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Radiology Positioning > L-Spine > Flashcards

L-Spine Flashcards

1
Q

what occupies the posterior abdominal region

A

lumbar vertabrae

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2
Q

How many vertebrae are in the lumbar

A

5

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3
Q

what are the unique features of the lumbar

A

Transverse processes are smaller than T-spine
Pars interarticularis – part of lamina between articular processes

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4
Q

what is the part of lamina between articular processes

A

pars interarticularis

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5
Q

what is seen on the obliques in the lumbar spine

A

Zygapophyseal joint
Seen on obliques
45degrees

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6
Q

what is seen on the laterals for the lumbar spine

A

Intervertevbral Foramen
Seen on Lateral
90degrees

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7
Q

Formed by fusion of five sacral segments into curved, triangular bone

A

sacrum

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8
Q

wedged between iliac bones of pelvis

A

articulation=sacroilliac (SI) joints

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9
Q

Curves inferiorly and anteriorly from articulation with sacrum

A

Coccyx

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10
Q

Formed by fusion of three to five rudimentary vertebrae

A

Coccyx

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11
Q

Anatomic features for coccyx.

A

Cornu

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12
Q

Anatomic features
of sacrum

A

Promontory
Canal
Foramina
Cornu

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13
Q

how is the body different in the lumbar

A

broader

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14
Q

how is the lamina in the lumbar spine

A

shorter

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15
Q

how is the spinous processes in the lumbar

A

shorter and broader

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16
Q

where is the apex and base on the coccyx

A

apex at the bottom and base at the top

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17
Q

essential projections for L spine

A

AP
Lateral
Lateral L5-S1
AP oblique
RPO
LPO
AP axial lumbosacral (LS) junction and SI joints (Ferguson)

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18
Q

patient position for AP L spine

A

Supine or upright

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19
Q

part position for AP L Spine

A

MSP centered to midline

Shoulders and hips in same horizontal plane

Arms crossed on chest

Reduce lordosis by flexing hips and knees to place lower back closer to table

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20
Q

CR for AP L spine

A

perp to IR

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21
Q

CR For lumbosacral exams

A

enters patient at iliac crests (L4)

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22
Q

CR For lumbar only

A

enters patient at 1½ inches (3.8 cm) above iliac crests (L3)

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23
Q

what does the lateral L spine demonstrate

A

Lateral L-spine demonstrates
intervertebral foramina

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24
Q

part position for lateral L spine

A

True lateral with MCP vertical
Knees flexed and superimposed
Arms, with elbows flexed, at right angle to body
Place radiolucent support under lower spine to place horizontal, if needed

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25
Q

patient position for lateral L spine

A

Recumbent or upright
Use same as for AP

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26
Q

CR for Lateral L spine

A

Perpendicular to IR

Enters patient on MCP at iliac crests (L4)

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27
Q

if spine is not horizontal for the lateral L spine , what should the degree of angulation be?

A

horizontal, angle caudad 5 to 8 degrees

More for females

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28
Q

Part position for L5-S1

A

MCP perpendicular to IR

Hips extended

Superimposed knees, may be slightly flexed

With elbows flexed, place arms at right angle to body

Support lower spine in horizontal position in same manner as for lateral projection

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29
Q

CR for Lateral L5-S1

A

When spine is horizontal, perpendicular to a coronal plane 2 inches (5 cm) posterior to anterior superior iliac spine (ASIS) and 1½ inches (3.8 cm) inferior to iliac crest
If not, angle 5 degrees caudad for males, 8 degrees caudad for females

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30
Q

if the spine is not horizontal for L5-S1 what degree of angulation should be used?

A

If not, angle 5 degrees caudad for males, 8 degrees caudad for females

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31
Q

what does the oblique projection of the lumbar vertebrae demonstrate?

A

Oblique projections demonstrate
zygapophyseal joints
of most lumbar vertebrae.

