Spine and Pelvis
28 Cervical Spine
Anatomy
body, vertebral arch, vertebral foramen, vertebral canal, intervertebral disks, transverse processes, spinous process, laminae, pedicle, superior articular process, inferior articular process, zygapophyseal joints (a.k.a.. apophyseal jts. or interarticular facet joints), atlas, axis, dens (odontoid), vertebra prominens, transverse foramina, articular pillar
Projections
[Part], PA or AP
CR Location
[Part], PA or AP –
Evaluation Criteria
AP Image Criteria: C3 to T1 well visualized. Equal distance from sternoclavicular joints to spine (no rotation). Intervertebral disk space open (because of tube angle). Mandible and base of skull superimposed.
Lateral Image Criteria: C1-7 clearly seen. Mandible should not superimpose the spine. Mandibular rami should be superimposed (no rotation of head).
Posterior Obliques Image Criteria: C1 -7 clearly seen. Open intervertebral foramina (correct central ray angle) and intervertebral disk space.
Odontoid (AP open mouth) Image Criteria: Entire atlas and axis should be seen.
.
Hows & Whys of Cervical Spine Radiography
- How many cervical vertebrae are there?
- 7
- What type of curve does the cervical spine have?
- The cervical spine has a lordotic curve, which is a secondary spinal curve.
- How does C1 (the atlas) differ from typical vertebrae?
- It articulates with the skull and consists of an anterior arch, a posterior arch, two lateral masses, and two transverse processes.
- C1 does not have pedicles or laminae.
- What divides the ring formed by the arches into anterior and posterior portions?
- The ring formed by the arches is divided into anterior and posterior portions by the transverse atlantal ligament.
- What does the anterior arch articulate with?
- The anterior arch articulates with the odontoid process.
- What do the lateral masses articulate with?
- The lateral masses have superior articular processes (articulating with occipital condyles) and inferior articular processes (articulating with C2).
- How does C2 (the axis) differ from typical vertebrae?
- It has an odontoid process (dens) that extends upward from the body.
- The odontoid passes through the anterior arch of C1, facilitating rotation.
- What is unique about C7 compared to other vertebrae?
- C7 has a longer spinous process called the “vertebra prominens.”
- What is the occipitocervical joint, and what motion does it allow?
- The occipitocervical joint is a gliding joint.
- It allows you to shake your head “yes.”
- What is the atlantoaxial joint (C1-2), and what motion does it allow?
- The atlantoaxial joint is a pivot joint.
- It allows you to shake your head “no.”
- What type of joints are the intervertebral joints?
- The other vertebral joints are amphiarthrotic, meaning they are slightly movable.
- How are cervical vertebrae distinguished from thoracic and lumbar vertebrae?
- All cervical vertebrae have two transverse foramina.
- Their spinous processes are shorter and have bifid tips (forked ends).
- What does the lateral projection of the cervical spine demonstrate?
- Zygapophyseal joints, intervertebral disk spaces, vertebral bodies, and spinous processes.
- What does the AP projection of the cervical spine demonstrate?
- Transverse processes and the odontoid, although vertebral disk spaces and bodies are not as clearly seen.
- What does the oblique projection of the cervical spine demonstrate?
- Intervertebral foramina.
- Posterior obliques demonstrate the side up.
- Anterior obliques demonstrate the side down.
- Intervertebral foramina.