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Donny Rad positioning 2 > Ch9 Lumbar + Sacrum/ Coccyx > Flashcards

Ch9 Lumbar + Sacrum/ Coccyx Flashcards

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1
Q

Exam:
Where is the subarachnoid space?

A

L3-L4

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2
Q

Exam:
LPO best demonstrates _____ Z joints.
Upside or downside?

A

left zygapophyseal joints
downside

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3
Q

Exam:
RPO best demonstrates _____ Z joints.
Upside or downside?

A

right zygapophyseal joints
downside

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4
Q

Exam:
The ear of the scotty dog is?

A

superior articular process

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5
Q

Exam:
The eye of the scotty dog is?

A

Pedicle

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6
Q

Exam:
The nose of the scotty dog is?

A

Transverse process

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7
Q

Exam:
The feet of the scotty dog is?

A

inferior articular process

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8
Q

Exam:
The neck of the scotty dog is?

A

Pars interarticularis

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9
Q

Exam:
The body of the scotty dog is?

A

Lamina

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10
Q

Exam:
The tail of the scotty dog is the?

A

Spinous process

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11
Q

Exam:
What is an intrathecal procedure?

A

Administering drugs through the spinal canal
(Ex: MP with chemo)
(intrathecal= spinal space)

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12
Q

Exam:
What is the CR for Sacrum and coccyx?
What is the angle?

A

midway between pubis symphysis and ASIS or 2 inches inferior to ASIS
or 2 inches superior to pubis symphysis
(all mean the same thing)
15 cephalic for sacrum
10 caudad for coccyx

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13
Q

Exam:
What do you see in a Myleogram?
1. posterior disk herniation
2. posttraumatic spinal cord swelling
3. internal disk legions

A

1 & 2
We can’t see the internal disk legions because the contrast goes up and down the spinal cord.
We can’t see because the “gusher” in the disc space.

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14
Q

Exam:
What is the angle for a AP sacrum and coccyx?
PA?

A

15 cephalic for sacrum
10 caudad for coccyx
PA: 15 caudad for sacrum & 10 cephalic for coccyx

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15
Q

Exam:
When are Zygapophyseal joints seen for cervical?

A

Lateral
90 degrees *

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16
Q

Exam:
What is the angle for a PA sacrum and coccyx?

A

15 caudad for sacrum
10 cephalic for coccyx
(AP to PA changes angle)

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17
Q

Exam:
When are the Zygapophyseal joints seen for thoracic?

A

70–75-degree oblique *

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18
Q

Exam:
When performing obliques if the pedicle appears to be too posterior what is the cause?
How do we fix it?

A

over rotated (too lateral/posterior)
oblique less

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19
Q

Exam:
Which vertebrae are lordotic curves?
What kind of curves are these?
Convex or Concave?

A

Cervical & lumbar
1st & 2nd compensatory curves
concave

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20
Q

Exam:
Which vertebrae are kyphotic curves?
What kind of curves are these?
Convex or Concave?

A

Thoracic & Sacrum
1st and 2nd primary curves
Convex

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21
Q

Exam:
What are compensatory curvatures (secondary)?
What are primary curvatures?

A

Compensatory: Cervical & lumbar
Primary: Thoracic & Sacrum

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22
Q

Exam:
RPO best shows?

A

right zygapophyseal joints
downside

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23
Q

Exam:
RAO best shows?

A

left zygapophyseal joints
upside

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24
Q

Exam:
LAO best shows?

A

right zygapophyseal joints
upside

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25
Q

Exam:
If we are doing a lateral lumbar spine, what plane is perpendicular to the IR?

A

mid-coronal plane

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26
Q

Exam:
What is in-between the superior (Ear) and inferior (leg) articular process?

A

Pars interarticularis

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27
Q

Exam:
When are the Zygapophyseal joints shown for lumbar?

A

45-degree oblique

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28
Q

Exam:
What connects the arch for the spinous process to the transverse process?

A

Lamina

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29
Q

Exam:
What is the pathology that involves the PARS?
What projection best shows this?

A

Spondylosis
Oblique lumbar

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30
Q

Exam:
What connects the vertebral body to the transverse process?

A

pedicle

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31
Q

Exam:
You are performing a 5 view lumbar the patient is complaining of lower back pain from an old sports injury. After the AP projection you roll the patient into a RPO position and make an exposure. The right transverse process projects from the front of the vertebral body and the pedicle is near the anterior aspect of the body in the image. What correction could we do?

