Ch. 9 Lumbar Spine Flashcards
How many bones make up the lumbar spine?
5 bones
AP L Spine Patient and Part position?
- Supine or Upright
- MSP is centered to the midline of the grid
- Shoulders and hips are in the same horizontal plane
- Arms crossed on chest
- Reduce lordosis by flexing hips and knees to place lower back closer to the table
What are the 5 projections for the lumbar spine?
AP
Lateral
Lateral L5-S1
AP Oblique RPO and LPO
What is the central ray and collimation for AP L-Spine?
Perpendicular to the IR at the level of the iliac crest (L4) for lumbosacral exams or 1.5 inches above the iliac crest for lumbar spine only
Collimation: 8 x 17 inches for lumbosacral spine
and 8 x 14 inches for lumbar spine only
Lateral L-Spine patient position and part position?
-Recumbent or upright
- True lateral with MCP vertical
- Knees flexed and superimposed
- Arms with elbows flexed, at right angle to body
- Place a radiolucent support under the lower spine to place horizontally if needed
Structures shown and Elevation Criteria for an AP L Spine:
Pg. 472
What is the central ray and collimation for a lateral L Spine projection?
- CR is perpendicular to the IR, at the level of the iliac crest (L4) for the lumbosacral spine and 1.5 inches above the iliac crest for the lumbar spine only
- If the spine is not horizontal, angle caudad 5 for men and 8 for females
- Collimation 8 x 17 inches
What is the patient and part position for a Lateral L5-S1 projection?
- Lateral recumbent patient position
- MCP perpendicular to the IR
- Hips extended
- Superimposed knees, maybe slightly flexed
- When elbows flexed, place arms at a right angle to the body
- Support the lower spine in a horizontal position in the same manner as for lateral projection
What is the central ray and collimation for a lateral L5-S1 projection?
Center on coronal plane 2 inches posterior to the ASIS and 1.5 inches inferior to the crest
Collimation: 6x8
Structures shown and Elevation Criteria for L5-S1 projection:
Pg. 478
AP Oblique Projections demonstrate ____ joints of most lumbar vertebrae.
Both RPO and LPO positions are examined for ____
Zygapophyseal
Comparison
Patient and part position for an AP Oblique L spine?
Recumbent or upright, use the same position as for AP projection
- 45 degree posterior oblique position
What is the central ray and collimation for an AP Oblique L Spine projection?
- Perpendicular to IR
- Enters patient 2 inches medial to the elevated ASIS and 1 to 1.5 inches above the iliac crest
- Collimation ????
Structures shown and elevation criteria for AP Oblique L Spine Projections
Pg. 479
What projection of the lumbar spine shows the zygapophyseal joints?
AP Oblique
The lumbar curve is convex or concave anteriorly?
Convex
When the spine is not horizontal, how is the CR angled and directed for a lateral projection of the lumbar spine, for men ___ and for women ____
5 degrees caudal for men
8 degrees caudal for women
For an AP oblique projection of the lumbar spine, the CR is directed to enter ________
Enters patient 2 inches medial to the elevated ASIS and 1 to 1.5 inches above the iliac crest
If an AP oblique projection of the lumbar spine is taken, which position would the patient be in to show the right zygapophyseal joint?
RPO, meaning they are rotated 45 degrees towards their right side while lying supine
What is the breathing respiration for a lateral projection of the lumbar spine?
Suspend
How is the CR directed to enter for an AP projection of the lumbar spine?
1.5 inches above the iliac crest for the lumbar spine only, and at the level of the iliac crest for a lumbosacral spine
If the pedicle of the scottie dog is too anterior on the vertebral body, is the patient too steep or not steep enough?
not steep enough
What is the breathing respiration for the L5-S1 spot projection of the lumbar spine?
suspend
If the patient is laying prone on the radiographic table with their right side angled 45 degrees away from the tabletop. What anatomy of the lumbar spine is demonstrated?
Right lumbar zygapophyseal joints
When referring to the development of the vertebral curvature, the lumbar curve is considered primary or secondary?
Secondary Curve
(Cervical and Lumbar develop after birth)
When viewed from the side the vertebral column has 4 curves, the lumbar curve is considered?
Lordotic
What projection of the lumbar spine will show the intervertebral foramina?
Lateral projection
How is the CR angled and directed for the L5-S1 spot projection of the lumbar spine?
Perpendicular to enter 2 inches medial to the elevated ASIS and to a point midway between the lilac crest and ASIS
Is the lumbar curve convex or concave posteriorly?
Concave
If the pedicle of the scottie dog is too posterior to the vertebral body, is the patient too steep or not steep enough?
too steep
L2-L3
Inferior Costal Margin
L4-L5
Level if superior most aspect of iliac crest
What is the eye of the Scottie dog on an oblique lumbar spine?
Pedicle
Know Parts of Scottie Dog!
Pg. 480
What is the SID and CR for AP Lumbar Spine Projection?
- 40-48 SID
- CR perpendicular to the IR at the level of iliac crest (L4) for Lumbosacral Examination, OR 1.5 inches above the iliac crest for the Lumbar Spine only
What is the SID and CR for Lumbar Lateral Projection?
40 SID
CR is perpendicular; at the level of the iliac crest (L4) for the lumbosacral spine OR 1.5 inches above the iliac crest for lumbar spine only
What is the SID and CR for Lumbar Lateral (Right or Left position) L5-S1 Projection?
40 SID
CR; center on the coronal plane 2 inches posterior to the ASIS and 1.5 inches inferior to the iliac crest
What is the SID and CR for Lumber AP Oblique Projection RPO and LPO?
40 SID
CR-
Lumbar Region: Perpendicular to enter 2 inches medial to the elevated ASIS and 1 to 1.5 inches above the iliac crest
L5-S1 Zygapophyseal Joint: Perpendicular to enter 2 inches medial to the elevated ASIS and to a point midway between the iliac crest and the ASIS
What projection of the lumbar spine do you see the Scottie dog?
AP Oblique!
What is the ear of the Scottie dog?
Superior articular process
What is the nose of the Scottie dog?
Transverse Process
What is the neck of the Scottie Dog?
Pars interarticularis
What is the lamina of the Scottie dog?
Body of Scottie
What is the front foot of the Scottie dog?
Inferior articular process