Chapter 9 lumbar spine, sacrum, and coccyx,
1. A portion of the lamina located between the superior and inferior process is called the?
2. The superior and inferior vertebral notches join together to form the?
3. Which radiographic position best demonstrates the intervertebral foramina?
4. The small foramina found in the sacrum are called?
Pelvic sacral foramina
5. The anterior and superior aspect of the sacrum that forms the posterior wall of the pelvic inlet is called the?
6. What is another name for the sacral horns?
7. The sacroiliac joints lie at an oblique angle of? to the coronal plane
8. What is the formal term for the tail bone?
9. What is the name for the superior broad aspect of the coccyx?
10. Classification, mobility, and movement type for Zygapopseal joint?
synovial, dIarthroidal, plane, or gliding
11. Classification, mobility, and movement type for Intervertebral Joints
cartilaginous, amphiarthrodial, no movement
12. List the specific joints or foramina that are demonstrated with the LPO position
Left zygapophyseal joints
13. List the specific joints or foramina that are demonstrated with the RAO position
Left zygapophyseal joints
14. List the specific joints or foramina that are demonstrated with the Lateral position
15. List the specific joints or foramina that are demonstrated with the RPO position
Right zygapophyseal joints
16. List the specific joints or foramina that are demonstrated with the LAO position
Right zygapophyseal joints
17. The degree of obliquity required for an oblique projection at the T12- L1 level is approximately
18 The L5-S1 level spine requires a ___ degree oblique
19. A ___ oblique is performed for the general lumbar spine.
20. ASIS is at what vertebral level
21. Xiphoid process is at what vertebral level
22. Lower costal margin is at what vertebral level
23. Iliac crest is at what vertebral level
24. Symphysis pubis is at what vertebral level
Tip of coccyx
25. True or False: The use of higher kV and lower mA seconds for a lumbar spine improves contrast but increases patient dose?
26. True or False: Placing a lead blocker mat behind the patient for a lateral spine position improves image quality?
27. True or False: Gonadal shielding should always be used for male and female patients for studies of the lumbar, sacrum and coccyx.
28. True or False: The anteroposterior (AP) projection of the lumbar spine opens the intervertebral joint spaces better than the PA projection.
29. True or False: The knees and hips should be extended for an AP projection of the lumbar spine.
30. True or False: An increased SID of 44 or 46 reduces distortion of spine anatomy.
31. True or False: The lead blocker mat and close collimation must not be used when performing digital imaging or the lumbar spine.
32. What is the best modality that demonstrates the pathological features of osteoporosis
33. What is the best modality that demonstrates the pathological features of soft tissues of lumbar spine
34. What is the best modality that demonstrates the pathological features of structures within the subarachnoid space
35. What is the best modality that demonstrates the pathological features of Inflammatory condition such as pagets disease
36. What is the best modality that demonstrates the pathological features of compression fractures of the lumbar spine
37. Lateral curvature of the vertebral column
38. Fracture of the vertebral body caused by hyperflexion force
39. Congenital defect in which the posterior elements of the vertebral fail to unite.
40. Most common at the L4-L5 level and may result in sciatica
Herniated nucleus pulposus
41. Forward displacement of one vertebra onto another vertebra
42. Inflammatory condition that is most common in males in their thirties
43. Dissolution and separation of the pars interarticularis
44. A type of fracture that rarely causes neurologic deficits
45. CR is centered at the level of ____ for an AP and lateral lumbar spine projections
46. What two structures can be evaluated to determine whether rotation is present on a radiograph of an AP projection of the lumbar spine?
Sacroiliac joints and Spinous process
47. How much rotation is required to properly visualize the zygapophyseal joints at L5-S1?
48. What set of zygapophyseal joints is demonstrated with an LAO position?
49. The _______ which is the eye of the "scottie dog" should be near the center of the vertebral body on a correctly obliqued lumbar spine?
