Cervical Review Flashcards
(32 cards)
1
Q
Pediatric X-rays in kids is uncommon. At what age does the odontoid appear?
A
2-3 years old
2
Q
Trauma Series in order
A
1) Lateral
2) APOM
3) AP
4) Obliques (Ant usually)
5) Flex/Ext Lateral
3
Q
Lateral Cervical \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 72”
- 10x12
- 8x10 (soft tissue)
- Line from the bottom of the front teeth to the mastoid parallel to floor
- Through mastoid
- Level with thyroid cartilage (C4)
- Exhale and stop breathing
“Mark side closet to film under the chin”
4
Q
Image criteria for a Lateral Cervical film
A
- Include anatomy from Occ Base to T1
- All disc spaces and Z joints open
- Spinouses in profile
- Mandibular angles anterior to bodies
5
Q
A-P Open Mouth \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 40”
- 10x12
- Vertically to below lens of the eyes and horizontally to mastoids
- CR to center of mouth
- Bottom of the front teeth to the mastoid parallel to floor
- Don’t breathe, don’t move
6
Q
APOM Image criteria
A
- Include all of C1 and C2
- Lateral masses equidistance from mandibular rami
- Upper occlusal plate and occipital base superimposed
- Mouth open
7
Q
AP Cervical \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 40”
- 10x12 (ID blocker up)
- 8x10
- From the bottom of the front teeth to the mastoid parallel to floor (15 degree cephalic tilt)
- CR through thyroid cartilage
- Don’t breathe, don’t move
8
Q
AP Cervical Image criteria
A
- Include all anatomy C3-T1 and lung apices
- Disc spaces open, uncinates visible, spinouses at bottom of bodies
- Bottom of mandible superimposed over base of occiput
- Base of occiput and tip of mandible superimposed
- C4 is in center of image
9
Q
Anterior Cervical Obliques \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 72”
- 10x12
- 8x10
- From the bottom of the front teeth to the mastoid parallel to the floor
- 15 degree caudal tilt enters mid cervical region (C4) through mastoid
- Don’t breath, don’t move
Rotate patient 45 degrees from PA position
10
Q
Cervical oblique image criteria
A
- Include base of occiput to T1
- IVF’s open (oval-shaped)
- Disc spaces open
- No “z” joints or uncinates seen
- Mandible clear of vertebrae
11
Q
Cervical Flexion/Extension \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 72”
- 10x12
- 10x12
- Through mid cervicals (C4)
- Include VP in collimation field
- Exhale and stop breathing
Either elevate chin (extension) or tuck chin (flexion) to patients tolerance
12
Q
Function of Flexion and Extension views?
A
Demonstrate both ligament instability and range of motion
13
Q
Swimmer's \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 40”
- 10x12
- 8x10
- CR enters T1
- Patient lateral with arm closest to Bucky in full extension (acts as a natural filter)
- Expiration and hold
14
Q
Posterior Obliques \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 72”
- 10x12
- 8x10
- Rotate patient 45 degrees from A-P position
- 15 degree cephalic tube tile entering mid cervical (front of ear)
- Don’t breathe and don’t move
15
Q
Function of having patient upright, standing, or seated?
A
Puts patient in weight-bearing and may also help to stabilizes the patient and avoid military neck (if seating)
16
Q
T/F When doing a trauma cervical series, each film needed to be viewed individually before proceeding to the next view.
A
True
17
Q
Function of PUC
A
Done for biomechanical analysis of Upper cervicals and occipital condyles (all about C1)
18
Q
What is the main difference between normal cervicals and PUC, relative to patient placement?
A
PUC
- Patient is seated for all views/set ups.
- patient must be in natural/neutral position/posture for entire PUC series
19
Q
PUC Cervical Series
A
- Palmer Lateral
- AP cervical
- Palmer Open Mouth
- Nasium
- Base Posterior (or Vertex)
20
Q
PUC Lateral \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 72”
- 10x12
- CR through C1 TVP
- Collimate out the eyes laterally, but don’t clip the spinous processes
- Exhale and stop breathing
21
Q
What is the function of the AP cervical in the PUC series?
