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Bontrager Ch 9

Lumbar, Sacrum, Coccyx

QuestionAnswer
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