ARRT positioning review (1st yr exit exam)

What is the positioning for a PA chest?

Pt. erect; hands on hips; shoulders rotated forward; coronal plane parallel & midsagittal plane perpendicular; expose on suspended full inspiration

What is the CR for a PA chest?

Enters midsagittal plane @ level of T7 (inferior angle of scapulae); 7-8" below vertebra prominens

What is the positioning for a left lateral chest?

Pt. erect; hands & arms above head; coronal plane perpendicular & midsagittal plane parallel; expose on suspended full inspiration

What is the CR for a left lateral chest?

Enters midcoronal plane @ level of T7

What is the positioning for an AP chest?

Pt. erect, semi-erect or supine; arms down by sides; coronal plane parallel & midsagittal plane perpendicular; expose on suspended full inspiration

What is the CR for an AP chest?

Enters midsagittal plane @ level of T7 (mid sternum); 3"-4" below jugular notch

What is the positioning for an left lateral decubitus chest?

Pt. L lateral recumbent; arms above head; horizontal x-ray beam; sponge under chest; expose on suspended full inspiration

What is the CR for an AP lateral decubitus chest?

Enters midsagittal plane @ level of T7 (mid sternum); 3"-4" below jugular notch

What is the positioning for an AP lordotic chest?

Pt. erect with back against Bucky; hands on hips; move feet moved 1 foot forward & arch back; expose on suspended full inspiration

What is the CR for an AP lordotic chest?

Enters midsagittal plane @ level of T7 (mid sternum) *15°-20° cephalad CR angle if patient supine or cannot arch back

What is the positioning for oblique chests?

Pt. erect; body rotated RAO & LAO 45°; expose on suspended full inspiration

What is the CR for oblique chests?

Enters @ level of T7

What is the positioning for a portable chest?

Pt. sitting erect, semi-erect, or supine; back against IR; chin up; coronal plane parallel & midsagittal plane perpendicular; expose on suspended full inspiration

What is the CR for a portable chest?

Enters midsagittal plane @ level of T7 (mid sternum - 3"-4" below jugular notch) *5°+ caudal angle to prevent clavicles from obscuring the apices

What are all the projections of the upper airway?

AP

Lateral

What is the positioning for an AP upper airway?

Pt. erect; chin elevated until AML perpendicular to IR; expose on slow deep inspiration

What is the CR for an AP upper airway?

Enters 1"-1.5" above jugular notch @ level of T1/T2

What is the positioning for a lateral upper airway?

Pt. erect; chin elevated; shoulders rotated posteriorly; expose on slow deep inspiration

What is the CR for a lateral upper airway?

Enters midway between thyroid cartilage & jugular notch @ level of C6/C7

What is the positioning for a KUB?

Pt. supine; arms down by sides; expose on suspended full expiration

What is the CR for a KUB?

Enters midsagittal plane @ level of iliac crest

What is the positioning for a PA abdomen?

Pt. prone; arms down by sides; expose on suspended full expiration

What is the CR for a PA abdomen?

Enters midsagittal plane @ level of iliac crest

What is the positioning for an erect AP abdomen?

Pt. erect; arms down by sides; expose on suspended full expiration

What is the CR for an Erect AP Abdomen?

Enters midsagittal plane @ level of 2" above iliac crest

What is the positioning for a left lateral decubitus abdomen?

Pt. L lateral recumbent; arms above head; horizontal x-ray beam; expose on suspended full expiration

What is the CR for a left lateral decubitus abdomen?

Enters midsagittal plane @ level of 2" above iliac crest

What is the positioning for a dorsal decubitus abdomen?

Pt. supine; arms above head; horizontal x-ray beam; expose on suspended full expiration

What is the CR for a dorsal decubitus abdomen?

Enters midcoronal plane @ level of 2" above iliac crest

What is the positioning for a lateral abdomen?

Pt. R or L lateral recumbent; arms above head; expose on suspended full inspiration

What is the CR for a lateral abdomen?

Enters midcoronal plane @ level of iliac crest

What is the positioning for a portable KUB?

Pt. supine; arms down by sides; expose on suspended full expiration

What is the CR for a portable KUB?

Enters midsagittal plane @ level of iliac crest*Enters @ level of 2" above iliac crest for NG tube placement

What is the positioning for an AP thumb?

Hand internally rotated; thumb extended & parallel to IR

What is the CR for an AP thumb?

Enters 1st MCP joint

What is the positioning for a PA thumb?

Hand lateral; thumb extended (PA) & parallel to IR

What is the CR for a PA thumb?

Enters 1st MCP joint

What is the positioning for a PA oblique thumb?

Hand pronated; thumb in "natural" 45° oblique to IR

What is the CR for a PA oblique thumb?

Enters 1st MCP joint

What is the positioning for a lateral thumb?

Elbow flexed 90°; fingers & hand arched until thumb perpendicular to IR

What is the CR for a lateral thumb?

Enters 1st MCP joint

What is the positioning for an AP axial (Roberts) thumb?

