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Radiology Positioning > L-Spine > Flashcards

L-Spine Flashcards

1
Q

what occupies the posterior abdominal region

A

lumbar vertabrae

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2
Q

How many vertebrae are in the lumbar

A

5

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3
Q

what are the unique features of the lumbar

A

Transverse processes are smaller than T-spine
Pars interarticularis – part of lamina between articular processes

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4
Q

what is the part of lamina between articular processes

A

pars interarticularis

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5
Q

what is seen on the obliques in the lumbar spine

A

Zygapophyseal joint
Seen on obliques
45degrees

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6
Q

what is seen on the laterals for the lumbar spine

A

Intervertevbral Foramen
Seen on Lateral
90degrees

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7
Q

Formed by fusion of five sacral segments into curved, triangular bone

A

sacrum

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8
Q

wedged between iliac bones of pelvis

A

articulation=sacroilliac (SI) joints

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9
Q

Curves inferiorly and anteriorly from articulation with sacrum

A

Coccyx

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10
Q

Formed by fusion of three to five rudimentary vertebrae

A

Coccyx

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11
Q

Anatomic features for coccyx.

A

Cornu

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12
Q

Anatomic features
of sacrum

A

Promontory
Canal
Foramina
Cornu

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13
Q

how is the body different in the lumbar

A

broader

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14
Q

how is the lamina in the lumbar spine

A

shorter

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15
Q

how is the spinous processes in the lumbar

A

shorter and broader

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16
Q

where is the apex and base on the coccyx

A

apex at the bottom and base at the top

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17
Q

essential projections for L spine

A

AP
Lateral
Lateral L5-S1
AP oblique
RPO
LPO
AP axial lumbosacral (LS) junction and SI joints (Ferguson)

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18
Q

patient position for AP L spine

A

Supine or upright

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19
Q

part position for AP L Spine

A

MSP centered to midline

Shoulders and hips in same horizontal plane

Arms crossed on chest

Reduce lordosis by flexing hips and knees to place lower back closer to table

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20
Q

CR for AP L spine

A

perp to IR

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21
Q

CR For lumbosacral exams

A

enters patient at iliac crests (L4)

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22
Q

CR For lumbar only

A

enters patient at 1½ inches (3.8 cm) above iliac crests (L3)

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23
Q

what does the lateral L spine demonstrate

A

Lateral L-spine demonstrates
intervertebral foramina

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24
Q

part position for lateral L spine

A

True lateral with MCP vertical
Knees flexed and superimposed
Arms, with elbows flexed, at right angle to body
Place radiolucent support under lower spine to place horizontal, if needed

