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Lumbar, Sacrum, Coccyx, SI Joints
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Lumbar, Sacrum, Coccyx, SI Joints

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Questions and Answers

What is the termination level of the lumbar spinal cord?

L1-L2

Which part of the lumbar vertebrae is thicker compared to cervical or thoracic vertebrae?

Laminae

What is the shape of the body of the L5 lumbar vertebra for articulation with the sacrum?

Wedge-shaped

How are the lumbar transverse processes of L1-L3 directed?

<p>Laterally</p> Signup and view all the answers

Where are the accessory processes located in the lumbar vertebrae?

<p>At the back of the root of the transverse process</p> Signup and view all the answers

What is the characteristic shape of the lumbar vertebra L5 spinous process?

<p>Shorter and smaller</p> Signup and view all the answers

Describe the natural curve of the lumbar spine.

<p>Lordotic</p> Signup and view all the answers

Which part of the lumbar vertebrae has a smooth rounded projection on the back of each superior articular process?

<p>Mamillary Process</p> Signup and view all the answers

What is the position of the hips, shoulders, and knees in a left lateral L-spine position?

<p>On top of one another, with knees flexed</p> Signup and view all the answers

Where should the Central ray be angled if the L-spine is not horizontal?

<p>5-8 caudal</p> Signup and view all the answers

What is the breathing instruction for an L5-S1 spot X-ray?

<p>Suspend</p> Signup and view all the answers

What structures are seen in an AP Axial L5-S1 X-ray?

<p>Intervertebral foramina L1-L4</p> Signup and view all the answers

What is the position of the patient in a lateral hyperflexion L-spine X-ray?

<p>Lean forward as far as possible</p> Signup and view all the answers

Where should the Central ray be placed in an AP axial sacrum X-ray?

<p>Midway between ASIS and symphysis</p> Signup and view all the answers

What is the breathing instruction for an AP coccyx X-ray?

<p>Suspend</p> Signup and view all the answers

What is the purpose of lateral hyperflexion/hyperextension L-spine X-ray?

<p>To determine motion in the area of a spinal fusion</p> Signup and view all the answers

What is the angle at which the majority of the Lumbar Vertebra Zygapophyseal Joints are demonstrated?

<p>45° oblique position</p> Signup and view all the answers

How many sacral vertebrae fuse together to form the Sacrum?

<p>5</p> Signup and view all the answers

What is the structural difference between the male and female sacrum?

<p>The Female sacrum is more acutely curved than the male.</p> Signup and view all the answers

What is the name of the prominent ridge on the base of the sacrum?

<p>Sacral Promontory</p> Signup and view all the answers

What is the anatomical feature present on the sacral ala that contains the articular surface for the iliac bones of the pelvis?

<p>Wing-like lateral mass</p> Signup and view all the answers

Where is the sacral canal located in relation to the bodies of the sacral segments?

<p>Behind</p> Signup and view all the answers

How many processes project from the posterolateral aspect of the last sacral segment?

<p>Two</p> Signup and view all the answers

What are the components that compose the coccyx?

<p>4 rudimentary vertebrae fused into one bone</p> Signup and view all the answers

What is the recommended patient breathing technique for 45° RPO/LPO L-SPINE radiographs?

<p>Expiration</p> Signup and view all the answers

What is the position of the patient for Left Lateral L-Spine radiographs?

<p>True lateral position against the image receptor</p> Signup and view all the answers

What is the role of the lead strip in Left Lateral L-Spine radiographs?

<p>To reduce scatter</p> Signup and view all the answers

Where should the central ray be positioned for Left Lateral L-Spine radiographs?

<p>At the iliac crest, but angled caudal by 5°-8° if L-spine is not horizontal</p> Signup and view all the answers

What structures are seen in Left Lateral L-Spine radiographs?

<p>Intervertebral foramina of L1-L4, open intervertebral disk spaces, spinous processes, and sometimes the entire sacrum</p> Signup and view all the answers

How should the central ray be angled for L5-S1 Spot radiographs?

<p>Caudal by 5° for males and 8° for females</p> Signup and view all the answers

Where is the central ray positioned for L5-S1 Spot radiographs?

<p>Midway between iliac crest and level of ASIS (2 inches posterior to ASIS and 1.5 inches inferior to iliac crest)</p> Signup and view all the answers

What are some of the structures seen in L5-S1 Spot radiographs?

<p>Lateral aspect of L5-S1, open lumbosacral intervertebral joints, and sometimes the entire sacrum</p> Signup and view all the answers

What is the purpose of correcting the tube angle in an AP coccyx view?

