Lumbar Spine for Radiology

Cards

Front Back
IR for AP Lumbar 14x17
SID for AP Lumbar 48 inches
Patient lower body position for AP Lumbar hips and knees flexed
IR position for AP Lumbar centered 1.5 inchest above iliac crests
Breathing instructions for AP Lumbar suspend at end of respiration
CR position for AP Lumbar perpendicular to IR
What vertebrae is centered for AP Lumbar L3
Position of patient for lateral lumbar patient on left side, hips and knees flexed
How do you prevent rotation in the lateral lumbar? Knees should be exactly superimposed and a small sponge placed between them.
Why is an unlevel spine optimal in a lateral lumbar? divergent beam opens up joint space
IR size for lateral lumbar? 14x17
IR position for lateral lumbar? Center 1.5 inches above iliac crests
Breathing instructions for lateral lumbar? suspend at end of respiration
CR position for lateral lumbar? Perpendicular to IR, 1.5 inches above iliac crests.
CR enters what line of the body? Mid-axillary line
How can radiographic quality be improved in the lateral lumbar? placing a lead strip behind patient
What purpose does the lead strip serve in the lateral lumbar? it absorbs scatter from patient and table
CR centering for L5-S1 2 inches posterior to ASIS and 1.5 inchest inferior to iliac crest
CR angle for L5-S1 5 degrees caudally for male and 8 degrees for females
Francis method for L5-S1 to demonstrate interspace when spine is not horizontal Draw an imaginary line between the two points of interiliac plane and then angle CR to be parallel with line.
What is the purpose of the L5-S1? opening joint space makes the posterior aspects of vertebrae more clearly visualized
Breathing instructions for L5-S1 suspend on respiration
The plane of the zygopophyseal joints of lumbar vertebrae form what angle? 30 to 60 degrees midsagittally
How many degrees of rotation for the AP Oblique for zygopophyseal joints? 45 degrees
When joints are of interest in the AP Oblique? Closest
In the oblique plane, the lumbar spine lies in the longitudinal plane that passes where? 2 inchest medial to elevated ASIS
Breathing instructions for AP Oblique Zygapophyseal joints? suspend at the end of expiration
CR position for the AP Oblique Zygapophyseal joints in lumbar region 2 inches medial to elevated ASIS and 1.5 inchest above iliac crests
CR position for the AP Oblique Zygapophyseal joints for 5th zygapophyseal joint 2 inches medial to elevated ASIS and midway between iliac crest and ASIS
What technique would you use for the AP Oblique Zygopophyseal joint? Manual, based off the AP
Which joints are of interest in PA Oblique Zygopophyseal joint? Furthest from IR
Patient position for PA Oblique Zygopophyseal joint 45 degree angle, L3 centered to midline of grid.
CR positioning for PA Oblique Zygapophyseal joints perpendicular to enter L3 (1.5 inches above iliac crests) and entering elevated side 2 inches lateral to palpable spinous process.
IR size for AP Axial Projection of Lumbosacral Junction and SI joints 8x10, lengthwise
Breathing instructions for AP Axial Projection of Lumbosacral Junction and SI joints Suspend respiration
CR position for AP Axial Projection of Lumbosacral Junction and SI joints Directed throught lumbosacral joint at 30-35 degrees cephalad, about 1.5 inchest superior to public symphysis for AP.
What is the average angle of degree for males and females in AP Axial Projection of Lumbosacral Junction and SI joints? 30 for men and 35 for women
IR centering for AP Axial Projection of Lumbosacral Junction and SI joints 2 inches above pubic sypmphysis
The pieces of bone that border the inferior and superior vertebral notches are pedicles
Why is the PA Axial Projection of Lumbosacral Junction and SI joints used instead of AP? PA opens SI joints and decreases OID with divergent beam
What will occur if you center too low for the AP Axial Projection of Lumbosacral Junction and SI joints Pelvic bones will obscure SI joints
In the AP Oblique position for sacroiliac joints, which side is of interest? Side farthest from IR
What is the degree of obliquity for AP Oblique SI joints? 25-30 degrees
Typical degree of obliquity for males for AP Oblique SI joints and why. 25 degrees; because their iliac wings are more narrow
Alignment of body for AP Oblique SI joints Sagittal plane passing 1 inch medial to ASIS of elevated side is centered to midline of grid
IR centering for AP Oblique SI joints at level of the ASIS
Breathing instructions for AP Oblique projection SI joints Suspend respiration
CR positioning for AP Oblique SI joints perpendicular to IR, one inch medial to elevated ASIS
Which side is of interest in PA Oblique SI joints Side closer to IR
Patient position in PA Oblique SI joints 25-30 degrees, balanced on forearm and flexed knee
Body position in PA Oblique SI joints a point 1 inch medial to ASIS closest to IR is centered to grid
IR positioning for PA Oblique SI joints centered at level of ASIS
breathing instructions for PA Oblique SI joints suspend respiration
CR positioning for PA Oblique SI joints perpendicular to IR and centered 1 inch medial to the ASIS closest to IR
What size IR for AP and PA Axial sacrum and coccyx 8x10
Patient position for AP and PA axial sacrum and coccyx Supine
Breathing instructions for AP and PA Axial sacrum and coccyx Suspend respiration
CR for AP Axial Sacrum Sacrum: supine:15 degrees cephalad, 2 inchest superior to pubic symphysis
IR size for Lateral sacrum and coccyx 8x10
Patient position for Lateral sacrum and coccyx patient on left side, hips and knees flexed
Place a support under the lumbar spine to achieve what in the Lateral sacrum and coccyx placing the spine horizontal and the interiliac plane perpendicular to IR
How do you prepare for accurate positioning for Lateral sacrum and coccyx Adjust pelvis and shoulders to ensure true lateral and center sacrum and coccyx to midline of grid
CR for Lateral sacrum perpendicular to level of ASIS and 3.5 inches posterior and
