What r u looking for in Long AP?
Spinous Processes align (look out for Bifid)
No single space should be 50% wider than once immediately above (unless pt is in spasm which will pull column one way and it will be less than 50)
Psoas major significance in AP XRay?
If you can\'t see it there could be a hematoma or anuerism thats clocking the shadow
A lateral protrusion at L4-5 would be detected how? L5-S1?
a) Touch at lateral calf because it\\\'s the L5 dermatome - a prolapse only affects those down from it.
b) Touch at lateral ankle or middle calf
Why a lumbar and not a thoracic puncture/spinal tap and where is it done?
Because plexuses create a bulge or cystern of fluid. Done between L2-S2 because conus medularis is approx at top of L2 and so only subarachnoid space and not chord exists. Perhaps best at L4, the top of which is even with Iliac crest.
Kyphosis, Lordosis, Primary and Secondary curves?
Kyphosis - hunchback, Lordosis - increase curvature of the lumbar region
Primary curves - cervical and lumbar
Secondary curves - thoracic
Pelvic tilt spectrum
Normal - Ant Sup Iliac spine flush Pubic tubercle
Ky-Lordosis posture - spine ant of tubercle
Flat-back - spine most post of tubercle
Sway-back - spine post of tubercle
Spina bifida types
Occulta - spinal cord doesn\\\'t protrude, tuft of hair
Meningocele - Meninges forced through gap
Meningomyelocele - Membranes covering spinal cord emerge out of skin
Hangman\\\'s fracture? Wedge fracture?
a) C2 axis b) Vertebral bodies narrow anteriorly due to compression
\"listhesis\" - sliding forward
a) Fracture pars interarticularis
b) Anterior displacement of L5 vertebra (forced hyperextension)
Prolapsed Intervertebral Disc - Nucleus pulposus pushes through annulus fibrosis thus pressuring nerve
Venous Plexus of Column - Batson
External (outside vertebral canal) Plexuses anastomose with the internal (inside vertebral canal) plexuses. The basivertebral vein emerges from post foramena of the vertebral bodies to the internal plexus. No valves, so flow can be reversed by raised intra-abdominal pressure or postural alterations. (Cancer (especially prostate) can spread). Anastomoses to cavae and Azygous (which takes blood to vena cavae) leads to spread of cancer
\"Shingles\" - Infects a dorsal root ganglion and you won\'t know which until it manifests itself at the corresponding dermatome