Week 5 Flashcards
(255 cards)
What were canadian C-spine rules developed for?
Used to rule in the need for a radiograph following cervical spine trauma
What does it mean when a person is negative on the cervical spine rule?
It is almost certain that they do not have a c-spine fracture. (High sensitivity)
What does it mean when a person is negative on the cervical spine rule?
It does not necessarily mean that they have a fracture, but that a x-ray is needed to further rule out a possible C-spine fracture
What are the standard x-ray views for a cervical spine?
- Lateral view (standard)
- AP view (standard)
- Oblique view (special)
- Odontoid view (special)
- Swimmer’s view (special)
What are the characteristics of the lateral view that is used in a x-ray of the C-spine?
- Initial view
- Evaluate alignment, spacing, soft tissues & vertebrae\
- Stress View
- Standard cervical view
What is the AP view in a x-ray of the C-spine used to see?
Alignment, oblique fractures. This is a standard cervical view
What are the characteristics of the oblique view that is used in a x-ray of the C-spine?
Done only after fracture or dislocation are ruled out – neural foraminal narrowing and alignment of facet joints. This is a special cervical view to compare IV foramina
What is the odontoid view in a x-ray of the C-spine used to see?
C1-C2 relationship (mouth open). This is a special cervical view to assess atlas and axis
What is the swimmer’s view in a x-ray of the C-spine used to see?
View of C7–T1. This is a special cervical view used when
shoulder superimposition obscures C7 on a lateral view
What is the patient position during an AP view of the C-spine?
• Patient standing or supine
• Chin extended slightly
• Central ray centered on
C4, angled 15-20° cephalad (toward the head)
What part of the spine does the AP projection of the c-spine allow visualization of?
• Lower 5 cervical vertebral bodies • Upper 2-3 thoracic vertebral bodies • Interpediculate spaces • Intervertebral disc spaces • Superimposed transverse processes and articular pillars • Spinous processes
What types of conditions can be seen in an AP projection of the c-spine?
- Fractures: vertebral bodies C3-C7
- IVD space abnormalities
- Uncovertebral joint abnormalities
What is the patient position during a lateral view of the C-spine?
- Patient sitting or standing
- Shoulders depressed
- Chin elevated slightly
- Central ray centered on C4
What part of the spine does the lateral projection of the c-spine allow visualization of?
• Cervical vertebral bodies and interspaces • Articular pillars • Lower 5 facet joints • Spinous processes • C7-T2 may be visualized with enough shoulder depression, but usually starts to get radioopaque
What types of conditions can be seen in a lateral projection of the c-spine?
- Occipito-cervical dislocation, esp in stress views when the person is in 60degs or more of flexion
- Fractures
- Unilateral and bilateral locked facets
- IVD space and Atlanto-odontoid space abnormalities
What types of fractures can be seen in a lateral projection of the c-spine?
- Anterior and posterior arches of C1
- Odontoid process
- Vertebral bodies of C2-7
- Spinous processes
- Hangman’s fracture
- Burst fracture
- Teardrop fracture
- Clay-shoveler’s fracture
- Compression fracture
What are the characteristics of the performance of Hyperflexion or Hyperextension during a lateral c-spine x-ray?
- NOT attempted until fracture ruled out
- Performed to demonstrate normal movement (or lack of) due to trauma or disease
- Becomes less diagnostic if someone can’t get to 60 degs of flexion
What is the patient position during an oblique view of the C-spine?
• Patient upright or supine • Patient’s body and head adjusted to a 45° angle • Elevate chin slightly • Central ray centered on C4, angled 15-20° cephalad
What part of the spine does the oblique projection of the c-spine allow visualization of?
• Intervertebral foramina
and pedicles farthest from
film (closest to the central ray)
• Vertebral bodies
What types of conditions can be seen in an oblique projection of the c-spine?
- Intervertebral (neural) foramina abnormalities
* Apophysial joint abnormalities
What is the patient position during an odontoid/open mouth view of the C-spine?
• Patient supine • Patient opens mouth as wide as possible • Central ray centered on the midpoint of the open mouth
What part of the spine does the odontoid/open mouth projection of the c-spine allow visualization of?
- Atlas and axis through the open mouth
- C1-2 interspace
- Dens of C2 (primary target)
- Occipital base
- Occlusal surface of teeth
- Mandibular ramus
- Lateral mass of atlas
- Inferior articular process of atlas
- Spinous process
What types of conditions can be seen in an odontoid/open mouth projection of the c-spine?
• Fractures including: - Lateral masses of C1 - Odontoid process - Vertebral body of C2 - Jefferson fracture • Atlantoaxial joint abnormalities
What is the patient position during a swimmer’s view of the C-spine?
• Arm closest to film extended overhead
• Patient can rest head on arm in sidelying position
• Depress shoulder closest to central ray as much as possible
• Central ray centered on C7-T1
interspace