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622: Human Imaging I > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

1
Q

Sometimes there appears to be 4 lumbar vertebrae, what is this called?

A

“sacralization” of L5

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2
Q

Sometimes there appears to be 6 lumbar vertebrae, what is this called?

A

“lumbarization” of first sacral segment

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3
Q

What are the 5 views of the lumbar spine?

A

1) Anteroposterior (AP)
2) Left oblique
3) Right oblique
4) Lateral
5) “Coned-down view” of lumbosacral joint

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4
Q

At minimum which views must be taken to perform basic evalution of the lumbar spine?

A

AP and lateral view

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5
Q

Why does the Coned-down Viewof L5 to S1 subject patients to highest dose of radiation of any standard-plain film view?

A

The x-rays must penetrate both sides of iliac bones in order to properly view this segment

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6
Q

In an anteroposterior view of the lumbar spine, what do the vertebral bodies represent on the “totem pole”?

A

Bird’s head

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7
Q

In an anteroposterior view of the lumbar spine, what do the pedicles represent on the “totem pole”?

A

Bird’s eyes

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8
Q

In an anteroposterior view of the lumbar spine, what do the transverse processes represent on the “totem pole”?

A

Feathers from bird’s head

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9
Q

What do the lamina and spinous processes form?

A

The bird’s beak

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10
Q

Which vertebral structure can be assessed to evaluate rotation?

A

Pedicles

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11
Q

Assessment of alignment in AP view relies upon what bony landmarks?

A
  • The spinous processes should align vertically

- The lateral surfaces of the vertebral bodies should line up vertically

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12
Q

If the spinous processes do not align vertically what is this an indication for?

A

Rotation at one or more segments

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13
Q

If the lateral surfaces of the vertebral bodies do not align vertically what is this an indication for?

A

Unilateral compression fracture or osteoporotic collapse of portion of vertebral body

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14
Q

“Double lamina” is a sign of what?

A

Ssevere spondylolisthesis caused by inferior displacement of L5 on S1 when viewed in AP plane

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15
Q

Why do the laminae in “double lamina” sign appear so close to one another?

A

Because L5 has slid anteriorly and inferiorly on S1

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16
Q

Oblique views are taken with patient supine and shoulders and lower spine and pelvis rotated ____ side to be imaged

A

toward

Left oblique with left side rotated
Right oblique with right side rotated

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17
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s eye?

A

Pedicles

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18
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s ear?

A

Superior articular facet

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19
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s front leg?

A

Inferior articular facet

20
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s tail?

A

Superior facet on opposite side

21
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s back leg and back foot?

A

Spinous process

Inferior articular facet on opposite side

22
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s muzzle?

A

Transverse processes

23
Q

In an oblique view of the lumbar spine, what is represented by the Scottie dog’s neck?

A

Pars interarticularis

24
Q

If the Scottie dog appears to be wearing a collar (lucency) what does this indicate?

A

fracture of pars interarticularis

25
Q

If there is a fracture of the pars interarticularis what is this diagnostic of?

A

spondylolysis

26
Q

At which vertebral level is spondylolysis most common?

A

L5

27
Q

How can you tell the difference between spondylolysis and spondylolisthesis?

A

Spondylolysis is represented by a Scottie dog with a collar

Spondylolisthesis is represented by a decapitated Scottie dog

28
Q

Spondylolysis vs. spondylolisthesis

A

Spondylolysis occurs when there is a fracture of the pars portion of the vertebra.
Spondylolisthesis occurs when the vertebra shifts forward due to instability from the pars defect

29
Q 
Spondylolisthesis Grades: 
Grade 1 = \_\_% displacement
Grade 2 = \_\_% displacement
Grade 3 = \_\_% displacement
Grade 4 > \_\_% displacement
A

25
50
75
>75

30
Q

What is retrolisthesis?

A

Occurs when a superior vertebral body is displaced posteriorly to the vertebrae directly inferior to it

31
Q

Describe the cone-down view

A

It is a lateral view of the L5-S1 joint with x-ray energy so high that iliac crests become invisible

32
Q

Which vertebral bodies are visible in a coned-down view?

A

Lumbar and sacral bodies

33
Q

Is the interspace greater between L4- L5 or L5-S1?

A

L4-L5

34
Q

What is the Vacuum Phenomenon?

A

It is an accumulation of gas, principally nitrogen, in crevices within the intervertebral disk or vertebra produced by surrounding soft tissues

35
Q

In synovial joints the vacuum phenomenon is related to what?

A

The distraction of articular surfaces

36
Q

In intervertebral discs the vacuum phenomenon is related to what?

A

Degenerative processes most of the time.

Rare cases of tumors and infections.

37
Q

When assessing alignment in the cone-down view what are you looking for?

A

Making sure that the inferior portion of L5 body is aligned with superior body of S1

38
Q

Dimensions in superior-inferior and anteroposterior planes should be how large?

A

approximately equal

39
Q

Can you assess soft tissue in a cone-down view? Why or why not?

A

No.

Soft tissue not visible as result of high dosage of radiation, which renders soft tissue invisible

40
Q

What may the absence of space between two vertebral bodies represent?

A
  • A herniation of the nucleus pulposis

- Failure of embryonic segmentation at one or multiple levels

41
Q

What are the 3 types of congenital vertebral anomalies?

A

1) block vertebrae
2) hemivertebrae
3) transitional vertebrae

42
Q

Describe block vertebrae

A

are wedge-shaped vertebrae that can cause an angle in the spine (such as kyphosis, scoliosis, and lordosis

43
Q

Describe hemivertebrae

A

Occur when adjacent vertebrae fuse through their intervertebral discs due to improper segmentation

44
Q

Describe transitional vertebrae

A

Occur when the particular vertebrae take on the characteristics of another. For example the transverse process of the last cervical vertebra may resemble a rib

45
Q

What is Spondylosis Deformans?

A

The degeneration of IVDs that is characterized by the formation of bony spurs called Sharpey’s fibers

622: Human Imaging I (7 decks)

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