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94 Cards in this Set
- Front
- Back
intervertebral foramina are spaces or openings between ________ when two vertebrae are stacked on each other.
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pedicles
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The intervertebral foramina in the lumbar region are best demonstrated on a ________ radiographic image
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lateral
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The intervertebral foramen are situated ______ degrees relative to the midsagittal plane
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90 degrees
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When vertebra are stacked, the superior and inferior vertebral notches line up and form a single opening called the _________
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intervertebral foramina
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Label
Lateral Lumbar Vertebra |
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How many articular processes does each typical lumbar vertebra have?
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Four
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The zygapophyseal joints form an angle open from ____ to ____ degrees to the midsagittal plane.
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30 to 50 degrees
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Demonstration of the zygapophyseal joints is achieved by rotating the patients body an average of _____ degrees
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45 degrees
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The portion of each lamina between the superior and inferior articular processes is the ____________
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pars interarticularis
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in which position is the pars interarticularis demonstrated?
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oblique lumbar image
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Label
Lumbar superior view |
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______ are the large masses of bone lateral to the 1st sacral segment
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Alae (wings)
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The CR projection labeled A in this drawing would best demonstrate the ________________
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Zygapophyseal joints
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The CR projection labeled B would best demonstrate the _____________
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Intervertebral foramina
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The upper or proximal lumbar vertebrae are nearer to a ______ degree angle while the lower or distal vertebra are nearer to a ______ degree angle.
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The upper or proximal lumbar vertebrae are nearer to a 50 degree angle while the lower or distal vertebra are nearer to a 30 degree angle.
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Label the sacrum
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The anterior ridge of the body of the first sacral segment helps to form the posterior wall of the inlet of the true pelvis and is termed the ____________
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promontory
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This is a continuation of the vertebral canal and contains certain sacral nerves.
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sacral canal
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Another term for sacral horns
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cornua
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This is formed by fused spinous processes of the sacral vertebrae
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median sacral crest
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What does the sacrum articulate with?
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ilium of the pelvis
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What is the surface called where the sacrum articulates with the ilium of the pelvis
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auricular surface
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Each sacroiliac joint opens obliquely and posteriorly at an angle of _______
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30 degrees
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Whats the formal name for the tail bone?
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coccyx
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Whats the name for the upper broad aspect of the coccyx?
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Base
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Whats the most distal portion of the vertebral column?
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coccyx
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An average of _____ coccygeal segments have fused in the adult to form the single coccyx.
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four
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The distal pointed tip of the coccyx is termed the _______
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apex
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This photograph shows the vertebra in a __________ oblique position and demonstrates the _________ of the zygapophyseal joint
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This photograph shoes the vertebra in a posterior oblique position and demonstrates the downside of the zygapophyseal joint
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This figure represents a ________ oblique projections and demonstrates the _______ zygapophyseal joints.
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This figure represents a anterior oblique projections and demonstrates the upside zygapophyseal joints.
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The zygapophyseal joints of the L-spine are classified as _________, have a _________ mobility type, and a ________ movement
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The zygapophyseal joints of the L-spine are classified as synovial, have a diarthrodial mobility type, and a plane (gliding) movement
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The intervertebral joints of the L-spine are classified as _________, and have an ________ mobility type.
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The intervertebral joints of the L-spine are classified as cartlaginous and have an amphiarthodial mobility type.
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Name the vertebral level of each landmark
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Identify what each part of the scottie dog represents on the vertebra
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What does the eye of the scottie dog represent on a oblique lumbar vertebrae?
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pedicle
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Which zygapophyseal joint is demonstrated with an LAO position of the lumbar spine?
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Right upside joints
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What does the nose of the scottie dog represent on a oblique lumbar vertebrae ?
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transverse process
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What does the neck of the scottie dog represent on a oblique lumbar vertebrae?
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pars interarticularis
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What does the leg of the scottie dog represent on a oblique lumbar vertebrae?
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inferior articular process
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What does the ear of the scottie dog represent on a oblique lumbar vertebrae?
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superior articular process
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The ASIS is at the level of _______
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S1-2
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The xiphoid tip is at the level of ______
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T9-T10
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The lower costal margin is at the level of ______
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L2-3
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The Iliac crest is at the level of _______
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L4-L5
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The Symphysis pubis is at the level of
_________ |
tip of coccyx
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Does the AP or PA projection of the lumbar spine open the intervertebral joint spaces better?
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PA
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Should the knees be extended or slightly flexed for a AP projection of the lumbar spine?
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slightly flexed
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True of False
It would be advantageous to increase the SID to 44 or 46 inches for AP and lateral lumbar projections. |
true
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Where is the CR centered for AP lumbar projection?
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CR centered to level of iliac crest
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What should the collimation width be for AP lumbar projection
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collimation width to the SI joints
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Where is the CR for oblique lumbar spine
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CR is 1½ inches (4 cm) above iliac crest
2 inches (5 cm) medial to upside ASIS |
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Which two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the lumbar spine
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1.) sacroiliac joints should be equidistant from the spine
2.) spinous process should be midline to the vertebral column |
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Where should the pedicle (which is the eye of the scottie dog) be on a well positioned oblique lumbar spine
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center of the vertebral body
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If the eye of the scottie dog is projected too far posterior on a obl lumbar spine what positioning error has occurred?