How to improve radiographic quality for Lateral sacrum and coccyx use a lead strip
What vertebrae is centered to when doing PA Lumbar intervertebral disks? L3
What scouts are used for PA Lumbar intervertebral disks One of the patient bending to the left and bending to the right
CR for PA Lumbar intervertebral disks perpedicular to L3 at an angle of 15 to 20 degrees caudal
IR for Lumbar Spine: spinal fusion 14x17
Patient position for Lumbar Spine: spinal fusion lateral recumbent; 1st: patient is bent forward, knees pulled up, 2nd: lean backwards and bend thighs backwards
What can be used to decrease movement in Lumbar Spine: spinal fusion compression band
IR centering for Lumbar Spine: spinal fusion centered at level of spinal fusion
CR for Lumbar Spine: spinal fusion perpendicular to spinal fusion area or L3
Breathing instructions for Lumbar Spine: spinal fusion suspend on respiration
What is the term used to describe an abnormal, excessive amount of the normal curvature of the thoracic region? kyphosis
What is the term used to describe the normal curvature of the cervical spine? lordotic
What is the term used to describe the normal curvature of the lumbar spine? lordotic
What is the term used to describe the abnormal lateral bending and rotation of the vertebral column? scoliosis
The intervertebral disc is composed of two parts. The soft, semigelatinous inner portion is: nuclus pulposus
The intervertebral disc is composed of two parts.The fibrous, outer portion is the: annulus fibrosus
The vertebral arch is attached to the body of the vertebra by what structures? pedicles
The transverse processes are connected to the spinous process by what structures? lamina
The small bony area between the superior and inferior articular processes that is part of the lamina is the: pars interarticularis
In the structural classification system, what is the intervertebral joint? cartilaginous symphysis
What is the term used to describe a defect in the lamina of a vertebra just caudal to the pedicle that may allow the gradual forward displacement of the vertebral column? spondylolysis
Spondylolysis most often occurs in what vertebra? 5th lumbar
What is the term used to describe the gradual forward displacement of the vertebra that occurs as a result of the defect spondylolysis? spondylolisthesis
When the two sides of the vertebral arch failure to unite and is possibly only a slight defect to almost complete failure of the arch to appear is known as spina bifida
The most anterior, superior portion of the sacrum is called the: sacral promintory
the holes in the anterior surface of the sacrum that allow for the passage of nerves and vessels are anterior sacral foramina
The holes in the posterior surface of the sacrum that allow for the passage of nerves and vessels are the posterior sacral foramina
How many segments fuse to form the sacrum? 5
Describe the CR (degree, direction, centering) for the AP axial projection of the sacrum. 15 degrees cephalad and centered to a point 2 inches superior to pubic symphysis.
Describe the CR (degree, direction of angulation, centering) for the AP axial projection of the coccyx. 10 degrees caudal and center 2 inches superior to pubic symphysis
With the patient in a posterior oblique position for the lumbar spine, are the zygapophyseal joints demonstrated those cloese or farthest from film? closest
The zygapophyseal joints in the T12-L5 region and in the L5-S1 region will require differing degrees of obliquity of the patient. What are they and why? Thoracic joints are 70 degrees and the angle of the lumbar vertebrae are angling back to 90 degrees.
The patient is in the RAO position for demonstration of the zygapophyseal joints in the lumbar region. Are the joints demonstrated those on the right or left? left
Describe the CR (direction, angulation, centering) when performing the AP axial projection of the L5-S1 interspace. 30-35 cephalad, 1.5 inches superior to pubic symphysis
How does the sex of the patient influence the degree of angulation used for the AP projection of the L5-S1 interspace? females have greater angle in L5-S1, resulting in more tube angle
Descibe the CR (degreee, direction, centering) of the central ray for demonstration of the lateral L5-S1 joint space perpendicular to coronal plane 2 inches posterior to ASIS and 1.5 inches inferior to iliac crests
In order to place the lumbar spine in a postion closer to the film and decrease the amount of lordotic curvature for an AP radiograph, how do you position the patient? bend knees up
If there is an angle for the L5-S1 joint space, what is it? 5 degrees in males, 8 degrees in females
To determine the exact angle on L5-S1, what is used? the interiliac line (Francis)
Where does the central ray enter the patient for demonstration of the lateral sacrum? perpendicular and directed to level of ASIS and to a point 3.5 inches posterior
What would you do if the doctor requested an xray to evaluate the pars interarticularis on L5? rotate patient 45 degrees for AP oblique
How does one determine the angle to use for demonstration of the lateral L5-S1 joint space? Exact- by the interiliac line (Francis), not by sex or inexact- sex of the patient
Describe the patient position, and the CR, for the AP oblique of the SI joints Pt supine, head elevated, CR perpendicular to center of IR, entering 1 inch medial to elevated ASIS
Describe patient position, and the CR, for the AP axial of the SI joints Patient supine, abducted thighs, extended lower limbs, CR angled 30-35 degrees cephalad, 1.5 inchest superior to pubic symphysis.
CR position for PA Axial projection of lumbosacral junction and SI joints Directed through lumbosacral joint, angled 30-35 degrees caudal for PA.
CR for PA Axial Coccyx 15 degrees caudal and center to sacral curve
CR for AP Axial Coccyx 10 degrees caudad and center 2 inches superior to pubic symphysis
CR for PA Axial Coccyx 10 degrees cephalad and center to coccyx
CR for Lateral Coccyx perpendicular and 3.5 inchest posterior to ASIS and 2 inches inferior