CHAPTER 8 SPINE

Name the 2 main parts of typical vertebra.

Body-most anterior part of the vertebra Vertebral arch-most posterior part of the vertebra

What type of technique is used for the lateral tspine?

Breathing Technique

What is the most distinguishing feature of the thoracic vertebrae?

Facets for rib articulations

Costotransverse joints are located where and on what vertebrae?

Facets or demifacets are located on each side of the body of the vertebra and each facet or combination of 2 facets accepts the head of a rib.

What do the terms convex and concave mean in regards to the spinal column?

It is the way the spine is curved. C-concave-lordotic T-convex L-concave-lordotic Sacrum-convex These primary and compensatory curvatures are normal and serve an important function by increasing the strength of the ver- tebral column and helping maintain balance along a center line of gravity in the upright position.

Name some of the topographic landmarks found in the tspine region?

Jugular notch-T3; Xiphoid process-T9-10; Mid thoracic spine-3-4" below T3-4

The LPO position with a 15 degree cephalad angle shows what cervical intervertebral foramina?

Right

How would you describe a slipped disk? What is the medically correct term?

When this soft inner part protrudes through the outer fibrous layer, it presses on the spinal cord and causes severe pain and numbness that radiates into the lower limbs. This condition, also known as a slipped disk, is termed the herniated nucleus pulposus (hnP).

What anatomy should be visualized for a lateral cervical spine, how is this achieved, what is the SID used?

Zygapophyseal joints; 72" SID

lordosis refers to an

abnormal anterior con- cavity of the lumbar spine.

Kyphosis is an

abnormal condition characterized by increased convexity of the thoracic spine curvature.

Scoliosis is an

abnormal or exaggerated lateral curvature of the spine

Each typical vertebra has 4 articular processes, 2 superior and 2 inferior which comprise___________________________ of the spinal column.

zygapophyseal joints

There are how many thoracic vertebrae?

12 thoracic vertebrae

The CR angle for anterior oblique cervical spine should be? Posterior oblique? What are you anatomic structure will you visualize?

45°oblique Anterior obliques CR 15-20° caudad---C4 Posterior obliques CR 15-20° cephalad—C4 Intervertebral foramina

What is the position for the oblique tspine? What anatomic structure is demonstrated on which oblique?

70-75 ° oblique from AP or 20° lateral Zygapophyseal joints upside (posterior oblique) and downside (anterior oblique)

Thoracic zyagapophyseal joints form an angle of______70-75°________________ from the _______________MSP______________. In what position can these joints be visualized radiographically?

70-75° oblique

The zyagpophyseal joints are located at _________________ to the midsagittal plane.

90°

What projection demonstrates the pillars of the cspine? What CR angle is used?

AP axial-vertebral arch (pillars)- 20-30° caudad

In what projection are the zyapophyseal joints of C1 and C2 visualized?

AP open mouth projection

What is the issue in regards to uniformity when imaging the tspine?

Achieving uniform density throughout the tspine due to the varying slice thickness.

What is the angle and CR entrance for the AP axial cervical spine?

Angle CR 15° to 20° cephalad. Direct CR to enter at the level of the lower margin of thyroid cartilage to pass through C4.

Intervertebral foramina of the cervical spine are located at ______45°_________________ ____angle____________ to the midsagittal plane, they are also directed _________________15° inferior_______ _____angle_______________ because of the shape and overlapping of the cervical vertebrae. How must these joints be imaged in order to visualize them radiographically?

Cervical intervertebral foramina radiographically, a 45° oblique position combined with a 15° cephalad angle of the x-ray beam would be required

Name the sections of the vertebral column and 1 fact about each?

Cspine- seven vert. articular pillars, atlas and axis Tspine- 12 vert. which connect to a pair of ribs Lspine- 5 largest and strongest, common sites for injury Sacrum/coccyx-multiple sections then fuse together

What is the purpose of flexion/extension radiographs of the cervical spine?

Functional study to demonstrate anteroposterior vertebral mobility.

What are 2 anatomic areas that need to be demonstrated radiographically during spine imaging?

Intervertebral formania and zgyapophyseal joints

The LAO and 15 degree caudad angle would show what cervical intervertebral foramina?

Left

What line needs to be perpendicular to the tabletop for a Fuchs method? What needs to be done if that line is it perpendicular? Why is this projection done?

MML-mentomeatal line; angle the tube so that the CR is parallel to the MML; to visualize the dens if obscured on the open mouth projection.

Name some of the topographic landmarks found in the cervical spine region?

Mastoid process/EAM-C1; gonion C3; thyroid cartilage-C4; vertebral promins-C7

What is the method name for the AP "wagging jaw" projection of the cervical spine?

Ottonello method

The posterior oblique of the tspine will show which zyapophyseal joints? An anterior? What is the obliquity for the tspine?

Posterior oblique-upside Anterior oblique-down side 70-75° from AP or 20° from lateral

Describe the zygapophyseal joints.

The four articular processes described on the preceding page are seen projecting from the area of the junction of the pedicles and laminae. The term facet sometimes is used interchangeably with the term zygapophyseal joint, but the facet is actually only the articulating surface instead of the entire superior or inferior articular process.

What 2 anatomical structures must be aligned when positioning a patient for the AP open mouth projection for C1 and C2?

The line from lower margin of upper incisors to the base of the skull (mastoid tips) is perpendicular to table and/or IR, or angle the CR.

The intervertebral foramen are formed by and why are they radiographically important?

The upper surface of each pedicle is a half-moon-shaped area termed the superior vertebral notch, and along the lower surface of each pedicle is another half-moon-shaped area called the inferior vertebral notch. When vertebrae are stacked, the superior and inferior vertebral notches line up. These two half-moon-shaped areas form a single opening, the intervertebral foramen. Therefore, between every two vertebrae are two intervertebral foramina, one on each side, through which important spinal nerves and blood vessels pass.

Why would erect be the preferred method of radiographing the spine?

To demonstrate alignment and ligament stability; allow the natural curvature of the spine to be demonstrated.

Why is a cervicothoracic swimmers lateral position done?

To demonstrate the intervertebral disks spaces of C5-T3, especially C7-T1.

The first cervical vertebra is called_________________________. The second cervical vertebra is called the ____________________________.

atlas, axis

Intervertebral joints are what kind of joints, where can they be found, and what is the purpose?

located in these joints are tightly bound to adjacent vertebral bodies for spinal stability, but they also allow for flexibility and movement of the vertebral column.

1. The spinal cord begins at the _________________ and extends distally into the ____________________. The canal contains spinal cord.

medulla oblongata-base of skull, Conus medullaris-distally to the sacrum

In a typical vertebra the 2 _______________________ and the 2 ______________________ form the vertebral_arch vertebral formania and the spinal cord that contain the spinal cord.

pedicles, lamina

The 2 transverse processes extend laterally and 1 spinous process extend

posteriorly

Normally the articulations of C1 and C2 are _____________________________.

symmetric

What are the unique characteristics of cervical vertebrae?

transverse foramina bifid spinous process tips overlapping vertebral bodies