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Cervical and Thoracic Spine Positioning
Radiographic Positioning Questions
55
Health Care
01/17/2011

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Term
What two structures must be parallel to demonstrate the correct anatomy on an AP "Open Mouth" Projection.
Definition
The lower margin of the upper incisors and the base of the skull
Term
What is the central Ray placement for an AP "Open Mouth" Projection?
Definition
CR perpendicular to the IR directed throught the center of the open mouth
Term
If the teeth are superimposed over the dens on an AP "Open Mouth" projection, what positioning correction do you need to make?
Definition
Slightly hyperextend the neck or angle the CR cephalic
Term
If the base of the skull is superimposed over the dens, what positioning correction needs to be made?
Definition
Slightly hyperflex the neck or direct the CR slightly caudad
Term
Where should the patient's tounge be to prevent it's shadow from superimposing the axis and atlas?
Definition
In the lower jaw
Term
If the upper dens is not clearly demonstrated, what view should you do?
Definition
Fuchs or Judd
Term
How should the head be positioned for an AP Axial Projection of the C-spine?
Definition
Adjust the head so a line from the occlusal plane to the base of the skull is perpendicular to the table/IR
Term
What is the CR angle for an AP Axial Projection of the C-Spine?
Definition
Angle the CR 15 degrees cephalic when the patient is supine, and 20 degrees cephalic when the patient is upright
Term
What is the SID for an AP Axial Projection of the C-spine?
Definition
40 inches
Term
How can you determine that you have the correct CR angle when viewing an AP Axial Projection of the C-spine?
Definition
Open intervertebral joint spaces
Term
What oblique Cervical spine position is prefered to reduce thyroid dose?
Definition
Anterior Oblique
Term
Why do you extend the chin when doing an oblique projection of the c-spine?
Definition
To prevent the mandible from superimposing the upper vertebrae of the c-spine
Term
To what degree do you rotate the patient for an oblique projection of the c-spine?
Definition
45 degrees
Term
What is the CR position for an Anterior oblique c-spine?
Definition
15 degrees caudad
Term
What is the CR position for a posterior oblique c-spine?
Definition
15 degrees cephalic
Term
What does an anterior oblique spine demonstrate?
Definition
Intervertebral foramina and pedicles closest to the IR
Term
What does the posterior oblique spine demonstrate?
Definition
The intervertebral foramina and pedicles farthest from the IR
Term
How can you determine that you have the correct CR angulation and the correct patient roation on a radiograph?
Definition
Open intervertebral disk spaces and open intervetebral foramina, and the pedicles should be demonstrated in full profile
Term
What does on-end pedicles aligned at the midline of the cervical body and visualization of the zygapophyseal joints on an oblique c-spine radiograph indicate?
Definition
Over rotation of the patient
Term
What is the SID for an oblique c-spine?
Definition
60-72 inches
Term
What is the SID for a Lateral C-spine?
Definition
72 inches
Term
What is the IR placement for a Lateral c-spine radiograph?
Definition
Place the top of the IR 1in above the EAM
Term
What is the central ray placement for a lateral c-spine radiograph?
Definition
CR is perpendicular to the IR, directed horizontally to C4
Term
If the junction of C7-T1 is not demonstrated on a Lateral Raddiograph, what other radiograph should you do?
Definition
Swimmers or Twining
Term
What respiration technique should you use for a Lateral C-spine radiograph?
Definition
Suspend respiration on full expiration
Term
Why use a 72 in SID for a lateral c-spine radiograph?
Definition
To compensate for increased OID and to reduce magnification
Term
Where is the CR centered for a swimmer's view?
Definition
CR is centered to T1
Term
Which arm do you place above the patient's head for a swimmer's view of the c-spine?
Definition
The arm nearest the IR
Term
What is the central ray placement for flexion-extension c-spine radiographs?
Definition
CR perpendicular to the IR, directed to the area of C4
Term
How do you position the patient's head for a hyperflexion view of the c-spine?
Definition
Chin should be depressed until it touches the chest or as much as the patient can tolerate
Term
How should the patient's head be positioned for a hyperextension view of the c-spine?
Definition
The chin should be raised and head leaned back as far as the patient can tolerate
Term
How should the spinous processes appear on a hyperflexion film of the c-spine?
Definition
Spinous processes should be separated
Term
How should the spinous processes appear on a hyperextension radiograph of the c-spine?
Definition
Spinous processes should be in close proximity
Term
What is the SID for hyperflexion and hyperextension views of the C-spine?
Definition
72 inches
Term
What is the position of the head for Fuchs Method?
Definition
Elevate the chin to bring the MML near perpendicular to the table top
Term
What is the CR placement for the Fuchs Method?
Definition
CR is parallel to MML, directed to inferior tip of mandible
Term
What is the position of the dens on a radiograph of the Fuchs or Judd Method?
Definition
The dens should be centered within the foramen magnum
Term
How can you determine that you have correctly extended the patient's head and neck for a Fuchs or Judd Method?
Definition
The tip of the mandible is superior to the foramen magnum
Term
How do you position the head for an AP "wagging jaw" projection of the c-spine?
Definition
Adjust the head so that a line drawn from the lower margin of the upper incisors to the base of the skull is perpendicular to the table
Term
For what projection is the mandible in continous motion?
Definition
AP "wagging jaw" projection
Term
What methods will create more uniform density on an AP projection of the T-spine?
Definition
The anode heel effect and a wedge compensating filter
Term
How do you position the patient for the anode heel effect?
Definition
Position the patient so that the abdomen is under the cathode side
Term
What is the CR placement for an AP projection of the T-spine?
Definition
CR centered to T7, which is 3-4 inches below the jugular notch
Term
What is the SID for an AP projection of the c-spine?
Definition
40 inches
Term
Why should you flex the knees during an AP thoracic spine projection?
Definition
To reduce the thoracic curvature of the spine
Term
Why should you suspend expiration on an AP projection of the T-spine?
Definition
Expiration reduces air volume in the thorax for more uniform brightness/density
Term
What size film should you use for a Lateral projection of the T-spine?
Definition
14x17
Term
What is the CR placement for a Lateral projection of the T-spine?
Definition
CR centered at T7
Term
What can you do to reduce the amount of scatter radiation on a lateral T-spine radiograph?
Definition
Apply close collimation and place a lead mat behind the patient
Term
How far should you oblique your patient for an oblique T-spine radiograph?
Definition
20 degrees from lateral or 70 degrees from the midsagittal plane
Term
Where is the CR centered for an oblique projection of the T-spine?
Definition
T7
Term
Which oblique of the T-spine is prefered to reduce breast dose?
Definition
anterior obliques
Term
What does an anterior oblique radiograph of the T-spine demonstrate?
Definition
Zygapophyseal joints closest to the IR
Term
What does a posterior oblique radiograph of the T-spine demonstrate?
Definition
Zygapophyseal joints farthest from the IR
Term
Definition