Lumbar Flashcards
What structures are best demonstrated on an RPO lumbar?
Right zygapopyseal joints
What structures are best seen on an RAO?
Left zygapophyseal joints
What position best shows the intervertebral foramina?
R or L lateral
Which positions best demonstrate the left and right zygapophyseal joints?
RPO-right joints
LPO-left joints
RAO-left joints
LAO-right joints
Spinal nerves and blood vessels exit the spinal column through the:
Intervertebral foramina
What does spina bifida literally mean?
Split spine
What is the difference between meningocele and myelomeningocele?
Men: a sack of spinal fluid on back. No nerve damage usually
Mye: when spinal cord comes through the back as well. Yes nerve damage
What population does spina bifida affect?
Unborn fetus, infants, and children
What positioning best demonstrates spina bifida?
PA and lateral lumbar spine
T or F: spina bifida is one of the most common birth defects in the US?
True
Scoliosis requires repay exams over several years. What projection can help to reduce overall pt dose and how does it help?
PA. Reduces dose to pt by 90% over AP
T or F: thoracolumbar curvature most often presents on the right side of the pt
True
At which age is scoliosis most common diagnosed?
10-14 years old
Which modality/modalities are the most diagnostic in the treatment of scoliosis?
X-ray
Name at least three treatment options for scoliosis
Surgical intervention Chiropractic manipulation Bracing Dietary supplements Electrical stimulation
Find fracture and loss of height in both the anterior and posterior aspects of L3 vertebrae. Which fracture is this most likely? Give name and what classification it falls under.
Axial burst/loading fracture, flexion classification.
What is the leading cause of lumbar spine fractures?
Osteoporosis
Which types of fractures are usually the most severe and serious?
Rotation fractures
What is the name of the fracture that is most often caused from lap belts in MVA?
Chance fractures
Pt on backboard, cannot move. Suspected lumbar spine fracture. What positioning routine?
AP recumbent and horizontal beam lateral
What portion of the spine does spondylolisthesis most commonly affect?
L4-5
What part of the upper and lower facets is affected by spondylitis?
Pars interarticularis
Spondyloisthesis most often effects: A infants B teens C 40-50 years old D both B and C
D
Spondylolisthesis is caused by A genetic weakness B injury C repeated stress fractures D all of the above
D
What is a common radiographic sign of spondylosis in an oblique image?
The Scottie dog has collar or broken neck
Scoliosis routine imaging and special imaging
AP (PA) erect
Erect lateral
AP (Ferguson method) ( one normal and one with convex foot elevated 3-4 inches)
AP right and left bending
Lateral flexion and extension
Primary vs secondary vs compensatory curves
Primary: pelvic, thoracic
Secondary: lumbar, cervical
What is lordosis?
Abnormal increase in the anterior convexity of lumbar curve
What is scoliosis?
Causes vertebra to rotate TOWARD the concavity. A 2nd curve develops in opposite direction to compensate and keep head centered over feet
Zygapophyseal joints are what type of movement?
Synovial, gliding joints
Allow free movement
What is the surgical procedure which removes a herniated vertebral disc?
Discectomy
Where does HNP most commonly occur?
L4-5 level
What modality is of superior diagnostic quality but also the most invasive? (For HNP)
Myelography
What can HNP cause/lead to?
Sciatica
What 2 parts make up the intervertebral discs?
Annulus fibrosis (outside)
Nucleus pulposus (inside)
How many bones in spine in adult vs child
26 adult
33 kids
Level of terminal end solid spinal cord
Conus medullaris at L1-2
Collection of nerve roots resembling horsetail
Cauda equina L2-S1 ish
Want to see L5-S1 on male pt. What projection and what angle?
AP axial with 30 degree cephalic
CR to ASIS
Females are 35 cephalic
To see L5-S1 on oblique, how much degree?
30
To see T12-L1, how much oblique?
50
How much oblique for usual lumbar spine anatomy?
45 degrees
If top and bottom of lumbar spine on lateral has double edging what does that mean?
Top is shoulders are over obliqued (or lack of total body positioning)
Bottom is either abdomen was not supported or insufficient angle.
CR should be parallel to interiliac plane not 5-8 caudal like book says
Patho:
Collar or break on dog neck?
Spondylosis
Which projection best shows compression fractures?
Lateral
Or horizontal beam lateral if can’t lay on side
Where is the pars interarticularis found?
Between the superior and inferior articular processes