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32
Q

Patient position
for AP Oblique L-Spine

A

Patient position
Recumbent or upright
Use same position as AP

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33
Q

Part position
for AP Oblique L-Spine

A

45-degree posterior oblique position

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34
Q

CR for AP oblique L spine

A

CR
Perpendicular to IR

Enters patient 2 inches (5 cm) medial to elevated ASIS at L3 (1½ inches or 3.8 cm above iliac crests

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35
Q

KNOW SCOTTIE DOG

A

ear= superior articular process
body=lamina
leg=inferior articular process
eye=pedicle
nose= transverse process
neck= pars interarticularis

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36
Q

what does it mean if the pedicle is anterior on the vertebral body in the obliques for L spine

A

which means that the patient is not rotated enough.

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37
Q

what does it mean if the pedicle is posterior on the vertebral body in the obliques for L spine

A

which means that the patient is rotated too much.

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38
Q

patient position for AP Axial (ferguson)

A

Supine

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39
Q

part position for AP Axial (Ferguson )

A

MSP centered to IR

Extend lower limbs, or abduct thighs and place vertical

40
Q

what is the degree of angulation for AP axial (ferguson)

A

Angled cephalad 30 to 35 degrees
Use less angle on males, more on females

41
Q

CR for AP Axial Ferguson

A

Angled cephalad 30 to 35 degrees
Enters patient on MSP at 1½ inches (3.8 cm) above pubic symphysis

42
Q

are you able to do the L spine PA Axial as well ?

A

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.

43
Q

Essential projections for the SI joints

A

AP oblique
RPO
LPO
25-35 degrees

44
Q

what side is being best demonstrated in the AP oblique SI joints

A

SI joint farther from IR
is demonstrated (elevated side).

45
Q

patient position for AP oblique SI joints

A

supine

46
Q

part position for AP oblique si joints

A

25- to 30-degree posterior oblique position
Support body in position
Long axis parallel with table
IR centered at level of ASIS

47
Q

how much should the patients body be rotated for the ap oblique SI joints

A

25 to 30 degrees posterior oblique position

48
Q

CR for AP oblique SI joints

A

Perpendicular to IR

Enters patient 1 inch (2.5 cm) medial to elevated ASIS

49
Q

if you are doing a pa oblique si joint what side is being shown

A

LAO shows left joint

50
Q

Essential Projections: Sacrum and Coccyx

A

Sacrum
-AP axial
-Lateral
Coccyx
-AP axial
-Lateral

51
Q

patient position for Ap axial sacrum

A

Supine

May also be performed with patient prone (PA axial projection), if needed for comfort

52
Q

Part position for ap axial sacrum

A

MSP in midline of table

ASIS equidistant from table

Arms in comfortable, symmetric position out of field

Support knees, if supine

53
Q

how much of an angle is needed for ap axial coccyx

A

10degrees caudal (AP)
10 degrees cephalic if PA

54
Q

how many degrees is needed for ap axial sacrum

A

15degrees cephalic(supine)

55
Q

CR for ap axial sacrum

A

Enters MSP at 2 inches (5 cm) superior to pubic symphysis
For prone – enters MSP at level of sacral curve

56
Q

patient position for AP/PA axial coccyx

A

Supine or prone

Choose position that maximizes patient comfort

57
Q

Part position for
AP/PA Axial Coccyx

A

Same as used for sacrum

58
Q

CR for AP/PA Axial Coccyx

A

Enters MSP at 2 inches (5 cm) superior to pubic symphysis
For PA, enters MSP at coccyx

58
Q

patient position for lateral sacrum

A

Patient position
Recumbent lateral
Hips and knees flexed for comfort
Arms at right angle to body
Knees superimposed
Support spine to horizontal position
Interiliac plane perpendicular to IR
Shoulders and pelvis in true lateral
MCP vertical
Sacrum centered to IR

59
Q

CR for lateral sacrum

A

CR
Perpendicular to level of ASIS and to a point 3½ inches (9 cm) posterior

60
Q

patient position for lateral coccyx

A

Patient position
Recumbent lateral
Hips and knees flexed for comfort
Arms at right angle to body
Knees superimposed
Support spine to horizontal position
Interiliac plane perpendicular to IR
Shoulders and pelvis in true lateral
MCP vertical

