THE NECK
Cervical C –7 Thoracic Th –12 Lumbar L – 5 (L1-5) Sacral S -5 (fixed vertebræ) Coccygeal C- 4 (fixed vertebræ)
Vertebra Body vertebral foramen vertebralneural arch pedicleslaminæ 7 processesarticular, transverse,spinous
C2 - Axis
C-spine lateral anatomy
C-spine AP anatomy
C Spine open mouth-dens
Examination of cervical spine .1 Cross - table LATERAL: view vertebral 7 • bodies must be seen lines 5 • C1-2 area • Disk spaces • Cervical •
C - spine initial radiograph after diving into a shallow pool
C1 C2 C3 C4 C5
C - spine initial radiograph after diving into a shallow pool with the shoulders lowered C1
C 7 is not visualized -
C2 C3 C4
Dislocation of C5 on C6
C5 C6
the shoulders must be lowered even more
Spine anatomy Swimmer's view
Examination of cervical spine .1 Cross - table LATERAL: view vertebral 7 • bodies must be seen lines 5 • C1-2 area • Disk spaces • Cervical •
Examination of cervical spine קו - 1רקמות הרכות : מספר ממ’ בגובה C1-3 ורוחב של פחות מגוף החוליה בגובה C4- 7 קו - 2גבול הקדמי של החוליות קו - 3גבול האחורי של גופי החוליות
5
Examination of cervical spine .1 Cross - table LATERAL: view vertebral 7 • bodies must be seen lines 5 • C1-2 area • Disk spaces • Cervical •
Examination of cervical spine .1 Cross - table LATERAL: view vertebral 7 • bodies must be seen lines 5 • C1-2 area • Disk spaces • Cervical •
C - spine radiograph
• Soft tissue
swelling Anterior gaping
C3
Dislocated de
Examination of cervical spine 2. If LATERAL C - spine view appear normal and if the patient can cooperate FLEXION and EXTENSION views are obtained ) patient makes them without help ! (
C-spine LAT ANATOMY
Flexion
Extension
Examination of cervical spine 3. Anterior view with closed mouth: • lower cervical spine • alignment • oblique fractures
Examination of cervical spine 4. Open-mouth view of dens: • Dens • C1 )inferior and lateral margins ( • C2 )superior and lateral
Examination of cervical spine 5. Oblique views: Neural foramina )C2T1( Articular facets
C spine LAO anatomy
C spine RAO anatomy
C SPINE MRI ANATOMY
C SPINE MRI ANATOMY
Examination of cervical spine 6. Computed tomography: • Narrow slices • Bone window • MPR
C SPINE CT ANATOMY
C SPINE CT ANATOMY
C SPINE CT ANATOMY
C SPINE CT ANATOMY )CT-myelo(
C1 חוליה- atlas שת הקדמית של C2 חוליה- axis שלDE C1 חוליה- atlas שלLateral ma
subarachnoid spa spinal co C1 חוליה- atlas שת האחורית של
C SPINE CT ANATOMY )CT-myelo(
transverse proces C6 ף החוליה foramen of vertebral arter spinal cor lamin
spinous proces
Most common
MAJOR PATHOLOGIC ENTITIES INFECTION:
HEMORRHAGE:
VASCULAR DISEASE:
MAJOR PATHOLOGIC ENTITIES DEMYELINATING DISEASE :
MENINGITIS
OSTEOMYELITIS OF THE C - SPINE
Trauma of Spine • Motor vehicle accident • Falls • Sport injuries
Trauma of Spine Most common: Upper (C1-C2) cervical spine Lower (C5-C7) cervical spine Thoracolumbar junction (T9-L2)
Imaging studies • X-rays • CT -bones fractures • MRI- soft tissues, spinal cord, CSF, neural roots
Radiology of trauma • Always get two radiographs at 90 degrees to each other! • Look for the second fracture!
Trauma of cervical spine
nterior - flexion forces Following hyperextension forces
FRACTURE OF C1 Jefferson’s fracture
FRACTURE OF C1 Jefferson’s fracture
שבר של הלסת תחתונה
DENS FRACTURE
DENS FRACTURE
DENS FRACTURE
FRACTURE OF C2 Hangman’s fracture
Posterior elements of the C2 fractured and displaced inferiorly
FRACTURE OF C2 Hangman’s fracture שבר של אלמנטים אחוריים ותזוזה של C2קדימה לעומת C3
Teardrop fracture Disruption of posterior ligaments and anterior compression of a vertebral body
TRAUMA SEVERE BURST FRACTURE WITH POSTERIOR DISLOCATION OF C5 BODY
COMPRESSED FRACTURE OF C6 BODY
Dislocated den
Unstable cervical spine fractures
Anatomical Considerations
Clinicians use the following triangles to navigate neck anatomy
Anatomical Considerations
Salivary Glands Parotid Gland Submandibular Gland Sublingual Glands Minor Salivary Glands
C SPINE CT ANATOMY
CERVICAL ,,MAP,,
USES OF THYROID U S
CONGENITAL THYROID ABNORMALITYS
NODULAR THYROID DISEASE
PAPILLARY FOLLICULAR MEDULLARY ANAPLASTIC
DIFFUSE THYROID DISEASE ACUTE SUPPURATIVE THYROIDITIS SUBACUTE THYROIDITIS HASHIMOTO (CHRONIC LIMPHATIC) GRAVES’ DISEASE DIFFUSE GOITER
HASHIMOTO THYROIDITIS
MULTINODULAR GOITER
DIFFUSE GOITER
ADENOMA
BENIGN CALCIFICATION
COARSE PERIFERAL
EGG-SHELL
MEDULLARY CA HORMON CALCITONIN
FAMILAL COMPONENT OF MEN 2
MICROCALCIFICATION
MALIGNANT FROM BENIGN LESIONS
FNA
Lymph nodes
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