<p>Curvature (anterior and inferior) of the coccyx</p> Signup and view all the answers

If a coccyx view is performed in a PA position, what angle should be used?

<p>Cephalic</p> Signup and view all the answers

Where is the central ray directed in a lateral sacrum X-ray?

<p>ASIS - 3.5 inches posterior</p> Signup and view all the answers

What structure is closely superimposed with the lateral aspect of the sacrum in a lateral sacrum X-ray?

<p>Superior margins of ischia and ilia</p> Signup and view all the answers

How many sacral vertebrae fuse to form the sacrum?

<p>5</p> Signup and view all the answers

What are the characteristics of the spinal cord termination?

<p>L1-L2</p> Signup and view all the answers

What are the unique characteristics of the lumbar vertebrae L5?

<p>Wedge-shaped body, shorter spinous process, thickest transverse process</p> Signup and view all the answers

How many coccygeal segments fuse to form the coccyx bone in adulthood?

<p>4</p> Signup and view all the answers

Study Notes

Lumbar Spinal Cord

  • The termination level of the lumbar spinal cord is L1-L2.

Lumbar Vertebrae Characteristics

  • The lumbar vertebrae have thicker bodies and shorter spinous processes compared to cervical and thoracic vertebrae.
  • The body of the L5 lumbar vertebra is kidney-shaped for articulation with the sacrum.

Transverse Processes

  • The lumbar transverse processes of L1-L3 are directed laterally and slightly backward.

Accessory Processes

  • The accessory processes are small and located near the base of the transverse processes in the lumbar vertebrae.

Spinous Processes

  • The spinous process of the lumbar vertebra L5 is triangular and blunt.

Lumbar Spine

  • The natural curve of the lumbar spine is lordotic.

Superior Articular Process

  • The superior articular process of the lumbar vertebrae has a smooth rounded projection on the back.

Radiography Techniques

  • In a left lateral L-spine position, the hips, shoulders, and knees are aligned.
  • For an L-spine that is not horizontal, the central ray should be angled accordingly.
  • The breathing instruction for an L5-S1 spot X-ray is to hold breath and not move.
  • In an AP Axial L5-S1 X-ray, the sacrum, L5, and S1 are seen.

Lateral Hyperflexion L-Spine X-ray

  • The patient position for a lateral hyperflexion L-spine X-ray is flexion.

AP Axial Sacrum X-ray

  • The central ray for an AP axial sacrum X-ray should be placed at the midpoint of the sacrum.

Breathing Instruction

  • The breathing instruction for an AP coccyx X-ray is to exhale slowly.

Lateral Hyperflexion/Hyperextension L-Spine X-ray

  • The purpose of lateral hyperflexion/hyperextension L-spine X-rays is to demonstrate the lumbar spine in flexion and extension.

Zygapophyseal Joints

  • The majority of the Lumbar Vertebra Zygapophyseal Joints are demonstrated at an angle of 45°.

Sacrum

  • Five sacral vertebrae fuse together to form the sacrum.
  • The sacrum is wider and more curved in females compared to males.
  • The prominent ridge on the base of the sacrum is called the apex.
  • The sacral ala contains the articular surface for the iliac bones of the pelvis.
  • The sacral canal is located posterior to the bodies of the sacral segments.
  • Four processes project from the posterolateral aspect of the last sacral segment.

Coccyx

  • The coccyx is composed of 3-5 fused coccygeal segments.
  • The recommended patient breathing technique for 45° RPO/LPO L-SPINE radiographs is to hold breath and not move.

Radiographs

  • In Left Lateral L-Spine radiographs, the patient position is left lateral.
  • The lead strip in Left Lateral L-Spine radiographs is used to reduce scatter radiation.
  • The central ray for Left Lateral L-Spine radiographs should be positioned at the midpoint of the lumbar spine.
  • In Left Lateral L-Spine radiographs, the lumbar spine, sacrum, and coccyx are seen.
  • For L5-S1 Spot radiographs, the central ray should be angled 10-15° caudad.
  • The central ray for L5-S1 Spot radiographs is positioned at the midpoint of the L5-S1 disk space.
  • In L5-S1 Spot radiographs, the L5-S1 disk space and surrounding bones are seen.

AP Coccyx View

  • The purpose of correcting the tube angle in an AP coccyx view is to demonstrate the coccyx.
  • If a coccyx view is performed in a PA position, the angle should be 10-15° cephalad.

Lateral Sacrum X-ray

  • The central ray for a lateral sacrum X-ray should be directed at the midpoint of the sacrum.
  • The structure closely superimposed with the lateral aspect of the sacrum in a lateral sacrum X-ray is the ilium.

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