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Positioning 1 > Ch. 9 Lumbar Spine, Sacrum, and Coccyx Workbook > Flashcards

Ch. 9 Lumbar Spine, Sacrum, and Coccyx Workbook Flashcards

1
Q

a portion of the lamina located between the superior and inferior articular processes is called this

A

pars interarticularis

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2
Q

the superior and inferior vertebral notches join together to form this

A

intervertebral foramina

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3
Q

which radiographic position best demonstrates the intervertebral foramina of the lumbar spine

A

lateral position

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4
Q

what does the oblique position of the lumbar spine best demonstrate

A

zygapophyseal joints

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5
Q

the small foramina found in the sacrum are called what

A

pelvic sacral foramina

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6
Q

the anterior and superior aspect of the sacrum that forms the posterior wall of the pelvic inlet is called this

A

promontory

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7
Q

what is another term for the sacral horns

A

cornua

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8
Q

the sacroiliac joints lie at an oblique angle of what to the coronal plane

A

30 degrees

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9
Q

formal term for tailbone

A

coccyx

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10
Q

what is the name of the superior broad aspect of the coccyx

A

base

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11
Q

what type of joint is the zygapophyseal joint

A

diarthrodial, synovial - plane (gliding)

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12
Q

what type of joint is the intervertebral joint

A

amphiarthrodial, cartilaginous - symphysis

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13
Q

what is demonstrated in the LPO lumbar position

A

left zygapophyseal joint

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14
Q

what is demonstrated in the RAO lumbar position

A

left zygapophyseal joint

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15
Q

what is demonstrated in the lateral lumbar position

A

intervertebral foramina

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16
Q

what is demonstrated in the RPO lumbar position

A

right zygapophyseal joints

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17
Q

what is demonstrated in the LAO lumbar position

A

right zygapophyseal joints

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18
Q

what is the degree of obliquity required for a projection of the T12-L1 level

A

50 degrees

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19
Q

what is the degree of obliquity required for a projection of the L5-S1 level

A

30 degrees

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20
Q

what is the obliquity required for a general lumbar spine

A

45 degrees

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21
Q

what level is ASIS at

A

S1-S2

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22
Q

what level is the xiphoid process at

A

T9-T10

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23
Q

what level is the lower costal margin at

A

L2-L3

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24
Q

what level is iliac crest at

A

L4-L5

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25
Q

what level is the prominence of the greater trochanter at

A

symphysis pubis

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26
Q

should gonadal shielding always be used for male and female patients

A

no - just always males, only females if it doesn’t obscure anatomy

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27
Q

what position opens up the intervertebral joint spaces better

A

PA

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28
Q

how should the knees and hips be positioned for a recumbent AP projection of the lumbar spine

A

they should be flexed

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29
Q

when positioning an obese patient, the iliac crest is typically at the level of this

A

inferior margin of the flexed elbow

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30
Q

what imaging modality would be used to see osteoporosis

A

bone densitometry

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31
Q

what imaging modality would be used to see soft tissues of the lumbar spine

A

MRI

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32
Q

what imaging modality would be used to see structures within the subarachnoid space

A

MRI and/or myelography

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33
Q

what imaging modality would be used to see inflammatory conditions such as paget disease

A

nuclear medicine

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34
Q

what imaging modality would be used to see compression fractures of the lumbar spine

A

CT

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35
Q

this is lateral curvature of the vertebral column

A

scoliosis

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36
Q

this is a fracture of the vertebral body caused by hyperflexion force

A

chance fracture

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37
Q

this is a congenital defect in which the posterior elements of the vertebrae fail to unite

A

spina bifida

38
Q

most common at the L4-L5 level and may result in sciatica

A

herniated nucleus pulposus

39
Q

forward displacement of one vertebra onto another vertebra

A

spondylolisthesis

40
Q

inflammatory condition that is most common in males in their 30s

A

ankylosing spondylitis

41
Q

dissolution and separation of the pars interarticularis

A

spondylolysis

42
Q

a type of fracture that rarely causes neurologic deficits

A

compression fracture

43
Q

with a 14x17 IR where is CR for an AP and lateral lumbar spine

A

iliac crest

44
Q

which two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the lumbar spine

A
  • SI joints equidistant to spine
  • spinous process midline to vertebral column
45
Q

how much rotation is required to visualize the zygapophyseal joints properly at the L5-S1 level

46
Q

which specific set of zygapophyseal joints is demonstrated with an LAO position

47
Q

this is the eye of the scottie dog, and it should be near the center of the vertebral body on a correctly oblique lumbar spine position

48
Q

what positioning error has been committed if the pedicle is projected too far posterior with a 45 oblique position of the lumbar spine

A

over rotated

49
Q

which position or projection of the lumbar spine series best demonstrates a possible compression fracture

50
Q

a patient with a wide pelvis and narrow thorax may require this on the lateral position for the lumbar spine

A

5-8 degree caudal angle

51
Q

how should the spine of a patient with scoliosis be positioned for a lateral position of the lumbar spine

A

convex side down, closer to IR

52
Q

why should the knees and hips be flexed for a recumbent AP lumbar spine projection

A

less curvature of the spine and opens up the intervertebral joint spaces

53
Q

how much female ovarian dose is a PA lumbar v. an AP lumbar

54
Q

where is CR for a lateral L5-S1 projection of the lumbar spine

A

1.5” below crest and 2” posterior to ASIS

55
Q

what is the amount and direction of CR angulation required for an AP axial L5-S1 projection on a male

