Which position should the patient be into demonstrate the right zygapophyseal joints of the lumbar spine?

The Correct Answer is: B
The typical vertebra has a body and a neural/vertebral arch surrounding the vertebral foramen (Figure 2-58). The neural arch is composed of two pedicles and two laminae that support four articular processes, two transverse processes, and one spinous process. The pedicles are short, thick processes extending back from the posterior aspect of the vertebral body, each one sustaining a lamina. The laminae extend posteriorly to the midline and join to form the spinous process. Each pedicle has notches superiorly and inferiorly (superior and inferior vertebral notches) that—with adjacent vertebrae—form the intervertebral foramina, through which the spinal nerves pass. The neural arch also has lateral transverse processes for muscle attachment and superior and inferior articular processes for the formation of apophyseal joints (classified as diarthrotic). The vertebral column permits flexion, extension, and lateral and rotary motions through its various articulations. (Frank, Long, and Smith, 11th ed., vol. 1, p. 376)

The Correct Answer is: C
When imaging a patient with a possible traumatic spine injury, it is appropriate to either maneuver the x-ray tube head or, if the patient must be moved, to use the log-rolling method. This cannot be done by one person; the radiographer must summon assistance. If the patient is on a backboard and in a neck collar, as most patients with suspected spine injury are, it is never appropriate to ask the patient to turn, scoot, or slide over. The only movement that should be permitted is movement of the entire spine, body, and head together, as in log-rolling. Any twisting could cause severe and permanent damage to the spinal cord, resulting in paralysis or even death. (Torres et al., pp. 77-79)

The Correct Answer is: A
The sacroiliac joints angle posteriorly and medially 25 degrees to the MSP. Therefore, to demonstrate the sacroiliac joints with the patient in the AP position, the affected side must be elevated 25 degrees. This places the joint space perpendicular to the IR and parallel to the CR. Therefore, the RPO position will demonstrate the left sacroiliac joint, and the LPO position will demonstrate the right sacroiliac joint. When the examination is performed with the patient in the PA position, the unaffected side will be elevated 25 degrees. (Frank, Long, and Smith, 11th ed., vol. 1, pp. 438-441)

The Correct Answer is: A
The cervical intervertebral foramina lie 45° to the midsagittal plane (MSP) and 15° to 20° to a transverse plane. When the posterior oblique position (LPO, RPO) is used, the central ray is directed 15° to 20° cephalad and the cervical intervertebral foramina demonstrated are those farther from the image recorder. There is therefore some magnification of the foramina (because of the OID). In the anterior oblique position (LAO, RAO), the central ray is directed 15° to 20° caudad, and the foramina disclosed are those closer to the image recorder. (Frank, Long, and Smith, 11th ed., vol. 1, pp. 404-406)

The Correct Answer is: B
The cervical intervertebral foramina lie 45 degrees to the midsagittal plane (MSP) and 15 to 20 degrees to the transverse plane. When the posterior oblique position (i.e., LPO or RPO) is used, the CR is directed 15 to 20 degrees cephalad, and the cervical intervertebral foramina demonstrated are those farther from the IR. There is, therefore, some magnification of the foramina (because of the OID). In the anterior oblique position (i.e., LAO or RAO), the CR is directed 15 to 20 degrees caudad, and the foramina disclosed are those closer to the IR. (Frank, Long, and Smith, 11th ed., vol. 1, pp. 404-406)

The Correct Answer is: A
A diagnostic image of C1-2 depends on adjusting the flexion of the neck so that the maxillary occlusal plane and the base of the skull are superimposed. Accurate adjustment of these structures usually will allow good visualization of the odontoid process and the atlantoaxial articulation. Should patient anatomy occasionally prevent the usual visualization, the odontoid process can be visualized through the foramen magnum, either AP or PA. In the AP position (Fuchs method) or the PA position (Judd method), the patient's chin is extended to be in line vertically with the mastoid tip (similar to a Waters' or reverse Waters' position). The CR is directed to the midline and perpendicularly at the level of the mastoid tip. The resulting image demonstrates the odontoid process through the foramen magnum. These positions should not be attempted if the patient has a suspected, new, or healing fracture or destructive disease. (Frank, Long, and Smith, 11th ed., vol. 1, pp. 392-394)

The Correct Answer is: D
The 45-degree oblique position of the lumbar spine generally is performed for demonstration of the apophyseal joints. In a correctly positioned oblique lumbar spine, "Scotty dog" images are demonstrated. The Scotty's ear corresponds to the superior articular process, his nose to the transverse process, his eye to the pedicle, his neck to the pars interarticularis, his body to the lamina, and his front foot to the inferior articular process. (Frank, Long, and Smith, 11th ed., vol. 1, p. 432)

Which position of the lumbar spine best demonstrates the zygapophyseal joints?

Which of the FF positions will demonstrate the right Apophyseal joints of the lumbar spine?

Which zygapophyseal joints are demonstrated on the AP oblique projection of the lumbar spine?

Which position or projection of the cervical spine best demonstrates the zygapophyseal joints?