Purpose and Structures Shown An additional view to demonstrate the dens and atlas through the foramen magnum. The mandible, cranium, and vertebrae should be symmetric. The dens should be clearly demonstrated in the foramen magnum. The patient is asked to suspend respiration when the exposure is taken. Position of part The gonads are shielded. The neck is extended until the tips of the chin and mastoid process are oriented vertically. A support may be placed under the knees for comfort. The patient’s arms are placed by the side of the body and the shoulders are flat on the table. The midsagittal plane of the body is centered and perpendicular to the grid. This position is NOT to be attempted in patients with fracture or degenerative disease of the upper cervical spine. Purpose and Structures Shown An additional view to demonstrate the dens in the foramen magnum. The patient should be asked to stop breathing when the exposure is taken. Position of part Remove necklaces, hair grips, and anything else from the hair. This view is used in patients who cannot sit due to injuries. Purpose and Structures Shown An additional view of the cervical spine for patients with injuries. Video Credit : Jocelyn Caldwell Cervical Spine AP Supine The patient should be turned to the other side for the other oblique view and the process repeated. The patient should be positioned so that he or she is at a 45-degree angle to the cassette holder. Purpose and Structures Shown An additional view of the cervical spine. Video Credit : CentralazRAD Cervical Spine Oblique In uninjured patients, a 1 kg (2 lb) weight should be placed in each hand. The arms should be by the sides and the shoulders should be as low as possible. The patient should be positioned with the shoulder against the cassette holder. The knob at the back of the head should be at the same level as the lower jaw (chin). The patient should be asked to place the chin against the cassette holder. Purpose and Structures Shown A basic view of the cervical spine. The density should be appropriate with soft tissues and bony structures well visualized. Radiologists consider a cervical spine X-ray to be of good quality when the lateral view shows all 7 cervical vertebrae plus the C7-T1 junction. Cervicothoracic Region Lateral Twinning Method.if the patient is not on spinal precautions i.e.This article discusses radiographic positioning of the cervical spine for the Radiologic Technologist (X-Ray Tech).use two filters, one filter anterior and one superior this will even out the density.take your time setting the patient up, rushing this projection will only cause you headaches down the road.collimate incredibly tight, because this is such a high dose projection the scatter will be at an all-time high collimation will alleviate this.This projection is regularly high stakes in resuscitation rooms and is utilized to assess critical anatomy, for those who do not have the privilege to use a superior modality such as CT 1. The technique will vary from radiographer to radiographer however, they will all have their pitfalls. This projection is technically demanding and very hard to replicate consistently. The concept of this projection is to clear the superimposing humeral heads of the cervical spine, the offset of the arms attempts to achieve this. the articular pillars and zygapophyseal joints are superimposed.the vertebral bodies are superimposed laterally.there should be a clear visualization of C7 to T1.anterior to the extent of the vertebral bodies.2.5 cm above the jugular notch at the level of T1.the opposite arm is placed by the patient's side, as posterior to the patient as possible (maintaining spinal precautions if they are in place).the arm closest to the detector is placed above the patient's head, resting on the head for support.the detector is placed running parallel to the long axis of the cervical spine.the patient is supine or erect, depending on trauma or follow up.It can help to visualize subluxation and fractures involving the inferior cervical spine, superior thoracic spine and adjacent soft tissue. This view is most often performed when a standard lateral view cannot image the cervicothoracic junction due to patients having a dense, muscular shoulder.
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