Exam 9: Image Analysis of the Lumbar Vertebrae, Sacrum, and Coccyx

For a lateral lumbar projection obtained with maximum extension, the 1)patient arches the back by extending the shoulders and legs as far posteriorly as possible. 2)lumbar vertebral column demonstrates an increase in lordotic curvature. 3)lumbar vertebral column demonstrates a decrease in lordotic curvature. 4)patient rolls into a tight ball.

An AP axial sacral projection with accurate positioning demonstrates 1)the long axis of the median crest aligned with the long axis of the collimated field. 2)foreshortening of the first through fifth sacral segments. 3)the median sacral crest positioned closer to the right side. 4)the ischial spines equally demonstrated and aligned with the pelvic brim.

For an AP axial sacral projection, the 1)patient should empty the bladder and colon before the procedure. 2)central ray is angled 15 degrees cephalically. 3)ASISs are positioned at equal distance to the imaging table. 4)hips and knees are flexed.

An AP axial coccygeal projection with accurate positioning demonstrates the 1)coccyx aligned with the symphysis pubis. 2)longitudinal axis of the coccyx aligned with the longitudinal axis of the IR. 3)first through third coccygeal vertebrae. 4)coccyx without foreshortening.

An AP axial coccygeal projection demonstrates the symphysis pubis superimposed over the second and third coccygeal vertebrae. How was the positioning setup mispositioned for such a projection to be obtained?

A spot lateral L5-S1 projection with accurate positioning demonstrates 1)the L5-S1 intervertebral disk space in the center of the collimated field. 2)an open L5-S1 intervertebral disk space. 3)obscured intervertebral foramina. 4)near-superimposition of the greater sciatic notches.

A lateral sacral projection with poor positioning demonstrates a closed L5-S1 intervertebral disk space and foreshortening of the sacrum. How could the positioning setup have been mispositioned for such a projection to be obtained? 1)The patient was rotated. 2)The central ray was angled too cephalically. 3)The vertebral column was not aligned parallel with the imaging table. 4)The patient's legs were extended.

The posterior surfaces of the vertebral bodies are demonstrated without superimposition on a left lateral lumbar vertebrae projection. The most magnified ribs are demonstrated posteriorly. How should the positioning setup be adjusted to obtain an optimal projection?

An AP lumbar projection with accurate positioning demonstrates 1)open intervertebral disk spaces. 2)the vertebral bodies without distortion. 3)the spinous processes aligned with the midline of the vertebral bodies. 4)the sacrum and coccyx aligned with the symphysis pubis.

For a lateral sacral projection, the 1)patient's legs are flexed. 2)midcoronal plane is aligned parallel with the imaging table. 3)posterior ribs and the posterior pelvic wings are aligned perpendicular to the imaging table. 4)longitudinal axis of the sacrum is aligned with the short axis of the collimated field.

A left lateral lumbar projection with poor positioning demonstrates rotation. The posterior ribs that are most magnified and projected inferiorly are rotated anteriorly. How should the patient be repositioned for an optimal projection to be obtained?

For an AP oblique lumbar projection (RPO or LPO position), the 1)patient's thorax is rotated until the midcoronal plane is at a 45-degree angle with the IR. 2)side of interest is positioned closer to the IR. 3)central ray is centered 2 inches (5 cm) medial to the elevated ASIS at a level 1.5 inches (4 cm) superior to the iliac crest. 4)long axis of the vertebral column is aligned with the short axis of the collimated field.

A left lateral coccygeal projection with accurate positioning demonstrates 1)the median sacral crest in profile. 2)the first coccygeal vertebra in the center of the collimated field. 3)almost superimposed greater sciatic notches. 4)a left marker.

For an AP axial coccygeal projection, the 1)central ray is angled 10 degrees cephalically. 2)shoulders and ASISs are positioned perpendicular to the imaging table. 3)patient should empty the bladder and colon before the examination. 4)central ray is centered to the midsagittal plane at a level 2 inches (5 cm) superior to the symphysis pubis.

An AP lumbar projection obtained with the patient rotated toward the right side demonstrates 1)the spinous processes positioned closer to the left pedicles. 2)the sacrum and coccyx rotated toward the right side. 3)closed intervertebral disk spaces. 4)distorted vertebral bodies.

Appropriate positioning procedures for a lateral lumbar projection include 1)align the vertebral column parallel with the imaging table. 2)align the shoulders, posterior ribs, and posterior pelvic wings perpendicular to the imaging table. 3)for a patient with scoliosis, the patient is positioned on the imaging table so that the central ray is directed into the abnormal spinal curve. 4)flex the patient's knees and place a pillow or radiolucent sponge between them.

For a lateral coccygeal projection, 1)the longitudinally and transversely collimated fields can be closed to a 4-inch (10-cm) field size. 2)the posterior ribs and the posterior pelvic wings are positioned perpendicular to the imaging table. 3)the patient's legs are extended. 4)a small focal spot improves recorded detail sharpness.

A lateral sacral projection with accurate positioning demonstrates 1)the long axis of the sacrum aligned with the long axis of the collimated field. 2)near-superimposition of the greater sciatic notches. 3)an open L5-S1 intervertebral disk space. 4)the median sacral crest in profile.

A less than optimal AP axial sacral projection demonstrating sacral foreshortening

An AP oblique lumbar projection (RPO or LPO position) obtained with the patient underrotated demonstrates 1)obscured zygapophyseal joints. 2)the pedicles closer to the lateral surface of the vertebral bodies than the midline. 3)the intervertebral foramina. 4)the inferior and superior articular processes in profile.