for AP projection, L-spine Ⓡ or Ⓛ bending max Ⓡ or Ⓛ lat flex; early scoliosis; motion of spinal fusion; localize herniated disk
IR for Lateral projection, L-spine Ⓡ or Ⓛ hyperflexion & hyperextension 35 x 43 cm (14" x 17") ↕
Patient position for Lateral projection, L-spine Ⓡ or Ⓛ hyperflexion & hyperextension lateral recumbent; 1st knees fwd & 2nd lean thorax bkwd
Location of IR for Lateral projection, L-spine Ⓡ or Ⓛ hyperflexion & hyperextension IR CTR @ spinal fusion
Respiration for Lateral projection, L-spine Ⓡ or Ⓛ hyperflexion & hyperextension Suspend
CR for Lateral projection, L-spine Ⓡ or Ⓛ hyperflexion & hyperextension ⊥ to spinal fusion area or L3
Area of interest for Lateral projection, L-spine Ⓡ or Ⓛ hyperflexion & hyperextension motion in spinal fusion area, or localize herniated disk
prep for sacrum & coccyx exams bowel free of gas & fecal material; bladder empty
IR for AP or PA axial Sacrum 24 x 30 cm (10 x 12")
IR for AP or PA axial Coccyx 8 x 10" (18 x 24 cm)
Location of IR for AP or PA axial Sacrum IR CTR to CR
Location of IR for AP or PA axial Coccyx IR CTR to CR
Patient position for AP axial Sacrum or Coccyx supine
Patient position for PA axial Sacrum or Coccyx prone
Respiration for AP or PA axial Sacrum or Coccyx Suspend
CR for AP axial Sacrum 15° cephalad @ 2" ↑ to pubic symphysis
CR for PA axial Sacrum 15° caudad @ sacral curve
CR for AP axial Coccyx 10° caudad @ 2" ↑ to pubic symphysis
CR for PA axial Coccyx 10° cephalad @ coccyx
Area of interest for AP or PA axial Sacrum & Coccyx Sacrum or Coccyx free of superimposition
True or false? Females can be shielded for sacrum & coccyx x-rays. False
IR for Lateral projection of sacrum, Ⓡ or Ⓛ 24 x 30 cm (10 x 12")
IR for Lateral projection of coccyx, Ⓡ or Ⓛ 8 x 10" (18 x 24 cm ↕)
Area of interest for Lateral projection of sacrum & coccyx, Ⓡ or Ⓛ lateral sacrum & coccyx
Location of IR for Lateral sacrum & coccyx, Ⓡ or Ⓛ IR CTR to CR w/ sacrum or coccyx to midline of grid
CR for Lateral sacrum, Ⓡ or Ⓛ ⊥ to ASIS level @ point 3½" (9 cm) posterior
CR for Lateral coccyx, Ⓡ or Ⓛ ⊥ toward point 3½" (9 cm) posterior to ASIS & 2" (5 cm) ↓
Respiration fof Lateral sacrum & coccyx Suspend
What is AP/PA* scoliosis series also known as? Ferguson method
IR for PA projection of thoracolumbar spine, scoliosis series, Ferguson method 14 x 36" (35 x 90 cm) or 14 x 17" (35 x 43 cm) ↕
Position of patient for PA thoracolumbar spine, scoliosis series, Ferguson method seated or standing
Location of IR for PA thoracolumbar spine, scoliosis series, Ferguson method Bottom of IR 1" (2.5 cm) ↓ to iliac crests
CR for PA thoracolumbar spine, scoliosis series, Ferguson method ⊥ to midpoint of IR
True or False? Patient support or compression bands are NOT to be used in PA thoracolumbar, Ferguson method radiographs. True
Respiration for PA thoracolumbar spine, scoliosis series, Ferguson method Suspend
How many radiographs are taken for PA thoracolumbar spine, scoliosis series, Ferguson method 2; 1st normal seated/standing & 2nd w/ hip or foot elevated
Area of interest for PA thoracolumbar spine, scoliosis series, Ferguson method comparison to distinguish deforming or primary curve from compensatory curve in patients w/ scoliosis
Created by: GWCCRad12