Lumbopelvic Exam

Question 1

Where are ID blockers?

Answer 1

up and out of the way of anatomy

Question 2

Where should the side markers be (generally)?

Answer 2

within collimation, but not in the way of anatomy

Question 3

What are the breathing instructions for all views?

Answer 3

exhale and hold

Question 4

What does expiration do to the diaphragm?

Answer 4

elevates it

Question 5

what is the general flow of a setup for lumbopelvic views?

Answer 5

set SID
align cassette in bucky
measure for all set-ups in the series
set control panel
apply gonad shield (if needed)
position patient
center CR, part and cassette

Question 6

the center of the “lumbopelvic” area is ___the iliac crest

Answer 6

below

Question 7

the center of the lumbar spine is ____the iliac crest

Answer 7

above

Question 8

where do you measure for AP lumbopelvic?

Answer 8

A-P at the thickest part the abdomen

Question 9

when do you apply a gonad shield?

Answer 9

for AP lumbopelvic and full spine only

Question 10

film size for APLP?

Answer 10

14x17

Question 11

collimation for APLP?

Answer 11

14x17

Question 12

central ray for APLP goes where for females?

Answer 12

1” below the crest

Question 13

central ray for APLP goes where for males?

Answer 13

2” below the crest

Question 14

what should be included in the APLP?

Answer 14

L1-ischial tuberosities, bottom of collimation light just below greater trochanters
top of light 1” below xyphoid

Question 15

if you cannot get all the anatomy on an APLP, what should you do?

Answer 15

ALWAYS get the ischial tuberosities

the lumbars that got cut off can be spot shot

Question 16

where should the anatomical marker be for APLP?

Answer 16

mid-film, along edge of collimation

Question 17

gonad shielding for APLP

Answer 17

males: tip of shield should be just below the pubic arch (1 1/2” below top of symphysis)
females: tip of heart should be just above the pubic symphysis, position widest part just medial and inferior to the ASIS

Question 18

what should you look for in an APLP?

Answer 18

symmetry of iliac wings and obturator foramina

Question 19

where should you measure for a lateral lumbar?

Answer 19

right to left, rest calipers on iliac crest

Question 20

where is the CR located for a lateral llumbar?

Answer 20

1” above the crest and midway between ASIS and PSIS (on midaxillary line)

Question 21

film size for lateral lumbar?

Answer 21

14x17

Question 22

collimation for lateral lumbar?

Answer 22

10X17

Question 23

If the patient has a lateral curve, what should you do for their lateral lumbar?

Answer 23

place the convexity next to the bucky

Question 24

for lateral lumbar, what do you do with females patients with hips larger than the waist?

Answer 24

add a filter down to the crest

Question 25

does the lateral lumbar include the whole pelvis and sacrum?

Answer 25

no

Question 26

why do we need to collimate for lateral lumbar?

Answer 26

reduces scatter fog/higher contrast critical for CR and DR produces better image large enought to accommodate hyperlordosis or XL patients

Question 27

what features should you see on a lateral lumbar?

