Positioning of the C-Spine & T-Spine

What is the technique for the left lateral C-spine?

70-80 @ 24-32 mAs

What is the technique for the oblique C-spines?

70-80 @ 24-32 mAs

What is the IR size/orientation for the left lateral C-Spine?

10×12 LW

What is the IR size/orientation for the oblique C-Spines?

10×12 LW

What is the SID for the left lateral C-spine?

72 inches

What is the SID for the oblique C-spines?

72 inches

What is the tube angle for the oblique C-spines?

15 degrees cephalic

Where is the CR for the left lateral C-spine?

C4-C5 and MCP

Where is the CR for the oblique C-spines?

C4-C5

How would you position for a left lateral C-spine?

• shoulder against IR (will be OID)

• go to front and check for tilt/rotation

• elevate chin slightly (so don’t superimpose mandible on upper vertebrae)

How would you position for an oblique C-spine?

• align MSP to CR and midline of IR

• rotate body and head 45 degrees

• elevate chin slightly

Where is your marker for the left lateral C-spine?

Left marker by neck curve (not in soft tissue)

What is the breathing for the left lateral C-spine?

Full expiration

What is the breathing for the oblique C-spines?

Suspend respiration

What might you have to do for the left lateral C-spine to get the shoulders down?

Use weights

What does the left lateral C-spine demonstrate?

Zygapophyseal joints

If doing anterior obliques for the C-spine, what angle would you have?

15 degrees caudal

Why would you do an anterior oblique C-spine?

To reduce dose to thyroid

What do the posterior oblique (RPO/LPO) C-spines demonstrate?

Intervertebral foramina (and pedicles) on the side of the pt furthest from the IR

What is the technique for the AP axial C-Spine?

70-80 kVp @ 18 mAs

What is the technique for the AP open mouth C-Spine?

70-80 kVp @ 24-32 mAs

What is the technique for the Swimmers view C-Spine?

80 kVp @ 80-125 mAs

What is the IR size/orientation for the AP axial C-spine?

8×10 LW

What is the IR size/orientation for the AP open mouth C-spine?

Collimate down to 7×7 (approximately)

What is the IR size/orientation for the Swimmers view C-spine?

10×12 LW

What is the SID for the AP axial C-spine?

40 inch

What is the SID for the AP open mouth C-spine?

40 inch

What is the SID for the Swimmers view C-spine?

72 inches

What is the tube angle for the AP axial C-spine?

15 degree cephalic

Where is the CR for the AP axial C-spine?

C4-C5

Where is the CR for the AP open mouth C-spine?

Center of the open mouth

Where is the CR for the Swimmers view C-spine?

T1 (1” above jugular notch)

How would you position for an AP axial C-spine?

• align MSP to CR and midline of table/IR

• elevate chin slightly

How would you position for an AP open mouth C-spine?

• align MSP to CR midline of the table/IR
  adjust head to that, with open mouth, a line form lower margin of upper incisors to the base of the skull (mastoid tips) is perpendicular to table/IR

How would you position for a Swimmers view of the C-spine?

• align MCP to CR and midline of table/IR

• arm near Bucky goes up, resting on head, and lower other shoulder (to separate humeral heads)

What is the breathing for the AP axial C-spine?

Suspend respiration

What is the breathing for the AP open mouth C-spine?

Suspend respiration

What is the breathing for the Swimmers view C-spine?

Expiration

How should you angle the CR on an AP axial C-spine if a more lordotic curvature is present?

20 degrees

Why would you do a Swimmers view of the C-spine?

To get C5-T3 when cannot get C7-T1 on lateral view

What should you do if you cannot separate the shoulder for a swimmers view?

Use a 3-5 caudad tube angle

What is the technique for the flexion/extension C-spine?

70-80 kVp @ 24-32 mAs

What is the technique for the PA Judd C-spine?

70-80 kVp @ 24-32 mAs

What is the technique for the AP Fuchs C-spine?

