EXAM #2 (L-SPINE, SACRUM, COCCYX, SI) Flashcards
[Anatomy: Vertebral Column]
Forms the _____ _____ of the skeleton
Centered in the _____ plane
Located in _____ _____
[Anatomy: Vertebral Column]
Forms the central axis of the skeleton
Centered in the midsagittal plane
Located in posterior trunk
[Anatomy: Vertebral Column]
- Functions:
Encloses and protects _____ _____
Supports _____ and _____
Provides _____ attachments
[Anatomy: Vertebral Column]
- Functions:
Encloses and protects spinal cord
Supports trunk and skull
Provides muscle attachments
[Anatomy: Vertebral Column ]
Composed of _____, _____ bones called vertebrae
Total of __ vertebrae in early life
__ are true, movable vertebrae (__-C, __-T, __-L)
Sacral and coccygeal segments are _____, _____ vertebrae
[Anatomy: Vertebral Column]
Composed of small, irregular bones called vertebrae
Total of 33 vertebrae in early life
24 are true, movable vertebrae (7-C, 12-T, 5-L)
Sacral and coccygeal segments are false, fixed vertebrae
[Anatomy: Vertebral Column]
Sacral vertebrae fuse into the _____
Coccygeal vertebrae fuse to form _____
[Anatomy: Vertebral Column]
Sacral vertebrae fuse into the sacrum
Coccygeal vertebrae fuse to form coccyx
[Anatomy: Vertebral Column ]
Divided into five groups named according to region they occupy…
[Anatomy: Vertebral Column]
Divided into five groups named according to region they occupy
Cervical vertebrae
Thoracic vertebrae
Lumbar vertebrae
Sacral vertebrae
Coccygeal vertebrae
[Anatomy: Vertebral Column]
Has _____ curves that arch _____ and _____ from _____ plane
[Anatomy: Vertebral Column]
Has four curves that arch anteriorly and posteriorly from mid-coronal plane
[Anatomy: Vertebral Column]
Lordotic curves are _____ anteriorly (looking _____ at air)
Kyphotic curves are _____ anteriorly (looking _____ at ground)
[Anatomy: Vertebral Column]
Lordotic curves are convex anteriorly (looking up at air)
Kyphotic curves are concave anteriorly (looking down at ground)
[Anatomy: Vertebral Column]
Each curve named for region
Cervical = _____
Thoracic = _____
Lumbar = _____
Pelvic = _____
[Anatomy: Vertebral Column]
Each curve named for region
Cervical = lordotic
Thoracic = kyphotic
Lumbar = lordotic
Pelvic = kyphotic
[Anatomy: Vertebral Column]
_____ is a condition of abnormal lateral curvature of the spine
_____ is a condition of increased kyphotic curve of the thoracic spine (T-spine)
[Anatomy: Vertebral Column]
Scoliosis is a condition of abnormal lateral curvature of the spine
Kyphosis is a condition of increased kyphotic curve of the thoracic spine (T-spine)
[Anatomy: Vertebral Column]
Vertebrae separated by intervertebral disks, composed of _____
Function as _____
[Anatomy: Vertebral Column]
Vertebrae separated by intervertebral disks, composed of fibrocartilage
Function as cushions
[Anatomy: Vertebral Column]
HNP = ?
“?” – see on x-ray more visible for CT or MRI
[Anatomy: Vertebral Column]
HNP = herniated nucleus pulposus
“Slipped disk” – see on x-ray more visible for CT or MRI
[Anatomy: Typical Vertebra ]
Two main parts:
_____ (anterior)
_____ (posterior)
[Anatomy: Typical Vertebra]
Two main parts:
Body (anterior)
Vertebral arch (posterior)
[Anatomy: Typical Vertebra]
The two parts enclose a space – ?
The articulation of vertebral foramina form the … ?
