Cervical,thoracic,lumbar,sacral,coccyx

Front 1

1st Cervical Vertebra: C-1

Back 1

a. "Atlas"
b. Has no body but anterior arch
c. Function: Holds up you head
d. Landmark: mastoid tip
e. no spinous process but
posterior tubercle w/bifid
tip
f. Lat masses(articular pillar
g. Superior facets for atlanto
occipital articulations

Front 2

2nd Cervical Vertebra: C-2

Back 2

a. "Axis"
b. Has an odontoid process or
Dens (tooth-like projection)
c. Function: Allows head to turn with C-1

Front 3

7th Cervical Vertebra: C-7

Back 3

a. "Vertebra prominens"
b. Longest spinous process of
C-Spine
c. Landmark: Top of shoulders

Front 4

C-Spine Landmarks

Back 4

a.EAM (External Acoustic Meatus): 1 inch above C1

b. Mastoid tip or base of skull: C-1

c. Thyroid Cartilage: C-4,C5
d. Top of shoulders: C-7

Front 5

C-Spine Odds and Ends

Back 5

a. Lordotic curve naturally
b. Have transverse foramina
c. Bifid Spinous Processes C2-C6
d. Articular Pillar

Front 6

Cervical Spine - AP Axial

Back 6

1. CR: 15-20 degrees cephalad
to thyroid cartilage
>SId: 40 inches, bucky
>10x12 inch, lengthwise
>patient stand erect
>elevate mandiblesuperimpose
>collimate width of neck and
open to EAM
>marker, shield
2. Should see C-3 to C-7
3. Taken to see intervertebral
disc spaces

Front 7

Cervical Spine - AP Open Mouth

Back 7

1. CR: perpendicular to CR
>8x10 lengthwise, bucky
>Cassette center to CR
>CR directly into mouth
>mastoid tip & bottom inci-
sor is perpendicular
>collimate 4 sided 4x4
>marker, shield

2. Taken for C-1 and C-2
3. Important to superimposethe
top teeth onto the back of
the head

Front 8

Cervical Spine - Obliques

Back 8

1. 45 degrees rotation of body
and head standing erect
>10x12 lengthwise, bucky
>SID 40 inches
>CR perpendicular 90 degrees
>CR 15 degrees cephalic
>Center spine CR & midline
IR
>extend chin prevent
mandible from superimpose
of vertebra
>CR level of thyroid-
jungular view
>collimte to width of neck
up to EAM
2. Show intervertebral foramina
** Anterior obliques show
closest to film
** Posterior obliques show
furthest from film
3. CR is 15 degrees
*Anterior Obliques:Caudad
*Posterior Oblique:Cephalad

Front 9

Cervical Spine - Lateral

Back 9

1. Taken to see zygapophyseal
joints
2. Flexion & Extension aterals
taken for ossible"Whiplash"
3. SID 72 inch
>no grid due to OID
>10x12 inch lengthwise
>Position patient erect LAT
>Shoulder against cassette
>Align midcoronal plane to
CR & midline of IR
>Center CR to IR
>Ask patient to relax, drop
shoulder down & forward as
possible(do this last step
>Extend chin slightly(to
prevent superimpose of
mandible on upper
vertebrae
>CR @ level of thyroid
>Collimate to width of neck
up to EAM
>marker, shield

Front 10

All cervical vertebrae?

Back 10

Three foramina each

Front 11

C2-6

Back 11

Short spinous processes w/bifid tips

Front 12

Spinal Canal

Back 12

-begins at the base of the skull & extends distally into the sacrum.

-canal contains the spinal cord and is filled with cerebrospinal fluid

Front 13

Spinal Cord

Back 13

-w/c is enclosed and protected by the spinal canal.

