Chapter 8

C - spine

Spinal Curvatures

• Normal curvatures– _______________– _______________

• Abnormal curvatures– _______ exaggerated concavity (Swayback)– _______exaggerated convexity (Humpback)– _______ exaggerated lateral curvature

Vertebral Anatomy

• ___________ – Thick rounded area.

• ___________– Posterior arch of bony projections

Axial View

• ______________– Opening for spinal cord

• ____________– Posterior protrusions from body

• ___________– Posterior portion of arch off of pedicle meets

midline

Axial View

• ______________– Lateral projections

• _____________– Most posterior protrusions midline

Lateral View

• Body – Thick _________ portion

• Pedicle – __________ to body

• Laminae – _________ to transverse process/pedicle

Lateral View• Transverse Process

– Termination of ___________

• Spinous process – Posterior termination __________

• _________________articular process – Superior and inferior projections

Vertebral Joints• _______________ (Apophyseal, Facet)

– Superior and inferior articular process

• ______________– Area of disks.

• Disks - ______________(outer borders). - ______________(Inner material).

• HNP

Intervertebral Foramina

• Hole formed by ________________– Superior and Inferior ____________

• Space for _______________vessels to pass

C-spine Variations

• __________________– Hole in transverse process for vertebral

artery/veins/nerves

• ___________ spinous process – Split spinous process on ________

C-spine Variations

• Zygapophyseal joints - __________seen on lat. ____ seen on _____

• Articular pillars– Lateral Masses

C-spine Intervertebral foramina

• _______angle from mid sagittal

• _________ inferior angle

• Important to know for __________ imaging

C1

• __________

• Skull rests on ____________Facets– Atlantooccipital articulation

• _________ arch with tubercle

• _________ arch with tubercle

C2

• __________

• ____________(Dens)– Resting posterior to the anterior arch of C1

• Pivot for rotating head

Imaging the C-Spine

Routine• AP 40”SID• AP Open Mouth 40” SID• Lt Lateral 60-72”SID• RPO/RAO 60-72” SID• LPO/LAO 60-72”SID• 75-80 kV

AP C-Spine

• Supine or Erect• Slightly __________• ________________angle• CR mid-sagittal• Level of thyroid cartilage ________• C3-7 seen well• Collimate to _________

AP Open Mouth

• For ______________view

• Have pt __________

• Align top ___________surface is in line with _____________

• CR through mouth

Open Mouth

• Collimate to outer edges of mouth

• Shows ________________of ____

• Dens

RPO/LPO

• Place pt in ___________

• Angle tube ___________

• CR to the level of C4

• Shows intervertebral foramina _____________ from IR

RAO/LAO

• Pt in __________

• ____________angle

• CR to the level of C4

• Shows intervertebral foramina __________

Lateral C-Spine

• Erect or X-table• SID ___________• _________ shoulders with pt straight• Slightly extend chin• CR to thyroid cartilage (C4-6)• Must visualize ___________

X-Table

• If pt presents with a C-spine collar• _____________• __________________________• Collar must be __________

Swimmers

• If ___________not on Lateral• Place pt in lateral• Arm closest to ____________head• Arm farthest from ____________• CR __________jugular notch• May put slight _________ angle if needed.