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Positioning chap 9
| Question | Answer |
|---|---|
| A portion of the lamina located between the superior and inferior articular processes is called the? | Pars interarticularis |
| The superior and inferior vertebral notches join together to form the? | Intervertebral foramina |
| Which radiographic position best demonstrates the intervertebral foramina? | lateral position |
| The small foramina found in the sacrum are called? | Pelvic sacral foramina |
| The anterior and superior aspect of the sacrum that forms the posterior wall of the pelvic inlet is called the? | Promontory |
| What is another term for the sacral horns? | Cornua |
| The sacroiliac joints lie at an oblique angle of what degree to the coronal plane? | 30* |
| What is the formal term for the "tail bone"? | Coccyx |
| What is the name for the superior broad aspect of the coccyx? | Base |
| whats the classification, mobility type, and movement type of a zygapophyseal joint | Classification: synovial Mobility: diarthrodial Movement: plane or gliding |
| whats the classification, mobility type, and movement type of a intervertebral? | Classification :cartilaginous Mobility type: amphiarthrodial (slightly movable) Movement type:none |
| Which specific joints or foramina are demonstrated on an LPO lumbar spine position? | Left zygapophyseal joints |
| Which specific joints or foramina are demonstrated on an RAO lumbar spine position? | Left zygapophyseal joints |
| Which specific joints or foramina are demonstrated on an RPO lumbar spine position? | Right zygapophyseal joints |
| Which specific joints or foramina are demonstrated on an LAO lumbar spine position? | Right zygapophyseal joints |
| The degree of obliquity required for an oblique projection at the T12-L1 level is approximately ___, whereas the L5-S1 level spine requires __ oblique. therefore, a __ oblique is performed for the general lumbar spine? | 50*, 30*, 45* |
| What is the vertebral level for the ASIS? | S1-S2 |
| What is the vertebral level for the Xiphoid process? | T9-T10 |
| What is the vertebral level for the Lower costal margin? | L2-L3 |
| What is the vertebral level for the Iliac crest? | L4-L5 |
| What is the vertebral level for the symphysis pubis? | Tip of coccyx |
| The use of higher kV and lower mAs for lumbar spine radiography improves radiographic contrast but increases patient does? | False |
| Placing a lead blocker may behind the patient for lateral lumbar spine positions improves image quality. | True |
| Gonadal shielding should always be used for male and female patients for studies of the lumbar spine, sacrum, and coccyx. | False |
| The anteroposterior (AP) projection of the lumbar spine opens the intervertebral joint space better than the posteranterior (PA) projection. | False |
| The knees and hips should be extended for an AP projection of the lumbar spine. | False |
| An increased source image receptor distance (SID) of 44 or 46 inches (112 to 117cm) reduces distortion of the spine anatomy. | true |
| The lead blocker mat and close collocation must not be used when performing digital imaging of the lumbar spine. | false |
| What imaging modality is used to best demonstrate Osteoporosis? | bone densitomertry |
| What imaging modality is used to best demonstrate soft tissue of the lumbar spine? | MRI |
| What imaging modality is used to best demonstrate structures within subarachnoid space? | MRI |
| What imaging modality is used to best demonstrate inflammatory conditions such as Paget's disease? | Nuclear medicine |
| What imaging modality is used to best demonstrate compression fractures of the lumbar spine? | Computed tomography (CT) |
| Lateral curvature of the vertebral column? | Scoliosis |
| Fracture of the vertebral body caused by hyperflexion force? | Chance fracture |
| Congenital defect in which the posterior elements of the vertebral fail to unite? | Spina bifida |
| Most common at the L4-L5 level and may result in sciatica. | Herniated nucleus pulposus (HNP) |
| Forward displacement of one vertebra onto another vertebra | Spondylolisthesis |
| Inflammatory condition that is common in males in their thirties | Ankylosing spondylitis |
| Dissolution and separation of the pars interarticulates | Spondylolysis |
| A type of fracture that rarely causes neurologic deficits | compression fracture |
| With a 14X17 inch IR, the CR is centered at the level of the what for AP and lateral lumbar spine projection | Iliac crest |
| What two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the lumbar? | A. sacroiliac (SI) joints are equidistant from spine. B. Spinous process should be midline to the vertebral column (transverse processes are equal length) |