A
Same as routine AP cervical
- Done to complete the series and check for pathology
- DO SEATED to provide consistency of posture between set-ups
22
Q
PUC APOM \_\_ SID \_\_ Film \_\_ Collimation \_\_ Line \_\_ CR Vertical \_\_ CR Horizontal \_\_ Breathing instructions
A
- 40”
- 10x12
- 8x10
- Patient seated with bucky touching the back of the head and shoulders
- CR directed from a line from the bottom of the upper teeth to mastoid tip (may need to utilize a 5-15 degree cephalic tilt)
- Filter out orbit
- Apply head clamp
- Don’t breathe, don’t move
23
Q
Rationale for Bucky tilt in PUC series
A
To visualize C1 while maintaining the body’s natural posture
-To minimize/decrease magnification distortion
24
Q
How to use the template to get the right angle for the PUC Nasium
A
Place a point of converging lines on narrowest part of C1 arch
- Align bottom of film parallel to grid lines at bottom of template
- Locate center of anterior tubercle of C1 and follow the line to the number at the edge of the template. This is the direction and amount of tube tilt to be used on the nasium view
25
```
PUC Nasium
__ SID
__ Film
__ Collimation
__ Line
__ CR Vertical
__ CR Horizontal
__ Breathing instructions
```
- 40"
- 10x12
- 8x10
- Tilt bucky to touch back of head and shoulders
- Caudal tube tilt determined by the lateral film and Atlas Plane Line
- CR exits inferior tps of mastoids
- Filter eyes
- Apply head clamps
- Don't breathe, don't move
26
```
PUC Base-Posterior
__ SID
__ Film
__ Collimation
__ Line
__ CR Vertical
__ CR Horizontal
__ Breathing instructions
```
- 38 to 42"
- 10x12
- 8x10
- Bucky should be tilted parallel to the APL, but difficult with most equipment, so tilt to 45 degrees.
- Vertex to center of bucky (top of head)
- Adjust stool to highest position
- CR enters 1" behind chin, goes in front of EAM and exits vertex
- Filter eyes and apply headclamps
- Don't breathe and don't move
- CR should be perpendicular to APL and bucky
27
```
PUC Vertex
__ SID
__ Film
__ Collimation
__ Line
__ CR Vertical
__ CR Horizontal
__ Breathing instructions
```
- 38 to 42"
- 10x12
- 8x10
- Bucky should be tilted parallel to APL, but may need to settle for 45 degrees opposite direction of Base Posterior
- Adjust stool to lowest position
- Place chin 1" above center of bucky/film
- CR exits vertex, goes infront of EAM, and exits 1" behind tip of chin
- Apply head clamps, don't breathe, don't move
28
PUC vs. Conventional Lateral Stress Points
- 10x12 cassette (include all cervicals)
- Seated (for consistent body position)
- Natural body position (posture)
- Centered to C1 (tip of mastoid)
- Eyes should be out of collimation field either by patient position or collimation
29
PUC vs. Conventional APOM stress points
- Seated
- Natural body position (posture)
- Bucky tilt (touching head and shoulders)
- CR may be tilted so as to be parallel to occlusal plane/base of occiput
- Collimate to film size
- Filter eyes
- Use head clamps
30
PUC AP vs. Conventional AP stress points
- Patient is seated
- All other criteria is the SAME
- Included to complete a sectional series and rule out pathology in the lower cervicals
31
Radiation Protection for PUC series
- Eyes must be out of collimation field either by patient position of collimation.
- Filter eyes for APOM, Nasium, and Base-Posterior/Vertex
- Filters reduce exposure and DO NOT eliminate it.
- Filter material/thickness should allow the visualization of the orbits
32
T/F Filters should be applied before centering and collimating the patient, but after placing the R or L marker
FALSE
| -Apply filter AFTER centering and collimating, but BEFORE placing the R or L marker
