Chp 9: L-Spne, Sacrum, And Coccyx

Front 1

A portion of the lamina located between the superior and inferior articular processes is called the ________.

Back 1

Pars interarticularis

Front 2

The superior and inferior vertebral notches join together to form the:

Back 2

Intervertebral Foramina

Front 3

Which radiographic position best demonstrates the Intervertebral foramina?

Back 3

Lateral position

Front 4

Label A-G

Back 4

A. Pedicle

B. Transverse processes

C. Superior articular process and facet

D. Lamina

E. Spinous process

F. This CR best demonstrates Zygapophyseal Joints

G. This CR best demonstrates Intervertebral Foramina

Front 5

Would the degree of angle to demonstrate the Zygapophyseal joints be greater or lesser for the lower lumbar vertebrae compared with the upper?

Back 5

50 degree for upper, 30 degree for lower vertebrae to the midsagittal plane.

Front 6

The small foramina found in the sacrum are called:

Back 6

Pelvic Sacral Foramina

Front 7

The anterior and superior aspect of the sacrum that forms the posterior wall of the pelvic inlet is called the:__

Back 7

Promontory

Front 8

What is another term for the sacral horns?

Back 8

Cornua

Front 9

The sacroiliac joints lies at an oblique angle of ____ degrees to the coronal plane?

Back 9

30 Degrees

Front 10

What is the formal term for the tail bone?

Back 10

Coccyx

Front 11

What is the name for the superior broad aspect of the coccyx?

Back 11

base

Front 12

What classification, mobility type, and movement type is the zygapophyseal joint?

Back 12

Synovial, diarthodial, plane

Front 13

What classification, mobility type, and movement type is the intervertebral joint?

Back 13

Cartilaginous, ampiarthrodial, none

Front 14

Label A-F

Back 14

A. Intervertebral disk space of L1-L2

B. Spinous Process of L2

C. Transverse process of L3

D. Region of lamina (body) of L4

E. Left ala of sacrum

F. Left sacroiliac joint

Front 15

Label G-K

Back 15

G. Body of L1

H. Pedicles of L2

I. Intervertebral foramina

J. Intervertebral disk space of L5-S1

K. Sacrum

Front 16

label L-Q

Back 16

L. Inferior articular process of L3

M. Zygapophyseal joint of L4-L5

N. Pars Interarticularis (neck) of L3

O. Pedicle of L3

P. Transverse process of L3 (nose)

Q. Superior articular process of L3 (ear)

Front 17

What joint or foramina is demonstrated in a LPO?

Back 17

Left Zygapophyseal Joint

Front 18

What joint or foramina is demonstrated in a RAO?

Back 18

Left Zygapophyseal Joint

Front 19

What joint or foramina is demonstrated in a Lateral

Back 19

Intervertebral Foramina

Front 20

What joint or foramina is demonstrated in a RPO?

Back 20

Right zygapophyseal joint

Front 21

What joint or foramina is demonstrated in a LAO?

Back 21

Right zygapophyseal joint

Front 22

The degree of obliquity required for an oblique projection at the T12-L1 level is approximately ____ degrees, whereas the L5-S1 level spine requires a(n) _____ degree oblique. Therefore, a(n) _____ degree oblique is performed for general lumbar spine?

Back 22

50 degrees, 30 degrees, 45 degrees

Front 23

What vertebral level is the ASIS at?

Back 23

S1-S2

Front 24

What vertebral level is the Xiphoid Process at?

Back 24

T9-T10

Front 25

What vertebral level is the Lower Costal Margin at?

Back 25

L2-L3

Front 26

What vertebral level is the Iliac Crest at?

Back 26

L4-L5

Front 27

What vertebral level is the Symphysis Pubis at?

Back 27

Tip of Coccyx

Front 28

T or F: The use of higher kV and lower mAs for L-spine radiography improves radiographic contrast but increases patient dose?

Back 28

False

Front 29

T or F: Placing a lead blocker mat behind the patient for lateral lumbar spine positions improves image quality

Back 29

True

Front 30

T or F: Gonadal shielding should always be used for male and female patients for studies of the L-Spine, Sarcrum, and coccyx

Back 30

False

Front 31

T or F: The AP projection of the L-Spine opens the intervertebral joint spaces better than than the PA projection

Back 31

False

Front 32

T or F: The knees and hips should be extended for an AP projection of the L-Spine

Back 32

False

Front 33

T or F: An increased SID of 44-46 inches reduces distortion of spine anatomy?

Back 33

True

Front 34

T or F: The lead blocker mat and close collimation must not be used when performing digital imaging of the L-Spine

Back 34

False

Front 35

With a 14x17 IR, the CR is centered at the level of the _____ for AP and lateral L-Spine projections

Back 35

Iliac Crest

Front 36

Which two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the L-Spine?

Back 36

A. SI joints are equidistant from the spine

B. Spinous process should be midline to the vertebral column (transverse processes are equal length)

Front 37

How much rotation is required to properly visualize the zygapophyseal joints at the L5S1 level?

Back 37

30 degrees

Front 38

Which specific set of zygapophyseal joints is demonstrated with an LAO position?

Back 38

Right (upside)

Front 39

The _____, which is the eye of the "Scottie dog", should be near the center of the vertebral body on a correctly obliqued lumbar spine.

Back 39

Pedicle

Front 40

Which positioning error has been committed if the pedicle is projected too far posterior with a 45 degree oblique position of the L-spine?

Back 40

Excessive rotation

Front 41

Which position or projection of the L-spine series best demonstrates a possible compression fracture?

Back 41

Lateral

Front 42

A patient with a wide pelvis and narrow thorax may require a CR angle of ______ degrees _____ for a lateral position of the L-spine?

Back 42

5-8 degrees caudad

Front 43

How should the spine of a patient with scoliosis be positioned for a lateral position of the L-Spine?

Back 43

With the sag or convexity of the spine closest to the IR

Front 44

Why should the knees and hips be flexed for an AP lumbar spine projection?

Back 44

Reduces lumbar curvature which opens up the intervertebral disk space

Front 45

Where is the CR centered fora lateral L5-S1 projection of the L-spine?

Back 45

1.5 inches inferior to the iliac crest and 2 inches posterior to ASIS

Front 46

What amount and direction of CR angulation is required for an AP Axial L5-S1 projection on a male patient?

Back 46

30 degrees cephalad

Front 47

T or F: A PA or AP projection for a scoliosis series frequently includes one erect and one recumbent position for comparison

Back 47

True

Front 48

T or F: The lower margin of the cassette must include the pubic symphysis for a scoliosis series

Back 48

False

Front 49

T or F: A PA projection for a scoliosis series produces only about 1/10 the dose to the breasts as compared with the AP projection, even if proper collimation is used

Back 49

True

Front 50

Which once of the following techniques or devices produces a more uniform density along the vertebral column for an AP/PA scoliosis projection?

a. use of a 14X36 inch cassette

b. lower kV

C. Higher mAs

D. Compensating Filter

Back 50

D. Compensating Filter

Front 51

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)?

Back 51

The Convex side of the spine

Front 52

During the AP (PA) right and left bending projectiions of the L-spine, the _____ must remain stationary during positioning.

Back 52

pelvis

Front 53

Which projections should be taken to evaluate flexibility following spinal fusion surgery?

Back 53

Hyperextension and Hyperflexion

Front 54

How much CR angulation is required for an AP projection of the sacrum for a typical male patient?

Back 54

15 degrees cephalad

Front 55

If a patient cannot lie on his back for the AP sacrum because it is too painful, what alternate projection scan be taken to achieve a similar view of the sacrum?

Back 55

A PA prone with 15 degree caudad CR angle

Front 56

Where is the CR centered for an AP projection of the Coccyx?