| How much rotation is required to properly visualize the zygapophyseal joints at the L5-S1 level? | 30* |
| Which specific set of zygapophyseal joints is demonstrated with an LAO position? | Right (upside) |
| The __, which is the eye of the "scottie dog," should be near the center of the vertebral body on a correctly obliqued lumbar spine? | Pedicle |
| What positioning error has been committed if the pedicles (eye of scottie dog)are projected too far posterior with a 45* oblique position of the lumbar spine? | excessive rotation |
| Which position or projection of the lumbar spine series best demonstrates a possible compression fracture? | lateral |
| A patient with a wide pelvis and narrow thorax may require a central ray angle of what for a lateral position of the lumbar spine | 5* to 8*, caudad |
| How should a patient with scoliosis be positioned for a lateral position of the lumbar spine? | with the sag or convexity of the spine closest to the IR |
| Why should the knees and hips be flexed for an AP lumbar spine projection? | reduces lumbar curvature, which opens the intervertebral disk space |
| The female ovarian dose used for a PA lumbar spine projection is approximately 30% less than the dose used for an AP projection. | true |
| Where is the CR centered for a lateral L5-S1 projection of the lumbar spine? | 1 1/2 inches (4cm) inferior to iliac crest and 2 inches (5 cm) posterior to ASIS |
| What amount and direction of CR angulation is required for an AP axial L5-S1 projection on a male patient? | 30* cephalad |
| A PA or AP projection for a scoliosis series frequently includes one erect and one recumbent position for comparison? | true |
| The lower margin of the cassette must include the symphysis pubis for a scoliosis series? | false (lower margin 1 to 2 inches below iliac crest) |
| A PA projection for a scoliosis series produces only about 1/10 the dose to the breast as compared with the AP projection, even if proper collimation is used. | true |
| What technique or devices produces a more uniform density along the vertebral column for an AP/PA scoliosis projection? | compensating filter |
| Which side of the spine should be elevated for the second exposure for the AP/PA projection (Ferguson method) scoliosis series (by having the patient stand on a block with one foot)? | the convex side of curve |
| During the AP (PA) right and left bending projections of the lumbar spine, the __ must remain stationary during positioning. | pelvis |
| Which projections should be taken to evaluate flexibility following spinal fusion surgery? | hyperextension and hyperflexion |
| How much CR angulation is required for an AP projection of the sacrum for a typical male patient? | 15* cephalad |
| If a patient cannot lie on his back for an AP sacrum because it is too painful, what alternate projection can be taken to achieve a similar view of the sacrum? | A PA (prone) with 15* caudad CR angle |
| Where is the CR centered for an AP projection of the coccyx? | 2 inches superior to the symphysis pubis |
| The AP projections of the sacrum and coccyx can be taken as one single projection to decrease gonadal/dose. | false (need different CR angles for AP projections; can combine lateral but not AP projections) |
| Patients should be asked to empty the urinary bladder before performing which projections of the vertebral column? | AP of sacrum and coccyx |
| In addition to good collimation, what should be done to minimize overall "fogging" on a lateral lumbar spine or lateral sacrum and coccyx radiograph? | Place lead blocker on tabletop behind patient |
| Which sacroiliac (SI) joint is visualized with an RPO position? | left |
| How much rotation of the body is required for oblique positions of the SI joints? | 25* to 30* |
| What type of CR angle is recommended for the AP axial projection of the SI joints on a female patients? | 35* cephalad |
| Where is the CR centered for an ablique projection of the SI joints? | 1 inch medial from upside ASIS |
| A radiograph of an AP projection of the lumbar spine reveals that the spinous processes are not midline to the vertebral column and distortion of the vertebral bodies is present. Which specific positioning error is present on this radiograph? | Rotation the spine |
| A radiograph of an LPO projection of the lumbar spine reveals that the downside pedicles and zygapophyseal joints are projected over the anterior portion of the vertebral bodies. Which specific positioning error is present on this radiograph? | Insufficient rotation of the spine (pedicle "eye" should be to midvertebral bodies) |