-begins with the medulla oblongata of the brain

-passess through the foramen magnum of the skull and continues through the first cervical vertebra all the way down to the lower border of the first lumbar vertebra where it tapers off to a point called the conus medullaris

Front 14

Vertebral Column

Back 14

commonly called spine or spinal column

complex succession of many bones called vertebrae

Front 15

Intervertebral disks

Back 15

-tough fibrocartilaginous disks separate typical adult vertebrae

-cushion like disks are tightly bound to the vertebraefor spinal stability

-allow for flexibility & movement of the vertebral column

Front 16

Concave

Back 16

>a rounded inward or depressed surface like a "cave"

>cervical & lumbar region have concave curvatures & described as lordotic

Front 17

Convex

Back 17

>a rounded outward or elevated surface

>thoracic & sacral region have convex curvature

Front 18

First Compensatory Curve

Back 18

Cervical, curvature, concave, lordotic

Front 19

Second Compensatory Curve

Back 19

Lumbar curvature concave lordotic

Front 20

First Primary Curve

Back 20

Thoracic curvature convex

Front 21

Second Primary Curve

Back 21

Sacral curvature convex

Front 22

Lordosis

Back 22

-meaning bent backward
-abnormally increased "sway back" curvature involving lumbar spine

Front 23

Kyphosis

Back 23

-meaning a hump
-abnormal or exaggerated thoracic "humpback" curvature with increased convexity

Front 24

Scoliosis

Back 24

-abnormal or exaggerated lateral curvature

-S shaped lateral curvature exist

-cause severe deformity of the entire thorax

-occurs in the lower vertebral column

limp or uneven walk

Front 25

Thoracic Spine

Back 25

1. 12 thoracic vertebrae
2. each of thoracic is associated with one pair of ribs
3. L1 & L2 do not show facets for rib articulation
4. Costovertebral joints:Head of Rib and vertebral body
5. Costotransverse joints:Tubercle of Rib and transverse process

>T1-full facet & a demifacet on its inferior margin

>T2-T8 have demifacets on their upper and lower margins

>T9 has only one demifacet on its upper mrgin

>T10-T12 have full facets

Rib 1 articulates with T1 only

Rib 2 articultes with T1 & T2 adn so on

Ribs 11 and 12 articulate only with T11 and T12 at the costovertebral joints

6. Kyphotic curve
7. Landmarks:
a.Suprasternal notch:T2-T3
b.Inferior angle scapula:T7
c.Xiphoid tip:T9-T10

Front 26

Thoracic Spine - AP

Back 26

1. CR: T7 (CR between jugular
notch & xiphoid tip)
2. See all 12 thoracic
vertebrae (C7-L1 s/b seen)
3. 14x17,7x17 lengthwise,bucky
4. SID 40 inches
5. CR center to cassette
6. Collimate to film 7 inches
7. Marker, Shield

Front 27

Thoracic Spine - Oblique

Back 27

1. 70 degrees oblique, 20 degree
from lateral
2. 14x17 inches lenghtwise,bucky
SID 40 inches
3. CR to T7
4. Cassette centere dto CR 2
2 inches above shoulder
5. Collimate
6. Should see all 12 thoracic
vertebral. Zygapophyseal

Front 28

Thoracic Spine - Lateral
(Breathing technique 2 second)

Back 28

1. See T3 or T4 thru T-12
2. Breathing technique to blur
out ribs
3. For the intervertebral
foramina
4. Intervertebral disk spaces
open
5. T1-L1 demonstrated
6. >14x17 lengthwise, bucky
>SID 40 inches
>CR perpendicular to T7
>CR feeling inferior of
scapula T7 posterior or CR
>2 inches back of midaxilary
line
>Cassettes center to CR
>Collimate length of film
until you see light in the
back. Then take lead blockr
place on side to stop scttr
>Marker, Shield

Front 29

Thoracic Spine - Swimmers LAT

Back 29

Cervico thoracic region

Front 30

Anode Heel Effect

Back 30

-anode toward the head and cathode toward the feet

Front 31

Lumbar Spine

Back 31

1. strongest vertebral column because the load of body weight increases toward the inferior end of the column.

