C spine

1
Chapter 9

• C - spine

2
The Spinal Column

• _________ 7 vertebrae
• _________ 12 vertebrae
• __________ 5 vertebrae
• __________ fused vertebrae

3
Spinal Curvatures

• Normal curvatures
• ______________
• ______________
• Abnormal curvatures
• __________ exaggerated concavity
• ________ exaggerated convexity (Humpback)
• __________ exaggerated lateral curvature

4
Vertebral Anatomy

• ___________
• Thick rounded area.
• ____________
• Posterior arch of bony projections

5
Axial View

• __________________
• Opening for spinal cord
• ______________
• Posterior protrusions from body
• _______________
• Posterior portion of arch off of pedicle meets
  midline

6
Axial View

• _________________
• Lateral projections
• _________________
• Most posterior protrusions midline

7
Lateral View

• ____________
• Thick anterior portion
• ____________
• Posterior to body
• _____________
• Posterior to transverse process/pedicle

8
Lateral View

• ________________
• Termination of pedicle
• _______________
• Posterior termination of laminae
• ___________________________
• Superior and inferior projections

9
Vertebral Joints

• ____________________________
• Superior and inferior articular process
• __________________
• Area of disks.
• ______________
• Annulus fibrosus (outer borders).
• Nucleus pulposus (Inner material).
• ________

10
Intervertebral Foramina

• Hole formed by __________________
• Superior and Inferior Vertebral arch
• Space for _____________________ to pass

11
C-spine Variations

• ____________________
• Hole in transverse process for vertebral
  artery/veins/nerves
• _____________________
• Split spinous process on C2-6.
• Zygapophyseal joints
• - _________________________________

12
C-spine Intervertebral foramina

• _______________from mid sagittal
• ______________angle
• Important to know for oblique imaging

13
C1

• ____________
• Skull rests on ______________
• Atlantooccipital articulation
• ______________with tubercle

14
C1

• ________________with tubercle
• ______________
• Lateral Masses

15
C2

• ____________
• ________________
• Resting posterior to the anterior arch of C1
• Pivot for rotating head

16
Imaging the C-Spine

• Routine
• AP 40SID
• AP Open Mouth 40 SID 8 x 10
• Lt Lateral 72SID
• RPO/RAO 60-72 SID
• LPO/LAO 60-72SID
• 75-80 kVp

17
AP C-Spine

• Supine or Erect
• Slightly extend chin
• ____________________
• CR mid-sagittal
• Level of thyroid cartilage ___________
• ____________seen well
• Collimate to skin

18
AP Open Mouth

• For __________________
• Have pt open mouth
• Align top teeth biting surface is in line with
  ______________________
• CR through mouth
• Collimate to outer edges of mouth
• _____________________________
• Dens

19
RPO/LPO

• Place pt in ______________
• Angle tube ________________
• CR to the level of C4
• Shows _________________________ away from IR

20
RAO/LAO

• Pt in _______________
• _______________
• CR to the level of C4
• Shows _________________________ to IR

21
Lateral C-Spine

• Erect or X-table
• Increase ________________
• Depress shoulders with pt straight
• Slightly extend chin
• CR to thyroid cartilage (C4-6)
• Must visualize ______________

22
X-Table

• If pt presents with a C-spine collar
• ____________________
• ___________________
• Collar ____________ be cleared
• Once cleared collar can be removed and proceed
  with the routine series.

23
Swimmers

• If ________________ not on Lateral
• Place pt in lateral
• Arm ______________raise above head
• Arm ______________IR depress
• CR _____________jugular notch
• May put slight caudal angle if needed.