Radiographic Techniques - Lumbar Vertebrae

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the correct location for centering the vertical X-ray beam?

Parallel to the lumbar spine

At the level of the upper costal margin

Anteroposterior to the 3rd lumbar spinous process

Anterior to the 3rd lumbar spinous process at the lower costal margin (correct)

What must be demonstrated clearly for proper diagnosis from T12 to L5/S1?

Clear intervertebral disc space (correct)

Alignment of the patient's head

Elasticity of the lumbar vertebrae

Presence of scoliosis

What can cause high-contrast images in X-ray imaging?

Improper patient positioning

Inadequate exposure time

Failure to use a grid

Insufficient or excessive image density (correct)

What might poor superimposition of vertebral bodies indicate?

Patient was rolled too far forward or backward Signup and view all the answers

In which position is the patient most commonly situated for lateral projection?

Seated on a stool against the vertical Bucky Signup and view all the answers

What is the purpose of lateral projections in flexion and extension?

To demonstrate mobility and stability of the lumbar vertebrae Signup and view all the answers

What does the Bucky need to be centered at during X-ray exposure?

Level of the lower costal margin Signup and view all the answers

What is a consequence of the spine not being perfectly parallel with the receptor?

Poor visibility of anatomical structures Signup and view all the answers

What position should the patient be in while lying supine on the Bucky table?

Supine with hips and knees flexed Signup and view all the answers

Where should the central ray (CR) cassette be centered for lumbar vertebra imaging?

At the level of the lower costal margin Signup and view all the answers

Why should the exposure be made on arrested expiration?

To prevent diaphragm movement and maintain image contrast Signup and view all the answers

What should the essential image characteristics include when imaging the lumbar vertebrae?

T12 down and sacro-iliac joints Signup and view all the answers

How can you assess rotation in the lumbar vertebrae images?

Check that the sacro-iliac joints are equidistant from the spine Signup and view all the answers

What common fault might occur in lumbar vertebrae imaging?

Missing some or all of the sacroiliac joint Signup and view all the answers

In addition to lying supine, what other position can be used for lumbar vertebrae imaging?

Erect with the patient standing or sitting Signup and view all the answers

What is an appropriate method to stabilize the patient while lying on their side?

Flexing the knees and hips Signup and view all the answers

Study Notes

Radiographic Techniques - Lumbar Vertebrae

Antero-posterior (AP) Projection (Basic):
- Patient positioning: Supine on Bucky table, median sagittal plane aligned with the table's midline and perpendicular to the Bucky. Anterior superior iliac spines equidistant from the tabletop. HIPS and knees flexed, feet on tabletop to flatten the lumbar arch.
- Image receptor: Large CR cassette including the lower thoracic vertebrae and sacro-iliac joints centered at the lower costal margin.
- Exposure: Made during arrested expiration to prevent diaphragm movement, which would cause density differences between upper and lower lumbar vertebrae.

Lateral Projection (Basic):

Patient Positioning: Patient lies on either side of the Bucky table. Raise and rest patient's arms on the pillow in front of head; knees and hips are flexed for stability.
Image Receptor Alignment: The coronal plane of the spine should coincide and be perpendicular to the Bucky's midline, non-opaque pads may be necessary to align the vertebral column parallel to the image receptor.
Image Receptor Centering: The image receptor is centered at the level of the lower costal margin.
Exposure: Exposure should be made during arrested expiration.
Additional Projection: This projection can be performed with the patient standing or sitting.

Lateral - Flexion and Extension Projections

Patient positioning:
- Patient positions: Erect, seated on a stool with either side against the vertical Bucky.
- First exposure: patient leans forward, flexing the lumbar region as much as possible grip front of seat for stability.
- Second exposure: patient leans backward, extending the lumbar region as far as possible and grips the back of the seat or a support. The Bucky is positioned at the lower costal margin.
Note: Exposure is during arrested expiration in both flexion and extension.

Sacroiliac Joints (AP Axial):

Patient Positioning: Supine on Bucky table, median sagittal plane aligned with table's midline and perpendicular to the Bucky.
Pelvic Rotation: No rotation of the pelvis. ASIS (Anterior Superior Iliac Spine) should be the same distance from the tabletop.
X-ray Beam: Collimated vertical beam directed cephalad. 5 cm below the ASIS.

Essential Image Characteristics (General):

Image Inclusion: Include entire area of interest (e.g., T12 downward to sacral junction) in both projections.
Exposure Time: Short exposure for patient stability is desirable.
Density: Ensure sufficient density for diagnosis (e.g., bone detail throughout the region), including all bony structures
Rotation: Sacroiliac joints equidistant from spine.
Common Image Faults and Solutions:
- Missing sacroiliac joint: Additional projection of the sacroiliac joint is needed.
- High-contrast image/poor density: Software application to correct image density of overexposed areas is needed.
- Poor superimposition of anterior/posterior margins : This could mean the patient was positioned improperly (rolled too far in either direction).
- Spinous processes missing from image: Check collimation and ensure enough exposure.
- Failure to demonstrate intervertebral disc space: Ensure adequate space for visibility

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers essential radiographic techniques for imaging the lumbar vertebrae, including the antero-posterior (AP) and lateral projections. It focuses on patient positioning, image receptor alignment, and exposure settings to ensure accurate imaging results. Test your knowledge on the basics of lumbar spine radiography!