Ch 9 Lumbar Spine, Sacrum

Question 1

The largest of the lumbar spine is the inferior body of_____

Answer 1

L5

Question 2

Th intervertebral foramen sit at what degree to the midsaggital plane?

Answer 2

90*

Question 3

Each pedicle is a half moon shape that forms the

Answer 3

Inferior or superior articular processes

Question 4

The zygapophyseal joints form an angle of _________To the midsaggital plane.

Answer 4

30-50*

Question 5

To view the zygapophyseal joints on the lumbar spine; we must position the patient in a ?

Answer 5

45* angle

Question 6

The portion of the lamina between the inferior and superior articular processes is the:

Answer 6

Pars interarticularis

Question 7

The sacrum articulates with the ilium of the pelvis at the auriclar surface to form the :

Answer 7

Sacroiliac joint

Question 8

Each sacroiliac joint opens obliquely at a ______ posterior angle

Answer 8

30*

Question 9

The most distal portion of the vertebral column is the

Answer 9

Coccyx

Aka tailbone

Question 10

3-5 segments fuse together to form the

Answer 10

Single coccyx

Question 11

The superior position of the coccyx is called_____the distal tip of the coccyx is called ________

Answer 11

Base

Apex

Question 12

A_______ is more likely to experience a fracture to the coccyx than a _____

Answer 12

Female

Male

Question 13

The lateral view will demonstrate ________

The oblique view will demonstrate_______

Answer 13

Intervertebral foramina

Zygapophyseal joints

Question 14

A good 45* oblique of the lumbar spine will demonstrate ______

Answer 14

“The Scottie dog”

Question 15

RPO oblique positions demonstrate the __________

The RAO is opposite to see the zygapophyseal joints

Answer 15

Downside (right side)

Question 16

The ASIS is at the same level as the ________

What level corresponds to L2-L3?

Answer 16

S1-s2

Lower costal margin

Question 17

The most superior portion of the iliac crest is at the same level of the

Answer 17

L4-L5

Question 18

The xiphoid tip is at the level of

Answer 18

T-9-T10

Question 19

The PA projection of lumbar spine is best for females bcuz

Answer 19

It reduces ovarian dose by 25-30%

Question 20

The _______position of the lumbar spine places the intervertebral disk spaces more parallel to the divergent beam

Answer 20

Prone

Question 21

Patients with kyphosis may be more comfortable in a _________ position

Answer 21

Erect

Question 22

The fracture that may occur to those that weAr a lap belt causing a hyperflexion force to the spine

Answer 22

Chance Fracture

Question 23

A congenital condition where the posterior aspects of vertebra fail to develop; exposing part of the spinal cord

Answer 23

Spina bifida

Question 24

Development defect in the pars interarticularis or spondylosis

Answer 24

Spondylolisthesis

Question 25

separation of the pars interarticularis.. oblique projection of the neck of “the Scottie dog” appears broken

Answer 25

Spondylolysis

Question 26

The anterior/superior ridge of the upper sacrum is called the:

Answer 26

Promontory

Question 27

The ear and the front leg of the “Scottie dog” make up the _____________

Answer 27

Zygapophyseal joints; | best seen in oblique position

Question 28

The zyga joints are best visualized at L5-S1 level with how much rotation?? And at T12-L1?

Answer 28

30* | 50*

Question 29

Most common level of HNP?

Answer 29

L4-L5 | & May result in sciatica

Question 30

``` Scottie Dog** Nose- Eye- Ear- Neck- Front leg- Behind ear- ```

Answer 30

``` Transverse process Pedicle Superior articular process Para interarticularis Inferior articular process Zyga joint ```

Question 31

For An AP lumbar spine important factors CR at level of Iliac Crest and:

Answer 31

*Flex knees (to straighten spine n open intervertebral Disk spaces) **Suspend on expiration!! T12-S1 must be shown & S.I joints

Question 32

For the Oblique lumbar spine positions, direct CR at ? Position body at??

