Ch 9 Lumbar Spine, Sacrum Flashcards

1
Q

The largest of the lumbar spine is the inferior body of_____

A

L5

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2
Q

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

A

90*

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3
Q

Each pedicle is a half moon shape that forms the

A

Inferior or superior articular processes

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4
Q

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

A

30-50*

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5
Q

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

A

45* angle

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6
Q

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

A

Pars interarticularis

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7
Q

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

A

Sacroiliac joint

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8
Q

Each sacroiliac joint opens obliquely at a ______ posterior angle

A

30*

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9
Q

The most distal portion of the vertebral column is the

A

Coccyx

Aka tailbone

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10
Q

3-5 segments fuse together to form the

A

Single coccyx

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11
Q

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

A

Base

Apex

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12
Q

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

A

Female

Male

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13
Q

The lateral view will demonstrate ________

The oblique view will demonstrate_______

A

Intervertebral foramina

Zygapophyseal joints

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14
Q

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

A

“The Scottie dog”

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15
Q

RPO oblique positions demonstrate the __________

The RAO is opposite to see the zygapophyseal joints

A

Downside (right side)

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16
Q

The ASIS is at the same level as the ________

What level corresponds to L2-L3?

A

S1-s2

Lower costal margin

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17
Q

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

A

L4-L5

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18
Q

The xiphoid tip is at the level of

A

T-9-T10

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19
Q

The PA projection of lumbar spine is best for females bcuz

A

It reduces ovarian dose by 25-30%

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20
Q

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

A

Prone

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21
Q

Patients with kyphosis may be more comfortable in a _________ position

A

Erect

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22
Q

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

A

Chance Fracture

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23
Q

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

A

Spina bifida

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24
Q

Development defect in the pars interarticularis or spondylosis

A

Spondylolisthesis

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25
Q

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

A

Spondylolysis

26
Q

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

A

Promontory

27
Q

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

A

Zygapophyseal joints;

best seen in oblique position

28
Q

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

A

30*

50*

29
Q

Most common level of HNP?

A

L4-L5

& May result in sciatica

30
Q
Scottie Dog**
Nose-
Eye-
Ear-
Neck-
Front leg-
Behind ear-
A
Transverse process
Pedicle 
Superior articular process 
Para interarticularis 
Inferior articular process
Zyga joint
31
Q

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

A

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

32
Q

For the Oblique lumbar spine positions, direct CR at ?

Position body at??

A

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!!

33
Q

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

A

*Place radiolucent block under waist.
CR to level of iliac crest
*Lead masking on tabletop

Wider pelvis need a 5-8* caudad CR angle

34
Q

Spot film is known as??

A

Lateral L5-S1 -Lumbar Spine

35
Q

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

A

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

36
Q
AP Axial ( L5-S1 ) lumbar spine is used to see SI joints:
What must be done to perform this projection ?
A

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

Suspend respiration

37
Q

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

A

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

38
Q

What does the AP projection of the Coccyx require?

A

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..

39
Q

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

A

CR 3-4inches posterior of ASIS

More near butt side

40
Q

Lateral Coccyx requires??

A

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

41
Q

Ap axial Sacraliliac joints requires what?

A

CR 30-35* cephalad

2 inches below ASIS at midline

42
Q

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

A

25-30* w side of interest elevated

CR 1in medial go upside ASIS

43
Q

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

A

15-30* cephalad

44
Q

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

A

Lower KV in the coccyx to lower pt dose

45
Q

For the AP Coccyx, the coccyx should be

A

Free of any superimposition and superior to pubis

46
Q

The female sacrum is generally shorter and

A

Wider than a male sacrum

47
Q

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

A

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

48
Q

Spondylosis

Spondylethesis

A

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

49
Q

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

A

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

50
Q

What is the bending scoliosis series used for?

A

Assess the range of motion of vertebral column

51
Q

The lateral scoliosis series is used to see

A

Spondylthesis and degree of kyphosis or lordosis.

52
Q

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

A

Open joint for image

53
Q

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

A

Down!

54
Q

Lordosis is the _________ exaggerated curvature

A

Concave (normal) !!

55
Q

Kyphosis is the ________ curvature.

A

Convex (humpback)

56
Q

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

A

Destructive disease

Increased bony lesions (^kvp)

57
Q

A PA of the lumbar spine provides an advantage bcuz

A

It places the intervertebral disks almost parallel to divergent beam

58
Q

Another term used for zyga joints ??

A

The facet

59
Q

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

A

The lateral perspective

60
Q

The zyga joints are classified as:

The intervertebral foramina are classified as:

A

Synovial, diathrodial, gliding

Cartilaginous, amohrithrodial

61
Q

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

A

Hyperflexion/hyperextension

62
Q

The best lumbar spine projection to see advanced spondylosis ??

A

R and L obliques