Cervical Spine Lect

7/31/2019 Cervical Spine Lect

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Anatomy

The cervical spine is made up of the first seven vertebrae in the spine. It starts just below the

skull and ends at the top of the thoracic spine. The cervical spine has a backward "C" shape

(lordotic curve) the cervical spine has special openings in each vertebrae for the arteriesthat carry blood to the brain.

The first two vertebral bodies in the cervical spine are called the atlas and the axis. The atlas

is named after a Greek god who supported the weight of the world on his shoulders,

because this is the vertebral body that supports the weight of you head. The atlas and axis

vertebrae in the cervical spine differ from all other vertebrae because they are designed

primarily for rotation. The atlas has a thick forward (anterior) arch and a thin back (posterior)

arch, with two prominent masses.

The axis sits underneath the atlas and has a bony knob called the odontoid process that

sticks up through the hole in the atlas. It is this mechanism that allows the head to turn fromside to side. There are special ligaments between these two vertebrae to allow for rotation

between these two bones

Between each vertebra in the cervical spine are discs which act as cushions or shock

absorbers and also permit some movement between the vertebral bodies


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Altas Inferior View


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Altas Superior View


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Axis Posterior View

Axis is the second cervical vertebra. The dens of C2 articulates with C1 a

Axis is the second cervical vertebra. The dens of C2 articulates


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C4 Superior View


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C4 Lateral


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Cervical Spine - Odontoid View


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The most common routine cervical projections are the anteroposterior (AP), AP open mouth,

and lateral.

Lateral projection of the cervical spine

Technical factors

70-80 kVp range, mAs 28

Use of grid is optional

Minimum SID of 60 inches-72 inches (150-180 cm

Positioning for a lateral projection of the cervical spineFor non-trauma cases, position the patient in a lateral position, either seated orstanding, with the patients shoulder against a vertical cassette holderCenter the mid-coronal plane (the plane that passes through the mastoid tips) to the midline

of the cassette.

Adjust the shoulders to lie in the same horizontal plane and be sure the patientsbody is in a true lateral position with the long axis of the cervical vertebrae parallel tothe plane of the cassette.

Ask the patient to elevate the chin slightly (to prevent superimposition of the uppercervical spine by the mandible).


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As a final step before exposure, ask the patient to relax and drop the shoulders down and

forward as far as possible. Be careful to ensure that the patient does not elevate the shoulders.

When radiographing a trauma patient, do not remove cervical collar and do not

manipulate the head or neck. With the patient in the supine position on a stretcher orradiographic table, support the cassette vertically against their shoulder, or place thestretcher next to a vertical grid device.

The central ray (CR) should be perpendicular to the cassette and will be directed horizontally to

C-4 (level of upper margin of thyroid cartilage

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Cervical Spine Lect