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chapter 9 lumbar spine sacrum and coccyx
Terms in this set (89)
a portion of the lamina located between the superior and inferior articular processes is called the ?
the superior and inferior vertebral notches join together to form the ?
which radiograph position best demonstrates the structure identified in the previous question ?
the small foramina found ion the sacrum are called ?
pelvic sacral foramina
the anterior and superior aspect of the sacrum that forms the posterior wall of the pelvic inlet is called the ?
what is another term for the sacral horns ?
the sacroiliac joints lie at an oblique angle of ? degree to the coronal plane
what is the formal term for the "tailbone" ?
what si the name of the superior broad aspect of the coccyx ?
what is the mobility type and movement type for zygapophyseal joints ?
synovial and diathordial, plane or gliding
what is the mobility type and movement type for intervertebral joints ?
cartilaginous and amphiarthridial (slightly moveable)
a left posterior oblique LPO demonstrate what joints or foramina ?
left zygapophyseal joint
a right posterior oblique RPO demonstrates what joints or foramina ?
right zygapophyseal joints
a left anterior oblique LAO demonstrates what joints or foramina ?
right zygapophyseal joints
a right anterior oblique RAO demonstrates what joints or foramina ?
left zygapophyseal joints
the degree of obliquity required for an projection at the T12-L1 level is approximately ? whereas the L5-S1 spine level requires a ? oblique therefore a ? oblique is performed for the general lumbar spine ?
50 degree / 30 degree/ 45 degree
what topographic landmark to the correct vertebral level/ ASIS ?
what topographic landmark to the correct vertebral level/ xiphoid process?
what topographic landmark to the correct vertebral level/ lower costal margin ?
what topographic landmark to the correct vertebral level/ iliac crest ?
what topographic landmark to the correct vertebral level/ symphyses pubis ?
prominence of greater trochanter
true/false: the use of higher kv and lower mA seconds mas for lumbar spine radiography improves radiographic contrast but increases patient dose ?
true/false: placing a lead blocker mat behind the patient for lateral lumbar spine positions image quality ?
true/false: gonadal shielding should always be used for male and female for studies of the lumbar spine, sacrum, and coccyx ?
true/false: the anteriorsuperior AP projection of the lumbar spine opens the intervertebral joints space better than the posteroanterior PA projection ?
false PA would open intervertebral joint space better
true/false: the knees and hips should be extended for an AP projection of the lumbar spine ?
false knees should be flexed
true/false: an increased source image receptor distance of 44 to 46 inches reduces magnification of the spine anatomy ?
true/false: a lead blocker mat and close collimation must not be used when performing digital imaging of the lumbar spine ?
true/false: when positioning the obese patient the iliac crest is typically at the level the inferior margin of the flexed elbow?
what is osteoporosis ?
what is soft tissues of lumbar spine ?
magnetic resonance imaging MRI
what is structures within subarachnoid space ?
what is inflammatory conditions such as pagets disease ?
what is compression fracture of lumbar spine ?
what is a lateral curvature of the vertebral column ?
what is fracture of the vertebral body caused by hyperflexion force ?
what is congenital defect in which the posterior elements of the vertebrae fail to unite ?
what is most common at the L4-L5 level and may result in sciatica ?
herniated nucleus pulposus HNP
what is forward displacement of one vertebrae onto another vertebrae ?
what is inflammatory condition that is most common in males in their 30s ?
what is dissolution and separation of the pars interarticularis ?
what is a type of fracture that rarely causes neurologic deficits ?
with a 14x17 IR the central ray is centered at the level of the ? for AP and lateral lumbar spine projections
which two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the lumbar spine ?
sacroiliac joints are equidistant from the spine / spinous process should be midline to the vertebral column (transverse process are equal length)
how much rotation is required to visualize the zygapophyseal joints properly at the L5-S1 level ?
which specific set of zygapophyseal joints is demonstrated with an LAO position ?
the ? which is the eye of the "Scottie dog" should be near the center of the vertebra body on a correctly oblique lumbar spine projection ?
which positioning error has been committed if the structure s described in the previous question are projected too far positioning with a 45degree oblique position of the lumbar spine ?
which position of projection of the lumbar spine series best demonstrates a possible compression fracture ?
a patient with a wide pelvis and narrow thorax may require a central ray of ? degrees ? for a lateral position of the lumbar spine
5-8 degrees, caudad
how should the spine of a patient with scoliosis be positioned for a lateral position of the lumbar spine ?
with the sag or convexity of the spine closest to the IR
why should the knees and hips be flexed for an AP lumbar spine projection ?
reduces lumbar curvature which opens the intervertebral disk space
true/false: the female ovarian dose used for a PA lumbar spine projection is approximately 25-30% less than the dose for an AP projection ?
where is the central ray centered for a lateral L5-S1 projection of the lumbar spine ?
1 1/2 inches inferior to iliac crest and 2 inches posterior to ASIS
what amount and direction of central ray angulation is required for an AP axial L5-S1 projection on a male patient ?
30 degree cephalad
true/false: a PA or a PA projection for a scoliosis series frequently includes one erect and one recumbent position for comparison ?
false, lower margin 1-2 inches below iliac
which of the following techniques or devices produce a more uniform density along the vertebral column for an AP/PA scoliosis projection ?
which side of the spine should be elevated for the second exposure for the AP/PA projection (Ferguson method) scoliosis series (by having the patient stand on a block with one foot) ?
the convex side of the foot
for the Ferguson method the elevated foot must be raised a minimum of ?
during the AP/Pa right and left bending projections of the lumbar spine the ? serves as a fulcrum during positioning
which projection should be taken to evaluate flexibility following spinal fusion surgery ?
hyperextension nd hyperflexion lateral projections
what is the recommended kV range for lateral hyperflexion and hyperextension positions of the spine for a digital imaging system?
how much central ray angulation is required for an AP projection of the sacrum for a typical male patient ?