A

30 degrees cephalic

56
Q

a scoliosis series frequently includes these for comparison

A

erect and recumbent

57
Q

what must the lower margin of the IR for the scoliosis series include

A

1-2” below iliac crest

58
Q

a PA projection for scoliosis series produces how much less dose to the breasts as compared with the AP projection

A

1/10 the dose

59
Q

what produces a more uniform density along the vertebral column for an AP/PA scoliosis projection

A

compensating filter

60
Q

which side of the spine should be elevated for the second exposure for the AP/PA projection (Ferguson method) scoliosis series

A

elevate side with the convexity

61
Q

for the Ferguson method, the elevated foot must be raised a minimum of how much

A

3-4” (8-10 cm)

62
Q

during the AP/PA right and left bending projections of the lumbar spine, this serves as a fulcrum during positioning

63
Q

which projection should be taken to evaluate flexibility following spinal fusion surgery

A

hyperextension and hyperflexion lateral projections

64
Q

what is the recommended kVp range for lateral hyperflexion and hyperextension positions of the spine for a digital imaging system

65
Q

how much CR angulation is required for an AP projection of the sacrum for a typical male pateint

A

15 degrees cephalic

66
Q

where is the CR centered for an AP axial projection of the sacrum

A

2” superior to pubic symphysis

67
Q

if a patient cannot lie on his back for the AP sacrum because it is too painful, what alternate projection can be taken to achieve a similar view of the sacrum

A

PA sacrum with a 15 degree caudal angle

68
Q

where is the CR centered for an AP projection of the coccyx

A

2” above pubic symphysis

69
Q

how much is the CR angled for the AP axial coccyx projection

A

10 degrees caudal

70
Q

can the AP projection of the sacrum and coccyx be taken as 1 single projection to decrease gonadal dose

A

no - just the lateral can

71
Q

patients should be asked to empty the urinary bladder before performing which projection of the vertebral column

A

AP of sacrum and coccyx

72
Q

in addition to good collimation, what should be done to minimize scatter radiation on a lateral lumbar spine or lateral sacrum and coccyx radiograph

A

place a lead mat/masking behind patient on table

73
Q

which SI joint is visualized with an RPO position

74
Q

how much rotation of the body is required for oblique positions of the SI joints

A

25-30 degrees

75
Q

what type of CR angulation is recommended for the AP axial projection of the SI joints on a female patient

A

35 degrees cephalad

76
Q

where is the CR centered for an oblique projection of the SI joints

A

1” medial to upside ASIS

77
Q

a radiograph of an AP projection of the lumbar spine shows the spinous processes are not midline to the vertebral column and distortion of the vertebral bodies is present. What positioning error is present

A

rotation of the spine

78
Q

a radiograph of an LPO projection of the lumbar spine shows the pedicles and zygapophyseal joints are projected over the anterior portion of the vertebral bodies. what positioning error is present

A

under rotation

79
Q

a radiograph of a lateral projection of a female lumbar spine shows the mid- to lower intervertebral joints spaces are not open. the tech supported the mid section of the spine with sponges to straighten the spine. what else can be done to open the joint spaces during the repeat exposure

A

angle 5-8 degrees caudad

80
Q

a radiograph of a lateral L5-S1 projection shows the joint space is not open. the tech did support the middle aspect of the spine with a sponge. what else can the tech do to open up the joint space during the repeat exposure

A

angle 5-8 degrees caudad or place additional support beneath spine

81
Q

a radiograph of an AP axial projection of the coccyx shows the distal tip is superimposed over the symphysis pubis. what must the tech do to eliminate this problem during the repeat exposure

A

increase CR angle

82
Q

a radiograph of an oblique position of the lumbar spine shows the pedicle and zygapophyseal joint are posterior in relation to the vertebral body. what modification of the position must be made during repeat image

A

over rotation

83
Q

a patient comes to the radiology department for a follow-up study for a compression fracture of L3. the radiologist requests that collimated projections be taken of L3. what specific projections and centering would provide a quality study of L3

A

AP and lateral collimated to L3, centered about 2” above iliac crest

84
Q

a young female patients comes in for a scoliosis series, how can you limit their dose delivered

A
  • shoot PA rather than AP
  • use breast shields
  • use high kVp and low mAs
85
Q

a patient with an injury to the coccyx enters the ER. Patient complains that lying on their back is too painful, what else can be done to get the AP image

A

PA angled 10 cephalic instead of caudal

86
Q

a patient with a clinical history of spondylolisthesis at the L5-S1 level comes in. what lumbar spine position is most diagnostic in demonstrating the extent of this condition

A

lateral L5-S1

87
Q

a positioning series for SI joints is performed on a patient. the resultant radiographs do not demonstrate the inferior portion of the joints. what can be done to demonstrate this aspect

A

angle 15-20 degrees cephalic

88
Q

a patient comes to the radiology department for a lumbar series. He has clinical history of advanced spondylolysis. what projection of the lumbar spine series will best demonstrate this condition

A

obliques best demonstrate it

89
Q

a patient comes to the radiology department with a clinical history of HNP/ what imaging modalities provide the most diagnostic study for this condition

90
Q

a patient comes to the radiology department for a lumbar spine study following spinal fusion surgery. her surgeon wants a study to assess mobility of the spine at the fusion site. which radiographic positions provide this

A

hyperextension and hyperflexion lateral positions

91
Q

a patients comes to the radiology department for a lumbar spine series. she has a clinical history of severe kyphosis. how should the lumbar spine series be modified for this patient

A

routine lumbar in an erect position

Positioning 1 (53 decks)

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