Rad Quality 2- Exam 1- Spine Positioning

Most exposures are taken at what distance or closer?

40

A further OID creates?

More magnification

What are the important things to do before taking the image

De-artifact the patient

Grown the patient

Shield the patient (when appropriate)

What are Dr. Heston`s commandments for X-ray positioning

1. The comfortable position is almost always the wrong position

2. Never tell them then number of X-rays you are taking

3. Don't leave the patients hanging

4. Look for cheating patients

5. Explain your instructions CLEARLY to them before you go behind the wall

What is the 3 C spine series?

APOM

AP Cspine (APLC)

Lateral

What is the most common Cervical spine series

3 series Cspine

What is the 5 C spine seizures

The 3 series PLUS either obliques or flexion/extension

The obliques in the cervical spine allow us to see?

The IVF for encroachment

What C spine series is done for trauma cases and always starts with a neutral lateral?

It's EVERYTHING plus obliques plus flexion/extension

What is the standard cervical spine series

APOM

AP Cspine (AP lower cervical)

Lateral

What is a good check for the lateral cervical?

Cross hair follows the mandible and light at the AC joint and top of ear

What should the retropharyngeal space be on a lateral cervical?

1-7mm at C2

What should the retrotracheal space be on a lateral cervical?

9-22mm at C6

What is the main reason we do an AP cervical

Look at the uncinates

What cervical levels should you see with a lateral cervical

C2-T2/T3

Why do we do the cephalic tube tile in the AP cervical

To see the uncinates

What are pertinent negatives to look for in the AP cervical

Tracheal deviation

Lung apices are clear

Where should the tracheal air shadow be in an AP cervical

T1-T2 over the spinous processes

What can cause tracheal deviation

Cardiac or pulmonary disease

Flexion and extension projections of the cervicals assess?

Motion units

Joints

Stability

What anatomy do you want to see for lateral cervical flexion?

Entire cervical spine

(Occiput-C7-T1)

With flexion/extension the translation should be less than?

1.5 (adult)

2.5 (child)

Anterior obliques in the cervicals require what type of tube tilt to see the?

Caudal to see the IVFs

Posterior obliques in the cervicals require what type of tube tilt to see what?

Cephalic to see the IVFs

What is the rule for obliques?

Cervicals anterior show same side anatomy (IVFs)

Lumbar POSTERIOR show the same side anatomy (Pars)

What thoracic spine projection is good for seeing the CT junction?

Swimmers

What anatomy should you see with AP thoracic

C7/T1- T12/L1

How can you tell the difference between C7 and T1?

Cervical TVPs are caudal (go down)

Thoracic TVPs are cephalic (go up)

What do you check for in AP thoracic X-rays

Bone density

Costoclavicular and Rib joints

Calcifications

Alignment

Breast shadows

The heart is _________ from the Bucky on AP thoracic so it will appear_______

Further away

Larger

Lateral thoracic should cover what anatomy?

T1 down to T12

What are the PUC views where you move the film to the central ray inside the Bucky and DO NOT move the Bucky once it's tilted?

PUC APOM

PUC Nasium

PUC Base Posterior

PUC lateral provides us with?

The atlas plane line

On a PUC lateral the collimation is__________ then you should?

10x12

Then exclude the orbits

The CR on PUC APOM should travel through?

Mastoid tips

What is the Bucky tilt for PUC APOM

Bucky is tilted to touch back of patients head and shoulders without altering their posture

How do you get the tube tile for PUC nasium

Depends on the angle of the atlas, so you need the atlas plane line on the lateral projection (SO PUC lateral must be analyzed first)

-use the atlas plane line and then have caudal tube tilt

Axis plane line is how many degrees typically?

5-15 degrees

The PUC base posterior demonstrates what?

Atlas, axis and nasal septum

How do you measure the SID for PUC base posterior

Manually due to large tube tilt used

What is the scenario if the anatomy is in the correct spot of the image but part or half of the image is gone?

Patient and IR are aligned correctly, but the CR or collimation is wrong

What is the scenario if the anatomy is too high or low and part or half of the image is cut off?

CR is not aligned correctly with the patient and/or image receptor

-Move the tube, patient or image receptor, or all 3

What is the scenario if you get no image and just a blank screen?

1. You never made an exposure

2. The CR, IR and patient anatomy are not anywhere close to being lined up

The obliques in the lumbar are used to look for?

The pars articularis

With an AP lumbar projection, where do you put the shield?

Strap around ASIS level with red Velcro facing forward

How much of the shield should be on the image with a male patient?

Top of shield should be at public symphysis

How much of the shield should be on the image with a female patient

Entire female shield should be present on film

With the lumbars it is important to have the ________ against the Bucky with scoliosis

Convexity (back of the curve)