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Bontrager Ch 9
Lumbar, Sacrum, Coccyx
| 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: A. Vertebral foramen B. Intervertebral foramen C. Pedicle D. Lamina | B. Intervertebral Foramen |
| Which lumbar radiographic position best demonstrates the IVF? | Laterals |
| What is best demonstrated in an L-spine oblique projection? | zygapophyseal joints |
| What is best demonstrated in an L-spine lateral projection? | intervertebral foramina |
| Would the angle of degree of an oblique L-spine be greater or less for lower lumbar vertebrae as compared with the upper? | Lower is less - 30' Upper is greater - 50' |
| the small foramina 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 sacral horns? | Cornua |
| The sacroiliac joints lie at an oblique angle of _____ ' to coronal plane. | 30' |
| What is the formal name for the tailbone? | Coccyx |
| What is the name of the superior broad aspect of the coccyx? | Base |
| What type of mobility and movement does the Z-joint have? | synovial, diarthrodial, plane (gliding) |
| What type of mobility and movement do the intervertebral joints have? | cartilaginous, amphiarthrodial, none - moves only slightly |
| Name the parts of the Scottie Dog - ear, nose, eye, neck, front leg | EAR - superior articulating process; NOSE - transverse process; EYE - pedicle; NECK - Pars Interarticularis; FRONT LEG - inferior articulating process; |
| List the specific joints or foramina that are demonstrated in the LPO. | left zygapophyseal joint |
| List the specific joints or foramina that are demonstrated in the RPO. | right zygapophyseal joint |
| List the specific joints or foramina that are demonstrated in the RAO. | left zygapophyseal joint |
| List the specific joints or foramina that are demonstrated in the LAO. | right zygapophyseal joint |
| List the specific joints or foramina that are demonstrated in the lateral position | intervertebral foramina |
| The degree of obliquity required for an oblique projection at T12/L1 level is generally _____. | 50' |
| the degree of obliquity required for an oblique projection at L4-L5 level is generally _____. | 30' |
| What is the oblique angle for general lumbar spine? | 45' |
| Topographic landmarks of Lumbar spine region - ASIS | S1/S2 |
| Topographic landmarks of Lumbar spine region - Xiphoid process | T9/T10 |
| Topographic landmarks of Lumbar spine region - lower costal margin | L2/L3 |
| Topographic landmarks of Lumbar spine region - iliac crest | L4/L5 |
| Topographic landmarks of Lumbar spine region - symphysis pubis | prominence of greater trochanter |
| True/False The use of higher kV and lower mAs for lumbar spine radiography improves radiographic contrast but increases patient dose. | False |
| True/False Placing a lead blocker mat behind the patient for lateral lumbar spine positions improves image quality. | TRUE |
| True/False The AP projection of the L-spine opens the intervertebral joint spaces better than the PA projection. | FALSE |
| True/False The knees and hips should be extended for an AP projection of the L-spine. | FALSE |
| True/False An increased SID of 44-46" reduces magnification of the L-spine. | TRUE |
| True/False When positioning the obese patient, the iliac crest is typically at the level of the inferior margin of the flexed elbow. | TRUE |
| Which modality best demonstrates the pathology of OSTEOPOROSIS? | Bone Densitometry |
| Which modality best demonstrates the pathology of SOFT TISSUES OF LUMBAR SPINE? | MRI |
| Which procedure best demonstrates the pathology of STRUCTURES WITHIN SUBARACHNOID SPACE? | Myelography |
| Which modality best demonstrates the pathology of INFLAMMATORY CONDITIONS SUCH AS PAGET'S DISEASE? | Nuclear medicine |
| Which modality best demonstrates the pathology of COMPRESSION FRACTURE OF LUMBAR SPINE? | CT |
| Explain SCOLIOSIS | Abnormal lateral curvature of the vertebral column |
| Explain CHANCE FRACTURE | Fracture of the vertebral body caused by hyperflexion force (seatbelt fracture) |
| Explain SPINA BIFIDA | Congenital defect in which posterior elements of vertebrae fail to unite. |
| Explain HNP | Herniated Nucleus Pulposus - Most common at L4/L5; may result in sciatica - disk bulges out of IV space |
| Explain SPONDYLOLISTHESIS | Forward displacement of one vertebra onto another vertebra |
| Explain ANKYLOSING SPONDYLITIS | Inflammatory condition most common in males in their 30s |
| Explain SPONDYLOLYSIS | Dissolution and separation of the Pars Interarticularis |