Answer 27

``` posteiror ribs superimposed IVFs open iliac crests superimposed and mid film no "hourglassing" if L5/S1 is too light, do additional lateral "spot shot" ```

Question 28

where should yo umeasure for an L5/S1 lateral spot shot?

Answer 28

measure right to left, 2-3" below crest

Question 29

film size for L5/S1 lateral spot shot?

Answer 29

10x12 vertical

Question 30

how should patient be positioned for L5/S1 lateral spot shot?

Answer 30

side next to bucky, arms up

Question 31

where should CR be for L5/S1 lateral spot shot?

Answer 31

2-3" below crest and 1" posterior to midline

Question 32

what is the collimation for L5/S1 lateral spot shot?

Answer 32

8x10

Question 33

do we need a shield for L5/S1 lateral spot shot?

Answer 33

no

Question 34

How do we measure for anterior oblique lumbar?

Answer 34

A-P at the thickest part of the abdomen (same as APLP)

Question 35

film size for anterior oblique lumbar?

Answer 35

10x12

Question 36

Where do you center for anterior oblique lumbar?

Answer 36

1" above crest and 1" lateral to spine toward side of interest R pars- right side of the spine L pars- left side of the spine

Question 37

RAO, what do you see?

Answer 37

left pars

Question 38

LAO, what do you see?

Answer 38

right pars

Question 39

how far do you rotate for upper lumbars anterior oblique lumbar?

Answer 39

45 degrees

Question 40

how far do you rotate for lower lumbars for anterior oblique lumbar?

Answer 40

30 degrees

Question 41

why would we do a recumbent anterior oblique?

Answer 41

stabilizes patient compresses soft tissue, requiring 30% less mAs SAME CR, part, IR alignment as upright

Question 42

what part of the body do you put next to the bucky for a posteiror oblique?

Answer 42

side of interest

Question 43

What film size is required for posterior oblique?

Answer 43

10x12

Question 44

Where is the CR for posteiror oblique?

Answer 44

1" above the crest, approximately 2" medial to ASIS closes to tube

Question 45

RPO sees what?

Answer 45

right pars

Question 46

LPA sees what?

Answer 46

left pars

Question 47

what obliques are preferred?

Answer 47

Anterior less exposure to patient shooting into natural curvature

Question 48

what should you see in obliques?

Answer 48

scottie dogs should be apparent and similar from one level to next no IVFs iliac crest will be asymmetrical centering point slightly above crest

Question 49

where do you measure for AP sacrum?

Answer 49

anterior to posterior at mid-pelvis (midway between ASIS and PS)

Question 50

where is CR for AP sacrum?

Answer 50

perpendicular to sacrum with a 15 degree cephalic tube tilt

Question 51

do we shield for an AP sacrum?

Answer 51

no

Question 52

what are the breathing instructions for AP sacrum?

Answer 52

don't breathe, don't move

Question 53

how is patient postitioned for AP sacrum?

Answer 53

recumbent

Question 54

film size for lateral sacrum?

Answer 54

10x12 vertical

Question 55

how is patient positioned for AP sacrum?

Answer 55

recumbent

Question 56

where is the CR for lateral sacrum?

Answer 56

3" below the crest and 1" posterior to midaxillary plane

Question 57

do we need a shield for lateral sacrum?

Answer 57

no

Question 58

why does the CR need to be slightly posteiror to the spine when shooting a lateral sacrum?

Answer 58

because the sacrum is slightly posterior to the midaxillary plane

Question 59

how do you measure for an AP coccyx?

Answer 59

A-P at mid pelvis

Question 60

film size for AP coccyx?

Answer 60

10x12 vertical

Question 61

collimation for AP coccyx?

Answer 61

4x4

Question 62

CR for AP coccyx?

Answer 62

center mid pelvis with a 10 degree caudal tube tilt

Question 63

describe a lateral sacrum and coccyx "combo"

Answer 63

``` measure as for lateral sacrum 10x12, vertical load cassette with 2 films or filter coccyx or adjust image digitally ```

Question 64

film size for AP full spine?

Answer 64

14x36

Question 65

describe patient placemtn for AP full spine

Answer 65

back to full spine bucky arms abducted upper occlusal plane parallel to floor

Question 66

collimation for AP full spine?

Answer 66

open so it is just below the eyes and 3" below the pubic symphysis and 14" wide

Question 67

SID for AP full spine?

Answer 67

72"

Question 68

filter for AP full spine?

Answer 68

filter upper thoracics (down to axilla)

Question 69

breathing instructions for AP full spine?

Answer 69

inhale and hold

Question 70

full spine sectional series?

Answer 70

``` AP cervical spine APOM cervical spine Lat cervical spine AP thoracic spine Lat thoracic spine AP lumbo-pelvic spine Lat lumbar spine ```

Question 71

full spine series?

Answer 71

``` AP 14x36 APOM lat cervical spine lat thoracic spine lat lumbar spine ```