2. has 5 vertebrae
3. lordotic curve
4. Distinctive part: Pars interarticularis (the portion of each lamina between the superior and inferior articular processes

Front 32

Landmarks - Lumbar Spine

Back 32

a. lower costal margin: L3
b. iliac crest: L4
c. A.S.I.S:Secon sacral segment
d. Symphysis pubis or greter trochanter: Coccyx

Front 33

Lumbar Spine - AP

Back 33

1. Flex knees to open up intervertebral joint spaces
2. Deomonstrate all 5 vertebrae
3. CR *14x17: ilia crest
*10x12 or 11x14:
iliac crest

Front 34

Lumbar Spine - Obliques

Back 34

1. 45 degrees obliques,supine
a.11x14, lengthwise,bucky
b.CR 2 inches above iliac
crest, 2 inches of medial
of ASIS
c. CR center of cassette
d. Collimate lenght of by 7
inches by length of film

2. for zygapophyseal joints
3. a.posterior obliques show
side closest to film
b.anterior obliques show
side furthest from film

Front 35

Lumbar Spine - Lateral

Back 35

1. Patient lateral recumbent
2. Insure torso & pelvis are in
true lateral
3. 40 SID, bucky
4. 14x17 CR at iliac crest
or 11x14 CR 2" above iliac
crest
4. collimate by 7" wider & 2"
posterior to mid coronal or
midaxillary line
5. to see intervertebral for-
amena

Front 36

Lumbar Spine - L5 & S1 Left Lateral

Back 36

1. 8x10 lengthwise, bucky
40" SID
2. Patient lat recumbent feet
together, keep body
straight
3. Angle tube 5-10 degree
caudad
4. CR midway between ASIS and
iliac crest

Front 37

Sacrum

Back 37

1. sacrum is inferior to the
lumbar vertebrae

2. 5 fused segments in the
adult

3. alae or wings (lg masses of
bone latteral to the first
sacral segment

3. most anterior ride of bone:
sacral promontory

4. lower sacrum: cornua

Front 38

Sacrum - AP

Back 38

1. 10x12 crosswise
2. SID 40"
3. patient supine support
under knee
3. align midsagittal place to
CR & midline to table
4. endusre no rotation
5. angle tube 15 degrees
cephalic
6. CR between symphyis pubis
& ASIS
7. Collimate to ASIS by 7"

Front 39

Sacrum - Lateral

Back 39

1. 10x12 lengthwise, grid
2. 40" SID
3. patient lateral recumbent
3. center patient on table
4. CR perpindicular level of
ASIS 3" postior
5. Collimate 5" by length of
film

5. CR

Front 40

Coccyx

Back 40

1. coccyx most distal portion
of the vertebral column
(aka tailbone)
2. avearge, 4 fused segments
in adult
3. lower end: Apex - distal
pointed tip of the coccyx

Front 41

Coccyx - AP

Back 41

1. 10x12 lengthwise, bucky
2. Angle tube 10 degrees
caudad
3. CR between ASIS & syphyis
pubis

Front 42

Coccyx - Lateral

Back 42

1. 10x12 lengthwise, bucky, 40"
2. pt lateral, flex knees
3. CR at lefel of greater
trochanter 2 inches back
4. Collimate 4x4

Front 43

Sacral Horns (cornua)

Back 43

are small tubercles representing the interior articulr processes projecting inferirorly from each side of the fifth sacral segment

they project inferiorly and posteriorly to rticulate tiwht the corresponding hornes of the coccyx.

Front 44

Parts of Typical Vertebra

Back 44

a. Body
b. Pedicle
c. Transverse process
d. Lamina
e. Spinous Process
f. Vertebral notches form intervertebral foramina
g. Superior & Inferior articular Process: form zygapohysea joints
h. vertebral foramen: forms spinl cancal
I. Itervertebral disc:
1. nucleus pulposis
2. annulus fibrosis

Front 45

Body

Back 45

1. is the thick weight-bearing
part of the vertebra.

2. its superior and inferior
surfaces are flat and rough
for attachment of the
intervertebral disks

Front 46

Vertebral Arch

Back 46

ring or arch of bone extending
posteriorly from the vertebral body

Front 47

Vertebral Foramen

Back 47

posterior surface of the body and the arch form a circular
opening & contains the spinal
cord

Front 48

Pedicles

Back 48

extend posteriorly from either side o fthe vertebral body.

the pedicles form most of the sides of the vertebral arch

Front 49

Laminae

Back 49

1.posterior part of the
vertebral arch is formed by
two somewhat flat layers of
bone

