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
C2 visualized -

C3 the
shoulders
C4 must be
lowered
Dislocation C5 even more
of C5 on C6
C6
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

‫‪5‬‬ ‫גופי החוליות‬
 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 )C2-
T1(
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
Thank you