Upper Cervical X-ray Setups Establishing Normal Head Carriage - PowerPoint PPT Presentation

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Upper Cervical X-ray Setups Establishing Normal Head Carriage

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Upper Cervical X-ray Setups Establishing Normal Head Carriage Dr. Perry O. Rush Consistency of the patient s normal head carriage position from one film to the next ... – PowerPoint PPT presentation

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Title: Upper Cervical X-ray Setups Establishing Normal Head Carriage


1
Upper Cervical X-ray SetupsEstablishing Normal
Head Carriage
  • Dr. Perry O. Rush

2
Consistency of the patients normal head carriage
position from one film to the next is vital for
proper analysis.
3
1. Seat Patient Properly
  • Sitting straight and tall (not military posture)
  • Looking straight ahead
  • Hands on lap, palms down
  • Center of shoulder over center of hip
  • Feet positioned properly

4
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5
2. Marking points
  • Glabella
  • Filtrum
  • Symphysis menti
  • Episternal notch
  • Transverse process of atlas

6
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7
3. R.O.M. Flexion - Extension
  • Notation of canthis to ear plane line while
    patient flexes and extends head. (patients eyes
    closed) This plane line will be kept the same for
    all views.

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12
4. R.O.M. Head Rotation
  • Center yourself to patient with your finger tips
    touching patients shoulders.
  • With eyes closed have patient turn head toward
    one shoulder and back to what feels like
    center. Mark a line on neck directly under chin
    dot.

13
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15
R.O.M. Head Rotation (cont.)
  • Have patient turn head to opposite shoulder and
    back to what feels like center. Mark a line on
    neck directly under chin dot.
  • If points are different, split difference and
    mark another line directly above them to
    represent where the patient normally carries
    chin. The chin will remain in this position for
    all views.

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18
5. Correction of Head Rotation
  • Make sure chin dot is in line with the rotation
    dot and then rotate chair to square the face to
    the tube.

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21
6. Correction of Head Tilt
  • Use only the top three dots of face for a
    vertical visual line.
  • Lean patient from the waist to correct head tilt.
  • (Symphysis menti and ESN dots may not be directly
    over each other at this point.)

22
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23
R
L
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7. Head Shoulder Angle(A-P and Nasium)
  • Angle bucky to touch both head and shoulder

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27
8. Set Tube at 40 inches(The distance is pre-set
for the C-arm unit)
  • First, angle the tube upward 17 degrees (to get
    in the ball park)
  • Then, pull the tube forward and by raising or
    lowering the tube height put the horizontal
    crosshair between the t.p. and the tragus notch
    while going between the back molars. Raise or
    lower the bucky until the crosshair hits the
    center of the bucky.
  • Then, string the distance.

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29
(Eyes only appear superior because of camera
angle)
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32
9. Center Patient
  • Center patient to the bucky by sliding the chair
    laterally and using the vertical crosshair to
    line up the patient through the 3 face dots.
    (Fine tune tilt and rotation when necessary.)

33
(In this case the patient still has tilt which
will be left in the Nasium and A-P views but will
be corrected for the Lateral and Base Posterior
views.)
34
Comment Steps 5 6 may be reversed in order
the idea is to correct for which ever is
greatest, first. It should be a gross
correction. Fine-tuning comes at the end (step 9).
35
Comment (continued) These ninesteps will be
spread through out the twenty general steps for
the various cervical views. They are separated
out here to help the student grasp the concept of
establishing NHC.
36
The End
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