L spine test 1 (AP, PA, lateral, L5 and S1 spot, obliques)

Which of the following is true concerning the AP projection of the L spine?

• the midsagittal plane is centered to the IR

• The shoulders and hips should be adjusted to lie in the same horizontal plane

For a supine AP L spine, what should be done with the patients legs?

The hips and knees should be flexed until the back is in contact with the table

Which of the following would be an acceptable respiratory phase during which to expose an AP, Lateral, or oblique L spine projection?

Suspend at the end of expiration

Which of the following would be an acceptable respiratory phase during which to expose a L5 S1 lumbosacral junction lateral projection?

Suspend respiration

Which of the following is true concerning the lateral L5 S1 lumbosacral projection?

• the Midcoronal plane should be centered and perpendicular to the IR

• The entire spine should be placed parallel to the IR, using firm supports under the lower thorax as necessary

• CR enters perpendicular and enters 2” posterior to the ASIS and 1.5” inferior to the iliac crest

• When the spine is not in the true horizontal position, the CR angled 5 degrees caudally for male patients and 8 degrees caudally for female patients

Which of the following is true concerning the lateral L spine and lateral L5 S1 projection?

• arms should be placed at a 90 degree angle to the body

• Place a radiolucent support between the knees

• The knees, shoulders, and hips should be superimposed to prevent rotation

For the AP and PA oblique projections of the L spine, how much do you turn the patient from the recumbent position?

45 degrees

How much should the patient be rotated from the recumbent position for demonstration of the L5 S1 zygapophyseal joint?

60 degrees

True or false:

The entire long axis of the spine should be parallel to the IR for oblique positions of the lumbar spine

True

True or false:

Underwear, pants, and bras should be removed before L spine examination in order to avoid artifacts in the image

True

Where should you center for an AP lumbosacral examination?

More than one, but not all of the above

Where should you center for an AP L spine projection?

At the level of L3

Where should you center for the lateral L spine projection?

At the level of L3

If the spine can’t be placed parallel to the IR for the L spine lateral projection or L5 S1 lumbosacral junction lateral projection, what should be done with the CR?

More than one, but not all of the above

True or false:

For the L5 S1 lumbosacral junction lateral projection, the central ray should fall on a coronal plane 1.5 inches posterior to the ASIS and 3 inches inferior to the iliac crest

False

Where should the CR be located on a patient for an AP oblique lumbar spine projection for the lumbar region?

1.5 inches superior to the iliac crest and 2 inches medial to the elevated ASIS

Where should the CR be located on a patient for a PA oblique lumbar spine projection for the lumbar region?

1.5 inches superior to the iliac crest and 2 inches lateral ( toward the side up) to palpable spinous processes

Where should the CR be located on a patient for an AP oblique lumbar spine projection for the 5th zygapophyseal joint (L5 S1 zygapophyseal joint)?

2 inches medial to the elevated ASIS (from side to side) and midway between the iliac crest and ASIS (from superior to inferior)

For the AP projection of the L spine, which of the following are evaluation criteria?

• all five lumbar vertebrae are seen along with the distal t spine vertebrae to the sacrum

• Collimation to the lateral margin of the psoas muscles

For the lateral projection of the L spine, which of the following are evaluation criteria?

• superimposed posterior margins of the vertebral bodies

• Near superimposition of the iliac crests when a perpendicular beam is used

For the L5 S1 junction lateral projection, which of the following are evaluation criteria?

• superimposed posterior margins of the vertebral bodies

• Near superimposition of the iliac crests when a perpendicular beam is used

• Lumbosacral joint in the center of the IR and opened

• Only all of L5 and superior sacrum demonstrated

True or false:

Oblique lumbar projections should include anatomy from the lower cervical vertebrae to the sacrum

False

Why are “spinous processes in the middle of the vertebral bodies” on the AP lumbar spine projection an important evaluation criteria?

It proves a lack of rotation

Which of the following projections will demonstrate intervertebral disk spaces?

• AP

• lateral

• L5 S1 spot

• Obliques (AP or PA)

Which of the following lumbar spine projections will best demonstrate the interpediculate spaces?

AP

Which of the following lumbar spine projections will best demonstrate the spinous processes in profile?

• lateral

• L5 S1 spot

Which of the following lumbar spine projections will best demonstrate the intervertebral foramina?

Lateral

Which of the following lumbar spine projections will best demonstrate the zygapophyseal joints?

Obliques (AP or PA)

Which of the following positions will best demonstrate the right zygapophyseal joints of the lumbar spine?

• RPO

• LAO

which of the following lumbar spine projections is recommended to best demonstrate the intervertebral disk spaces?

PA

Which of the following lumbar spine projections would yield the least amount of magnification?

AP