encloses and protects spinal cord

supports trunk and skull

provides muscle attachment

Vertebral Column

4 curves

cervical - lordotic

thoracic - kyphotic

lumbar - lordotic

sacrum/coccyx (pelvic curve) - kyphotic

increased kyphotic curve

(think hunchbacked old lady)

body

vertebralarch

These 2 parts enclose vertebral foramen

The articulation of the vertebral foramina

form the ____________________

Cervical Vertebrae

What makes them special?

Transverse foramina

Bifid spinous processes

atlas

Has no body

Axis

has dens (odontoid process)

C-Spine

Respiration

Suspended during most projections

Exceptions:

lateral - full expiration to depress shoulders

AP open mouth - "ah"

Swimmer's - breathing technique to blue lung detail

MSP perpendicular to IR

Extend chin until tip is vertical

CR perpendicular just distal to chin tip

DEMONSTRATES DENS WITHIN FORAMEN MAGNUM

align edge of upper teeth and mastoid tip

mouth open as wide as possible

CR perpendicular thru midpoint of open mouth

Demonstrates C1/C2 articulation

CR to C4 & 15-20 degrees cephalic

MSP perpendicular to IR

Extend chin a bit

MCP perpendicular to IR

C4 in center

shoulders relaxed

CR perpendicular to C4

DEMONSTRATES ZYGAPOPHYSEAL JOINTS

C-Spine

Hyperflexion/Hyperextension

Used to evaluate range of motion

positioning and centering same as regular lateral

45 degree oblique

CR to C4 & 15-20 degrees cephalic

DEMONSTRATES UPSIDE INTERVERTEBRAL FORAMINA

*can do PA Axial Oblique (just angle the opposite direction)

Do when C7/T1 isn't demonstrated on lateral C-Spine

recumbent true left lateral with head resting on arm and right arm resting on right side

left shoulder up - right shoulder down

CR perpendicular to C7/T1 interspace if right shoulder is depressed Angle 3-5 degrees caudad if patient can't depress right shoulder

MSP centered

Top of IR 1.5 to 2 inches above shoulders to place T7 in center

CR perpendicular halfway between jugular notch and xiphoid

DEMONSTRATES INTERVERTEBRAL FORAMINA

Left lateral - Arms at right angle to body

Flex knees and hips for comfort

CR perpendicular at level of T7 if spine is horizontal

Spine not horizontal - angle 10-15 cephalad Ideally use breathing technique to blur ribs and lungs

perpendicular CR

CR at level of crest when using 14 x 17

CR 1.5 inches above crest when using 11 x 14

 include psoas muscles center on MSP

demonstrates zygapophyseal joints

perpendicular CR

center at level of crest (14 x 17) or

1.5 inches above crest (11 x 14)

45 degree oblique

CR enters 2 inches medial to upside ASIS

perpendicular CR (if spine is horizontal)

true lateral (normally left)

CR enters at level of crest or

1.5 inches above depending on IR size

DEMONSTRATES INTERVERTEBRAL FORAMINA

true lateral

CR: 5 degrees caudad - male

8 degrees caudad - female

flex hips and knees for pt comfort

CR enters 2 inches posterior to ASIS

and 1.5 inches below crest

CR 30-35 degree cephalad

enters on MSP 1.5 inches above pubic symphysis

looking at side up

do both obliques

CR perpendicular entering 1 inch medial

to elevated ASIS

25 - 30 degree oblique

CR 15 degrees cephalic

entering 2 inches superior

to pubic symphysis

CR 10 degrees caudad

entering 2 inches superior to pubic symphysis

true lateral

CR perpendicular entering 3.5 posterior to ASIS

true lateral

CR perpendicular entering 3.5 posterior

and 2 inches inferior to ASIS

upright to better demonstrate curvature

PA better to reduce dose

uses longer cassettes or stitching together images

increased SID (60 inches recommended)

demonstrate thoracic and lumbar vertebrae