1
The intervertebral foramina of the lumbar spine are located at an angle of _____ in relation to the midsagittal plane.
2
The small section of bone found between the superior and inferior articular processes of the lumbar spine is termed:
3
The zygapophyseal joints of the upper lumbar vertebrae are ____ in relationship to the midsagittal plane.
4
The anterior projecting bony process of the sacrum that forms part of the inlet of the true pelvis is the:
promontory of the sacrum.
5
Another term for the sacral horns is the:
6
Which specific aspect of the sacrum articulates with the ilium to form the sacroiliac joint?
7
Which one of the following structures of the sacrum is considered to be the most posterior?
8
What is the term for the superior aspect of the coccyx?
9
The long axis of the sacrum is generally angled more posteriorly in males than females.
10
What is the joint classification of the zygapophyseal joints?
11
The intervertebral joints in the lumbar spine are classified as
cartilaginous/amphiarthrodial.
12
What type of joint movement occurs with the zygapophyseal joints?
13
Which of the following topographic landmarks corresponds with the L4-5 vertebral level?
14
Which of the following structures is located at the level of the ASIS?
15
A female is more likely to suffer a fracture of the coccyx due to a backward, sitting type of fall than a male.
16
The Scottie dog sign is demonstrated with oblique projections of the thoracic and lumbar spine.
17
The anterior oblique (RAO and LAO) positions of the lumbar spine will demonstrate the zygapophyseal joints closest to the image receptor.
18
The average degree of rotation required to demonstrate the L3-4 zygapophyseal joints is:
19
Why should the hips and knees be flexed for an anteroposterior (AP) projection of the lumbar spine?
For patient comfort and To reduce the lumbar curvature (both A and B)
20
Which of the following should be done to reduce scatter radiation from reaching the image receptor for the lateral lumbar, sacrum, and coccyx projections?
Place a lead mat on the tabletop behind the patient.
21
Where is the central ray (CR) centered for an AP projection of the lumbar spine with a 14 17-inch (35 43-cm) IR?
22
An average of ____ segment(s) make up the adult coccyx.
23
If the waist is supported properly, an average-size patient does not require any CR angulation for the lateral lumbar spine projection.
24
If the patient has scoliosis, the convexity of the spine should be down toward the image receptor for the lateral spine projection.
25
Which of the following statements is NOT true about the lateral L5-S1 projection?
A 14 17-inch (35 43-cm) IR should be used.
26
What CR angulation should be used for an AP axial projection of the L5-S1 joint space on a male patient?
27
Carefully placed gonadal shielding must always be used on female patients for the AP lumbar spine projection.
28
MRI (magnetic resonance imaging) is superior to CT (computed tomography) for evaluation of spinal cord and intervertebral disks.
29
Bone densitometry produces very little skin dose to the patient.
30
Conventional radiography does not detect bone loss from conditions such as osteoporosis until bone mass has been reduced at least 30%.
31
The AP and lateral projections for a pediatric scoliosis study should include the entire lumbar and thoracic spine.
32
The second projection for the Ferguson method of the scoliosis series requires that the concave side of the curve be built up 3 to 4 inches (8 to 10 cm) by placing blocks beneath the patient’s foot.
33
A key advantage of a posteroanterior (PA) projection taken during a pediatric scoliosis study as compared with the AP projection is that it reduces:
breast and thyroid dose by 90%.
34
Where is the CR centered for an AP axial projection of the sacrum?
2 inches (5 cm) above the symphysis pubis
35
What type of CR angulation is required for an AP axial projection of the coccyx?
36
The radiographic appearance on an oblique lumbar spine in which the neck of the Scottie dog appears broken suggests the presence of:
37
A destructive type of lesion with irregular margins and increased density is an indication of possible:
osteoblastic type of metastases.
38
A fracture through the vertebral body and posterior elements caused by lap seat belts during an auto accident involvingsudden deceleration is a ____ fracture.
39
Which of the following is a condition of unknown cause in which calcification of bony ridges between vertebrae occurs, creating a lack of mobility with a “bamboo” appearance?
40
An anterior wedging of vertebrae with a loss of body height but rarely causing neurologic symptoms is called:
41
Sciatic type of pain resulting from a “slipped disk” indicates:
herniated nucleus pulposus
42
An abnormal lateral curvature of the spine is a congenital condition termed:
43
What CR angle should be used for a lateral sacrum/coccyx projection?
None. CR is perpendicular to the image receptor.
