Cervical Spine Questions 1. A patient arrived from the ER and the physician wants to best validate stability of the cervical spine. Which position(s) would be performed? Answer: Lateral flexion and extension 2. How many cervical vertebrae need to be visualized on the AP cervical image? Answer: C3–C7 3. If spinous processes are present on the oblique image and the intervertebral foramina are not open, what is the positioning error? Answer: Over-rotation 4. What is the positioning error if the right zygapophyseal joint is closed and the left zygapophyseal joint is open on an Open Mouth image? Answer: The patient’s head is tilted toward the right 5. When observing the Open Mouth image, the left C1–C2 joint is open while the right C1–C2 joint is closed. What is the positioning error? Answer: The patient’s head was tilted toward the right 6. On an AP cervical spine image, the base of the skull is superimposed on C3. What should be done for the repeat exposure? Answer: Tuck the mandible toward the chest 7. On an AP cervical spine image, the mandible is superimposed on C3. What needs to be corrected? Answer: Extend mandible 8. On an Open Mouth image, the patient’s teeth are superimposed on the dens. What positioning correction must be made? Answer: Extend the patient’s chin 9. On an oblique cervical spine image, the intervertebral foramina are not round and the pedicle is located posteriorly across the vertebral body. What is the positioning error? Answer: The patient was over-rotated 10. On an Open Mouth image, the dens is obscured by the base of the skull. What positioning correction must be made? Answer: Tuck the chin more 11. On a lateral cervical spine image, the zygapophyseal joints are not superimposed. What is the positioning error? Answer: The patient was rotated and not in a true lateral position 12. Which cervical spine projection best demonstrates the spinous processes? Answer: Lateral 13. Which anatomy is best demonstrated by the RAO position? Answer: Right intervertebral foramina 14. Which anatomy needs to be aligned for a properly positioned AP cervical spine? Answer: Mandible and base of skull 15. Which position best demonstrates the height of the vertebral body? Answer: Lateral 16. Which position best demonstrates the zygapophyseal joints? Answer: Lateral 17. Which projection of the cervical spine will open the left intervertebral foramina? Answer: LAO 18. How many vertebrae must be included on the lateral cervical spine image? Answer: C1–T1 19

What position(s) would be performed to validate the stability of the cervical spine?

Lateral flexion and extension

How many cervical vertebrae need to be visualized on the AP cervical image?

C3–C7

What is the positioning error if spinous processes are present on the oblique image and the intervertebral foramina are not open?

Over-rotation

What is the positioning error if the right zygapophyseal joint is closed and the left is open on an Open Mouth image?

The patient’s head is tilted toward the right.

What is the positioning error if the left C1–C2 joint is open while the right is closed on an Open Mouth image?

The patient’s head was tilted toward the right.

What should be corrected if the base of the skull is superimposed on C3 in an AP cervical spine image?

Tuck the mandible toward the chest.

What needs to be corrected if the mandible is superimposed on C3 in an AP cervical spine image?

Extend mandible.

What positioning correction must be made if the patient’s teeth are superimposed on the dens in an Open Mouth image?

Extend the patient’s chin.

What is the positioning error if the intervertebral foramina are not round and the pedicle is located posteriorly in an oblique cervical spine image?

The patient was over-rotated.

What positioning correction must be made if the dens is obscured by the base of the skull in an Open Mouth image?

Tuck the chin more.

What is the positioning error if the zygapophyseal joints are not superimposed in a lateral cervical spine image?

The patient was rotated and not in a true lateral position.

Which cervical spine projection best demonstrates the spinous processes?

Lateral.

Which anatomy is best demonstrated by the RAO position?

Right intervertebral foramina.

Which anatomy needs to be aligned for a properly positioned AP cervical spine?

Mandible and base of skull.

Which position best demonstrates the height of the vertebral body?

Lateral.

Which position best demonstrates the zygapophyseal joints?

Lateral.

Which projection of the cervical spine will open the left intervertebral foramina?

LAO.

How many vertebrae must be included on the lateral cervical spine image?

C1–T1.

What must a technologist perform if all vertebrae are not included on the lateral cervical spine image?

Perform the Swimmer’s projection.

Which anatomy is well demonstrated in the oblique position of the cervical spine?

Intervertebral foramina.

Cervical spine positions performed to demonstrate foramina closest to the image receptor are:

RAO and LAO.

What is the tube angle required for anterior oblique projections of the cervical spine?

15 degrees caudal.

Which projection(s) demonstrate stability of the vertebral column?

Flexion and extension – anterior/posterior.