[Anatomy: Typical Vertebra]
The two parts enclose a space – the vertebral foramen
The articulation of vertebral foramina form the vertebral canal
[Anatomy: Typical Vertebra]
Vertebral arch formed by:
?x _____
?x _____
The above support:
?x _____
?x _____
?x _____
[Anatomy: Typical Vertebra]
Vertebral arch formed by:
Two pedicles
Two laminae
The above support:
Four articular processes
Two transverse processes
One spinous process
[Anatomy: Typical Vertebra]
Pedicles project from _____ part of body
Bottom is _____ to form vertebral _____
Articulation of vertebral notches form _____ _____
[Anatomy: Typical Vertebra]
Pedicles project from posterior part of body
Bottom is concave to form vertebral notches
Articulation of vertebral notches form intervertebral foramina
[Anatomy: Typical Vertebra]
Laminae project _____ and _____ from _____
[Anatomy: Typical Vertebra]
Laminae project posteriorly and medially from pedicles
[Anatomy: Typical Vertebra]
Transverse processes project _____ and a little _____ from junction of _____ and _____
[Anatomy: Typical Vertebra]
Transverse processes project laterally and a little posteriorly from junction of laminae and pedicles
[Anatomy: Typical Vertebra]
Spinous process projects _____ and _____ from junction of both _____
_____ _____ is congenital condition in which the laminae fail to fuse
[Anatomy: Typical Vertebra]
Spinous process projects posteriorly and inferiorly from junction of both laminae
Spina bifida is congenital condition in which the laminae fail to fuse
[Anatomy: Typical Vertebra]
?x articular processes arise from junction of _____ and _____
?x _____
?x _____
Articulate with vertebrae above and below and form _____ joints
Also called _____ _____ joints
[Anatomy: Typical Vertebra]
Four articular processes arise from junction of pedicles and laminae
Two superior
Two inferior
Articulate with vertebrae above and below and form zygapophyseal joints
Also called interarticular facet joints
[Anatomy: Lumbar Vertebrae ]
?x in number
Occupy the _____ abdominal region
Unique features:
Transverse processes are _____ than T-spine
[*] _____ _____ – part of lamina between articular processes
[Anatomy: Lumbar Vertebrae]
Five in number
Occupy the posterior abdominal region
Unique features:
Transverse processes are smaller than T-spine
[*] Pars interarticularis – part of lamina between articular processes
[Anatomy: Sacrum ]
Formed by fusion of ?x sacral segments into curved, _____ bone
Wedged between _____ bones of pelvis
Articulation = _____ joints
[Anatomy: Sacrum]
Formed by fusion of five sacral segments into curved, triangular bone
Wedged between iliac bones of pelvis
Articulation = sacroiliac (SI) joints
[Anatomy: Sacrum]
Anatomic features:
_____
_____
_____
_____
[Anatomy: Sacrum]
Anatomic features:
Promontory
Canal
Foramina
Cornu
[Anatomy: Coccyx ]
Formed by fusion of ?x to ?x rudimentary vertebrae
Curves _____ and _____ from articulation with sacrum
Anatomic features:
_____
[Anatomy: Coccyx]
Formed by fusion of three to five rudimentary vertebrae
Curves inferiorly and anteriorly from articulation with sacrum
Anatomic features:
Cornu
Where is each fusion located for the sacrum?
Each fusion at the sacral foramina
If an x-ray is taken with the patient upright, what should be done?
Upright marker should be included because the spine looks different when in an upright position
[IR/Collimated Field Size ]
AP, Lateral, and Obliques: __” x __” IR (_____wise)
L5-S1 Spot: __” x __” (_____wise)
[IR/Collimated Field Size]
AP, Lateral, and Obliques: 14” x 17” IR (lengthwise)
L5-S1 Spot: 10” x 12” (lengthwise)
SID?
40”
Breathing technique?
Suspended suspended during most middle to lower vertebral column projections
Thoracic spine procedures can use breathing technique to blur lung and rib anatomy
[AP L-Spine ]
CR:
For lumbosacral exams, enters patient at…?
For lumbar only, enters patient at…?
[AP L-Spine]
CR:
For lumbosacral exams, enters patient at iliac crests (L4)
For lumbar only, enters patient at 1½ inches above iliac crests (L3)
[Lateral L-Spine ]
CR:
For lumbosacral exam, enters patient on…?
For lumbar spine exam, enters on MCP at…?
If spine is not horizontal…?
- More for males/females…?
[Lateral L-Spine]
CR:
For lumbosacral exam, enters patient on MCP at iliac crests (L4)
For lumbar spine exam, enters on MCP at 1.5” above iliac crests (L3)
If spine is not horizontal, angle caudad 5 to 8 degrees
- More for females
[Lateral L5-S1]
CR:
When spine is horizontal, perpendicular to a coronal plane __ inches posterior to anterior superior iliac spine (ASIS) and __ inches inferior to iliac crest
If not, angle __ degrees caudad for males, __ degrees caudad for females
Francis suggests alternative CR aligned with…?
[Lateral L5-S1]
CR:
When spine is horizontal, perpendicular to a coronal plane 2 inches posterior to anterior superior iliac spine (ASIS) and 1½ inches inferior to iliac crest
If not, angle 5 degrees caudad for males, 8 degrees caudad for females
Francis suggests alternative CR aligned with interiliac plane
[Lateral L5-S1 ]
Collimated field?
[Lateral L5-S1]
6” x 8”
[Lateral L-Spine]
Collimated field?
[Lateral L-Spine]
8” x 17”
[AP Oblique L-Spine]
[*] What is demonstrated?
[AP Oblique L-Spine]
[*] Oblique projections demonstrate zygapophyseal joints of most lumbar vertebrae.
