Procedures Chapter 10 L-Spine, Sacrum, Coccyx

Front 1

intervertebral foramina are spaces or openings between ________ when two vertebrae are stacked on each other.

Back 1

pedicles

Front 2

The intervertebral foramina in the lumbar region are best demonstrated on a ________ radiographic image

Back 2

lateral

Front 3

The intervertebral foramen are situated ______ degrees relative to the midsagittal plane

Back 3

90 degrees

Front 4

When vertebra are stacked, the superior and inferior vertebral notches line up and form a single opening called the _________

Back 4

intervertebral foramina

Front 5

Label
Lateral Lumbar Vertebra

Back 5

Front 6

How many articular processes does each typical lumbar vertebra have?

Back 6

Four

Front 7

The zygapophyseal joints form an angle open from ____ to ____ degrees to the midsagittal plane.

Back 7

30 to 50 degrees

Front 8

Demonstration of the zygapophyseal joints is achieved by rotating the patients body an average of _____ degrees

Back 8

45 degrees

Front 9

The portion of each lamina between the superior and inferior articular processes is the ____________

Back 9

pars interarticularis

Front 10

in which position is the pars interarticularis demonstrated?

Back 10

oblique lumbar image

Front 11

Label
Lumbar superior view

Back 11

Front 12

______ are the large masses of bone lateral to the 1st sacral segment

Back 12

Alae (wings)

Front 13

The CR projection labeled A in this drawing would best demonstrate the ________________

Back 13

Zygapophyseal joints

Front 14

The CR projection labeled B would best demonstrate the _____________

Back 14

Intervertebral foramina

Front 15

The upper or proximal lumbar vertebrae are nearer to a ______ degree angle while the lower or distal vertebra are nearer to a ______ degree angle.

Back 15

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.

Front 16

Label the sacrum

Back 16

Front 17

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 ____________

Back 17

promontory

Front 18

This is a continuation of the vertebral canal and contains certain sacral nerves.

Back 18

sacral canal

Front 19

Another term for sacral horns

Back 19

cornua

Front 20

This is formed by fused spinous processes of the sacral vertebrae

Back 20

median sacral crest

Front 21

What does the sacrum articulate with?

Back 21

ilium of the pelvis

Front 22

What is the surface called where the sacrum articulates with the ilium of the pelvis

Back 22

auricular surface

Front 23

Each sacroiliac joint opens obliquely and posteriorly at an angle of _______

Back 23

30 degrees

Front 24

Whats the formal name for the tail bone?

Back 24

coccyx

Front 25

Whats the name for the upper broad aspect of the coccyx?

Back 25

Base

Front 26

Whats the most distal portion of the vertebral column?

Back 26

coccyx

Front 27

An average of _____ coccygeal segments have fused in the adult to form the single coccyx.

Back 27

four

Front 28

The distal pointed tip of the coccyx is termed the _______

Back 28

apex

Front 29

This photograph shows the vertebra in a __________ oblique position and demonstrates the _________ of the zygapophyseal joint

Back 29

This photograph shoes the vertebra in a posterior oblique position and demonstrates the downside of the zygapophyseal joint

Front 30

This figure represents a ________ oblique projections and demonstrates the _______ zygapophyseal joints.

Back 30

This figure represents a anterior oblique projections and demonstrates the upside zygapophyseal joints.

Front 31

The zygapophyseal joints of the L-spine are classified as _________, have a _________ mobility type, and a ________ movement

Back 31

The zygapophyseal joints of the L-spine are classified as synovial, have a diarthrodial mobility type, and a plane (gliding) movement

Front 32

The intervertebral joints of the L-spine are classified as _________, and have an ________ mobility type.

Back 32

The intervertebral joints of the L-spine are classified as cartlaginous and have an amphiarthodial mobility type.

Front 33

Name the vertebral level of each landmark

Back 33

Front 34

Identify what each part of the scottie dog represents on the vertebra

Back 34

Front 35

What does the eye of the scottie dog represent on a oblique lumbar vertebrae?

Back 35

pedicle

Front 36

Which zygapophyseal joint is demonstrated with an LAO position of the lumbar spine?

Back 36

Right upside joints

Front 37

What does the nose of the scottie dog represent on a oblique lumbar vertebrae ?

Back 37

transverse process

Front 38

What does the neck of the scottie dog represent on a oblique lumbar vertebrae?

Back 38

pars interarticularis

Front 39

What does the leg of the scottie dog represent on a oblique lumbar vertebrae?

Back 39

inferior articular process

Front 40

What does the ear of the scottie dog represent on a oblique lumbar vertebrae?

Back 40

superior articular process

Front 41

The ASIS is at the level of _______

Back 41

S1-2

Front 42

The xiphoid tip is at the level of ______

Back 42

T9-T10

Front 43

The lower costal margin is at the level of ______

Back 43

L2-3

Front 44

The Iliac crest is at the level of _______

Back 44

L4-L5

Front 45

The Symphysis pubis is at the level of
_________

Back 45

tip of coccyx

Front 46

Does the AP or PA projection of the lumbar spine open the intervertebral joint spaces better?

Back 46

PA

Front 47

Should the knees be extended or slightly flexed for a AP projection of the lumbar spine?

Back 47

slightly flexed

Front 48

True of False

It would be advantageous to increase the SID to 44 or 46 inches for AP and lateral lumbar projections.

Back 48

true

Front 49

Where is the CR centered for AP lumbar projection?