A

More oblique
too AP (anterior) = under rotation
too lateral (posterior)= over rotation

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32
Q

Exam:
What is Spondylosis?

A

a fx (defect) to the PARS interarticularis
(“Scottie dog wearing a collar”)
Most common at L4-L5

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33
Q

Exam:
What is spondylolisthesis?
Best shown in?

A

forward slipping of one vertebrae
Originates from spondylosis
Common in L5-S1
“Slipped disc”
best shown in a lateral

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34
Q

Exam:
Why would we have the patient flex their knees or place a sponge during a supine AP lumbar projection?

A

fix the curvature of the spine
to reduce OID
decrease magnification

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35
Q

Exam:
What view best shows spondylthesis?

A

lateral

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36
Q

Exam:
When do we see the lumbar foramen?

A

lateral view

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37
Q

Exam:
LPO best shows?

A

left zygapophyseal joints
downside

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38
Q

Exam:
What view best shows spondylosis?

A

Oblique lumbar

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39
Q

Exam:
When performing obliques if the pedicle appears to be too anterior what is the cause?
How do we fix it?

A

under rotated (too AP/anterior)
oblique the patient more

40
Q

Exam:
What is the angulation for AP Axial SI joints?
What is the CR?

A

30 degrees cephalic for men
35 degrees cephalic for women
midway between pubis symphysis and ASIS

41
Q

Exam:
What does the Sacrum articulate with laterally?

A

ilium

42
Q

Exam:
What does SI joints stand for?

A

Sacroiliac joint

43
Q

Exam:
What is the CR for lateral coccyx?

A

3-4 inches posterior to ASIS
2 Inches distal from ASIS
(no more than 4!)

44
Q

Exam:
Where is the level of xiphoid tip?

A

T9-T10

45
Q

Exam:
What is the CR for the spot (L5-S1 lateral)?

A

1.5 inches inferior to crest
2 inches posterior to ASIS
5-8 degrees caudad

46
Q

Exam:
What is the CR for AP lumbar?
Lateral lumbar?
obliques?
flex Ext?

A

AP: Iliac crest (L4-L5)
Lateral: iliac crest (L4-L5)
Obliques: 2 inches medial and 1-2 inches superior to iliac crest + 45-degree PO rotations
Flex/Ext: iliac crest (L4-L5) + extension and flexion

47
Q

Exam:
Where is the level of the iliac crest?

A

L4-L5

48
Q

Exam:
What does flex/ext show?

A

posterior/anterior displacement

49
Q

Exam:
Where is the level of the lower coastal margin?

A

L2-L3

50
Q

Be able to label a xray
Know

A
51
Q

Exam:
Where is the level of ASIS?

A

S1-S2

52
Q

Exam:
What views show flexibility and lumbar fusions?

A

flex/ext

53
Q

Exam:
If we are shooting an AP projection of the coccyx and the distal tip is superimposed over the pubis symphysis, we could correct this by?

A

throw more of a caudad angle
from 10 to 15 degrees

54
Q

Exam:
What is the CR for AP SI joints?
What is the obliques?

A

AP: 30 cephalic for men 35 cephalic for women + 2 inches below ASIS or 2 inches superior to Pubis symphysis
Obliques: 25–30-degree PO + 1 inch medial to UPSIDE ASIS

55
Q

Exam:
What is the CR for AP axial sacrum and coccyx?

A

Sacrum: 15 cephalic 2 inches superior to pubic symphysis
Coccyx: 10 degrees caudad 2 inches superior to symphysis

56
Q

Exam:
What does sideways bending show?

A

lateral displacement

57
Q

Exam:
At what angle (oblique) does the SI joints open up at?

A

25-30 degrees oblique

58
Q

Exam:
At what angles do the zygapophyseal joints open up at?

A

50-30 degrees oblique
(45 oblique)

59
Q

Exam:
What is the CR for Lumbar spot?
Is there an angle?

A

1.5 inches inferior to crest & 2 inches posterior to ASIS + 5–8-degree caudad (supine only)

60
Q

Exam:
What is the CR for Lateral Sacrum and coccyx?

A

3-4 inches posterior to ASIS

61
Q

Exam:
What kind of joints are the Zygapophyseal joints?

