118 - Ch 9 Lumbar Spine, Sacrum Flashcards
The largest of the lumbar spine is the inferior body of_____
L5
Th intervertebral foramen sit at what degree to the midsaggital plane?
90*
Each pedicle is a half moon shape that forms the
Inferior or superior articular processes
The zygapophyseal joints form an angle of _________To the midsaggital plane.
30-50*
To view the zygapophyseal joints on the lumbar spine; we must position the patient in a ?
45* angle
The portion of the lamina between the inferior and superior articular processes is the:
Pars interarticularis
The sacrum articulates with the ilium of the pelvis at the auriclar surface to form the :
Sacroiliac joint
Each sacroiliac joint opens obliquely at a ______ posterior angle
30*
The most distal portion of the vertebral column is the
Coccyx
Aka tailbone
3-5 segments fuse together to form the
Single coccyx
The superior position of the coccyx is called_____the distal tip of the coccyx is called ________
Base
Apex
A_______ is more likely to experience a fracture to the coccyx than a _____
Female
Male
The lateral view will demonstrate ________
The oblique view will demonstrate_______
Intervertebral foramina
Zygapophyseal joints
A good 45* oblique of the lumbar spine will demonstrate ______
“The Scottie dog”
RPO oblique positions demonstrate the __________
The RAO is opposite to see the zygapophyseal joints
Downside (right side)
The ASIS is at the same level as the ________
What level corresponds to L2-L3?
S1-s2
Lower costal margin
The most superior portion of the iliac crest is at the same level of the
L4-L5
The xiphoid tip is at the level of
T-9-T10
The PA projection of lumbar spine is best for females bcuz
It reduces ovarian dose by 25-30%
The _______position of the lumbar spine places the intervertebral disk spaces more parallel to the divergent beam
Prone
Patients with kyphosis may be more comfortable in a _________ position
Erect
The fracture that may occur to those that weAr a lap belt causing a hyperflexion force to the spine
Chance Fracture
A congenital condition where the posterior aspects of vertebra fail to develop; exposing part of the spinal cord
Spina bifida
Development defect in the pars interarticularis or spondylosis
Spondylolisthesis
separation of the pars interarticularis.. oblique projection of the neck of “the Scottie dog” appears broken
Spondylolysis
The anterior/superior ridge of the upper sacrum is called the:
Promontory
The ear and the front leg of the “Scottie dog” make up the _____________
Zygapophyseal joints;
best seen in oblique position
The zyga joints are best visualized at L5-S1 level with how much rotation??
And at T12-L1?
30*
50*
Most common level of HNP?
L4-L5
& May result in sciatica
Scottie Dog** Nose- Eye- Ear- Neck- Front leg- Behind ear-
Transverse process Pedicle Superior articular process Para interarticularis Inferior articular process Zyga joint
For An AP lumbar spine important factors CR at level of Iliac Crest and:
*Flex knees (to straighten spine n open intervertebral Disk spaces)
**Suspend on expiration!!
T12-S1 must be shown & S.I joints
For the Oblique lumbar spine positions, direct CR at ?
Position body at??
L3 (2inches above iliac crest, 2 inches medial to upside of ASIS)
45* to see zyga joints and scottie dog
50* L1-L2
30* L5-S1
Suspend on Expiration!!
Lateral Lumbar Spine:
To place spine parallel to table what can be done?
What can be used to reduce scatter?
*Place radiolucent block under waist.
CR to level of iliac crest
*Lead masking on tabletop
Wider pelvis need a 5-8* caudad CR angle
Spot film is known as??
Lateral L5-S1 -Lumbar Spine
What is the difference between the lateral and the spot film?
Spot film CR is directed 5-8* if Spine is not sufficiently supported.
** 1.5 inches inferior to iliac crest, 2 inches posterior to ASIS
*****Suspend respiration
AP Axial ( L5-S1 ) lumbar spine is used to see SI joints: What must be done to perform this projection ?
Angle CR cephalad
30* male
35* female
CR at level of ASIS
Suspend respiration
For an AP axial projection of the sacrum, what is required?
CR angle 15* cephalad
(May be used prone 15* caudad)
CR 2 inches above public symphysis
What does the AP projection of the Coccyx require?
CR 2 inches above pubis symphysis
And CR 10* caudad
Bladder must be emptied before this procedure!!!!! And lower colon free of gas n facial matter..
A lateral position for the sacrum and Coccyx; requires ??
CR 3-4inches posterior of ASIS
More near butt side
Lateral Coccyx requires??
CR 3-4 inches posterior and 2 inches distal to ASIS
This is recommended to lower gonadal dose; but most orders include both the coccyx and sacrum
Ap axial Sacraliliac joints requires what?
CR 30-35* cephalad
2 inches below ASIS at midline
For the oblique SI joint positions, the body must be rotated
25-30* w side of interest elevated
CR 1in medial go upside ASIS
To demonstrate the inferior or distal part of the joint on the SI oblique, the CR May be angled
15-30* cephalad
The lateral coccyx and sacrum are normally ordered together but can be ordered separately.. if so, then
Lower KV in the coccyx to lower pt dose
For the AP Coccyx, the coccyx should be
Free of any superimposition and superior to pubis
The female sacrum is generally shorter and
Wider than a male sacrum
For the hyperflexion and hyperextension of the scoliosis series: the pelvis will act as a fulcrum pivot point. In Hyperflexion: the body will be
And hyperextension: the body will be
Fetal position (bend forward)
Torso and legs posteriorly
Direct CR to site of fusion!!
Spondylosis
Spondylethesis
*Separation of pars
*Defect in pars (common L5-S1)
(Forward displacement of one vertebra onto another)
What is used for a Ferguson method (scoliosis series) ?
PA projection with block under foot on convex curvature. 2 images
What is the bending scoliosis series used for?
Assess the range of motion of vertebral column
The lateral scoliosis series is used to see
Spondylthesis and degree of kyphosis or lordosis.
The CR angle on the L5-S1 is used to do what to our image??
Open joint for image
For a lateral spine, the recumbent position keeps the sag or convexity of the spine ________ to open up the intervertebral joint spaces
Down!
Lordosis is the _________ exaggerated curvature
Concave (normal) !!
Kyphosis is the ________ curvature.
Convex (humpback)
In metastasis; a patient has a form of cancer. But we need to know what stage the cancer is in to determine our technique.
Osteblastic=early stage
Osteolytic= late stage
Destructive disease
Increased bony lesions (^kvp)
A PA of the lumbar spine provides an advantage bcuz
It places the intervertebral disks almost parallel to divergent beam
Another term used for zyga joints ??
The facet
The best view to see the promontory of the sacrum is?
The lateral perspective
The zyga joints are classified as:
The intervertebral foramina are classified as:
Synovial, diathrodial, gliding
Cartilaginous, amohrithrodial
Which projection is used for a follow up after spinal fusion?
Hyperflexion/hyperextension
The best lumbar spine projection to see advanced spondylosis ??
R and L obliques
