Cervical
1-Lateral (Grandy) IR Size: 8x10 LW SID: 60-72'' Page #'s: 1:388,144	Positioning:   • Pt TLP   • Chin slightly elevated & protruded   • Shoulders in same plane   • (Center shadow on center AEC)	CR Entrance & Angle:   • _|_ to C4 (thyroid cartilage); Top of light to TEA; (Can rotate CR head & collimate)   • Collimation:   • 10'' Respiration:   • Suspend on Exhalation (or use sandbags) Best to Determine:   • Zygapophyseal joints & Spinous processes in profile	Eval Criteria:   • All 7 C vertebrae & at least 1/3 of T1   • SI mandibular rami   • Neck extended so mandibular rami not SI over atlas or axis   • NR or tilt of the cervical spine by SI open zygapophyseal joints & intervertebral disk spaces   • Spinous processes in profile   • C4 in the center of the radiograph
2,3-AP Axial Oblique (PRO/LPO) [PA-RAO/LAO] IR Size: 8x10 LW SID: 60-72'' Page #'s: 1:392-394,148-150	Positioning:   • Body (& head) 45°, head slightly turned to IR   • Chin slightly extended   • LPO 1st then RPO 2nd   • (PA Axial may be used except change CR 15°-20° caudad)	CR Entrance & Angle:   • to C4 (thyroid cartilage)   • 15°-20° cephalad Collimation:   • 10'' Respiration:   • Suspend Best to Determine:   • Open intervertebral foramina & pedicles farthest from IR (in PA closest to IR)	Anatomy to IR:   • Eval Criteria:   • Open intervertebral foramina farthest from the IR, from C2-3 to C7-T1   • Open intervertebral disk spaces   • Uniform size & contour of the foramina   • Elevated chin that does not overlap the atlas and axis   • No SI of Occipital bone on the axis   • Cl-7 and Tl
4-AP Axial IR Size: 8x10 LW SID: 40'' Page #'s: 1:386,142	Positioning:   • Pt supine or erect   • Chin extended   • PA may be used except change CR 15°-20° caudad   • (Light Top of Ear TEA)	CR Entrance & Angle:   • to C4 (thyroid cartilage)   • 15°-20° cephalad Collimation:   • 10'' Respiration:   • Suspend Best to Determine:   • C3-C7 & intervertebral disk spaces & presence/absence of cervical ribs	Anatomy to IR:   • Line from upper occlusal plane to mastoid tip _|_ Eval Criteria:   • C3-T2 visualized, Open disk spaces   • Spinous process equidistant to pedicles   • Mandibular angles & mastoid processes equidistant to the vertebrae   • Shadows of the mandible and occiput SI over the atlas & most of the axis
5-AP Open Mouth (Odontoid) IR Size: 8x10 LW SID: 40'' Page #'s: 1:383,138	Positioning:   • Pt supine or erect, Mouth open wide   • Pt softly ''ah''   • [If Occipital base SI dens-tilt pt chin downward, If upper incisors SI on dens-tip pt chin upward][If all three SI use Fuchs]	CR Entrance & Angle:   • _|_ to mid open mouth   • Collimation:   • tight Respiration:   • Suspend Best to Determine:   • Atlas & Axis	Eval Criteria:   • Lateral masses of C1, No SI of tongue   • Entire tip of Dens, Open entire atlantoaxial joint   • SI of occlusal plane of upper incisors & base of skull   • Mandibular rami equidistant from dens
AP Dens (Fuchs) IR Size: 8x10 CW SID: 40'' Page #'s: 1:382,140	Positioning:   • Pt supine	CR Entrance & Angle:   • _|_ to level of mastoid tips   • Collimation:   • tight Respiration:   • Suspend Best to Determine:   • Dens within circular foramen magnum	Eval Criteria:   • NR of head & neck   • Entire dens within foramen magnum
Lateral (R or L Hyperflexion & Hyperextension) IR Size: 10x12 LW SID: 60-72'' Page #'s: 1:390,146	Positioning:   • Rule out Fracture and pathology 1st   • Positioning like lateral except:   • Hyperflexion-drop head forward as close to chest as possible   • Hyperextension-elevate chin as much as possible	CR Entrance & Angle:   • _|_ to C4 (thyroid cartilage); Top of light to TEA; Can rotate CR head & collimate   • Collimation:   • Best to Determine:   • Shows motility of C-Spine	Eval Criteria: