RAD-143 THORACIC SCOLIOSIS SERIES SPINAL FUSION SERIES

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anatomy12
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269229
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RAD-143 THORACIC SCOLIOSIS SERIES SPINAL FUSION SERIES
Updated:
2014-04-26 18:13:31
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xray
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xray
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  1. how do we reduce thoracic curvature in ap projection of the spine
    flex knees and hips
  2. where is the cr for an ap thoracic spine
    do we need to collimate
    • CR perp to IR @ t7 (3-4 in below jug notch)
    • yes
  3. what is the breathing for an ap spine of thoracic vertebrae
    what is the reasoning for this
    • suspend respiration on expiration
    • expiration reduces air volume in thorax for more uniform brightness and density
  4. how do we use the anode heel effect when doing the ap thoracic spine
    place the patient so the more intense aspect of the beam (cathode) is over the thoracolumbar region of the spine
  5. what is also useful when obtaining uniform brightness, density
    wedge compensating filter use the thicker part of filter toward the upper vertebrae
  6. no rotation on an ap thoracic exam is identified by what structures
    sternoclavicular joints equidistant from spine
  7. on a lateral position of the thoracic spine what is the breathing method and usage of lead
    • breathing is orthostatic breathing technique with low ma and 3-4 second exposure
    • lead apron behind patient to absorbe scatter
  8. what is the position of the patients arms knees hips shoulders and pelvis on a lateral
    • arms are at 90 with elbows flexxed
    • knees and hips are flexxed
    • ensure no rotation of shoulders and pelvis
  9. where is the cr for the lateral thoracic spine
    @t7 3-4 in below jug notch or 7-8 in below vertebral prominens
  10. the inner and outer portions of the intervertebral disks are called
    • nucleus pulposus inner
    • annulus fibrosus = outer
  11. why is a pa scoliosis series more recommended than an ap scoliosis series
    because of significantly reduced dose to radiation sensitive areas such as female breasts and thyroid gland
  12. what is the cr for a pa erect scoliosis series
    the CR also depens on what other factor
    • cr IR lower margin @ 1-2in (3-5cm) below iliac crests
    • IR size and location of scoliosis
  13. what is the breathing for a pa scoliosis series
    suspend respiration on expiration
  14. how do we ensure no patient rotation of the bones on an xray
    indicated by thoracic and lumbar vertebrae with spinous processes aligned with the vertebral midline and symmetry of iliac alae/wings and upper sacrum
  15. where is cr for erect lateral scoliosis series
    what is the breathing
    • lower margin of IR 1-2 below iliac crests
    • suspend respiration on expiration
  16. what is the position of the arms for erect lateral scoliosis series
    arms up above and elevate or grasping something in front of them
  17. no rotation is indicated on a lateral scoliosis series by what structures
    superimposed greater sciatic notches and posterior vertebral bodies
  18. how many pa or ap scoliosis series are taken and what r they
    on erect ap or pa and one recumbent
  19. how many images are required in the ap or pa ferguson method: scoliosis series
    what is the breathing
    • 1 standard erect ap or pa and one with the foot or hip on the convex side of the curve elevated without assistance
    • same as regular scoliosis series
  20. where is the cr for ap or pa ferguson method:
    what is put under the foot or hip for the convex side of the curve
    • same as ap or pa scoliosis
    • 3-4 in block under
  21. in the right and left bending scoliosis series can the patient be recumbent or erect
    how many xrays needed for this
    • either one is fine
    • one xray
  22. right and left bending scoliosis series places the arm where
    the pelvis acts as what when bending the spine left or right
    if this exam can be done how would it be done
    • at sides
    • fulcrum (pivot point)
    • pa - to redce pt dose
  23. how many images are required for a lateral position hyperextension and hyperflexion: spinal fusion series
    two images in lat position hyperflexed and hyper extended
  24. what is the positioning instructions for spinal fusion hyperflexion and breathing instructions
    • ask patient to assume fetal position in later pos and bend forawrd draw legs as far as possible (while using pelvis as fulcrum)
    • suspend respiration on expiration
  25. what is the alternative positions to the lateral position hyperextension and hyperflexion: spinal fusion if the patient cannot lie on thier side
    position patient on stool or chair and ask patient to bend forward or backward while keeping the pivot as a fulcrum
  26. where is the cr  for a lateral position hyperextension and hyperflexion:spinal fusion series
    what exam is generally part of a spinal fusion series
    • cr @ site of fusion or to center of IR
    • right and left bending positions: scoliosis series
  27. two partial facets are called
    demifacets on body
  28. every thoracic has a ____ ______
    full facet on body
  29. each head or demifacet of the thoracic vertebrae articulates with what structure to form what joint
    • head of a rib
    • form costovertebral joint
  30. the articulations on the transverse process of the first 10 thoracic vertebrae that join with the tubercles of the ribs are
    costotransverse joints
  31. vertebrae 11 and 12 of the thoracic spine are missing what
    they dont have have facets on there transverse processes
  32. ribs 11 and 12 only articulate at what joints
    costovertebral because the they attach straight at the vertebrae
  33. the jugular notch is at the level of
    t2-t3
  34. the sternal angle is at the level of
    t4 and t5
  35. xiphoid process is at the level of
    t9-t10
  36. where is the level of t7 or the mid thorac mid lung field
    in the middle of jug notch and xiphoid tip or 3-4 in below jug notch
  37. the vertebral prominens is at the level of
    t1
  38. the intervertebral formaina on the thoracic spine are best demonstrated at what position
    lateral position or 90 deg to the midsagittal plane
  39. in the thoracic vertebrae the zygapophyseal joints form an angle of ____
    70-75deg from the midsagittal plane
  40. how would you position the thoracic spine for a zygapophyseal joint
    • oblique patient 70-75 deg
    • start at lateral first
  41. t1-10 have what joints
    each facet or combination of two demifacets articulate with what structure
    • costotransverse
    • head of the rib
  42. facets and demifacets:
    t1 =
    t2-t8 =
    t9 =
    t10-t12 =
    • t1 = one full facet and a one demifacet on inferior surface
    • t2-t8 = demifacets on their upper and lower margins
    • t9 = full facet one
    • t10-t12 = full facets
  43. what ribs have facets that articulate with the tubercle of the rib
    t1-t10 have facets on their transverse process that articulate with the tubercle of the rib
  44. what is the purpose of the scoliosis series freguson method, scoliosis series right and left bending and spinal fusion hyper and flexion
    • scoliosis series freguson method: asissts in differentiating deforming (primary) curve from compensatory
    • scoliosis series right and left bending: motion of vertebral column
    • spinal fusion hyper and flexion:mobility of spinal fusion site
  45. which zyga joints are shown in a 70 deg oblique RPO or LPO
    and anterior obliques
    • RPO = left upside zyga joints
    • LPO = right upside zyga joints
    • RAO =right downside zyga joints
    • LAO = left downside zyga joints

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