Radiographic Techniques - Cervical Vertebrae

Radiographic Techniques - Cervical Vertebrae

• The tip of the mastoid process indicates the level of C1.
• The spinous process of C7 creates a noticeable bump on the back of the neck's lower part.
• The thoracic spine's spinous processes can be palpated below C7.
• The inferior angle of the scapula marks T7 when arms are at the side.
• The sternal notch is at the junction of T2 and T3.
• T4 is indicated by the sternal angle; variable T9 is at the xiphisternal joint.
• The lower costal margin shows L3, easily used for spinal positioning.
• A line through the superior parts of the iliac crests indicates L4.
• The tubercle of the iliac crest indicates L5.
• The anterior and posterior iliac spines are at the level of the second sacral vertebra.
• The X-ray beam is centered over a point below the mastoid process, at the level of the thyroid cartilage's prominence.

Lateral Erect Position (Basic)

• The patient can stand or sit with a shoulder against the cassette or Bucky.
• The median sagittal plane should be aligned with the image receptor.
• The mandible's angle should not overlap the upper anterior cervical vertebra, or occipital bone obscure the atlas' posterior arch.
• To view the lower cervical vertebrae, the patient needs to lower their shoulders.
• This can be instructed by asking the patient to hold weight in their hands.

Lateral Erect Position (Essential Image Characteristics)

• The entire cervical spine must be displayed, from the atlanto-occipital joints to the first thoracic vertebra.
• The mandible or occipital bone shouldn't hide any upper vertebra.
• Soft tissue detail of the neck needs to be included.
• Adequate contrast for visualizing soft tissue and bone is vital.

Lateral Supine Position

• For trauma cases, the examination is usually done on a trolley, without moving the patient first.
• The Lateral cervical radiograph is taken first.
• A medical professional assesses the neck's mobility before further imaging.
• The patient is normally in a supine (lying down) position.
• The patient must depress their shoulders.
• The CR cassette can be vertical or placed in the erect cassette holder.

Antero-posterior - First and Second Cervical Vertebrae (Open Mouth)

• The patient should lie supine on the Bucky table, or, if preferred, sit or stand with the posterior aspect of the head and shoulders against the Bucky detector.
• The medial sagittal plane must align with the image receptor's middle.
• The neck should be extended as much as possible, creating a straight line from the mastoid process to the inferior edge of the upper incisors and to the cassette.
• The image receptor is positioned at the mastoid process level.
• If the image shows overlapping anterior teeth, repeat the imaging with the patient's chin raised.

Antero-posterior - Third to Seventh Cervical Vertebrae (Basic)

• The patient lies supine on the Bucky table or sits/stands with the posterior head and shoulders against the vertical Bucky.
• The median sagittal plane should be aligned with the image receptor's midline.
• The neck should be extended to clear the vertebral areas from the lower jaw.

Antero-posterior - Direction and Location of X-Ray Beam

• The collimated beam has a 5-15-degree cranial angle.
• The beam is centrally positioned towards a point just below the prominent thyroid cartilage, aligned with the fifth cervical vertebra.

Lateral - Flexion and Extension

• These views are supplementary to basic projections, often requested by a medical officer for cases of trauma or pathology, for example, subluxation or arthritis, to assess movement and changes in relation to insertions to endotracheal tubes.
• A medical professional must supervise the flexion and extension movements in cases of suspected neck injury.

Lateral Swimmers'

• In trauma cases, essential for all cervical vertebrae and cervico-thoracic junction visibility.
• Necessary to avoid shoulder overlay, critical for an acceptable radiograph, especially for accurate diagnosis.
• The use of the swimmers' lateral view produces images useful in evaluating vertebral alignment.

Additional Notes

• Page numbers and specific figure references have not been included in these notes, as they're not critical for understanding and are specific to the original document.

This quiz focuses on key radiographic techniques related to the cervical vertebrae. It covers anatomical landmarks important for accurate positioning and identification of the various vertebral levels during imaging. Assess your knowledge of spinal anatomy and radiographic positioning methods.