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25
patient position for lateral L spine
Recumbent or upright Use same as for AP
26
CR for Lateral L spine
Perpendicular to IR Enters patient on MCP at iliac crests (L4)
27
if spine is not horizontal for the lateral L spine , what should the degree of angulation be?
horizontal, angle caudad 5 to 8 degrees More for females
28
Part position for L5-S1
MCP perpendicular to IR Hips extended Superimposed knees, may be slightly flexed With elbows flexed, place arms at right angle to body Support lower spine in horizontal position in same manner as for lateral projection
29
CR for Lateral L5-S1
When spine is horizontal, perpendicular to a coronal plane 2 inches (5 cm) posterior to anterior superior iliac spine (ASIS) and 1½ inches (3.8 cm) inferior to iliac crest If not, angle 5 degrees caudad for males, 8 degrees caudad for females
30
if the spine is not horizontal for L5-S1 what degree of angulation should be used?
If not, angle 5 degrees caudad for males, 8 degrees caudad for females
31
what does the oblique projection of the lumbar vertebrae demonstrate?
Oblique projections demonstrate zygapophyseal joints of most lumbar vertebrae.
32
Patient position for AP Oblique L-Spine
Patient position Recumbent or upright Use same position as AP
33
Part position for AP Oblique L-Spine
45-degree posterior oblique position
34
CR for AP oblique L spine
CR Perpendicular to IR Enters patient 2 inches (5 cm) medial to elevated ASIS at L3 (1½ inches or 3.8 cm above iliac crests
35
KNOW SCOTTIE DOG
ear= superior articular process body=lamina leg=inferior articular process eye=pedicle nose= transverse process neck= pars interarticularis
36
what does it mean if the pedicle is anterior on the vertebral body in the obliques for L spine
which means that the patient is not rotated enough.
37
what does it mean if the pedicle is posterior on the vertebral body in the obliques for L spine
which means that the patient is rotated too much.
38
patient position for AP Axial (ferguson)
Supine
39
part position for AP Axial (Ferguson )
MSP centered to IR Extend lower limbs, or abduct thighs and place vertical
40
what is the degree of angulation for AP axial (ferguson)
Angled cephalad 30 to 35 degrees Use less angle on males, more on females
41
CR for AP Axial Ferguson
Angled cephalad 30 to 35 degrees Enters patient on MSP at 1½ inches (3.8 cm) above pubic symphysis
42
are you able to do the L spine PA Axial as well ?
Note: May also be performed with patient in prone position (PA axial) with CR angle 35 degrees caudad. Only AP axial is referred to as Ferguson method.
43
Essential projections for the SI joints
AP oblique RPO LPO 25-35 degrees
44
what side is being best demonstrated in the AP oblique SI joints
SI joint farther from IR is demonstrated (elevated side).
45
patient position for AP oblique SI joints
supine
46
part position for AP oblique si joints
25- to 30-degree posterior oblique position Support body in position Long axis parallel with table IR centered at level of ASIS
47
how much should the patients body be rotated for the ap oblique SI joints
25 to 30 degrees posterior oblique position
48
CR for AP oblique SI joints
Perpendicular to IR Enters patient 1 inch (2.5 cm) medial to elevated ASIS
49
if you are doing a pa oblique si joint what side is being shown
LAO shows left joint
50
Essential Projections: Sacrum and Coccyx
Sacrum -AP axial -Lateral Coccyx -AP axial -Lateral
51
patient position for Ap axial sacrum
Supine May also be performed with patient prone (PA axial projection), if needed for comfort
52
Part position for ap axial sacrum
MSP in midline of table ASIS equidistant from table Arms in comfortable, symmetric position out of field Support knees, if supine
53
how much of an angle is needed for ap axial coccyx
10degrees caudal (AP) 10 degrees cephalic if PA
54
how many degrees is needed for ap axial sacrum
15degrees cephalic(supine)
55
CR for ap axial sacrum
Enters MSP at 2 inches (5 cm) superior to pubic symphysis For prone – enters MSP at level of sacral curve
56
patient position for AP/PA axial coccyx
Supine or prone Choose position that maximizes patient comfort
57
Part position for AP/PA Axial Coccyx
Same as used for sacrum
58
CR for AP/PA Axial Coccyx
Enters MSP at 2 inches (5 cm) superior to pubic symphysis For PA, enters MSP at coccyx
58
patient position for lateral sacrum
Patient position Recumbent lateral Hips and knees flexed for comfort Arms at right angle to body Knees superimposed Support spine to horizontal position Interiliac plane perpendicular to IR Shoulders and pelvis in true lateral MCP vertical Sacrum centered to IR
59
CR for lateral sacrum
CR Perpendicular to level of ASIS and to a point 3½ inches (9 cm) posterior
60
patient position for lateral coccyx
Patient position Recumbent lateral Hips and knees flexed for comfort Arms at right angle to body Knees superimposed Support spine to horizontal position Interiliac plane perpendicular to IR Shoulders and pelvis in true lateral MCP vertical
61
CR for lateral coccyx
Perpendicular to 3½ inches (9 cm) posterior and 2 inches (5 cm) inferior to ASIS Close collimation improves visibility
62
Typical scoliosis examination may include
PA (or AP) upright PA (or AP) upright with lateral bending Lateral upright (with or without bending) PA (or AP) recumbent
63
Demonstrates amount/degree of curvature that occurs with force of gravity acting on body
Scoliosis Radiography
64
Also used to evaluate fixation devices, such as Harrington rods
Scoliosis Radiography
65
Bending studies used to differentiate between primary and compensatory curves
Scoliosis Radiography
66
Patient position Scoliosis: PA Thoracolumbar
Upright, facing vertical Bucky
67
Part position Scoliosis: PA Thoracolumbar
Ensure MCP parallel to Bucky Arms abducted and not in field
68
CR for Scoliosis: PA Thoracolumbar
Perpendicular to Bucky
69
Patient position Scoliosis: Lateral Thoracolumbar
Upright, lateral
70
Part position Scoliosis: Lateral Thoracolumbar
MCP perpendicular to Bucky Arms at right angle to body
71
CR Scoliosis: Lateral Thoracolumbar
Perpendicular to Bucky
72
Scoliosis: PA Thoracolumbar (Ferguson)
First radiograph taken in same manner as previously described PA Second PA radiograph taken with patient’s convex side elevated 3 to 4 inches (7.6 to 10.2 cm)
73
what view is compensating so both sides are level?
Scoliosis: PA Thoracolumbar (Ferguson)
73
where on the sacrum does a lot of injuries occur
base at top L5 joint S1
74
SID for AP L spine
40 inches
75
recomended breathing for AP L spine
Respiration suspended at end of expiration
76
what needs to be included in a lateral L spine
-L5, S1 junction -open disc space -intervertebral foramen
77
what lateral is standard for lumbar spine and why would you possibly change it
standard is left lateral but for scoliosis it is better to do a Right lateral
78
in the lateral L5-S1 how is the IR and CR to the interilliac line
IR is perp to interilliac line and the CR is parallel to interilliac line
79
what is AP Axial (ferguson) done for
Its done for L5-S1 *to open up the joint spaces
80
what is SI joints typically done for
arthiritis
81
what is the recommended breathing for the AP and PA oblique L spine
Respiration suspended at end of expiration
82
what is the SID for AP and PA oblique L spine
40 inches
83
what is the recomended breathing for the lateral lumbar
Respiration suspended at end of expiration
84
what is the SID for lateral lumbar
40 inches
85
what is a lateral curvature of the spine
scoliosis
86
why do we do ap or pa
ap- definition pa- radiation protection
87
what do you do to your technique for peristalsis or any movement of the bowels
increase mA decrease time
88
how is the spine in the thoracic and lumbar for scoliosis
right in thoracic, left in lumbar
89
what can you do for motion
decrease time, communicate better with patient
90
what is the breathing technique and SID for L5-S1 LUMBO- SACRAL JUNCTION
respiration suspended and 40 inches
91
recomended breathing for SI joints and SID
Respiration suspended 40” SID
92
what is the recomended breathing and SID for sacrum and coccyx
Respiration suspended 40” SID
93
what is the breathing and SID for lumbar spine
respiration suspended and 40 inches
94

Radiology Positioning (8 decks)

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