2. each lamina extends
posteriorly form each
pedicle to unit in the
midline

Front 50

Transverse Process

Back 50

extending laterraly from approximately the junction of each pedicle and lamina is a projection

Front 51

Spinous Process

Back 51

1. extends posteriorly at the
midline junction of the two
laminae

2. are the most posterior extensions of the vertebrae and can often be palpated along the posterior surface of the neck and back

Front 52

Superior Articular Processes & Inferior Articular Processes

Back 52

these processes provide for certain important joints that are unique and need to be visualized radiographically for each section of the vertebral column

parts are seen on this lateral view are the right and left superimposed and lower pair of right & left

Front 53

Typyical Vertebra

Back 53

has 2 pedicles and two laminae
that form the vertebral arch and the vertebral foramen containing the spinal cord

has 2 transverse processes extending laterally, one spinous process extending posteriorly and the large anterior body .

Each typical vertebra so has four articular processed , two superior and two inferior w/c formulate the important jooints of the vertebral column

Front 54

Interverterbral Joints

Back 54

are slightly movable joints between the vertebral bodies

Front 55

Intervertebral Disk

Back 55

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

Front 56

Zygapophyseal Joints
(aka apophyseal joints)

Back 56

Superior and inferior articular processess (4 processess)

Front 57

Facet

Back 57

sometimesused interchangeably with the term zygapophyseal joints

Front 58

Coastal Joints

Back 58

these articulations of the ribs to the thoracic vertebra

Front 59

Joints in the Vertebral Column

Back 59

1. Intervertebral Joints

2. Zygapophyseal Joints

3. Costal Joints

Front 60

Vertebral notches

Back 60

form intervertebral foramina

Front 61

Superior Vertebral notch

Back 61

upper surface of each pedicle is a half moon-shaped area

Front 62

Inferior Vertebral notch

Back 62

lower surface of each ;edicle is another half-moon shaped area

Front 63

Intervertebral Foramen

Back 63

2 half moon shape areas from a single opening.

between every two vertebrae are two intervertebral foramina one on each side, through w/c important spinal nerves and blood vessels pass

Front 64

Intervertebral Disk

Back 64

the typical adult vertebrae are separated by tough fibrocartilaginous disks between the bodies of every two vertebrae excep between the first and second cervical vertebra.

provides a resilient cushion between the vertebrae helping to absorb shock during movement of the spine

Front 65

Annulus Fibrosis
(Intervertebral Disk)

Back 65

each disk consist of an outer fibrous portion

Front 66

Nucleous Pulposis
(Intervertebral Disk)

Back 66

a soft semigelatinous inner part
when this soft inner part protrudes through the outer fibrous layer, it presses on the spinal cord and causes severe pain nd numbness that radiate into the lower limbs

Front 67

Scoliosis

Back 67

abnormal or exaggerated lateral curvature

curvature occurs in the upper thoracic region

associated w/dominant extremity so this curvature may be convex to the right in a right handed person and convex to the left in a left handed person

Best view AP

S-shaped lateral curvature exist

create a limp or uneven walk

Front 68

Kyphosis

Back 68

abnormal or exaggerated thoracic "humpback" curvature with increased convexity

Lateral thoracic spine view

may be cuased by compression fractures of the anterior edges of the vertebral bodies

Front 69

Spina Bifida

Back 69

-failure of lamina to unite
-is a congenital condition in w/c the posterior aspects of the vertebrae fail to develop exposing part of the spinal cord. this condition vaires greatly in severity and occurs most often at L5

Front 70

Spondylolisthesis

Back 70

vertebra slips forward

Front 71

Spondylolysis

Back 71

defect in the pars interarticularis ("Scotty dog" appearing to wear a collar)

Front 72

Lordosis

Back 72

meaning bent backward

abnormally increased "swayback" curvature involving the lumbar spine

Front 73

Herniated Nucleus Pulposis (HNP)

Back 73

-condition is sometimes called "slipped disk"

-if the soft inner part (nucleus pulposus) of an intervertebral disk protrudes through the fibrouse cartilage outer layer (annulus) into the psinal canal it may press on the spinal cord or spinal nerves and cause severe pain and possible numbness radiating into the extremities