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Rad Positioning Spine > Lumbopelvic Exam > Flashcards

Lumbopelvic Exam Flashcards

1
Q

Where are ID blockers?

A

up and out of the way of anatomy

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2
Q

Where should the side markers be (generally)?

A

within collimation, but not in the way of anatomy

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3
Q

What are the breathing instructions for all views?

A

exhale and hold

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4
Q

What does expiration do to the diaphragm?

A

elevates it

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5
Q

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

A 
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
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6
Q

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

A

below

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7
Q

the center of the lumbar spine is ____the iliac crest

A

above

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8
Q

where do you measure for AP lumbopelvic?

A

A-P at the thickest part the abdomen

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9
Q

when do you apply a gonad shield?

A

for AP lumbopelvic and full spine only

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10
Q

film size for APLP?

A

14x17

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11
Q

collimation for APLP?

A

14x17

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12
Q

central ray for APLP goes where for females?

A

1” below the crest

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13
Q

central ray for APLP goes where for males?

A

2” below the crest

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14
Q

what should be included in the APLP?

A

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

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15
Q

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

A

ALWAYS get the ischial tuberosities

the lumbars that got cut off can be spot shot

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16
Q

where should the anatomical marker be for APLP?

A

mid-film, along edge of collimation

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17
Q

gonad shielding for APLP

A

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

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18
Q

what should you look for in an APLP?

A

symmetry of iliac wings and obturator foramina

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19
Q

where should you measure for a lateral lumbar?

A

right to left, rest calipers on iliac crest

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20
Q

where is the CR located for a lateral llumbar?

A

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

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21
Q

film size for lateral lumbar?

A

14x17

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22
Q

collimation for lateral lumbar?

A

10X17

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23
Q

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

A

place the convexity next to the bucky

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24
Q

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

A

add a filter down to the crest

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25
Q

does the lateral lumbar include the whole pelvis and sacrum?

A

no

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26
Q

why do we need to collimate for lateral lumbar?

A

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

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27
Q

what features should you see on a lateral lumbar?

A 
posteiror ribs superimposed
IVFs open
iliac crests superimposed and mid film
no "hourglassing"
if L5/S1 is too light, do additional lateral "spot shot"
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28
Q

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

A

measure right to left, 2-3” below crest

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29
Q

film size for L5/S1 lateral spot shot?

A

10x12 vertical

30
Q

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

A

side next to bucky, arms up

31
Q

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

A

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

32
Q

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

A

8x10

33
Q

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

A

no

34
Q

How do we measure for anterior oblique lumbar?

A

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

35
Q

film size for anterior oblique lumbar?

A

10x12

36
Q

Where do you center for anterior oblique lumbar?

A

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

37
Q

RAO, what do you see?

A

left pars

38
Q

LAO, what do you see?

A

right pars

39
Q

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

A

45 degrees

40
Q

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

A

30 degrees

41
Q

why would we do a recumbent anterior oblique?

A

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

42
Q

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

A

side of interest

43
Q

What film size is required for posterior oblique?

A

10x12

44
Q

Where is the CR for posteiror oblique?

A

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

45
Q

RPO sees what?

A

right pars

46
Q

LPA sees what?

A

left pars

47
Q

what obliques are preferred?

A

Anterior
less exposure to patient
shooting into natural curvature

48
Q

what should you see in obliques?

A

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

49
Q

where do you measure for AP sacrum?

A

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

50
Q

where is CR for AP sacrum?

A

perpendicular to sacrum with a 15 degree cephalic tube tilt

51
Q

do we shield for an AP sacrum?

A

no

52
Q

what are the breathing instructions for AP sacrum?

A

don’t breathe, don’t move

53
Q

how is patient postitioned for AP sacrum?

A

recumbent

54
Q

film size for lateral sacrum?

A

10x12 vertical

55
Q

how is patient positioned for AP sacrum?

A

recumbent

56
Q

where is the CR for lateral sacrum?

A

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

57
Q

do we need a shield for lateral sacrum?

A

no

58
Q

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

A

because the sacrum is slightly posterior to the midaxillary plane

59
Q

how do you measure for an AP coccyx?

A

A-P at mid pelvis

60
Q

film size for AP coccyx?

A

10x12 vertical

61
Q

collimation for AP coccyx?

A

4x4

62
Q

CR for AP coccyx?

A

center mid pelvis with a 10 degree caudal tube tilt

63
Q

describe a lateral sacrum and coccyx “combo”

A 
measure as for lateral sacrum
10x12, vertical
load cassette with 2 films
or filter coccyx
or adjust image digitally
64
Q

film size for AP full spine?

A

14x36

65
Q

describe patient placemtn for AP full spine

A

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

66
Q

collimation for AP full spine?

A

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

67
Q

SID for AP full spine?

A

72”

68
Q

filter for AP full spine?

A

filter upper thoracics (down to axilla)

69
Q

breathing instructions for AP full spine?

A

inhale and hold

70
Q

full spine sectional series?

A 
AP cervical spine
APOM cervical spine
Lat cervical spine
AP thoracic spine
Lat thoracic spine
AP lumbo-pelvic spine
Lat lumbar spine
71
Q

full spine series?

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

Rad Positioning Spine (8 decks)

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