Lumbars and Such

Question 1

Where does the ID blocker go for the lumbosacral views?

Answer 1

UP (away from anatomy)

Question 2

What are the breathing instructions for all lumbosacral views?

Answer 2

Exhale and hold

Question 3

Why is the breathing instruction for lumbosacral views exhale and hold?

Answer 3

Expiration elevates the diaphragm to get it out of the way

Question 4

Which has a center BELOW the iliac crest: lumbo-pelvic or lumbar spine?

Answer 4

Lumbo-pelvic

Question 5

Which has a center ABOVE the iliac crest: lumbo-pelvic or lumbar spine?

Answer 5

Lumbar spine

Question 6

Where is the caliper measurement for the AP lumbo-pelvic?

Answer 6

A-P at the THICKEST part of the abdomen

Question 7

Where does the CR go for the AP lumbopelvic for both genders?

Answer 7

1 inch below crest for females, 2 inches below for males (due to pelvic girdle differences)

Question 8

What anatomy must be present for the AP lumbopelvic film?

Answer 8

L1 to ischial tuberosities

Question 9

Where should the bottom of the film be for the AP lumbopelvic film?

Answer 9

1 inch below ischial tuberosities or 3 inches below top of greater trochanter

Question 10

Where should the male shield be placed for the AP lumbopelvic?

Answer 10

Just below pubic arch (1.5 inches below top of symphysis)

Question 11

Where should the female shield be placed for the AP lumbopelvic?

Answer 11

Bottom tip (of heart) just superior to pubic symphysis and position widest part just medial and inferior to ASIS

Question 12

What should you do if L1 gets clipped with an AP lumbopelvic film?

Answer 12

Separate L1 AP shot

Question 13

What should you do if the ischial tuberosities get clipped with an AP lumbopelvic film?

Answer 13

Move film and CR down and take again

Question 14

What two pieces of anatomy should be specifically checked for symmetry following an AP lumbopelvic film?

Answer 14

Iliac wings and obturator foramina

Question 15

We must be careful to now allow the male shield to cover what pieces of anatomy in the AP lumbopelvic?

Answer 15

Symphysis or bottom of ischial tuberosities

Question 16

Where does the CR go for a lateral lumbar?

Answer 16

1 inch ABOVE crest (around L3) and midway between ASIS and PSIS on midaxillary line

Question 17

A shield is used for what lumbosacral views?

Answer 17

ONLY lumbopelvic (and AP full spine)

Question 18

What is the collimation for a lateral lumbar film?

Answer 18

10x17

Question 19

What do we do for a lateral lumbar when we have a patient with hips larger than the waist?

Answer 19

Add filter down to crest

Question 20

If the patient presents with a global curvature, which side should go next to the bucky?

Answer 20

Side of convexity

Question 21

What additional view should you take it L5/S1 is too light on a lateral lumbar?

Answer 21

Lateral L5/S1 spot shot

Question 22

Where do we measure with calipers for a L5/S1 spot shot?

Answer 22

Right to left 2-3 inches BELOW crest

Question 23

What is the collimation for a L5/S1 spot shot?

Answer 23

8x10 (10x12 film size)

Question 24

Where does the CR go for a L5/S1 spot shot?

Answer 24

2-3 inches below crest and 1 inches posterior to midline

Question 25

What is the purpose of oblique lumbar films?

Answer 25

View pars

Question 26

What is the angle of rotation for anterior oblique lumbars?

Answer 26

45 for uppers and 30 for lowers

Question 27

What pars are being viewed with a RAO lumbar film?

Answer 27

LEFT

Question 28

What pars are being viewed with a LAO lumbar film?

Answer 28

RIGHT

Question 29

Where does the CR go for an anterior oblique lumbar film?

Answer 29

1 inch above crest and 1 inch lateral to spine toward side of interest (which pars you want to see)

Question 30

The CR would go to which side of the spine for a RAO? LAO?

Answer 30

RAO toward left side of spine; LAO toward right side of spine

Question 31

What is a benefit for recumbent anterior oblique lumbars?

Answer 31

Flattens out tissue therefore requiring 30% less mAs (McLean prefers these)

Question 32

What side touches the bucky with oblique lateral films?

Answer 32

Side of interest

Question 33

Where is the CR for a posterior lumbar oblique?

Answer 33

1 inch above the crest and 2 inches medial to ASIS closest to tube

Question 34

Why are anterior oblique lumbars preferred compared to the posteriors?

Answer 34

Less exposure to patient and also shooting into natural curvature

Question 35

On which lumbar view can we see IVFs?

Answer 35

Lateral (NOT OBLIQUES like the cervicals)

Question 36

Where is the CR for an AP sacrum view?

Answer 36

Perpendicular to sacrum with 15 degree cephalic tube tilt

Question 37

What is the purpose of the 15 degree cephalic tube tilt of the AP sacrum view?

Answer 37

Open and elongate sacrum

Question 38

Where is the CR for a lateral sacrum view?

Answer 38

3 inches below crest and 1 inch posterior to mid-axillary line

Question 39

Why does the CR need to be 1 inch posterior to the mix-axillary plane for sacral films?

Answer 39

Sacrum lies posterior to rest of spine

Question 40

What is the collimation for the AP coccyx?

Answer 40

4x4

Question 41

What is the tube tilt associated with the AP coccyx?

Answer 41

10 degree caudal tilt

Question 42

What is the CR for the lateral coccyx?

Answer 42

Center 2 inches posterior to greater trochanter

Question 43

What is the collimation for the lateral coccyx?

Answer 43

Collimate to part size

Question 44

Where does the ID blocker go for the AP full spine?

Answer 44

UP

Question 45

What cassette size is used for the AP full spine?

Answer 45

14x36

Question 46

What is the patient placement for the AP full spine?

Answer 46

Arms abducted against full-spine bucky

Question 47

What is the collimation for the AP full spine?

Answer 47

Open so it's just below the eyes and 3 inches below the pubis symphysis (14 inches wide, of course)

Question 48

What is the SID for AP full spine?

Answer 48

72

Question 49

What is filtered with AP full spine view?

Answer 49

Upper thoracics down to axilla

Question 50

What are the breathing instructions for the AP full spine film?

Answer 50

Inhale and hold

Question 51

Which lumbosacral views have the CR above the crest? Below?

Answer 51

``` Above = lateral and obliques Below = AP and lateral L5/S1 spot ```

Question 52

What is the collimation for AP sacrum?

Answer 52

10x12

Question 53

What is the collimation for the APLP?

Answer 53

14x17