| Explain COMPRESSION FRACTURE | A type of fracture that rarely causes neurologic deficits |
| With a 14x17 IR, the CR is centered _____ for AP and lateral lumbar spine projections. | L4/L5 - Iliac crest |
| Which two structures can be evaluated to determine whether rotation is present on a radiograph of AP Lumbar Spine? | A. spinous processes equally midline of spine B. SI joints are equidistant from spine |
| How much rotation is required to visualize the Z joints properly at L5-S1 level? | 30' |
| Which specific set of Z joints is demonstrated with LAO position? | RIGHT |
| The _____, which is the eye of the Scottie dog, should be near the center of the vertebral body on a correctly oblique lumbar spine projection. | PEDICLE |
| Which positioning error has been committed if structures in oblique lumbar spine image are projected too far posterior with 45' oblique? | OVER 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 CR of _____ degrees and _____ angle for a lateral Lumbar spine | 5-8' and CAUDAD |
| How should the spine of a patient with scoliosis be postioned for a lateral lumbar spine? | CONVEX SIDE TOWARDS IR |
| Why should the knees and hips be flexed for AP lumbar spine projection? | to flatten lumbar spine to open IV joint spaces and reduces magnification |
| TRUE/FALSE The female ovarian dose for a PA lumbar spine is approx 25-35% less than for AP. | TRUE |
| Where is the central ray centered for a lateral L5-S1 projection? | 1.5" inferior to iliac crest and ASIS 2" posterior |
| What amount and direction of CR angulation is required for AP Axial L5-S1 on a male patient? | 30' cephalad |
| True/False A PA or AP projection for scoliosis series frequently includes one erect and one recumbent position for comparison. | TRUE |
| True/False The lower margin of the cassette must include the symphysis pubis for a scoliosis series. | FALSE lower margin 1-2 " below iliac crest |
| True/False A PA projection for scoliosis series produces only about 1/10 dose to the breasts as compared to AP, even with proper collimation. | TRUE |
| Which of the following techniques or devices produces a more uniform density along the vertebral column for an AP/PA scoliosis projection? A. Use of 14x36 image receptor B. Lower kV C. Higher mAs D. Compensating filter | D. Compensating filter |
| Which side of the spine should be elevated for the second exposure of the AP/PA projection (Ferguson) scoliosis series (by having patient stand on a block with one foot)? | The convex side of the spine |
| For the Ferguson method, the elevated foot must be raised a minimum of _____. | 3-4" |
| During AP/PA right and left bending projections of the lumbar spine, the _____ serves as a fulcrum during positioning. | Pelvis |
| Which projections should be taken to evaluate flexibility following spinal fusion surgery? | Hyperextension and Hyperflexion laterals |
| What is the recommended kV range for lateral-hyperflexion and hyperextension positions of the spine for DR? A. 70-75 B. 80-85 C. 85-95 D. 95-100 | D. 95-100 kVp |
| How much CR angulation is required for an AP projection of the sacrum for a typical male patient? | 15' cephalad |
| Where is the CR centered for an AP axial projection of the Sacrum? | 2" superior to the symphysis pubis |
| If a patient cannot be supine for AP sacrum, what is alternate position? | PA projection with 15' caudal angle; PRONE position |
| Where is the CR centered for AP Coccyx? | 2" superior to symphysis pubis |
| How much CR angulation for AP axial coccyx? | 10' caudad |
| True/False AP projections of the sacrum and coccyx can be taken as single projection to reduce patient gonadal dose. | FALSE different CR angles required. Can combine lateral for sacrum/coccyx |
| Patients should be asked to void bladder prior to which projection of the vertebral column? | AP sacrum and coccyx |
| In addition to good collimation, what should be done to minimize overall "fogging" on lateral lumbar spine/sacrum/coccyx radiograph? | place lead blocking on table behind patient |
| Which SI joint is visualized with RPO position? | Left SI joint |
| How much rotation of the body is required for oblique positions of the SI joints? | 25 - 30' |
| What type of CR angle is recommended for AP axial projection of the SI joints on female patient? A. 20' cephalad B. 30' cephalad C. 30' caudad D. 35' cephalad | D. 35' cephalad |
| Where is the CR centered for a oblique position of the SI joints? | 1" medial from upside ASIS |
Created by:
Larobbins
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