Cervical Spine Radiograph. Indications, Radiographic Positions, Image Critics and more. Applications in nursing Practice

1. RADIOLOGY TRAINING RESOURCE FOR MEDICAL
IMAGING TECHNOLOGISTS/SONOGRAPHERS,
NURSES, MIDWIVES AND RELATED MEDICS
Module 12: Cervical Spine Radiography and
Related Pathologies
Course lecturer
Nchanji Nkeh Keneth
Radiologic Technologist/Sonographer
CSMRR: 001012016
+237 671459765
B.TECH/HPD in MDIRT
(St. LOUIS UNIHEBS, Univ Buea)
excellence660@gmail.com
MedicalImagingTrainingResourceForMedicalImag
Tech,Nurses,MidwivesandMedics,NchanjiNkehKeneth
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10/23/2020

2. Presentation outline
 Review of C-Spine Anatomy
 C-Spine radiographic Projections
 Common pathological Findings on
the C-Spine radiographs
 Radiation Protection and Safety in
Cervical Spine radiography
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3. Outcome
 At the end of this presentation, students
would have:
Learned about radiography of the
Cervical Spine and pathologies
Be able to recognize abnormal
radiographic findings on the C-Spine
and correlate with clinical presentations
Radiation protection
10/23/2020
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Keneth
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4. Left: x-ray of the C-spine and
Right: C-Spine MRI Scan
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5. Requirements of this module:
All Students are Urged to review their anatomy and
physiology lectures on:
• the Musculoskeletal System
• And Pathological conditions
associated with this body
system
10/23/2020
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6. Requirements of this module:
All Students are Urged to review their anatomy and
physiology lectures on:
• the Musculoskeletal System
• And Pathological conditions
associated with this body
system
10/23/2020
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Midwives and Medics , Nchanji Nkeh
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7. The Cervical Spine
 There are 7 Cervical vertebrae
 They extend from the base of the skull to
the upper thoracic cage
 ALL CERVICAL VERTEBRAE have
Transverse FORAMEN
 They all have a Central Canal lined by
Ligaments through which the spinal cord
runs
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8. The Cervical Spine
 First cervical Spine Vertebra is called the
ATLAS vertebra
 Second cervical spine vertebra is called the
AXIS
 Cervical spine vertebrae are flexible and can
permit rotation of the head
 C-Spine vertebral fractures can be life
threatening
 C-Spine Vertebrae make up part of the Axial
Skeleton
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9. Cervical Vertebral Anatomy Con’t
 All Cervical vertebrae have posterior bifid
spinous processes except C-6 and C-7 in
some people with posterior elongated spinous
processes
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10. Functions of C-Spine
 Serves as Channels for The Spinal Cord and
spinal nerves
 Serve as channels for the Vertebral arteries
(please review the Will’s Polygon for
arterial Blood Supply to the Brain)
 Protects the Spinal cord
 Anchors the head in a steady position,
thereby giving it a good shape
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13. Typical C-Spine vertebra
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15. Vertebral Segments
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16. Secondary Curves Lateral
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17. Vertebral Column
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18. Osteology
 Typical Vertebrae
 Body
– Superior and inferior surfaces of body (plateaus)
– Thickened around the rim, location of
epiphyseal plates
– Cartilaginous end-plates
 Vertebral Arch
– Pedicles, Laminae
– Transverse Processes
– Spinous Process
– Facets – superior articular and inferior articular
 Spinal Foramen
 Intervertebral Foramen
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21. Cervical Spine radiographic
Projections
 Anterior Posterior View (AP- View)
 Lateral View
 AP-View with Open Mouth
 Left and Right Oblique Views
 Swimmer’s Projection
 AP/Lateral View with Flexion or Extension
of the head
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22. Radiographic Views requested are Based on the
Physical status of the patient and the suspected
Pathology
 AP Open Mouth View helps to View the
Dens or Odontoid Process of C-2 (Axis
Vertebra) and also shows C1(Atlas
vertebra)
 Swimmer’s View shows C-7 and T1(T1 is
first Thoracic Vertebra)
 Other special views are indication specific
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23. Question
Should the neck bracelet for a
Traumatic patient on the Trolley be
removed before Performing a Lateral
Projection of the C-Spine?
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24. Radiographic Projections for the Cervical
Spine
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25. Common Pathological Conditions of the C-spine
vertebrae
 Fractures
 Disc herniation (rare but common)
 Bony lesions
 Compressed disc spaces
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26. Some Indications for C-S radiography
To rule out C-Spine Vertebral
Fracture
Cause of Persistent neck pain
 To assess C1 and C2 in neck stiffness
 To assess the disc spaces and vertebral
bodies for any abnormalities
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37. Pathologic C-spine radiograph (L) vs Normal
Right Oblique C-Spine radiograph®
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38. Annotated C Spine Lateral radiograph
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40. Radiation Protection during C-Spine
radiography
All C-S X-Ray requests must be
justified
No patient should be mistaken for the
Other during the radiographic Process
Radiation exposure should be done as
per the age and gender of the patient
and body mass
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41. RaP in C-Spine radiography
 Requests for C-Spine X-rays should be
properly done
 C-S radiographs like others, should be
labelled with markers
 In case of any assistance to the patient,
the caregivers (e.g. Nurses) should be
protected from unnecessary radiation
exposure
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42. ANY QUESTIONS ?
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43. References
1. Nchanji nkeh Keneth(2017). Skeletal
Radiographic Anatomy. Training Course in
Medical Diagnostic Imaging. St Louis
University, Bamenda. MDI200.
www.slideshare.com
2. Nchanji nkeh keneth(2017). Vertebral
Column Anatomy. Training Course in
Medical Diagnostic Imaging. St Louis
University, Bamenda. MDI200.
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44. References con’t
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45. https://rpop.iaea.org/SAFRON/
https://rpop.iaea.org/safrad/
https://nucleus.iaea.org/isemir/
http://nucleus.iaea.org/HHW/MedicalPhysics/index.html
References con’t
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47. Medical Imaging Training Resource
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