| A radiograph of a lateral projection of a female lumbar spine reveals that mid-to lower intervertebral joint spaces are not open. The technologist support the midsection of the spine with sponges to straighten the spine. what can open joint spaces? | If the patient has a wide pelvis, the central ray can be angled 5* to 8* caudad. |
| A radiograph of a lateral L5-S1 projection reveals that the joint space is not open. The tech did support the middle aspect of the spine with a sponge. Wht else can the tech do to open the joint space during the respeat exposure? | Place additional support beneath the spine, or use a 5* to 8* caudad angle. |
| A radiograph of an AP axial projection of the coccyx reveals that the distal tip is superimposed over the symphysis pubis. What must the technologist do to eliminate this problem during the repeat exposure? | An increase in CR angle is required to separate the coccyx from the symphysis pubis. |
| radiograph of an oblique position of the lumbar spine reveals tht the downside pedicle and zygapophyseal joint r posterior in relation to the vertebral body. wht modification of the position must be made during the repeat exposure a more diagnostic image | Decrease rotation of the body and spine. |
| A patient comes to the radiology department with a clinical history of HNP. Which imaging modality provides the most diagnostic study for this condition? | MRI |
| What is topographic landmark? | Xiphoid tip-T9-T10. Lower costal margin L2-L3. Iliac crest L4-L5 ASIS S1-S2 |
| What projection will best demonstrate spondylolisthesis? | Lateral position |
| What projection are used after a spinal fusion surgery? | Right & left bending positions. Lateral: hyperextension & hyperflexion |
| Who's sacrum is angled more posteriorly male or female? | female |
| L spine joint and foramina positioning for a intervertebral foramina-90* lateral | R OR L lateral |
| L spine joint and foramina positioning for a zygapophyseal joints 45* obliques for a posterior oblique-downside for a RPO? | right joints |
| L spine joint and foramina positioning for a zygapophyseal joints 45* obliques for a posterior oblique-downside for a LPO? | left joints |
| L spine joint and foramina positioning for a zygapophyseal joints 45* obliques for a anterior oblique-upside for a RAO? | left joints |
| L spine joint and foramina positioning for a zygapophyseal joints 45* obliques for a anterior oblique-upside for a LAO | right joints |
| How can you tell under/over rotation on an oblique L-spine? | The pedicle demonstrated posteriorly on the vertebral body indicates over, rotation pedicle anteriorly is under rotated or eye of scotty dog |
| What body rotation, CR angle and placement for oblique SI joints? | Rotate body 25*-30* posterior oblique CR is perpendicular 1 inch medial to the upside ASIS. |
| What side is buikt up (with a block of wood) on the second position for the ferguson method? | build up side with convex curve |
| What position for SI joints will be demonstrate the left joint | joint farthest from the IR, so do an RPO to put the left joint furthest away. |
| How do you correct for superimposition of the symphysis pubis ? | Greater curvature of the coccyx requires greater angle. Increase caudad CR angle |
| What CR angle, placement, and centering for AP sacrum and AP coccyx? | AP sacrum-angle CR 15* cephalad, CR 2 inches superior to symphysis pubis. AP coccyx- angle CR 10* caudad CR 2 inches superior to symphysis pubis |
| If a patient has scoliosis, which side should be down? | the convex side down |
| How do you demonstrate the lower portion of SI joints on the oblique position? | CR angle must be angled 15* to 20* cephalad |
| What CR angles for AP axial L5-S1 position? | angle CR 30* on males and 35* on females |
| Can AEC be used on lateral L5-S1? | Yes |
| What does the CR need to be parallel to on the lateral L5-S1 position? | Parallel to the inter iliac plane |
| How much bone loss has to happen in order for conventional radiography to detect it? | Bone densitometry-30% of bone loss |
| What are the angles for the AP axial projection of sacroiliac joints? | CR 30* to 35* cephalad (generally males requires 30* & females 35*, with an increase in the lumbosacral curve. |
| Deforming curve is from? | scoliosis |
| Compensatory curve is? | one leg shorter than the other causing the curve. |
| What is the intervertebral foramen degree relative to the midsagittal plane? | sisuated 90* |
| What is the most inferior body of the lumbar vertebra? | L5, is the largest |
| Between every two vertebrae are what? | two intervertebral foramina, one on each side, through which two important spinal nerves and blood vessels pass |
| The intervertebral foramina in the lumbar region are demonstrated best on a radiographic image? | lateral |
| The intervertebral foramina for the lumbar spine are visualized on what projection? | true lateral |