Back 49

CR centered to level of iliac crest

Front 50

What should the collimation width be for AP lumbar projection

Back 50

collimation width to the SI joints

Front 51

Where is the CR for oblique lumbar spine

Back 51

CR is 1½ inches (4 cm) above iliac crest

2 inches (5 cm) medial to upside ASIS

Front 52

Which two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the lumbar spine

Back 52

1.) sacroiliac joints should be equidistant from the spine

2.) spinous process should be midline to the vertebral column

Front 53

Where should the pedicle (which is the eye of the scottie dog) be on a well positioned oblique lumbar spine

Back 53

center of the vertebral body

Front 54

If the eye of the scottie dog is projected too far posterior on a obl lumbar spine what positioning error has occurred?

Back 54

excessive rotation

Front 55

Which position or projection of the lumbar spine best demonstrates a compression fracture?

Back 55

lateral

Front 56

A patient with a wide pelvis and narrow thorax may require a central ray of?

Back 56

5-8 degrees caudal

Front 57

How should the spine of a patient with scoliosis be positioned for a lateral position of the lumbar spine?

Back 57

with the convexity of the spine closest to the IR

Front 58

Where is the CR for the L5-S1 lateral L-spine projection

Back 58

CR 1½ inches (4 cm) inferior to iliac crest and 2 inches (5 cm) posterior to ASIS

Front 59

What is this picture pointing to?

Back 59

zygapophyseal joint

Front 60

What type of angulation is required for an AP axial L5-S1 projection of a male patient

Back 60

30 degrees cephalad

Front 61

When performing a L5-S1 projection, if the abdomen is blocked it helps placed the interiliac line _______ to the IR

Back 61

perpendicular

Front 62

When performing the L5-S1 projection it may be necessary to angle _________ for a patient with a large waist

Back 62

cephalad

Front 63

the coccyx curves ________and _________ from articulation with sacrum

Back 63

the coccyx curves inferiorly and anteriorly from articulation with sacrum

Front 64

Where should the lower margin of the IR be for a scoliosis series

Back 64

1 to 2 inches below iliac crests

Front 65

Which side of the spine should be elevated for the second exposure for the Ferguson scoliosis series.

Back 65

convex side of the spine by having patient stand on a block with one foot.

Front 66

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

Back 66

15 degrees cephalad

Front 67

where is the CR for an AP of the coccyx?

Back 67

2 inches superior to the symphysis pubis

Front 68

The _______ projection of the sacrum and coccyx can be combined to decrease gonadal dose

Back 68

lateral

(AP cannot be combined because different CR angles are required)

Front 69

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

Back 69

AP of sacrum and coccyx

Front 70

Which sacroiliac joint is demonstrated with a RPO position

Back 70

Left joint (always upside)

Front 71

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

Back 71

25-30 degrees

Front 72

Which sacroiliac joint is demonstrated for a LPO position?

Back 72

right side (always the side that's up)

Front 73

Where is the CR for posterior OBL SI joints?

Back 73

CR perpendicular 1 inch medial to upside ASIS

Front 74

What type of fracture is in this picture?? described as anterior wedging of the vertebrae with loss of body height.

Back 74

Compression fracture

Front 75

What can cause a compression fracture?

Back 75

trauma, osteoporosis or metastatic disease.

Front 76

Name the fracture that results from hyperflexion force that causes fx through the vertebral body and posterior elements.

Back 76

Chance Fracture

Front 77

for which fracture are pts at risk when wearing lap type seat belts acting as a fulcrum during sudden deceleration

Back 77

chance fracture

Front 78

What are mostly malignant neoplasms that spread to distant sites through blood and lymphatics.

Back 78

matastases

Front 79

This can be visualized as destructive with irregular margins and decreased densities, osteoblastic, with increased densities or a combination of both.

Back 79

matastases

Front 80

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

Back 80

spina bifida

Front 81

Forward movement or slipping of one vertebra in relation to another
Usually occurs at L5-S1

Back 81

spondylolisthesis

Front 82

Why is this a bad lateral ?

Back 82

Upper thorax region rotated, no marker

Front 83

Why is this a bad L5-S1

Back 83

L5-S1 joint space is not open
waist support of caudal angle needed
underexposed

Front 84

Label

Back 84

Front 85

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

Back 85

rotation of the spine

Front 86

If on a LPO lumbar spine the downside pedicles and zygapophyseal joints are projected over the anterior portion of the vertebral bodies

Back 86

it's insufficient rotation because the pedicles should be to midverterbral bodies.

Front 87

For lumbar obliques, the pedicle demonstrated posteriorly on the vertebral body indicates ____________, and the pedicle demonstrated anteriorly on the vertebral body indicates ___________

Back 87

For lumbar obliques, the pedicle demonstrated posteriorly on the vertebral body indicates overrotation and the pedicle demonstrated anteriorly on the vertebral body indicates underrotation

Front 88

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?

Back 88

increase angle to separate

Front 89

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?

Back 89

patient is over rotated, decrease rotation.

Front 90

If a pt is in too much pain from a coccyx injury to perform an exam AP, what other options are available?

Back 90

PA instead of AP and reverse the CR angle from caudal to cephalad.

Front 91

Which degree of rotation will best demonstrate the zygapophyseal joints at the L1-L2 vertebral level?

Back 91

50 degrees

Front 92

Which of the following projections will best demonstrate the left zygapophyseal joints of the lumbar spine?

RPO
LAO
RAO
Lateral

Back 92

RAO

_____________________
Posterior = the same
Posterior = downside
Anterior = opposite
Anterior = upside

Front 93

which position best demonstrates advanced spondylolysis?

Back 93

posterior and anterior obliques best demonstrate advanced signes of spondylolysis.

Front 94

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?

Back 94

hyperflexion and hyperextension laterals