RAD 112 CH9 L-Spine, Sacrum and Coccyx Anatomy

The largest and strongest vertebrae

The 5 lumbar vertebrae

True or false, the cervical vertebrae holds the load of the body and increases toward the inferior end of the column

False, the lumbar vertebrae holds the load of the body and increase toward the inferior end of the column

Why are the cartilaginous disks between the inferior and lumbar vertebrae common sites of injury and pathological processes

Because it bears most of the body's load

The largest lumbar vertebrae is

L5

Unique characteristics of the lumbar vertebrae

Transverse processes are small

Spinous process is bulky and blunt

Is the zygapophyseal joint or intervertebral foramina situated 90º from the midsagittal plane for the lumbar vertebrae

Intervertebral foramina

The spaces or opening between pedicles when 2 vertebrae are stacked on each other and the superior and inferior vertebral notches line up.

Intervertebral foramen

What passes through the intervertebral foramen in the lumbar spine

Nerves and blood vessels

Which joints (zygapophyseal or intervertebral foramina) form an angle from 45-65º to the midsagittal plane in the lumbar spine

Zygapophyseal joints

Which lumbar vertebrae are nearer the 65º angle? Upper or lower

Upper

Which lumbar vertebrae are nearer the 45º angle? Upper or lower

Lower

What is the term for the bridge between the transverse processes, lateral masses, and spinous process

Laminae

Portion of each laminate between the superior and inferior articular processes

Pars interarticularis

In which projection of the lumbar spine is the pars interarticularis seen

Oblique

How many sacral foramina are there

4 sets

The 2 superior articular processes of the sacrum form what joints with the inferior articular processes of the 5th lumbar vertebrae

Zygapophyseal joints

The sacrum has what type of curve

Convex

The term for the anterior ridge of the body of the 1st sacral segment helps form the posterior wall of the inlet of the true pelvis and is best shown from a lateral perspective

Promontory

A continuation of the vertebral canal and contains certain sacral nerves. Its posterior to the body of the 1st sacral segment

Sacral canal

Term for the fused spinous processes of the sacral vertebrae

Median sacral crest

The sacrum articulates with the ilium of the pelvis at the....

Auricular surface

Small tubercles that represent the inferior articular processes projections inferiorly from each side of the 5th sacral segment. The project inferiority and posteriorly

Sacral horn

The sacroiliac joint opens obliquely at what angle

30º

How many segments does the coccyx have in a normal adult

3-5

True or false, the anterior curvature of the coccyx is more pronounced in men and less pronounced in women

True

If the coccyx projects into the birth canal in the woman, and if angled excessively forward, what can happen

It impedes the birth process

The most common injury associated with the coccyx results from

A direct blow to the lower vertebral column when a person is in a sitting position

Falling backward w forceful sitting action

Who is more likely to experience a fracture of the coccyx

Females because of the shape of the female pelvis and more vertical orientation of the coccyx

To demonstrate the zygapophyseal joints of the lumbar, what oblique angle is required

45º

To demonstrate the intervertebral foramina of the lumbar, what oblique angle is required

90º

The Scottie dog is associated with which lumbar spine projection

Obliques

The ear of the Scottie dog is what

Superior articular process

The nose of the Scottie dog is what

Transverse process

The eye of the Scottie dog is what

Pedicles

The neck of the Scottie dog is what

Pars interarticularis

The front legs of the Scottie dog is what

Inferior articular process

Zygapophyseal joints classification

Synovial, diarthroidal, plane (gliding) type

Intervertebral joints classification

Cartilaginous joints, amphiarthoridal, symphysis subclass

Movements of the spine

Flexion

Extension

Lateral flexion (bending)

Rotation

Intervertebral foramina of the lumbar spine are visualized in what projection

Lateral

In a posterior oblique for L-spine are the zygapophyseal joints seen in the downside or upside

Downside

In an anterior oblique for L-spine are the zygapophyseal joints seen downside or upside

Upside

Degree of rotation for the oblique L-Spine:

L1-L2

L3

L4-L5

L1-2: 65º

L3: 55º

L4-L5: 45º

Why do the upper thoracic vertebrae require a higher degree of rotation for the oblique

Because they resemble the thoracic vertebrae (which require 70º oblique)

Xiphoid Tip is at the level of

T9-T10

Lower costal margin is at the level of

L2-3

Iliac crest is at the level of

L4-L5

ASIS is at the level of the

S1-2

Why should you flex the knees for the AP lumbar spine when the PT is recumbent

Reduce lumbar curvature (lordosis)

Reduces OID

Spine is more parallel to the IR

PT comfort

Why does the PA projections offer an advantage

Places L-spine in a natural curvature

Better visualization of the intervertebral disk spaces

Lower ovarian dose

What's the disadvantage of PA projections

Increased OID

Magnification

Reduced image resolution

The 2 primary concerns in pediatrics

Patient motion

Safety

What can you do to reduce the risk of PT motion for pediatrics

Short exposure and use high mA

Decreased position awareness can cause what type of patient to feel fear of falling off the table

Geriatrics

To locate the symphysis pubis of the bariatric patients, what do you do

Ask the PT to flex their knees

The symphysis pubis is slightly above the level of the crease of the thigh