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the xipohid process is at the level of ___
t9-t10
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lower coastal margin is at the level of ____
l2 -l3
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the iliac crests are at the level of _____
l4-l5
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the ASIS is at the level of ____
the symphysis pubis is at the same level of -___
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for an oblique position of the lumbar spine what is the degree of rotation in an RPO
what side does it visualize
what is the alternative oblique positioning for this
- 45 deg
- right downside zygopophyseal joints
- 45 deg LAO
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what oblique positions view the upside of the zygo joints and the downside
- RPO and LPO show the downside
- LAO and RAO show the upside
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in a lumbar oblique radiograph we must align the spine to what and how do we ensure no rotation
- spine must be align to midline of table
- ensure no rotation of pelvis and sholders and flex kness for stability
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where is the CR for a lumbar oblique radiograph
- CR perp to IR at L3 at level lower coastal margins 1-2in above the ilica crests
- and 2 inches medial upside ASIS
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accurate 45 deg patient rotation shows what structure in detail
indicated by open zygo joints and the pedicle (eye of scottie dog) between the midline and anterior aspect of vertebral body
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what is the routine projections for lumbar spine and special
- ap (or pa)
- obliques (post. or anterior)
- lateral
- lateral l5-s1
- ap axial l5-s1
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how do we reduce lordotic curvature in an ap lumbar xray and increase patient comfort
which position of lumbar spine places the intervertebral spaces more closely parallel diverging xra beams
- flex knees and hips
- pa lumber spine
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for an ap lumbar spine which size casette can you use
where would u center for each
- 14x17 cr at crests
- 10x12 cr at 1.5 in above crests at l3 (area of lower coastal margin)
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where do you center for an ap lumbar spine
what is the breathing
- at crests
- hold your breath expiration
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in a lateral position of the lumbar spine we must align the _____ to the midline of the table
midcoronal plane
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in a lateral position of the lumbar spine what is needed to place the spine parallel to the table
a radiolucent sponge and palpating the spinous processes of the vertebrae
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where do we center for an lateral lumbar spine
what is the breathing
- cr at level of iliac crests at (l4-l5)
- hold your breath expxiration
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a patient with a wider pelvis and a narrow thorax may require what angle to compensate in lat position of the spine
5-8 degree caudad angle
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where is the cr for a lateral l5-s1 position of lumbar spine
do we need a sponge if so what is the angle and what structure is parallel to what
what is the breathing
- CR 1.5 in inferior to iliac crests and 2 in posterior to ASIS
- yess support if wide hips angle caudad 5-8 deg
- parallel to the interiliac plane
- suspend respiration
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when doing lateral projections of the spine lumbar spine lateral sacrum, coccyx and spine what must we consider (2 things)
what is the position of the legs in these lateral recumbent positions
- must consider excess scatter b/c of thick body part to compensate close collimation and place a lead mat behind patient
- legs and knees are flexxed
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we must ensure no rotation of what two strcutures when radiographing lumbar later spines
no rotation of thorax and pelvis
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bones of the spinal column are called
the spinal cord is enclosed in the _____
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the spinal canal ends and starts where
the spinal cord begins where and ends where
the region where the spinal cord ends is called the
- starts base of the skull and ends at distal sacrum
- starts a medulla oblongata and ends at first lumbar vertebrae
- conus medullaris
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what are intervertebral disks
tough fibrocartilaginous disks separate the adult vertebrae they are cushion like disks tightly bound to the vertebrae to allow movement and stability of the vertebral column
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what r the 5 sections of the vertebrae
cervical thoracic lumbar sacrum and coccyx
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how many vertebrae are there in the child and adult vertebral column
how many are in the adult and child of the five sections of the vertebral column
- 33 in child and 26 in adult
- adult, child:
- C = 7,7
- T= 12,12
- L = 5,5
- S=1,5
- Cyx= 1,4
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what bones are the strongest of the vertebral column
lumbar vertbrae
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what are the concave and convex parts of the vertebral column
list them
- concave = rounded inward depression
- convex = rounded outward or elevated surface
- concave = cervical
- thaoracic = convex
- lumbar = concave
- sacral and coccyx curve = convex
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after birth the thoracic curvature and the scaral and coccyx curvature are referred to as what
which is first and second
primary curves first is thoracic second is sacral
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what are the first and second compensatory curves of the vertebral column
- first cervical curve
- second lumbar curve
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how is the zygapophyseal formed
joint space btw the inferior articular process of one vertebrae and superior articular procesc of the vertebrae below
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describe the structures of the scottie dog produced by a good 45 deg oblique
- neck = pars interarticularis
- ear = one superior articular process
- eye = pedicle
- nose = transverse process
- front legs = inferior articular process
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what is the intervertebral foramina
are spaces or openings between pedicles of the inferior and superior notches when two vertebrae are stacked together on each other
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the upper and lower surface of the pedicle is the ____
superior and inferior vertebral notches
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lamina of the lumbar vertebrae is called
what is it
pars interarticularis bridge that connects superior and inf articular processes
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the intervertebral foramina are seen best on what radiograph
lateral lumbar spine
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if you are using a smaller IR how would you center for a lateral and ap lumbar spine
you ywould center 1.5 in above the crest instead at the level of the crest
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lumbar spine:
RAO oblique shows
LPO shows
RPO shows
RAO shows
- RAO=left upside zyga joints
- LPO = downside lt zyga joints
- RPO = downside rt zyga joints
- LAO= rt upside zyga joints
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what breathing instructions is required for the ap lumbar lumbar lateral oblique lumbar and lateral spine hyper extension and flexion
suspend respiration on expiration
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lordosis:
abnormal anterior concavity of the lumbar spine
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what are intervertebral joints
disks found between the vertebral bodies thy allow flexibility and movement of vertebral column
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in a lateral positon of the lumbar spine and lateral l5-s1 why must we angle the tube
to keep the tube parallel to the interiliac line and places the sag or convexity of the spine down to open disk space more
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what degree of obliquity is best measure to view the zygapophyseal joints at L1-L2 and L5-S1
- 50 deg for L1-L2
- 30 deg for L5-S1
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how do we reduce lordotic curvature on an ap lumbar spine
how do we ensure no rotation on an ap lumbar spine
- flex knees and hips
- si joint equidistant
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spondylolisthesis
why is it caused
- involves forward movement in of one vertebrae in relation to another
- developmental defect in pars articularis (lamina)
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Spondylosis
- is the dissolution of a vertebra such as from aplasia (lack of development) of vert arch and separation of pars interarticularis
- neck of scottie dog appears broken
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spina bifida
congenital condition in which the posterior aspects of the vertebrae fail to develop thus exposing part of the spinal cord
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herniated nucleus pulposus aka
herniated lumbar disk is usually due to trauma or improper lifting the inner part of the vertebral disk (nucleus pulposus) protrudes through and presses on a nerve
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what is the mobility of the zyga joints and intervertbral joints
- zyga joints = diarthordial
- intervertebral disks = amphiarthrodial
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which alternative projection of the lumbar spine places the intervertebral spaces more closely parallel to the diverging rays
pa prone method alternative to the ap
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metastases
primary malignant lesions that spread to distant sites via blood and lymphatics
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what is the breathing for an l5 s1 projection
hold breath on respiration
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