T and C spine A&P complete

AP T-Spine part position

Flex hips and knees; place IR 1.5 to 2 inches above shoulders

AP T-Spine central ray

Enters halfway between jugular notch and xiphoid process at MSP

AP T-Spine collimation

7x17

AP T-Spine breathing instruction

On expiration

Oblique T-Spine patient position

Body rotated 70° anterior oblique (RAO or LAO)

Oblique T-Spine part position

Arm closest to IR raised, shoulders and hips rotated together

Oblique T-Spine central ray

Perpendicular to T7

Oblique T-Spine collimation

7x17

Oblique T-Spine breathing instruction

On expiration

Oblique T-Spine structures visualized

Zygapophyseal joints

Lateral T-Spine patient position

Recumbent or upright

Lateral T-Spine part position

Arms extended at right angle to body

Lateral T-Spine central ray

Center to posterior half of thorax at level of T7

Lateral T-Spine collimation

7x17

Lateral T-Spine breathing instruction

On expiration

Cervicothoracic (Swimmer’s) part position

Arm closest to IR raised above head; depress shoulder farthest from IR

Cervicothoracic (Swimmer’s) central ray

Perpendicular to C7-T1; if shoulder cannot be depressed, angle 3-5 caudal

Cervicothoracic (Swimmer’s) collimation

10x12

AP Axial C-Spine part position

Lift chin up

AP Axial C-Spine central ray

15 cephalic at thyroid cartilage, about C4-C5

AP Axial C-Spine collimation

10x12

Oblique C-Spine part position

Head and body at 45° posterior oblique

Oblique C-Spine central ray

C4 with 15-20 cephalic

Oblique C-Spine collimation

10x12

Oblique C-Spine SID

72

Lateral C-Spine part position

Top of IR 1 inch above EAM; depress shoulders

Lateral C-Spine central ray

At C4

Lateral C-Spine collimation

10x12

Lateral C-Spine SID

72

Hyperflexion C-Spine part position

Drop head forward and draw the chin as close as possible to the chest

Hyperflexion C-Spine central ray

MCP at C4

Hyperflexion C-Spine collimation

10x12

Hyperextension C-Spine part position

Have patient elevate chin and relax head as far back as possible

Hyperextension C-Spine central ray

MCP at C4

Hyperextension C-Spine collimation

10x12

AP Atlas and Axis (Open Mouth) part position

Adjust head so line from lower edge of upper incisors to tip of mastoid process (occlusal plane) is perpendicular to IR

AP Atlas and Axis (Open Mouth) respiration

Keep mouth open and phonate “Ah”

AP Atlas and Axis (Open Mouth) collimation

5x5

AP Dens (Fuchs) part position

Extend chin until tip of chin is vertical; align MML

AP Dens (Fuchs) central ray

Enters MSP just distal to chin tip

AP Dens (Fuchs) collimation

5x5

AP Soft tissue central ray

MSP at C4

AP Soft tissue respiration

Slowly breathe in

AP Soft tissue collimation

10x12

AP Soft tissue SID

40

Lateral Soft tissue respiration

Slowly breathe in

Lateral Soft tissue central ray

C4

Lateral Soft tissue collimation

10x12

Lateral Soft tissue SID

72

Does the dens replace the open odontoid view?

1. Yes

2. No

No

Where is the thyroid cartilage? C-Spine

C4-C5

Which two bony landmarks must be superimposed for an AP open mouth Odontoid projection?

1. Front incisors and tip of mentum

2. Base of skull and tip of mentum

3. Front incisors and inion

4. Front incisors and base of skull

Front incisors and base of skull

If a patient is in a RAO position, what projection are they in?

PA oblique projection

Hyperflexion and hyper extension lateral C-spine SID

72

What is unique about T1?

T1 has a full superior costal facet and a demi-facet inferiorly

What is characteristic of T2–T8 thoracic vertebrae?

They typically have superior and inferior costal demi-facets for articulation with nearby ribs.