61
Q

CR for lateral coccyx

A

Perpendicular to 3½ inches (9 cm) posterior and 2 inches (5 cm) inferior to ASIS
Close collimation improves visibility

62
Q

Typical scoliosis examination may include

A

PA (or AP) upright
PA (or AP) upright with lateral bending
Lateral upright (with or without bending)
PA (or AP) recumbent

63
Q

Demonstrates amount/degree of curvature that occurs with force of gravity acting on body

A

Scoliosis Radiography

64
Q

Also used to evaluate fixation devices, such as Harrington rods

A

Scoliosis Radiography

65
Q

Bending studies used to differentiate between primary and compensatory curves

A

Scoliosis Radiography

66
Q

Patient position
Scoliosis: PA Thoracolumbar

A

Upright, facing vertical Bucky

67
Q

Part position
Scoliosis: PA Thoracolumbar

A

Ensure MCP parallel to Bucky
Arms abducted and not in field

68
Q

CR for Scoliosis: PA Thoracolumbar

A

Perpendicular to Bucky

69
Q

Patient position
Scoliosis: Lateral Thoracolumbar

A

Upright, lateral

70
Q

Part position
Scoliosis: Lateral Thoracolumbar

A

MCP perpendicular to Bucky
Arms at right angle to body

71
Q

CR
Scoliosis: Lateral Thoracolumbar

A

Perpendicular to Bucky

72
Q

Scoliosis: PA Thoracolumbar (Ferguson)

A

First radiograph taken in same manner as previously described PA

Second PA radiograph taken with patient’s convex side elevated 3 to 4 inches (7.6 to 10.2 cm)

73
Q

what view is compensating so both sides are level?

A

Scoliosis: PA Thoracolumbar (Ferguson)

73
Q

where on the sacrum does a lot of injuries occur

A

base at top L5 joint S1

74
Q

SID for AP L spine

A

40 inches

75
Q

recomended breathing for AP L spine

A

Respiration suspended at end of expiration

76
Q

what needs to be included in a lateral L spine

A

-L5, S1 junction
-open disc space
-intervertebral foramen

77
Q

what lateral is standard for lumbar spine and why would you possibly change it

A

standard is left lateral but for scoliosis it is better to do a Right lateral

78
Q

in the lateral L5-S1 how is the IR and CR to the interilliac line

A

IR is perp to interilliac line
and the CR is parallel to interilliac line

79
Q

what is AP Axial (ferguson) done for

A

Its done for L5-S1
*to open up the joint spaces

80
Q

what is SI joints typically done for

A

arthiritis

81
Q

what is the recommended breathing for the AP and PA oblique L spine

A

Respiration suspended at end of expiration

82
Q

what is the SID for AP and PA oblique L spine

A

40 inches

83
Q

what is the recomended breathing for the lateral lumbar

A

Respiration suspended at end of expiration

84
Q

what is the SID for lateral lumbar

A

40 inches

85
Q

what is a lateral curvature of the spine

A

scoliosis

86
Q

why do we do ap or pa

A

ap- definition
pa- radiation protection

87
Q

what do you do to your technique for peristalsis or any movement of the bowels

A

increase mA decrease time

88
Q

how is the spine in the thoracic and lumbar for scoliosis

A

right in thoracic, left in lumbar

89
Q

what can you do for motion

A

decrease time, communicate better with patient

90
Q

what is the breathing technique and SID for L5-S1 LUMBO-
SACRAL JUNCTION

A

respiration suspended and 40 inches

91
Q

recomended breathing for SI joints and SID

A

Respiration suspended

40” SID

92
Q

what is the recomended breathing and SID for sacrum and coccyx

A

Respiration suspended

40” SID

93
Q

what is the breathing and SID for lumbar spine

A

respiration suspended and 40 inches

94
Q
A

Radiology Positioning (8 decks)

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