procedures for chest projection

projection is

the path of center ray from the x-ray tube to the image receptor

AP projection

when the CR enters the anterior surface and exits the posterior surface

PA projection

when the CR enters the posterior surface and exits the anterior surface

lateral projection

the patient or part of the radiographed is on the side, rotated a full 90 degrees from AP or PA

oblique projection

the patient or the part to be radiographed is rotated some degree between 0 and 90 degrees AP or PA

axial projection

there is a longitudinal angulation of the CR 10 degrees or more along the long axis of the body or the body part

tangential projection

the CR skims between body parts to profile a bony structure and project it free of superimposition

view

describes the representation of an image as seen from the image receptor (opposite of projection)

method

is a radiologic procedure named after an individual

being upright, arms down, palms forward, and head and feet facing straight ahead is

anatomical position

recumbent position

lying down

supine (dorsal) position

lying on the back

prone (ventral) position

lying face down

supine position with the head tilted lower is

trendelenburg

supine position with the head tilted higher is

fowler's

supine with the knees and hips flexed, thighs abducted and rotated laterally

lithotomy

recumbent oblique with the patient lying on the left side with the right knee and thigh flex is the

sim's (recovery) position

right lateral recumbent position

the patient is laying on their right side

left lateral recumbent position

the patient is laying on their left side

for right and left lateral position how is it named

it is named according to the side of the body closest to the image receptor

in an RAO (right anterior position) what surface of the body is closest to the image receptor

right anterior

in an LPO (left posterior) what surface of the body is closest to the image receptor

left posterior

all decubitus positions have what direction of central ray?

directed horizontally down

if the patient is in a dorsal decubitus position (lying on the back), what position is the patient lying in with the CR directed horizontally?

supine position or dorsal recumbent

if the patient is in a ventral decubitus position (lying on the stomach), what position is the patient lying in with the CR directed horizontally?

prone position or ventral recumbent

lateral decubitus is when?

the patient is recumbent and lying on the right or left side with the C.R. directly horizontally

abduction

is movement of a part away from the central axis of the body

adduction

is movement of a part towards the central axis of the body

extension

Straightening of a joint (increasing angle)

flexion

bending a joint (decreasing the angle)

eversion

turn the foot outward

inversion

turn the foot inward

supinate

palm up

Pronate

palms down

rotations described as rotation of a part toward the midline of the body

medial/interal

rotations described as rotation of a part away from the midline of the body

lateral/external

Circumduction

circular movement of a limb

to turn away from the regular course is called?

deviation

on a PA projection, where is the C.R. centered at?

T7 (thoracic vertebrae)

why should the patient roll their shoulder forwarded and have palms facing out?

to remove the scapula from the lung field

how many inches should the relaxed shoulders be from the top of the IR?

2 inches

what is one reason why chest radiography taken in an upright position?

1. the diaphragm will be at it's lowest point

what is the second reason why chest radiography taken in an upright position?

2. demonstrates air and fluid levels in the lungs

what is the third reason why chest radiography taken in an upright position?

3. minimizes the blood vessels and heart

why is it important to take chest radiographs in 2nd full inspiration?

this is where the lungs have the most volume; 10 ribs should show up on the x-ray

why should the chest radiographs be taken at 72" SID?

this reduces magnification and increases detail in the image

why is it preferable to do a PA projection of the chest rather than an AP?

this minimizes or decrease the magnification of the heart

in obese patients needing a chest x-ray what is needed to do?

IR needs to be transverse

if a patient has large breast, what is needed to be done to get the chest x-ray?

patient needs to move the breast upward and outward

on a good chest x-ray, how should the clavicle be positioned on a PA position?

the clavicle should be on the same horizontal plane and below the apices

on a good chest x-ray, how should the clavicle be positioned on a PA position?

manubrium should be superimposed on the T4

how should the patient's neck be positioned?

extended to ensure that the chin and neck are not superimposing on the upper lung region

when should exposure be taken for chest x-ray

2nd full inspiration

on a left lateral projection of the chest, what level should the C.R. be at?

T7 and 2 inches anterior to the mid-coronal plane

the shoulders, posterior ribs, and posterior pelvic wing should be ____ to ensure the patient is not leaning forward or backwards

perpendicular

to identify rotation on a lateral position one should for?

gastric air bubble and left hemidiaphragm

how to tell the left lateral chest x-ray was done correctly:

1. posterior ribs are superimposed

2. sternum is in profile and intervertebral foramina of the thoracic vertebrae are open

3. arms are removed from the field

situation: A PA chest radiograph reveals only 8 ribs seen above the diaphragm

solution: repeat the exposure on the 2nd full inspiration

situation: A chest radiograph reveals that the pendulous breasts of the patient are obscuring the base of the lungs

solution: have the patient left their breast up and out

An ambulatory patient comes to radiology with a clinical history of possible pneumonia. The patient complains of pain in the center of her chest. What positioning routine should be performed on this patient?

upright PA and left lateral

in lateral position, how would the midsagittal plane be to the IR?

parallel with shoulder