Lumbar Spine procedures and positioning

where is the pars interarticularis

part of the lamina between the superior and inferior articular processes

what angle does the zygapophyseal joint form

30 to 60 degrees posteriorly

What angle does the intervertebral foramina form

opens 90 degrees to MSP

Curve of lumbar spine 

lordotic curve 

why would you flex knees for AP L spine

decrease lordotic curve

Breathing instruction for L spine

suspend at end of expiration

CR for AP L spine

enters at iliac crest

Structure shown for AP L spine

intervertebral disk space

Structures shown in Lateral L Spine

Intervertebral foramina

If spine cannot be adjusted for lateral L spine what is the angulation for a male

5 degrees caudal

If spine cannot be adjusted for lateral L spine what is the angulation for a female

8 degrees caudal

Why is the intervertebral foramina of L5 not well seen in a lateral

Due to oblique direction

Structures shown in oblique L spine

zygapophyseal joint closest to IR

CR for oblique L spine

2 inches medial to ASIS and 1.5 inches above iliac crest

CR for lateral L spine

Enters at iliac crest for lumbosacral spine 

1.5 inches above iliac crest for spine only 

How much do you oblique patient for AP oblique L spine to see L1-L4

45 degrees

How much do you oblique patient for AP oblique L spine to see L5-S1

30 degrees

What is the criteria for the AP oblique L spine

Appearance of scottie dog

What does a broken neck mean in scottie dog

spondylolysis

structures shown in lateral spot L spine

Lumbosacral junction L5-S1

CR for lateral spot L spine

2 inches posterior to ASIS and 1.5 inches inferior to iliac crest

AP Axial sacrum CR

15 degree cephalic 2 inches superior pubic symphysis

AP axial coccyx CR

10 degrees caudal and 2 inches superior to pubic symphysis

When performing an AP oblique (LPO) of the lumbar spine, which zygapophyseal joints are visualized, and what error is present if the pedicle is demonstrated too posterior on the vertebral body?

Left joints; patient too rotated

A technologist performs a lateral lumbar spine and the intervertebral disk spaces are not open. The technologist supported the knees but not the waist. What is the MOST likely error?

Waist sagging, causing spine to be non-parallel to table

Which lumbar structure forms the “nose” of the Scottie dog in an oblique projection?

Transverse process 

During a lateral L5–S1 spot, the joint space is not open and appears foreshortened superiorly. What correction is needed?

Increase caudal angle

Which projection best demonstrates spondylolysis?

obliques 

Which zygapophyseal joint does RPO L spine show

Right zygapophyseal joint

Which zygapophyseal joint does RAO L spine show

Left zygapophyseal joint

Spondylolysis

• Defect in pars interarticularis (Scottie dog neck).

best seen in oblique lumbar 

Spondylolisthesis

• Anterior displacement of one vertebra over another.

• Best shown on L5–S1 lateral spot.

Which positioning error most likely occurred if the zygapophyseal joints were not well demonstrated and the pedicle was quite anterior on the vertebral body in an image of an AP oblique projection of the lumbar vertebrae?

Patient not rotated enough

How many degrees and in which direction should the central ray be directed if it is necessary to have the patient prone for a PA axial projection of the sacrum?

15 degrees caudal

How many degrees and in which direction should the central ray be directed for AP axial projection of the sacrum?

15 degrees cephalad

How many degrees and in which direction should the central ray be directed for an AP axial projection of the coccyx?

10 degrees caudal 

How many degrees and in which direction should the central ray be directed if it is necessary to have the patient prone for a PA axial projection of the coccyx

10 degrees cephalic

How many degrees and in which direction should the central ray be directed for the lateral projection of the sacrum and coccyx 

perpendicular 

Lumbar articular facet for vertebrae L1 to L4 form what angle

30 - 60 degree angle

Facets of the last lumbar vertebrae form angle of what

45 degrees

breathing instructions for lateral L5 S1

Suspend

which project best demonstrates the transverse process

AP L spine 

Crest of ilium at the level of wat lumbar vertebrae

4,5

Where is the ASIS found

S1

CR for coccyx when patient is prone 

10 degrees cephalic

enter sacral curve