| The downside joints are visualized on what kind of oblique? | posterior |
| Positioning for oblique projection of the lumbar spine requires a good understand of what? | the anatomy of the vertebrae and the zygapophyseal joints. |
| What is the disadvantage of the PA projection is the? | increased object image receptor distance (OID) of the lumar vertebrae, which results in magnification unsharpness, especially for for a patient with a large abdomen |
| Why is close collimation vital with a high-kV? | to limit the amount of scatter radiation reaching the image and, as always to reduce the patient dose. |
| The superior and inferior surfaces of the vertebral body are driven together, producing a wedge-shaped vertebra? | compression fractures |
| Result from hyperflexion force that causes fractures through the vertebral body and posterior elements | chance fractures |
| Commonly known as a herniated lumbar disk (slipped disk), is usally due to trauma or improper lifting. The soft inner part of the intervertebral disk (nucleus pulposus )protrudes through the fibrous outer layer, pressing on the spinal cord or nerves. | herniated nucleus pulposus (HNP) |
| What describes the normal concave curvature of the lumbar spine and an abnormal or exaggerated concave lumbar curvature? | Lordosis |
| What are the primary malignant neoplasms that spread to distant sites via blood and lymphatics. | Metastases |
| Destructive lesions with irregular margins. | Osteolytic |
| Proliferative bony lesions of increased density. | Osteoblastic |
| Moth eaten appearance of bone resulting from the mix of destructive and blastic lesions | Combination Osteolytic and Osteoblastic |
| What is a lateral curvature of the vertebral column that usually occurs with some rotation of the vertebral. It involves the thoracic and lumbar lesions | Scoliosis |
| Congenital condition in which the posterior aspect of the vertebrae. It involves the thoracic and lumbar regions. | Spina Bifida |
| Involves the forward movement of one vertebra in relation to another. | spondylolisthesis |
| What is the dissolution of vertebra, such as from aplasia(lack of development) of the vertebral arch and separation of the pars interarticularis of the vertebra. On the oblique projection, the neck of the Scottie dog appears broken. most common at L4 / L5 | Spondylolysis |
| Where do you palpate for the AP OR PA projection: lumbar spine | 1.5 inches (4cm) above iliac crest |
| If the pedicle are demonstrated posteriorly on the vertebral for the oblique-posterior positions: lumbar spine what is the error? | body indicates over-rotation. |
| If the pedicle are demonstrated anteriorly on the vertebral on a anterior oblique position: Lumbar spine. | body indicates under-rotation. |
| Lateral lumbar spine position on an average male and sometimes female patients requires no CR angle but on a patient with wider pelvis and narrow thorax may require what angle? | |
| Where do you palpate for the AP OR PA projection: lumbar spine | 1.5 inches (4cm) above iliac crest |
| If the pedicle are demonstrated posteriorly on the vertebral for the oblique-posterior positions: lumbar spine what is the error? | body indicates over-rotation. |
| If the pedicle are demonstrated anteriorly on the vertebral on a anterior oblique position: Lumbar spine. | body indicates under-rotation. |
| Lateral lumbar spine position on an average male and sometimes female patients requires no CR angle but on a patient with wider pelvis and narrow thorax may require what angle? | 5* to 8* caudad to open joints |
| A PA rather than an AP on the scoliosis series projection is recommend because why? | significantly reduce dose to radiation-sensitive areas, such as the female breast and thyroid gland |
| For a PA/AP projection-Ferguson Method: Scoliosis series should any form of support (eg, compression band) is to be used in this examination? | NO. |
| How should the pelvis remain during positioning for the right&left bending: scoliosis series? | remain as stationary as possible. |
| On the Lat. positions- hyperextension & hyperflexion: spinal fusion series projection may also be done how? | with patient standing erect or sitting on a stool, 1st leaning forward far as possible and then leaning backwards as far as possible gripping back of the stool to maintain this position. |
| For an AP axial sacrum projection: Sacrum what should be emptied before the procedure begins? | urinary bladder |
| What anatomy should be demonstrated on an Lateral sacrum & coccyx position? | sacrum, L5-S1 joint, and coccyx |
| What is the CR angle for the AP axial projection: Sacroiliac joints? | Males generally require 30* cephalad and females 35* cephalad. |
Created by:
jackiblaylock