A

plane or gliding
(synovial/diarthrodial)

62
Q

Exam:
What kind of joints are the intervertebral joints?

A

slightly movable (Amphiarthrodial)
(cartilaginous/symphysis)

63
Q

Exam:
Lordotic curves are convex or concave?

A

Concave

64
Q

Exam:
Kyphotic curves are convex or concave?

A

Convex

65
Q

Exam:
If the coccyx appears to have a greater curvature, we should increase the angle to ___ ____

A

15
Caudad

66
Q

Exam:
If we go from supine to prone what happens to the angle?

A

changes from cephalic to caudad
(Vice versa)

67
Q

Exam:
What kind of joints are the lumbar zygapophyseal joints?

A

(synovial/diarthrodial)
plane or gliding

68
Q

Exam:
what kind of joints are the intervertebral joints?

A

Amphiarthrodial (slightly moveable)
(cartilaginous/ symphysis)

69
Q

General:
For L1-L2 rotation for oblique may be increased to _____
For L5-S1 rotation for oblique may be decreased to ______

A

50 degrees
30 degrees

70
Q

General:
What does the inferior and superior vertebral notch form?

A

intervertebral foramen

71
Q

General:
What forms the
median sacral crest?

A

fused spinous processes of the sacrum

72
Q

General:
What two anatomy structures come together to form the SI joint?

A

auricular surface (sacrum)
Ilium

73
Q

General: The ______ form a bridge between transverse process and lateral masses to the spinous process

A

Laminae

74
Q

General:
The portion of the lamina between superior and inferior articular processes are?

A

Pars interarticularis

75
Q

General:
What is the CR for lateral lumbar?

A

Iliac crest (L4-L5)

76
Q

General:
What is the CR for AP lumbar?
smaller IR?

A

Iliac crest (L4-L5)
Smaller: 1-2 inches inferior to crest (L3)

77
Q

General:
What are breathing techniques for lumbar spine?

A

suspend breathing after expiration

78
Q

General:
What is the CR for oblique lumbar?

A

1 to 2 inches above crest
2 inches medial to UPSIDE ASIS (2 up and 2 medial)

78
Q

General:
If waist is not supported sufficiently in L5-S1, what must we do?

A

5-8 degrees caudad
(CR must be parallel to interiliac line)

79
Q

General:
What is the CR for L5-S1 (spot)?

A

1.5 inches inferior to crest
2 inches posterior to ASIS

80
Q

General:
What is the CR for AP Axial L5-S1 (spot)?

A

CR: ASIS
30 cephalic for male
35 cephalic for women

80
Q

General:
What is the CR for AP Axial Sacrum?
What is CR prone?

A

2 inferior to ASIS or
2 inches superior to pubis
15 cephalic
Prone: 15 caudad

81
Q

General:
What is the CR for AP Axial Coccyx?
CR prone?

A

2 inches superior to pubis or
2 inches inferior to ASIS
10 caudad
Prone: 10 cephalic

82
Q

General:
What is the CR for AP axial SI joints?
CR prone?

A

2 inches inferior to ASIS
30 Cephalic (male)
35 cephalic (women)
Prone: 30-35 caudad

82
Q

General:
What is the CR for Oblique SI joints?
How much patient oblique?

A

1 inch medial to ASIS
20–30-degree oblique

82
Q

General:
What is the CR for lateral Sacrum and Coccyx?

A

3-4 inches posterior to ASIS
For coccyx: 2 inches distal to ASIS

83
Q

General:
To demonstrate the inferior distal SI joint more clearly, what could we do?

A

angle 15-20 cephalic

83
Q

Exam:
PO shows ____ z joints

A

Downside

84
Q

Exam:
AO shows ______ z joints

A

Upside

85
Q

Lordotic curves are _____ curves. Which are _____ that ______

A

Compensatory
Cervical & lumbar
Concave

86
Q

Exam:
Kyphotic curves are _____ curves. Which are ______ that _____

A

Primary
Thoracic & sacrum
Convex

87
Q

Exam:
If we are doing a left lateral lumbar what plane is parallel to the IR?

A

Mid-sagittal

87
Q
A
88
Q

Exam:
Pedicle to anterior means?
Correction:

A

Too AP
More oblique

89
Q

Exam:
Pedicle to posterior means?
Correction:

A

Too lateral
Less oblique

Donny Rad positioning 2 (8 decks)

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