50. Which positioning error has been committed if the "eye of the scottie dog" are projected too far posterior with a 45 oblique position of the lumbar spine
51. Which position or projection of the lumbar spine series best demonstrates a possible compression fracture?
52. A patient with a wide pelvis and narrow thorax may require a CR angle of ___ with caudad or cephalad for a lateral position of the lumbar spine
5 to 8 degress caudad
53. How should the spine of a patient with scoliosis be positioned for a lateral position of the lumbar spine
With the sag or convexity of the spine closest to the IR
54. Why should the knees and hips be flexed for an AP lumbar spine projection?
Reduces lumbar curvature, which opens the intervertebral disk space
55. True or False: the female ovarian dose used for a PA lumbar spine projection is approximately 30 percent less than the dose from an AP projection
56. Where is the CR centered for a lateral L5-S1 projection of the lumbar spine
1 1/2 inches inferior to the iliac crest and 2 inches posterior to ASIS
57. What amount of CR angle is required for an AP axial L5-S1 projection on a male patient.
30 degrees cephalad
58. True or False: PA or AP projection for a scoliosis series frequently includes one erect and one recumbent position for comparison.
59. True or False: 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.
60. Which techniques or devices produce a more uniform density along the vertebral column for an AP/PA scoliosis projection.
61. Which side of the spine should be elevated for the second exposure for the AP/PA projection scoliosis series (by having patient stand on a block with one foot.
The convex side of the spine
62. During the AP (PA) right and left bending projections of the lumbar spine, the ___ must remain stationary during positioning.
63. Which projections should be taken to evaluate flexibility following spinal fusion surgery?
Hyperextension and hyperflexion projections
64. How much CR angle is required for an AP projection of the sacrum for a typical male patient?
15 degrees cephalad
65. If a patient can not lie on his back for the AP sacrum because it is too painful, what alternative projection can be taken to achieve a similar view of the sacrum?
A PA with 15 degrees Caudad CR angle
66. Where is the CR for an AP projection of the coccyx.
2 inches superior to the pubis symphysis
67. True or False: The AP projection of the sacrum and coccyx can be taken as one single projection to decrease gonadal dose.
68. Patients should be asked to empty the urinary bladder before performing which projection fo the vertebral column?
AP of sacrum and coccyx
69. In addition to good collimation, what should be done to minimize overall "fogging" on a lateral lumbar spine or lateral sacrum and coccyx radiograph
Place led blocker table top behind patient
70. Which SI joint is visualized with an RPO position
71. How much rotation of the body is required for oblique position of SI joints
25 to 30 degrees
72. What type of CR angle is recommended of the AP axial projection of the SI joints on a female patient
73. Where is the CR centered for an oblique projection of the SI joints.
1 inch medial from upside ASIS joint
74. 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 positioning error is present on this radiograph
rotation of the spine
75. 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 positioning error is present on this radiograph
Insufficient rotation of the spine
76. 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?
If the patient has a wide pelvis, CR can be angled 5 to 8 degrees caudad
77. 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 repeated exposure?
Place additional support beneath the spine, or use a 5 to 8 degree caudad angle
78. A radiograph of an AP axial 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
Increase CR angle is required to separate the coccyx from the symphysis pubis.
79 . 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
Decrease rotation of the body and spine.
80. A patient comes to the radiology department for a follow-up study for a comparison fracture of L3. The radiologist requests that the collimated projections be taken of L3. Which specific projections and centering would provide a quality study of L3 and the intervertebral joint spaces.
AP or PA and collimated lateral projections would provide the best view. The CR should be about 2 inches above iliac crest.
81. A patient with injury to the coccyx enters the ER. 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 the study?
Perform PA rather than an AP projection and reverse the direction of the CR from caudad to cephalad.
82. A patient with a clinical history of spondylolisthesis 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?
A lateral postion would demonstrate the degree of forward displacement.
83. 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
The CR should be angled 15 to 20 cephalad.
84. A patient comes into the radiology department for a lumbar spine series. He has a clinical history of advanced spondylolysis. Which specific projection of the lumbar spine series will best demonstrate this condition
Although AP and lateral projections of the lumbar spine are helpful, posterior or anterior oblique positions best demonstrate advanced signs pf spondylolysis
85. A patient comes to the radiology department with a clinical history of HNP, Which of the following imaging modalities provide the most diagnostic study for this condition?
86. 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?
Routine lumbar spine projections should be performed erect.