Both sides are examined for comparison.
[Lateral L-Spine]
[*] What is demonstrated?
[Lateral L-Spine]
[*] Lateral L-spine demonstrates intervertebral foramina.
[AP Oblique L-Spine ]
Part position…?
[AP Oblique L-Spine ]
45-degree posterior oblique position
[AP Oblique L-Spine ]
CR:
Enters patient __ inches medial to elevated _____ at _____ (__ inches above iliac crests)
[AP Oblique L-Spine ]
CR:
Enters patient 2 inches medial to elevated ASIS at L3 (1½ inches above iliac crests)
[AP Oblique L-Spine ]
Collimated field
[AP Oblique L-Spine ]
9” x 14”
[AP Axial (Ferguson) ]
CR:
Angled cephalad __ to __ degrees
Use less angle on males, more on females
Ferguson originally recommended __-degree angle
Enters patient on MSP at __ inches above pubic symphysis
[AP Axial (Ferguson)]
CR:
Angled cephalad 30 to 35 degrees
Use less angle on males, more on females
Ferguson originally recommended 45-degree angle
Enters patient on MSP at 1½ inches above pubic symphysis
[AP Axial (Ferguson) ]
Collimated field?
8” x 10”
Note: May also be performed with patient in prone position (PA axial) with CR angle 35 degrees caudad. Only AP axial is referred to as Ferguson method.
[AP Oblique SI Joints]
What is demonstrated?
[AP Oblique SI Joints]
SI joint farther from IR is demonstrated (elevated side)
[AP Oblique SI Joints ]
Part position?
[AP Oblique SI Joints]
25- to 30-degree posterior oblique position
Support body in position
Long axis parallel with table
IR centered at level of ASIS
[AP Oblique SI Joints ]
CR:
Enters patient __ inch _____ to elevated _____
[AP Oblique SI Joints]
CR:
Enters patient 1 inch medial to elevated ASIS
[AP Oblique SI Joints]
Collimated field?
[AP Oblique SI Joints]
6” x 10”
[Sacrum and Coccyx ]
Note: Ideally, _____ should be prepped and _____ emptied before examination.
[Sacrum and Coccyx]
Note: Ideally, bowel should be prepped and bladder emptied before examination.
[AP Axial Sacrum ]
CR:
__ degrees cephalad, if supine
__ degrees caudad for prone
Enters MSP at __ inches superior to pubic symphysis
For prone – enters MSP at level of _____ _____
[AP Axial Sacrum]
CR:
15 degrees cephalad, if supine
15 degrees caudad for prone
Enters MSP at 2 inches superior to pubic symphysis
For prone – enters MSP at level of sacral curve
[AP Axial Sacrum]
Collimated field?
[AP Axial Sacrum]
10” x 12”
[AP/PA Axial Coccyx ]
CR:
Angled __ degrees _____
__ degrees _____ if PA performed
Enters MSP at __ inches superior to pubic symphysis
For PA, enters MSP at _____
[AP/PA Axial Coccyx]
CR:
Angled 10 degrees caudad
10 degrees cephalad if PA performed
Enters MSP at 2 inches superior to pubic symphysis
For PA, enters MSP at coccyx
[AP/PA Axial Coccyx]
Collimated field?
[AP/PA Axial Coccyx]
8” x 10”
[Lateral Sacrum ]
CR:
Perpendicular to level of _____ and to a point __ inches _____
[Lateral Sacrum]
CR:
Perpendicular to level of ASIS and to a point 3½ inches posterior
[Lateral Sacrum]
Collimated field?
[Lateral Sacrum]
10” x 12”
[Lateral Coccyx ]
CR:
Perpendicular to __ inches posterior and __ inches inferior to _____
[Lateral Coccyx]
CR:
Perpendicular to 3½ inches posterior and 2 inches inferior to ASIS
[Lateral Coccyx]
Collimated field?
6” x 8”
[AP Oblique L-Spine ]
When the joint is not well seen, and the pedicle is posterior on the vertebral body, patient _____ too much.
Vertebral column parallel with the tabletop so that __-__ and __-__ intervertebral joint spaces remain open
[AP Oblique L-Spine]
When the joint is not well seen, and the pedicle is posterior on the vertebral body, patient rotated too much.
Vertebral column parallel with the tabletop so that T12-L1 and L1-2 intervertebral joint spaces remain open
Location and position used to best demonstrate:
pars interarticularis
AP Oblique L-Spine
Location and position used to best demonstrate:
zygapophyseal joints
AP Oblique L-Spine
Location and position used to best demonstrate:
intervetebral foramina
Lateral L-Spine
Location and position used to best demonstrate:
scottie dogs
AP Oblique L-Spine