15 degrees cephalad
where is the CR centered for an AP axial projections of the sacrum ?
2 inches superior to pubic symphysis
if a patient cannot lie on his back for the AP sacrum because it is too painful what alternate projection can be taken to achieve a similar view of the sacrum ?
a PA prone with 15 degree caudad CR angle
where is the central ray centered for an AP projection of the coccyx ?
2 inches superior to the symphysis pubis
how much is the CR angled for the AP axial coccyx projection ?
10 degree caudad
true/false: the AP projections of the sacrum and coccyx can be taken as one singe projection to decrease gonadal dose?
false, need different CR angles
patients should be asked to empty the urinary bladder before performing which projections of the vertebral column ?
AP of sacrum and coccyx
in addition to good collimation what should be done to minimize overall "fogging" on a lateral lumbar spine or lateral sacrum and coccyx radiograph ?
place a lead blocker on tabletop behind patient
which sacroiliac joint is visualized with an RPO position ?
how much rotation of the body is required for oblique positions of the SI joints ?
25-30 degrees cephalad
what type of CR angle is recommended for the AP axial projection of the SI joint on a female patient ?
35 degree cephalad
where is the CR centered for a oblique projection of the SI joint ?
1 inch medial from upside ASIS
a radiograph of an AP projection of the lumbar spine shows that the spinous processes are not midline to the vertebral column and distortion of the vertebral bodies is present. which specific positioning error is present on this radiograph ?
rotation of the spine
a radiograph of an LPO projection of the lumbar spine shows that the downside pedicles and zygapophyseal joints are projected over the anterior portion of the vertebral bodies. which specific positioning error is present on this radiograph ?
insufficient rotation of the spine (pedicle "eye" should be to midvertebral bodies)
a radiograph of a lateral projection of a female lumbar spine shows that the mid to lower intervertebral joint spaces are not open the technologist supported the midsection of the spine with sponges to straighten the spine. what else can be done to open the joint spaces during the repeat exposure ?
if the patient has a wide pelvis the central ray can be angled 5 to 8 degree caudad
a radiograph of a lateral L5-S1 projection shows that the joint space is not open the technologist did support the middle aspect pf the spine with a sponge what else can the technologist do to open up the joint space during the repeat exposure ?
place additional support beneath the spine, or use a 5- to 8 degree caudad angel
a radiograph of an AP axial projection of the coccyx shows that the distal tip is superimposed over the symphysis pubis what must the technologist do to eliminate this problem during the repeat exposure ?
an increase in central ray angle is required to separate the coccyx form the symphysis pubis
a radiograph of an oblique position of the lumbar spine shows that the downside pedicle and zygapophyseal joint are posterior in relation to the vertebral body. what modification of the position must be during the repeat exposure to produce a more diagnostic image ?
decrease rotation of the body and spine
(situation) a patient comes to the radiology department for a follow up study for a compression fracture of L3 the radiologist request that collimate projections be taken of L3 which specific projections and centering would provide a quality study of L3 and the intervertebral joint space ?
AP or PA and collimated lateral projection would provide the best view of the L3 region the central ray should be about 2 inches above the iliac crest
(situation) a young female patient comes to the radiology department for a scoliosis series. she has had repeated radiation exposure throughout a period of time and is understandably concerned about the radiation. what three things can the technologists do to minimize the dose delivered to the patients breast ?
A, use high Kv technique B, perform a PA rather than an AP projection C, use breast shields
(situation) a patient with an injury to the coccyx enters the emergency room. when attempting the AP projection the patient complains that it is too uncomfortable to lie on his back. he is unable to stand what other options are available to compete the study ?
perform a PA rather than an AP projection and reverse the direction of the central ray from caudad to cephalad
(situation) a patient with a clinical history of spondylolisthesis at the L5-S1 level comes to the radiology department which specific lumbar spine positions is most diagnostic in demonstrating the extent of this condition ?
a lateral L5-S1 position would demonstrate the degree of forward displacement of L5 onto S1
a positioning series for sacroiliac joints is performed on a patient the resultant radiographs do not demonstrate the inferior portion of the joints, what can be done during the repeat exposure to demonstrating this aspect of the SI joint ?
the CR should be angled 15 to 20 degree cephalad
a patient comes to the radiology department for a lumbar spine series he has a clinical history of advanced spondylolysis which specific projections of the lumbar spine series will best demonstrate this condition ?
although AP and lateral projections of the lumbar sine are helpful posterior or anterior oblique positions best demonstrate advanced signs of spondylolysis
a patient comes to the radiology department with a clinical history of HNP which of the following imaging modalities provides the most diagnostic study or this condition ?
(situation) a patient comes to the radiology department for a lumbar spine study following spinal fusion surgery her surgeon wants a study to assess mobility of the spine at the fusion site which radiographic positions provide this information ?
hyperflexion and hyperextension lateral positions
a patient comes to the radiology department for a lumbar spine series she has a clinical history of severe kyphosis how should the lumbar spine series be modified for this patient ?
routine lumbar spine projections should be performed erect
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