Test 3 - Lumbar spine

Question 1

Lumbar spine

body, Transverse + spinous, Intervertebral foramina, Zagapophyseal, lami

Answer 1

body - lagre
Transver process - small
Spinous proncess - large and blunt
intervertebral foramina - 90 degrees from MSP
Zagapophyseal joints - 30-50 degrees from MSP, shown oblique
Lamina - large and sturdy

Question 2

Why are lumbar intervertebral disks so small?

Answer 2

because the evrtebral bodies are so closely packed

Question 3

Spondylolysis

Answer 3

a stress fracture through the pars interarticularis of the lumbar vertebrae (column remains in tact)

Question 4

Spondylolisthesis

Answer 4

happens when one of the vertabrae slips out of alignment and presses down on the vertebra below it.
(defect in the interarticularis, cause sforward slippage of vertebral body)

Question 5

Ankylosing Spondylitis

Answer 5

Inflamttion of lumbar spine
- also knwon as bamboo spine
- in severe cases, it can cause fusion of the vertebrae

Question 6

AP lumbar spine

kV, Pt pos, IR, CR, SID, Breathing, collimation

Answer 6

kV - 75-85
Supine or erect (must indicate on image)
35x43 IR
CR perpendicualr directed to level of crest
if smaller casette, level of L3
100cm SID
Suspended expiration
4 sided collimation

Question 7

Disadvantages to AP?

lumbar spine projection

Also one advantage

Answer 7

Disavantages: More exposure to reproductive organs
Close intervetebral joint spaces

Advantage: Less OID

Question 8

When doing a routine, why should we start with an AP?

Answer 8

To see if pateit has scoliosis (for the lateral)

Question 9

Lateral Lumbar spine

IR, kV, Pt. pos, SID, CR + exceptions, Breahting, collimation

Answer 9

IR 35x43
kV - 80-90
Erect (150 or 180cm)
Recumbent (100cm)
CR - perpendicualr to IR, directected to level of crest
For a small IR - level of T3
- may need a 5-8 degree caudad angle if eplvis is wide
suspended expiration
Collimation - especially lateral borders.

Question 10

Lateral L5-S1 junction

IR, kV, Pt. pos, CR, SID, collimation, brething

Answer 10

18x24
85-90 kV
Left lateral decub. w/ wait support
CR perpendicular or 5-8 degree caudad, centered 4cm inferior to crest, 5cm posterior to ASIS
SID: 100cm
Collimation: 4 sided (4x4”)
Suspended respiration

Question 11

Bes view to see L5-S1 joint pathologies?

Answer 11

Lateral L5-S1 spot image

Question 12

AP axial L5-S1

IR, CR, pt. pos, collimation

Answer 12

IR 18 x 24
CR males: 30 degree cephalic, MSP at level of ASIS
CR females: 35 degrees cephalic, MSP at level of ASIS
supine
Collimation 4x4”

Question 13

Protection

Answer 13

Close collimation

Question 14

Too high kV results in…

Answer 14

low contrast image
more scatter

Question 15

Indications for lumbar spine

Answer 15

Pain
Compressions fracture
Chance fracture
Herniated disk
Metastases
Spina Bifida
Scoliosis
Spondylolysis
Spndylolisthesis
Ankylosing Sondolysis

Question 16

what sign may be seen on an Oblique lumbar image

Answer 16

scotty dog sign

Question 17

AP lumbar structures seen

Answer 17

Lumbar and vertebral bodies
SI joints and sacrum
No rotation (equidistant crests, spinous & transverse processes)

Question 18

which projection shows intervertebral foramina?

Answer 18

Lateral (lumabr and thoracic)

Question 19

Later lumbar eval

Answer 19

vertebral bodies and intervertebral joint spaces
L5-S1 joint socae
Intervertebral foramina of L1-L4
No rotation (bent knees, arms raised, hips perpendicular to IR)

Question 20

WHat des cupping indicate?

Answer 20

tilt

Question 21

Spot image eval

Answer 21

Open L4-L5 and L5-S1 joint space
no rotation
no motion
tight collimation