L-Spine and coccyx A&P 1/21/26

What are the five major parts of the vertebral column

Cervical, Thoracic, Lumbar, Sacrum, Coccyx

Which vertebrae make up the cervical region

C1 to C7

Which vertebrae make up the thoracic region

T1 to T12

Which vertebrae make up the lumbar region

L1 to L5

What is the sacrum and where is it located

Triangular bone at base of spine, formed by fused sacral vertebrae

What is the coccyx and how many vertebrae does it contain

Tailbone, 3–5 rudimentary vertebrae

What is the normal curvature of the cervical spine called

Lordotic

What is the normal curvature of the thoracic spine called

Kyphotic

What is the normal curvature of the lumbar spine called

Lordotic

What is the normal curvature of the sacral/pelvic region called

Kyphotic

What is kyphosis in terms of spinal curvature

Excessive outward curvature of the thoracic spine

What is lordosis in terms of spinal curvature

Excessive inward curvature of the lumbar spine

What is scoliosis and how does it affect the spine

Abnormal “S” shaped lateral curvature

Which part of a typical vertebra bears most of the weight

Vertebral body

Which part of a vertebra forms the posterior portion surrounding the spinal canal

Vertebral arch

What are pedicles in a vertebra and where are they located

Short bony projections connecting body to laminae

What are the superior and inferior vertebral notches and what do they form

Indentations on pedicles that form intervertebral foramina

Which part of a vertebra connects the transverse processes to the spinous process

Laminae

What are transverse processes and where do they extend from

Lateral projections from vertebral arch

What is the spinous process and where is it located

Posterior projection from vertebral arch

What are the superior and inferior articular processes and what do they articulate with

Projections that articulate with adjacent vertebrae

What is the pars interarticularis in the lumbar vertebrae

Part of lamina between superior and inferior articular processes

How does the lumbar spinous process differ from cervical or thoracic spinous processes

Short, thick, and blunt, pointing posteriorly

How many sacral segments fuse, and between what ages does fusion occur

5 segments, fuse between ages 20–30

What is the sacral canal and what does it transmit

Continuation of vertebral canal, transmits sacral nerves

What are the sacral foramina and what passes through them

Openings on sacrum, transmit sacral nerves and vessels

How many vertebrae usually make up the coccyx

3–5

What type of joint is formed between vertebral bodies

Cartilaginous (symphysis)

What is the purpose of intervertebral disks

Shock absorption and mobility between vertebrae

What are zygapophyseal joints and what do they connect

Synovial joints connecting superior and inferior articular processes

What is a herniated nucleus pulposus (HNP)

Displacement of intervertebral disk nucleus through annulus fibrosus

What is a laminectomy and why is it performed?

Surgical removal of lamina to relieve spinal cord or nerve pressure

What is spondylolysis

Defect or fracture of pars interarticularis

What is spondylolisthesis

Forward displacement of a vertebra over the one below it

How does osteoarthritis affect the vertebral joints

Degeneration of cartilage and narrowing of joint spaces

AP Lumbar Spine part position

Flex hips and knees to reduce lumbar lordosis

AP Lumbar Spine central ray

CR to MSP at level of L4 iliac crest to include pubic symphysis; if pubic symphysis not required CR at L3 one inch above iliac crest

AP Lumbar Spine structures visualized

T12 through S1

Lumbar Spine obliques part position

Rotate patient 45 degrees supported with sponge

Lumbar Spine obliques central ray

Two inches medial to elevated ASIS and one to one and a half inches above iliac crest at L3

Lumbar Spine obliques structures visualized

Articular processes and zygapophyseal joints

Lumbar Spine obliques appearance

Scotty dog sign

Scotty Dog ear

Superior articular process

Scotty Dog nose

Transverse process

Scotty Dog eye

Pedicle

Scotty Dog neck

Pars interarticularis

Scotty Dog body

Lamina

Scotty Dog front leg

Inferior articular process

Lateral Lumbar Spine patient position

Upright or recumbent

Lateral Lumbar Spine part position

Arms flexed at elbows at right angle

Lateral Lumbar Spine central ray

CR at L4 iliac crest for lumbosacral exam or at L3 one to one and a half inches above crest for lumbar only

Spot central ray male angle

Five degrees caudal

L5 S1 spot central ray female angle

Eight degrees caudal

Spot centering

2 inches posterior to ASIS and 1.5 inferior to iliac crest

Lateral hyperflexion and hyperextension patient position

Recumbent or upright

Lateral hyperflexion and hyperextension part position

Flexion bend forward extension bend backward

Lateral hyperflexion and hyperextension central ray

Perpendicular to L3 on midcoronal plane

Lateral hyperflexion and hyperextension structures visualized

Motion at spinal fusion sites and possible herniated disks

AP hyperflexion and hyper extension central ray

MSP at level of L3 one to one and a half inches above iliac crest

AP axial sacrum part position

MSP centered support knees if supine

AP axial sacrum central ray

Fifteen degrees cephalic entering midline two inches inferior to ASIS

AP axial sacrum structures visualized

Sacrum free of superimposition

Lateral sacrum part position

Knees superimposed arms at right angle pelvis and shoulders in true lateral

Lateral sacrum central ray

Perpendicular to level of ASIS three and a half inches posterior

Lateral sacrum collimation

Ten by twelve

AP coccyx part position

MSP centered support knees if supine

AP coccyx central ray

Ten degrees caudal entering midline two inches inferior to ASIS

AP coccyx structures visualized

Coccyx free of superimposition

Lateral coccyx part position

Knees superimposed pelvis and shoulders in true lateral

Lateral coccyx central ray

Two inches inferior to ASIS and three and a half inches posterior

Lateral coccyx collimation

Six by eight

Lateral sacrum and coccyx combined

Sacrum and coccyx are typically imaged together in a lateral view

Lumbar spine level at iliac crest

L4

Lumbar spine level one to one and a half inches above iliac crest

L3

Oblique lumbar spine collimation

10×12

What is the breathing for all L-Spine views?

On exhalation

What goes in the intervertebral foramina?

Nerves