Back 56

2 inches superior to pubic symphysis

Front 57

T or F: The AP projections of the sacrum and coccyx can be taken as one single projection to decrease gonadal dose.

Back 57

False

Front 58

Patients should be asked to empty the urinary bladder before performing which projection(s) of the vertebral column?

Back 58

AP Sacrum and Coccyx

Front 59

In addition to good collimation, what should be done to minimize overall "fogging" on a lateral lumbar spine or lateral sacrum and coccyx radiograph?

Back 59

Place lead blocker on tabletop behind patient

Front 60

Which sacroiliac (SI) joint is visualized with an RPO position?

Back 60

Left

Front 61

How much rotation of the body is required for oblique positions of the SI joints?

Back 61

25-30 degrees

Front 62

What type of CR angle is recommended for the AP axial projection of the SI joints on a female patient?

a. 20 degrees cephalad

b. 30 degrees cephalad

c. 30 degrees caudad

d. 35 degrees cephalad

Back 62

d.35 degrees cephalad

Front 63

Where is the CR centered for an oblique projection of the SI joints?

Back 63

1 inch medial from upside

Front 64

A radiograph of an AP projection of the lumbar spine reveals 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?

Back 64

Rotation of the spine

Front 65

A radiograph of an LPO projection of the lumbar spine reveals 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?

Back 65

insufficient rotation of the spine

Front 66

A radiograph of a lateral projection of a female lumbar spine reveals 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?

Back 66

If the patient has a wide pelvis the CR can be angled 5-8 degrees with caudad

Front 67

A radiograph of a lateral L5-S1 projection reveals that the joint space is not open. The technologist did support the middle aspect of the spine with a sponge. What else can the technologist do to open up the joint space during the repeat exposure?

Back 67

Place additional support beneath spine or use a 5-8 degree caudad angle

Front 68

A radiograph of an AP axial projection of the coccyx reveals that the distal tip is superimposed over the symphysis pubis. What must the technologist do to eliminate this problem during the repeat exposure?

Back 68

An increase in CR angle is required to separate the coccyx from the pubic symphysis.

Front 69

A radiograph of an oblique position of the lumbar spine reveals that the downside pedicle and zygapophyseal joint are posterior in relation to the vertebral body. What modification of the position must be made during the repeat exposure to produce a more diagnostic image?

Back 69

Decrease rotation of the body and spine

Front 70

A patient comes to the radiology department for a follow-up study for a compression fracture of L3. The radiologist requests that collimated projections be taken of L3. Which specific projections are centering would provide a quality study of L3 and the intervertebral joint spaces.

Back 70

AP or PA and collimated lateral projections would provide the best view of the L3 region, CR 2inches above the the iliac crest

Front 71

A young female patient comes to the radiology department for a scoliosis series. She has had repeated radiation exposure over a period of time and is understandably concerned about the radiation. What 3 things can the technologist do to minimize the dose delivered to the patient's breasts?

Back 71

1. use high kV technique

2. Perform PA rather than AP

3. Use breast shield

Front 72

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 complete this study?

Back 72

Perform a PA rather than an AP projection and reverse the direction of the CR from caudad to cephalad.

Front 73

A patient with a clinical history of spondyloisthesis at the L5-S1 level comes to the radiology department. Which specific lumbar spine position is most diagnostic in demonstrating the extent of this condition?

Back 73

Lateral L5-S1 position would demonstrate the degree of forward displacement

Front 74

A positioning series for SI 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 demonstrate this aspect of the SI joints?

Back 74

The CR should be angled 15-20 degrees cephalad

Front 75

A patient comes to the radiology department for a lumbar spine series. He has a clinical history of advanced spondylolysis. Which specific projection(s) of the lumbar spine series will best demonstrate this condition?

Back 75

AP/PA and lateral of L-spine are helpful but posterior/anterior projections best demonstrates signs of spondylolysis

Front 76

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?

Back 76

Hyperflexion and hyperextension laterals

Front 77

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?

Back 77

Routine projections done erect