Quiz 2 Flashcards
What are the two additional views that can be taken in the Thoracic spine?
Swimmer’s lateral, oblique
Which structures require two views at 90 degrees to each other?
Ribs, Sternum (lateral and PA film, RAO projects sternum away from the heart)
What is the minimal diagnostic series for the Lumbar Spine?
AP or PA, Lateral
What are the additional views that can be taken of the Lumbar Spine?
Oblique, Lumbosacral (AP or lateral), Flexion/Extension
Do the posterior lumbar oblique views show the same or opposite side structures?
Same. RPO = right pars interarticularis. LPO = left pars interarticularis
Which 3 bones is the acetabulum formed by?
Ilium, Ischium, Pubis
What is the minimal diagnostic series for the Pelvis, Sacrum, Coccyx?
AP, Feet should be internally rotated 15 degrees
In what view can the Cobb Scoliosis Measurement be taken?
AP spine
What are the degrees of measurement that require bracing or surgery in the Cobb Scoliosis Measurement?
> 20 degrees require bracing, >40 degrees need surgery
In what view is the Risser-Ferguson Scoliosis Measurement taken?
AP spine; Gives a measurement 25%; 10 degrees below Cobb method
In what view is the Thoracic Kyphosis measurement taken?
Lateral Thoracic; Superior endplate of T1 and Inferior endplate of T12
What is the minimal distance found in the Thoracic Cage Dimension?
Males 11cm, Females 9 cm
What is the normal degree range in a Lumbar Lordosis measurement?
50-60 degrees
What is the normal range of the Sacral Base Angle?
26-57 degrees in a lateral lumbar view
What is the normal range of of the Lumbosacral Disc Angle measurement?
10-15 degrees. Increase >15 degrees facet impaction; LBP
What is the minimal measurement for the Eisenstein’s Method for Sagittal Canal Measurement?
must be greater than 14-15mm, spinal stenosis
What is the minimal diagnostic series for the Thoracic Spine?
AP, Lateral
What line can be used to determine thoracic kyphosis?
George’s/posterior body margin line. Lateral thoracic.
In a lateral thoracic, below the central ray which side of the patient is projected toward edges of the film?
The side farther from the film
What structures are best visualized on Swimmer’s?
Cervicothoracic junction. (lateral, arm above head)
What is the minimal diagnostic series when taking a bony thorax (ribs)?
Two views 90 degrees to each other (place site of pain closest to film)
Will the sternum be included on a lateral thoracic xray?
No
What is the minimal diagnostic series for taking films of the sternum?
Two views 90 degrees to each other. Lateral. PA film places the sternum closest to film. RAO projects sternum away from the heart shadow.
How much of the pelvic bowl does the sacrum consume in an AP view?
1/3 to 1/2 of pelvic bowl
How much of the pelvic bowl does the sacrum consume in a PA view?
> 1/2 of pelvic bowl (magnified sacrum)
Are the iliac wings wide or narrow in an AP view?
Wider, they are “en face”
Are the iliac wings wide or narrow in a PA view?
Narrower, they are “on end”
When is a curvature deemed scoliosis?
After 10 degrees
If you can’t see the whole curve, what is the curvature called?
Lateral list
Which structures are projected toward the edges of the film?
Structures further from the film
Anatomic positions add to what effect on an AP view?
Lordosis of lumbar spine
What is the basic alignment for a lateral lumbar?
Posterior body line (george’s line), lumbar lordosis, sacral base angle
Why would you take an oblique lumbar?
To visualize the pars interarticularis, z joints, posterior elements. ALWAYS taken left and right
What do the posterior elements look like in an oblique lumbar?
Scotty dog
What structure is the nose of the scotty dog?
Transverse process
What structure is the eye of the scotty dog?
Pedicle
What structure is the ear of the scotty dog?
Superior articular process
What structure is the front leg of the scotty dog?
Inferior articular process
What structure is the neck of the scotty dog?
Pars interarticularis
What structure is the back/tail of the scotty dog?
interlaminar space
What structure is the stomach of the scotty dog?
lamina
What is the AP axial lumbosacral spot used for?
Visualize through L5-S1 disc space, Visualize pars interarticularis in lower lumbar spine
What three bones is the acetabulum formed by?
Ilium, ischium, pubis
How do you measure the thoracic cage dimension?
Measure from ant. body margin of T8 to post. margin of sternum
How do you measure the sacral base angle?
Line parallel to sacral base, line parallel to bottom of image
What is the Meyerding’s grading of anterolisthesis?
Sacral base divided into 4 sections. Post-inf body corner of L5 marks degree of anterolisthesis
Grade 1 of Meyerding’s grading of anterolisthesis
posterior 25%
Grade 2 Meyerding’s grading of anterolisthesis
posterior 25%-50%
Grade 3 Meyerding’s grading of anterolisthesis
50%-75% from posterior margin of base
Grade 4 Meyerding’s grading of anterolisthesis
75%-100% from posterior
Grade 5 Meyerding’s grading of anterolisthesis
Spondyloptosis; posterior-inferior of L5 lies anterior to sacral promontory
What is Ullman’s line?
Method of identifying L5 anterolisthesis. One line parallel to sacral base, second line perpendicular to the first at the point of the sacral promontory, anterior of the L5 vertebral body behind perp. line
How do you measure the Eisentein’s method of sagittal canal diameter?
At any level, draw a line connecting the tip of the SAP and the tip of the IAP measuring from the line to the post. body margin
Interpedicular distance
measure from medial margin of one pedicle to medial margin of the opposite side pedicle. Generally increases from L1 - L5
Presacral space
Normal is less than 2cm in adults. Children less than 5mm (identified by gas)
Pubic symphysis width
Females- 6mm. Males- 7.2mm.
Lumbar gravity line
Center of L3, vertical line, intersect the ant. 1/3 of sacral base. No more than 10mm ant. to the base.
Degenerative lumbar spine instability
Lateral lumbar, George’s line should be no more than 4mm of translation from flex/ext or compression/traction
Oblique Lumbars
Always take left and right