What is unique about T9?

T9 has a superior demi facet and lacks an inferior demi-facet.

What distinguishes T10-T12 from other thoracic vertebrae?

T10 has full costal facet on each side and two transverse costal facets, T11 and T12 each have a single full facet on the vertebral body.

What is the function of the thoracic transverse processes?

They articulate with the tubercles of ribs (except T11 and T12).

How are thoracic spinous processes oriented?

They are long and angle sharply inferiorly.

What forms the thoracic intervertebral foramina?

The pedicles of adjacent vertebrae forming openings for spinal nerve exit.

What type of joint is the costovertebral joint?

A synovial (diarthrodial) gliding joint

What type of joint is the costotransverse joint?

Synovial (diarthrodial) gliding joint

What type of joint are thoracic zygapophyseal joints?

Synovial (diarthrodial) gliding joints.

At what angle are thoracic zygapophyseal joints oriented?

They angle anteriorly from the midcoronal plane approximately 15

How many cervical vertebrae are there

7

What are the unique features of cervical vertebrae?

The foramina is located on the transverse processes, there are bifid spinous processes.

Which cervical vertebrae are considered typical?

C3 through C6.

the articular processes in typical cervical vertebrae (C3–C6) are located between the ____and the ____

Pedicles and lamina

What are the articular pillars in cervical vertebrae formed by

The superior and inferior articular processes

What type of joint are cervical zygapophyseal joints?

Synovial joints

At what angle are cervical intervertebral foramina directed?

Directed anteriorly 45° from the midsagittal plane and 15° inferiorly from the horizontal plane.

Which cervical vertebrae are considered atypical?

C1 (atlas), C2 (axis), and C7.

What structures make up C1 (atlas)?

Anterior arch, posterior arch, two lateral masses, and two transverse processes.

Does C1 (atlas) have a vertebral body?

No, C1 has no vertebral body.

What articulates with the superior articular processes of C1?

The occipital condyles

How do the transverse processes of C1 compare to other cervical vertebrae?

They are longer than the other cervical vertebrae.

What is the dens (odontoid process)?

A projection on the upper anterior body of C2 (axis).

What does the dens articulate with?

Anterior ring of C1.

What articulates with the superior articular processes of C2?

The inferior articular processes of the atlas (C1).

Why is C7 called vertebra prominens?

Because of its long, prominent spinous process that is easily palpated.

What is demonstrated on an AP projection of the cervical spine?

Intervertebral disk spaces.

What is demonstrated on an AP projection of the thoracic spine?

Intervertebral disk spaces

What is demonstrated on an AP projection of the lumbar spine?

Intervertebral disk spaces.

What is demonstrated on RPO/LPO cervical spine?

Upside intervertebral foramina (45° oblique).

What is demonstrated on RAO/LAO cervical spine?

Downside intervertebral foramina (45° oblique).

What is demonstrated on RPO/LPO thoracic spine?

Upside zygapophyseal joints (70° to the image receptor).

What is demonstrated on RAO/LAO thoracic spine?

Downside zygapophyseal joints (70° to the image receptor).

What is demonstrated on RPO/LPO lumbar spine?

Downside zygapophyseal joints (45° oblique).

What is demonstrated on RAO/LAO lumbar spine?

Upside zygapophyseal joints (45° oblique).

What is demonstrated on a lateral thoracic spine?

Intervertebral foramina.

What is demonstrated on a lateral lumbar spine?

Intervertebral foramina.

What landmark corresponds to the C4-C5?

Thyroid cartilage

What landmark corresponds to the C7?

vertebra prominens

What landmark corresponds to the T2-T3?

Jugular notch

What landmark corresponds to T7?

inferior angle of the scapula

What landmark is at T11?

Xiphoid tip

What is the swimmer's view (Lateral C-Spine) used for?

To see C7-T1

What do you see in oblique C-Spines

intervertebral foramen

What do you see in Lateral C-spines

zygapophyseal joints