Lumbosacral and Full Spine

Question 1

Why should the patient exhale?

Answer 1

elevates the diaphragm

Question 2

Which lumbosacral/full spine views require shielding of the gonads?

Answer 2

APLP and AP Full Spine only

Question 3

Would “fluffy” patients take better films standing or recumbent?

Answer 3

recumbent (fat spreads out)

Question 4

When MUST a lumbar film be taken recumbent?

Answer 4

when ruling out fracture

Question 5

Where is the center of the lumbo-pelvic area? center of the lumbar spine?

Answer 5

below the iliac crest;

above crest

Question 6

What films are centered on the lumbar spine rather than the lumbo-pelvic area?

Answer 6

laterals and obliques

Question 7

Where do you measure (on the patient) before taking an APLP?

Answer 7

anterior to posterior at THICKEST part of abdomen

Question 8

Film size for APLP?
CR for APLP?
What anatomy should be included in the light field?

Answer 8

14x17;
1” below crest for females, 2”below crest for males;
1” below ischial tubes, 1”below xiphoid (L1-Tubes)

Question 9

Shields:
Who gets a heart?
Who gets the bell?

Answer 9

Girls get hearts,

Boys get bells

Question 10

Ideally, where should the shield be for males?

Answer 10

1.5” below top of symphysis (just below pubic arch)

Question 11

Ideally, where should the shield be for females?

Answer 11

bottom tip just above pubic symphysis

Question 12

Why would you palpate both ischial tubes while placing your patient?

Answer 12

in case they had differing leg lengths

Question 13

What do you do if L1 i clipped? If ischial tubes are clipped?

Answer 13

take a separate AP shot of L1;

move film and CR down and reshoot

Question 14

T/F: it’s ok if the male shied overlaps the top of the symphysis or bottom of the ischial tubes.

Answer 14

False, not ok

Question 15

CR for lateral lumbar?
collimation?
film size?

Answer 15

1” above crest, midaxillary;
10x17;
14x17

Question 16

If the patient has a lateral lumbar curve, which side do you place next to the bucky?

Answer 16

convex side

Question 17

For patients with hips larger than waist what should be filtered when taking lateral lumbar?

Answer 17

filter down to crest

Question 18

T/F: Sacrum is included in lateral lumbar films.

Answer 18

false; at least not all of sacrum

Question 19

collimation for lateral lumbar?

Answer 19

collimate into part size

Question 20

Where do you measure for a L5-S1 (lateral) spot films

Answer 20

2-3” below crest

Question 21

Film size for L5-S1 lateral spot film? CR? Collimation?

Answer 21

10x12;
2-3” below crest, 1” posterior to midline;
8x10

Question 22

Film size for anterior oblique lumbars? patient rotation for upper lumbars? for lower lumbars?

Answer 22

1012;
45 degrees for uppers;
30 degrees for lowers

Question 23

T/F: RAO=left pars and LAO= right pars

Answer 23

True

Remember CAOS?

Question 24

CR for RAO?

Answer 24

1”above crest and 1” lateral to spine toward the left side of the patient (looking at left pars with RAO)

Question 25

How much less mAs is needed for a recumbent anterior oblique as opposed to the standing?

Answer 25

30% less mAs

Question 26

For an RPO (looking at right pars), what part of the patient should be touching the bucky (or closest to it)?

Answer 26

right posterior side

Question 27

film size for posterior obliques? patient rotation? CR?

Answer 27

10x12; 30-45 degree; Cr 1" above crest, ~2" medial to ASIS closest to the tube

Question 28

Why are anterior obliques preferred over posterior obliques?

Answer 28

less exposure and shoots into the natural curvature of the spine

Question 29

Should you see the IVFs on a posterior oblique? anterior oblique?

Answer 29

neither

Question 30

What views do we take of the Sacrum?

Answer 30

AP Sacrum and Lateral Sacrum

Question 31

Where do you measure for an AP Sacrum?

Answer 31

A-P mid-way between ASIS and PS (mid pelvis)

Question 32

Tube tilt for AP Sacrum?

Answer 32

15 degree cephalic

Question 33

Film size for AP sacrum? CR? Breathing instructions?

Answer 33

10x12; 2" below ASIS (mid pelvis); Don't breathe, don't move

Question 34

Film size for Lateral Sacrum? | CR?

Answer 34

10x12; | 3" below crest and 1" posterior to mid-axillary plane

Question 35

Why do we center posterior to mid-axillary plane for lateral sacrum?

Answer 35

sacrum is posterior to the rest of spine

Question 36

Views for Coccyx?

Answer 36

AP coccyx and Lateral coccyx

Question 37

Film size for AP Coccyx? tube tilt? CR? Collimation?

Answer 37

10x12; 10 degrees caudal; mid pelvis; part size (4x4)

Question 38

Film size for Lateral Coccyx? CR? collimation?

Answer 38

10x12; 2" posterior to greater trochanter; collimate to part size

Question 39

When taking a Sacrum/Coccyx Combo, ow would you get a 2 for 1?

Answer 39

load cassette with 2 films, filter coccyx, OR adjust image digitally

Question 40

film size for AP Full Spine? Patient positioning? Collimation?

Answer 40

14x36; back to bucky, arms abducted, upper occlusal plane parallel to floor; collimate just below the eyes and 3"below pubic symphysis, and 14" wide

Question 41

SID for AP Full Spine? Mouth open or closed? filter? breathing instructions?

Answer 41

72"; can be open OR closed; filter upper thoracics down to axilla; inhale and hold

Question 42

What 5 views make up the series when taking a Full Spine view?

Answer 42

``` AP 14x36, APOM, Lat C-spine, Lat T-spine, Lat L-spine ```

Question 43

How many views are needed to do a full sectional series (without doing an AP full spine)? What are they?

Answer 43

``` 7; AP C-spine, APOM, Lat C, AP T, Lat T, APLP, Lat L ```

Question 44

Collimation for APLP? Lateral Lumbar? L5S1 Spot? AP Sacrum?

Answer 44

14x17; 10x17; 8x10; 10x12

Question 45

T/F: LAO/RPO=left pars

Answer 45

False; LAO/RPO=right pars | RAO/LPO=left pars