During a lateral extension cervical spine radiograph, how should the patient's chin be positioned?

• A. Tucked toward the chest
• B. Raised to the ceiling
• C. Neutral
• D. Depressed downward

Answer: (B)

To obtain a lateral extension view of the cervical spine, you want the neck to be extended so the chin is raised toward the ceiling. Raising the chin moves the mandible and tongue away from the upper cervical levels, reducing superimposition and allowing a clear, true lateral projection of the cervical vertebrae, especially the area around C1 and the upper facet joints. This positioning helps open the spaces between the vertebrae and provides better visualization of alignment and posterior elements.

If the chin is tucked toward the chest, kept neutral, or depressed, the neck remains partly flexed or not sufficiently extended, causing the mandible to obscure the upper cervical spine and compromising the quality of the extension view.