Spinographic Landmarking
PUC Series Ramneek Bhogal

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1. All materials contained in this PowerPoint Presentation are protected by copyright laws, and may not be reproduced, republished, distributed, transmitted electronically, displayed, broadcast or otherwise exploited in any manner without the express prior written permission of Ramneek S. Bhogal, DC, DABCI. Ramneek S. Bhogal, DC, DABCI either owns the intellectual property in all the information and media in this PowerPoint Presentation or has obtained permission of the owner to use the content in this presentation. You may download or print this material for your own personal and educational use only, without altering or removing any trademark, copyright or other notice from such material. Viewing this PowerPoint Presentation constitutes explicit agreement with the terms of this copyright declaration. © 2016 Bhogal

2. Spinographic Landmarking PUC Series © 2016 Bhogal

3. Chiropractic X-Rays Generally taken weight bearing This provides good biomechanical feedback Generally taken from A-P but analyzed from P-A (functional view) Analysis is referred to spinography and is chiropractic/technique specific © 2016 Bhogal

4. Chiropractic X-Rays Advantages Correlate postural distortions Correlate clinical findings Identify pathologies…. Facilitate safer/conscientious care Qualify and quantify misalignment Derive Listings for C1 and C2 More specific adjusting (LOC) © 2016 Bhogal

5. Chiropractic X-Rays Disadvantages Static picture of a dynamic spine Limited sensitivity to pathologies Exposure risk (consider benefit) Financial start up costs Maintenance Portability Digital is less of an issue © 2016 Bhogal

6. PUC Series Views © 2016 Bhogal Common Name Projection Name Lateral Longitudinal Nasium Horizontal Base Posterior Vertical APOM Verticohorizonal

7. Why these views?? © 2016 Bhogal View Primary Purpose Secondary Purpose Lateral Determine AS / AI of C1 Evaluate cervical curve & pathologies Nasium Determine laterality of C1 70% Finding & Condyle asymmetry Base Posterior Determine rotation of C1 Evaluate for pathologies APOM Determine C2 listing Assumed Atlas & Pathologies

8. © 2016 Bhogal Lateral / Longitudinal

9. © 2016 Bhogal Occipital Condyle Line Front and back of occipital condyle Atlas Plane Line Anterior tubercle and posterior arch Listing Line Parallel to OCL

10. © 2016 Bhogal Nasium / Horizontal

11. © 2016 Bhogal Ocular Orbit Line: Analagous points in the orbits (head tilt/pitch)

12. © 2016 Bhogal Superior Basic Line: Medial inferior condyle tips Inferior Basic Line : Lateral inferior tips of C1 lateral masses Vertical Median Line : Drawn through the center of the foramen magnum and is 90˚ to the OOL

13. © 2016 Bhogal Superior Basic Line: Medial inferior condyle tips Inferior Basic Line : Lateral inferior tips of C1 lateral masses Vertical Median Line : Drawn through the center of the foramen magnum and is 90˚ to the OOL

14. © 2016 Bhogal Superior Basic Line: Medial inferior condyle tips Inferior Basic Line : Lateral inferior tips of C1 lateral masses Vertical Median Line : Drawn through the center of the foramen magnum and is 90˚ to the OOL

15. © 2016 Bhogal Base Posterior / Vertical

16. © 2016 Bhogal Atlas Plane Line: Middle of transverse foramina

17. © 2016 Bhogal Perpendicular Skull Line: Originates high and centrally on the nasal septum and then intersects the middle of the basiliar process.

18. © 2016 Bhogal APOM / Verticohorizontal

19. © 2016 Bhogal Ocular Orbit Line: Analagous points in the orbits to ascertain the tilt or pitch of the head In this film, the tops of the orbits were “cut off” so moving down into the zygomatic area is acceptable for analogous points

20. © 2016 Bhogal Superior Basic Line: Jugular processes or alternate points. Where the floor of the skull turns upward: “V’s” Inferior Basic Line : Same as Nasium view.

21. PUC Series Lines © 2016 Bhogal Lateral Nasium Base Posterior APOM Occipital Condyle Line Ocular Orbit Line Atlas Plane Line Ocular Orbit Line Atlas Plane Line Superior Basic Line Perpendicular Skull
Line Superior Basic Line Listing Line Inferior Basic Line Inferior Basic Line Vertical Median Line Vertical Median Line