T + L - Spine Projections

Merill's Atlas - CH 9

Where is the CR directed for all t-spine projections?

T7, between jugular notch and xiphoid process

What is the tube angulation for a lateral t-spine if the spine isn’t horizontal?

10 to 15 degrees cephalad

Where should the CR be directed for an AP projection, specifically for lumbosacral exams?

L4, level of iliac crests

Where should the CR be directed for an AP projection, specifically for lumbar - only exams?

L3, 1.5 in (3.8 cm) above iliac crests

Where should the CR be directed for a lateral projection of the l-spine?

L4 (iliac crests)

What is the tube angulation if the spine isn’t horizontal for a lateral projection of the l-spine?

5 to 8 degrees caudad

Where should the CR be directed for an L5-S1 projection of the l-spine?

2 in posterior to the ASIS, and 1.5 in below the iliac crest

What is the tube angulation if the spine isn’t horizontal for a L5-S1 projection on a female?

8 degrees caudad

What is the tube angulation if the spine isn’t horizontal for a L5-S1 projection on a male?

5 degrees caudad

Where is the CR directed for an AP oblique projection of the l-spine?

2 in inward from the ASIS, and 1.5 above the iliac crests

What joints are well demonstrated on an AP oblique projection of the l-spine?

zygapophyseal joints closest to IR

How much should the patient be rotated for an AP oblique projection of the SI joints?

25 to 30 degrees

Where is the CR directed for an AP oblique projection of the SI joints?

1 in inward from the elevated ASIS

Where is the CR directed for an AP Axial projection of the sacrum and the coccyx?

2 in superior to pubic symphysis

What is the tube angulation for an AP Axial projection of the sacrum?

15 degrees cephalad

What is the tube angulation for an AP Axial projection of the coccyx?

10 degrees caudad

Where is the CR directed for a lateral sacrum?

level of ASIS and 3.5 in posterior

Where is the CR directed for a lateral coccyx?

level of ASIS, 3.5 in posterior, and 2 in inferior

What must scoliosis exams capture when exposing the T and L vertebrae?

1 in of the iliac crests

What is a scoliosis exam known as?

a thoracolumbar exam!

Where should the CR be directed for all scoliosis exams?

to the center of the IR

What is the projection, position, and anatomy?

Lateral t-spine

What is the projection, position, and anatomy?

AP Axial oblique l-spine

What is the projection, position, and anatomy?

AP Axial oblique l-spine

What anatomy is demonstrated on a lateral t-spine projection?

intervertebral foramina

What anatomy is demonstrated on a lateral l-spine projection?

intervertebral foramina

What anatomy is demonstrated on oblique t-spine projections?

zygapophyseal joints

What is the projection, position, and anatomy?

AP oblique SI joints

What is the projection, position, and anatomy?

AP Axial sacrum

What is the projection, position, and anatomy?

AP/PA Axial coccyx

What is the projection, position, and anatomy?

Lateral sacrum

What is the projection, position, and anatomy?

Lateral coccyx

Which SI joint is demonstrated on an AP Oblique projection?

the SI joint farthest from the IR (on the elevated side)

What is the SID for scoliosis exams?

60 inches

How long is the IR for scoliosis exams?

36 inches