70-80 kVp @ 24-32 mAs

What is the IR size/orientation for the flexion/extension C-spine?

10×12

What is the IR size/orientation for the PA Judd C-spine?

8×10

What is the IR size/orientation for the AP Fuchs C-spine?

8×10

What is the SID for the flexion/extension C-spine?

72 inches

What is the SID for the PA Judd C-spine?

40 inch

What is the SID for the AP Fuchs C-spine?

40 inch

How should you collimate for the PA Judd C-spine?

7×7 (approximately)

How should you collimate for the AP Fuchs C-spine?

7×7 (approximately)

Where is the CR for the flexion/extension C-spine?

C4-C5

Where is the CR for the PA Judd C-spine?

Parallel to MML

Where is the CR for the AP Fuchs C-spine?

Parallel to MML

How would you position for flexion C-spine?

• align MCP to CR and midline of table/IR

• ensure true lateral position

• relax and depress shoulders

• depress chin until it touches the chest or as much as pt can tolerate

How would you position for an extension C-spine?

• align MCP to CR and midline of table/IR

• ensure true lateral position

• relax and depress shoulders

• raise chin and tilt head back as much as possible

How would you position for a PA Judd C-spine?

• chin is resting on tabletop/upright Bucky and is extended to bring MML near perpendicular

• ensure no rotation of head

• ensure CR is parallel to MML, through mid occipital bone about 1 inch inferoposterior to mastoid tips and angle of mandible

How would you position for an AP Fuchs C-spine?

• elevate chin as needed to bring MML near perpendicular

• ensure no rotation of head exists

• CR parallel to MML, directed to inferior tip of mandible

What marker would you use for the flexion/extension C-spine?

Left

What is the breathing for the flexion/extension C-spine?

Full expiration

What is the breathing for the PA Judd C-spine?

Suspend respiration

What is the breathing for the AP Fuchs C-spine?

Suspend respiration

What is the technique for the AP T-spine?

75-85 kVp @ 12-20 mAs

What is the technique for the left lateral T-spine?

80-95 kVp @ 40-60 mAs

What is the technique for the oblique T-spine?

75-85 kVp @ 12-20 mAs

What is the IR size/orientation for the AP T-spine?

14×17 LW

What is the IR size/orientation for the left lateral T-spine?

14×17 LW

What is the IR size/orientation for the oblique T-spine?

14×17 LW

What is the SID for the T-spine?

40 inch

What is the collimation for the AP T-spine?

10×17

What is the collimation for the left lateral T-spine?

12×17

What is the collimation for the oblique T-spine?

Collimate down on two sides of anatomy

Where is the CR for the AP T-spine?

T7 (3-4 inches below jugular notch)

Where is the CR for the left lateral T-spine?

T7 (inferior angle of the scapula)

Where is the CR for the oblique T-spine?

T7

How would you position for an AP T-spine?

• align MSP to CR and midline of table/IR

• flex knees and hips to reduce thoracic curvature

• ensure no rotation of thorax of pelvis

How would you position for a left lateral T-spine?

• find MCP then go back and inch or two from midline

• raise pts arms to rich angles to the body with elbows flexed

• flex hips and knees with support between knees

• ensure no rotation of shoulder or pelvis

How would you position for an oblique T-spine?

• rotate body back 20 degrees from true lateral (creates 70 degree oblique from table)

• ensure equal rotation of shoulder and pelvis

• flex knees for stability

What is the breathing for the AP T-spine?

Expiration

What is the breathing for the left lateral T-spine?

Orthostatic

What is the breathing for the oblique T-spine?

Full expiration

Where should your IR be for the AP T-spine?

1-2 inches above jugular notch

What else should you use for a left lateral T-spine?

Both sponge and lead blocker

What does the left lateral T-spine demonstrate?

Intervertebral foramina

What does the anterior oblique positions demonstrate on a oblique T-spine?

Downside zygapophyseal joints

What does the posterior oblique positions demonstrate on an oblique T-spine?

Upside zygapophyseal joints