Compared with the spinous processes of the cervical and thoracic spine, the lumbar spinous processes are:

a. Smaller                          c.  Larger and more 

                                            blunt

b. Pointed downward more   d. Absent

C.  Larger and more blunt

 The anterior ridge of the upper sacrum is called the :

A.  Median sacral crest     C. Promontory

B. Cornua                       D. Saral horns

C. Promontory

  Each Sacroiliac joint is obliqued posteriorly  ____ degrees.

A.  20         C.  45

B.  30         D.  50

B.  30

  The angle of the midlumbar spine zygapophyseal joints in relation to the midsagittal plane is _____ degrees.

45

   Where is the pars interarticularis found?

A.  Superior and inferior aspect of the pedicle

B.  Between the intervertebral disk and vertebra

C.  Between the superior and inferior articular processes.

D.  Between the lamina and body spinous processes.

C.  Between the superior and inferior articular processes.

What are the caracteristics of the lumbar vertebra that differeniate it from the thoracic?

Large vetebral body and large, blunt spinous process

 The zygapophyseal joints of the lumbar spine are classified as _______________ joints with _____________ type of movement.

Synovial,

plane (gliding)

A. Superior articular process (ear)

B. Transverse process (nose)

C. Pedicle (eye)

D. Inferior articular process (leg)

E. Par interarticularis (neck)

F. Zygopophyseal joint (betwen ear of one spine and leg of another)

The ear and front leg of the "Scotty dog" make up the __________________, best seen in the oblique position.

zygapophyseal joint

 Which one of the following topographic landmarks corresponds to the L2-3 level?

A. Xiphoid process          C. Iliac crest

B. Lower costal margin    D. ASIS

B. Lower costal margin

True/False:  It is possible to shield females for an AP projection of the sacrum or coccyx if the gonadal shields are correctly placed.

False (would obscure essential anatomy since the ovaries are located near the lower lumbar spine.)

True/False: The female gonadal dose is approximately that of the midline dose and is almost the same for either AP or PA projections of the lumbar spine.

False (ovaries are slightly anterior, thus AP results in about 30% greater gonadal dose than PA).

True/False:  A lead blocker for lateral positions of the lumbar spine should not be used with digital imaging.

False

Why should the knees and hips be flexed for an AP projection of the lumbar spine?

Opens the intervertebral disk space by reducing the normal lumbar curvature of the spine.

True/False:  The efficiency of CT and MRI of the spine is reducing the number of myelograms being performed.

True

Anterior wedging and loss of vertebral body height are characteristic of:

A.  Chance fracture          C.  Compression fracture

B.  Spina bifida               D.  Spondylolysis

C.  Compression fracture

Which one of the following conditions is often diagnosed by prenatal ultrasound?

A.  Scoliosis          C.  Spondylolisthesis

B.  Spina bifida     D.  Ankylosing spondylitis

B.  Spina bifida

Which one of the following conditions usually requires an increase in manual exposure factors?

A.  Ankylosing spondylitis     C.  Spina bifida

B.  Spondylolysis                 D.  Spondylolisthesis

A.  Ankylosing spondylitis

Where is the central ray centered for an AP projection of the lumbar spine with a 30 X 35 cm

(11 X 14 inch) IR?

1 to 1.5 in (3-4 cm) above the iliac crest

Which set of zygapophyseal joints of the lumbar spine is best demonstrated wtih an LAO position?

Right, or upside joints

How much rotation of the spine is required to demonstrate the zygapophyseal joint space between L1-2?

50 degrees from the plane of the table.

Describe the body build that may requre central ray angulation to open the intervertebral joint spaces with a leteral projection of the lumbar spine, even if the patient has some support under the waist.

A patient with a wide pelvis and narrow thorax.

What type of central ray angulation should be used for the lateral L5-S1 projection if the waist is not supported?

A.  Central ray perpendicular to IR 

B.  5 - 8 degrees caudad

C.  10-15 degrees cephalad

D.  3 - 5 degrees cephalad

B.  5-8 degrees caudad

What type of central ray angulation should be used for an AP axial projection for L5-S1 on a female patient?

A.  35 degrees cephalad

B.  30 degrees cephalad

C.  5-8 caudad

D.  Central ray perpendicular to IR

A.  35 degrees cephalad

Level of ASIS at the midline of the body.

True/False:  The center ionization chamber should be used when utilizing automatic exposure control (AEC) for either a lateral lumbar spine or a lateral

L5-S1 projection.

True

What projection or method is designed to demonstrate the degree of scoliosis deformity between the primary and compensatory curves as part of a scoliosis study?

PA (AP) projection, Ferguson method (with and withougt block under convex side of curve)

Which projections are designed to measure anteroposterior movement at the site of a spinal fusion?

Hyperextension and hyperflexion lateral projections.

Where is the central ray centered for an AP projection fo the sacrum?

Midway between the symphysis pubis and ASIS

What two things can be done to reduce the high amounts of scatter reaching the IR during a lateral projection ofthe sacrum and coccyx?

A.  Close collimation

B.  Use a a lead blocker on tabletop behind patient

Why should a single, lateral projection of the sacrum and coccyx be performed rather than separate laterals of the sacrum and coccyx?

To reduce gonadal dose

The skin dose on a lateral sacrum and/or coccyx projection on an average-size patient is in the _________ range.

A.  200-500 mrad     C.  1000-1500 mrad

B.  500-700 mrad     D.  1500-2000 mrad

C.  1000-1500 mrad

A radiograph of an AP projection of the lumbar spine reveals that the sacroiliac (SI) joints are not equidistant from the spine.   The right ala of the sacrum appears larger, and the right SI joint is more open than the left.  Which specific positioning error is evident on this radiograph?

Rotation to the patient's right.

A radiograph of an LPO projection of the lumbar spine reveals that the downside pedicles are projected toward the posterior aspect of the vertebral bodies.  What must be done to correct this error during the repeat exposure?

Decrease rotation of the spine.

An AP projection of the sacrum reveals that the sacrum is foreshortened and the foramina are not open.  What positioning error led to this radiographic outcome?

Insufficient cephalad CR angulation or the CR was angled in the wrong direction.

A patient with a possible compression fracture of L3 enters the emergency room.  Which projection(s) of the lumbar spine best demonstrate(s) the extent of this injury?

A lateral projection

A patient with a clinical history of spondylolisthesis of the L5-S1 region comes to the radiology department.  What basic (i.e., routine) and special (i.e., optional) projections should be included in this study?

AP, lateral, L5-S1 spot lateral and right and left 30 degree oblique positions.