Answer 32

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!!

Question 33

Lateral Lumbar Spine: To place spine parallel to table what can be done? What can be used to reduce scatter?

Answer 33

*Place radiolucent block under waist. CR to level of iliac crest *Lead masking on tabletop Wider pelvis need a 5-8* caudad CR angle

Question 34

Spot film is known as??

Answer 34

Lateral L5-S1 -Lumbar Spine

Question 35

What is the difference between the lateral and the spot film?

Answer 35

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

Question 36

``` AP Axial ( L5-S1 ) lumbar spine is used to see SI joints: What must be done to perform this projection ? ```

Answer 36

Angle CR cephalad 30* male 35* female CR at level of ASIS Suspend respiration

Question 37

For an AP axial projection of the sacrum, what is required?

Answer 37

CR angle 15* cephalad (May be used prone 15* caudad) CR 2 inches above public symphysis

Question 38

What does the AP projection of the Coccyx require?

Answer 38

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..

Question 39

A lateral position for the sacrum and Coccyx; requires ??

Answer 39

CR 3-4inches posterior of ASIS | More near butt side

Question 40

Lateral Coccyx requires??

Answer 40

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

Question 41

Ap axial Sacraliliac joints requires what?

Answer 41

CR 30-35* cephalad | 2 inches below ASIS at midline

Question 42

For the oblique SI joint positions, the body must be rotated

Answer 42

25-30* w side of interest elevated | CR 1in medial go upside ASIS

Question 43

To demonstrate the inferior or distal part of the joint on the SI oblique, the CR May be angled

Answer 43

15-30* cephalad

Question 44

The lateral coccyx and sacrum are normally ordered together but can be ordered separately.. if so, then

Answer 44

Lower KV in the coccyx to lower pt dose

Question 45

For the AP Coccyx, the coccyx should be

Answer 45

Free of any superimposition and superior to pubis

Question 46

The female sacrum is generally shorter and

Answer 46

Wider than a male sacrum

Question 47

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

Answer 47

Fetal position (bend forward) Torso and legs posteriorly Direct CR to site of fusion!!

Question 48

Spondylosis | Spondylethesis

Answer 48

*Separation of pars *Defect in pars (common L5-S1) (Forward displacement of one vertebra onto another)

Question 49

What is used for a Ferguson method (scoliosis series) ?

Answer 49

PA projection with block under foot on convex curvature. 2 images

Question 50

What is the bending scoliosis series used for?

Answer 50

Assess the range of motion of vertebral column

Question 51

The lateral scoliosis series is used to see

Answer 51

Spondylthesis and degree of kyphosis or lordosis.

Question 52

The CR angle on the L5-S1 is used to do what to our image??

Answer 52

Open joint for image

Question 53

For a lateral spine, the recumbent position keeps the sag or convexity of the spine ________ to open up the intervertebral joint spaces

Answer 53

Down!

Question 54

Lordosis is the _________ exaggerated curvature

Answer 54

Concave (normal) !!

Question 55

Kyphosis is the ________ curvature.

Answer 55

Convex (humpback)

Question 56

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

Answer 56

Destructive disease | Increased bony lesions (^kvp)

Question 57

A PA of the lumbar spine provides an advantage bcuz

Answer 57

It places the intervertebral disks almost parallel to divergent beam

Question 58

Another term used for zyga joints ??

Answer 58

The facet

Question 59

The best view to see the promontory of the sacrum is?

Answer 59

The lateral perspective

Question 60

The zyga joints are classified as: | The intervertebral foramina are classified as:

Answer 60

Synovial, diathrodial, gliding Cartilaginous, amohrithrodial

Question 61

Which projection is used for a follow up after spinal fusion?

Answer 61

Hyperflexion/hyperextension

Question 62

The best lumbar spine projection to see advanced spondylosis ??

Answer 62

R and L obliques