When performing an AP axial projection of the cervical spine, what is the correct degree and angulation of the X-ray tube?

• A. 0 degrees
• B. 5-10 degrees caudal
• C. 25-30 degrees cephalic
• D. 15-20 degree cephalic

Answer: (D)

For an AP axial projection of the cervical spine, the beam must be angled cephalad to align with the anatomy and to reduce overlap from the base of the skull and mandible. Angling 15–20 degrees toward the head provides the proper projection of the lower cervical vertebrae (C3–C7) while keeping the upper cervical region in view. This cephalad tilt helps open the intervertebral areas and minimizes superimposition that would occur if the beam were not angled or angled in the wrong direction. Using 15–20 degrees cephalad strikes a balance—enough tilt to visualize the intended vertebrae clearly without introducing distortion from an excessive angle.