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excessive rotation
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Which position or projection of the lumbar spine best demonstrates a compression fracture?
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lateral
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A patient with a wide pelvis and narrow thorax may require a central ray of?
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5-8 degrees caudal
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How should the spine of a patient with scoliosis be positioned for a lateral position of the lumbar spine?
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with the convexity of the spine closest to the IR
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Where is the CR for the L5-S1 lateral L-spine projection
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CR 1½ inches (4 cm) inferior to iliac crest and 2 inches (5 cm) posterior to ASIS
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What is this picture pointing to?
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zygapophyseal joint
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What type of angulation is required for an AP axial L5-S1 projection of a male patient
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30 degrees cephalad
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When performing a L5-S1 projection, if the abdomen is blocked it helps placed the interiliac line _______ to the IR
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perpendicular
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When performing the L5-S1 projection it may be necessary to angle _________ for a patient with a large waist
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cephalad
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the coccyx curves ________and _________ from articulation with sacrum
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the coccyx curves inferiorly and anteriorly from articulation with sacrum
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Where should the lower margin of the IR be for a scoliosis series
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1 to 2 inches below iliac crests
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Which side of the spine should be elevated for the second exposure for the Ferguson scoliosis series.
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convex side of the spine by having patient stand on a block with one foot.
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How much CR angulation is required for an AP projection of the sacrum for a typical male patient?
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15 degrees cephalad
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where is the CR for an AP of the coccyx?
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2 inches superior to the symphysis pubis
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The _______ projection of the sacrum and coccyx can be combined to decrease gonadal dose
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lateral
(AP cannot be combined because different CR angles are required) |
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Patients should be asked to empty the bladder before performing which projection of the vertebral column?
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AP of sacrum and coccyx
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Which sacroiliac joint is demonstrated with a RPO position
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Left joint (always upside)
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How much rotation of the body is required for oblique positions of the SI joints
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25-30 degrees
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Which sacroiliac joint is demonstrated for a LPO position?
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right side (always the side that's up)
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Where is the CR for posterior OBL SI joints?
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CR perpendicular 1 inch medial to upside ASIS
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What type of fracture is in this picture?? described as anterior wedging of the vertebrae with loss of body height.
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Compression fracture
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What can cause a compression fracture?
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trauma, osteoporosis or metastatic disease.
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Name the fracture that results from hyperflexion force that causes fx through the vertebral body and posterior elements.
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Chance Fracture
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for which fracture are pts at risk when wearing lap type seat belts acting as a fulcrum during sudden deceleration
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chance fracture
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What are mostly malignant neoplasms that spread to distant sites through blood and lymphatics.
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matastases
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This can be visualized as destructive with irregular margins and decreased densities, osteoblastic, with increased densities or a combination of both.
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matastases
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Failure of the posterior elements of the vertebrae to close, exposing part of the spinal cord.
Varies in severity and occurs most often at L5 |
spina bifida
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Forward movement or slipping of one vertebra in relation to another
Usually occurs at L5-S1 |
spondylolisthesis
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Why is this a bad lateral ?
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Upper thorax region rotated, no marker
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Why is this a bad L5-S1
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L5-S1 joint space is not open
waist support of caudal angle needed underexposed |
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Label
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An AP lumbar radiograph reveals that the spinous processes are not midline to the vertebral column and the vertebral bodies are distorted. Name the positioning error
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rotation of the spine
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If on a LPO lumbar spine the downside pedicles and zygapophyseal joints are projected over the anterior portion of the vertebral bodies
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it's insufficient rotation because the pedicles should be to midverterbral bodies.
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For lumbar obliques, the pedicle demonstrated posteriorly on the vertebral body indicates ____________, and the pedicle demonstrated anteriorly on the vertebral body indicates ___________
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For lumbar obliques, the pedicle demonstrated posteriorly on the vertebral body indicates overrotation and the pedicle demonstrated anteriorly on the vertebral body indicates underrotation
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An AP axial coccyx projection reveals that the distal tip of the coccyx is superimposed over the symphysis pubis? what can be done to correct this?
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increase angle to separate
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An OBL lumbar radiograph reveals the downside pedicle and zygapophyseal joint are posterior in relation to the vertebral body, what needs to be done to fix this?
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patient is over rotated, decrease rotation.
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If a pt is in too much pain from a coccyx injury to perform an exam AP, what other options are available?
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PA instead of AP and reverse the CR angle from caudal to cephalad.
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Which degree of rotation will best demonstrate the zygapophyseal joints at the L1-L2 vertebral level?
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50 degrees
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Which of the following projections will best demonstrate the left zygapophyseal joints of the lumbar spine?
RPO LAO RAO Lateral |
RAO
_____________________ Posterior = the same Posterior = downside Anterior = opposite Anterior = upside |
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which position best demonstrates advanced spondylolysis?
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posterior and anterior obliques best demonstrate advanced signes of spondylolysis.
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A patient has just had spinal fusion surgery, the surgeon wants to asses mobility of the spine at the fusion site, which position is best?
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hyperflexion and hyperextension laterals
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