44
A radiograph of a lateral projection of the lumbar spine reveals that the mid- to lower-intervertebral joint spaces are not open. The patient’s waist was supported. Which of the following modifications will help open these joint spaces during the repeat exposure?
Increase waist support and/or angle CR 5 to 8 caudal.
45
A radiograph of an AP axial sacrum reveals that it is foreshortened and the sacral foramina are not clearly seen. The patient was in an AP supine position, and the technologist angled the CR 10° cephalad. What specific positioning error is present on this radiograph?
Insufficient CR angulation
46
A radiograph of an AP axial coccyx reveals that the symphysis pubis is superimposed over the distal end of the coccyx. Which of the following modifications will correct this problem during the repeat exposure?
Increase the CR angulation.
47
A radiograph of an AP axial L5-S1 projection reveals that the joint space is not open. The following factors were used on this female patient: 80 kV, 40-inch (102 cm) SID, grid, 35 caudad angle, and CR centered to the ASIS. Which of the following factors needs to be modified to produce a more diagnostic image?
Change the direction of the CR angulation.
48
A radiograph of an AP projection of the lumbar spine on an average-size patient reveals that the psoas major muscles and transverse processes are not visible. The following analog factors were used for this projection: automatic exposure control (AEC) with center ionization chamber, 95 kV, 40-inch (102-cm) SID, grid, and 14 17-inch (35 43-cm) image receptor. Which of the following modifications will be most effective in demonstrating these structures?
49
A patient comes to radiology for a study of the lumbar spine. The initial radiographs demonstrate potential pathology involving the L5-S1 zygapophyseal joint. Which of the following positions and/or projections would best demonstrate this joint space?
Right and left 30 oblique projections
50
A patient comes to radiology for a study of the lumbar spine. He has a clinical history of spondylolisthesis of L5. Which of the following projections will best demonstrate the severity of this condition?
51
A patient comes to radiology for a follow-up study of the lumbar spine. The patient had a spinal fusion performed at the L3-4 level 4 months earlier. Which of the following would best demonstrate the degree of movement at the fusion site?
Lateral hyperextension and hyperflexion projections
52
A young female patient comes to radiology for a scoliosis study. The patient has had this series performed frequently. How much will the breast dose be decreased if a PA rather than an AP projection is taken?
53
A patient comes in with a possible compression fracture of L3. Which one of the following positioning routines would best demonstrate the body of L3 and the intervertebral joint spaces above and below it?
Collimated PA and lateral projections
54
A geriatric patient comes to radiology for a lumbar spine series. She has severe kyphosis of the thoracolumbar spine. Which one of the following modifications should be applied to this patient?
Perform all positions erect.
55
A female patient is brought to the emergency department (ED) because of a MVA (motor vehicle accident). Her chief complaint is pain in the lower lumbar region. The ED physician orders a lumbar series. Upon questioning, the technologist learns that the patient is pregnant. The ED physician is made aware of the pregnancy but still wants the lumbar spine series performed. What canthe technologist do to minimize dose to the fetus and mother?
Use higher kV than normal, reduce mAs accordingly. b. Use smallest IR possible. c. Collimate as much as feasible.
56
The use of digital radiography is not recommended for studies of the sacrum and coccyx.
57
Which of the following fractures is due to a hyperflexion force injury?
58
The “nose” of the Scottie dog represents the spinous process of a lumbar vertebra.
59
The pelvis must remain stationary for the AP right and left bending projections of the scoliosis series.
60
For a lateral L5-S1 projection, the CR must be parallel to the:
61
AEC (automatic exposure control) should not be used for an L5-S1 lateral or a lateral sacrum and coccyx.
62
How much obliquity of the body is required for posterior oblique positions for the sacroiliac joints?
63
The LPO position for sacroiliac joints will best demonstrate the right joint.
64
A radiograph of the left sacroiliac joint demonstrates it open and clearly seen. Which of the following positions was performed?
65
Radiographs of oblique projections of the SI joints do not clearly demonstrate the inferior/distal aspect of the joints. What can the technologist do to better demonstrate this region?
Angle CR 15 to 20 cephalad.
66
Where is the CR centered for posterior oblique projections of the SI joints?
1 inch (2.5 cm) medial to upside ASIS
67
A radiograph of a left posterior oblique (LPO) projection of the lumbar spine reveals that the downside pedicle is projected too far posterior on the vertebral body. What specific positioning error is present on this radiograph?
Excessive rotation of the spine