Hand internally rotated; thumb extended & parallel to IR

What is the CR for an AP axial (Roberts) thumb?

15° proximal CR angle to 1st CMC joint

What is the positioning for a PA digit (2-5)?

Elbow flexed 90°; hand pronated; fingers extended & spread; fingers parallel to IR

What is the CR for a PA digit (2-5)?

Enters affected PIP joint

What is the positioning for an oblique 2nd digit?

Elbow flexed 90°; hand pronated & rotated medially - thumb tucked under hand; finger 45° to IR

What is the CR for an oblique 2nd digit?

Enters affected PIP joint

What is the positioning for an oblique digit (3-5)?

Elbow flexed 90°; hand pronated & rotated laterally; fingers 45° to IR ("OK sign")

What is the CR for an oblique digit (3-5)?

Enters affected PIP joint

What is the positioning for a lateral 2nd digit?

Elbow flexed 90°; hand pronated & rotated medially - thumb tucked under hand; finger extended; flex other fingers out of way; finger perpendicular to IR

What is a CR for a lateral 2nd digit?

Enters affected PIP joint

What is the positioning for a lateral digit (3-5)?

Elbow flexed 90°; hand lateral; affected finger extended; flex other fingers out of way; finger perpendicular to IR

What is the CR of a lateral digit (3-5)?

Enters affected PIP joint

What is the positioning for a PA hand?

Elbow flexed 90°; forearm on table; hand pronated; fingers extended & spread; hand parallel to IR

What is the CR for a PA hand?

Enters 3rd MCP joint

What is the positioning for a PA oblique hand?

Elbow flexed 90°; forearm on table; hand pronated & rotated laterally; hand 45° to IR ("partial OK sign")

What is the CR for a PA oblique hand?

Enters 3rd MCP joint

What is the positioning for a lateral extension hand?

Elbow flexed 90°; forearm on table; hand lateral; fingers 2-5 extended; thumb parallel to IR; hand perpendicular to IR

What is the CR for a lateral extension hand?

Enters 2nd MCP joint

What is the positioning for a fan lateral hand?

Elbow flexed 90°; forearm on table; hand lateral; fingers 2-5 spread into "fan" position; thumb parallel to IR; hand perpendicular to IR

What is the CR for a fan lateral hand?

Enters 2nd MCP joint

What is the positioning for an AP bilateral oblique (Norgaard) hands?

Arms extended; hands partially supinated & rotated 45° internally/medially to IR; fingers extended - "ball catcher's position"

What is the CR for an AP bilateral oblique (Norgaard) hands?

Enters midpoint between both hands @ level of 5th MCP joints

What is the positioning for a PA wrist?

Elbow flexed 90°; forearm on table; hand pronated; fingers & hand arched slightly; wrist parallel to IR

What is the CR for a PA wrist?

Enters mid carpals

What is the positioning for a PA oblique wrist?

Elbow flexed 90°; forearm on table; hand pronated & rotated laterally; wrist 45° to IR

What is the CR for a PA oblique wrist?

Enters mid carpals

What is the positioning for a lateral wrist?

Elbow flexed 90°; forearm on table; hand lateral; fingers 2-5 extended; thumb up; wrist perpendicular to IR

What is the CR for a lateral wrist?

Enters mid carpals

What is the positioning for a PA scaphoid?

Elbow flexed 90°; forearm on table; hand pronated; wrist flexed externally (ulnar deviation); wrist placed on 20° angle sponge

What is the CR for a PA scaphoid?

Enters scaphoid - 3⁄4" distal & medial to radial styloid process

What is the positioning for a PA axial scaphoid?

Elbow flexed 90°; forearm on table; hand pronated; wrist flexed externally (ulnar deviation); wrist placed on 20° angle sponge

What is the CR for a PA axial scaphoid?

10°-15° proximal to scaphoid

What is the positioning for a PA scaphoid Stetcher method?

Elbow flexed 90°; forearm on table; hand pronated; wrist flexed externally (ulnar deviation); wrist parallel to IR

What is the CR for a PA scaphoid Stetcher method?

Enters scaphoid - 3⁄4" distal & medial to radial styloid process

What is the positioning for a Tangential inferosuperior carpal canal?

Palm down with hand & wrist hyperextended; hand rotated 10° toward radius (medial); hand & fingers as close to vertical as possible

What is the CR for a Tangential inferosuperior carpal canal?

25°-30° proximal to 1" distal to the base of the 3rd metacarpal (enters palm of hand)

What are all the views of the forearm?

AP

LAteral (lateromedial)

What is the positioning for an AP forearm?

Arm fully extended; shoulder dropped & entire limb on same plane; epicondyles parallel to IR

What is the CR for an AP forearm?

Enters mid forearm

What is the positioning for a lateral forearm?

Elbow flexed 90°; hand & wrist lateral; shoulder dropped & entire limb on same plane; epicondyles perpendicular to IR

What is the CR for a lateral forearm?

Enters mid forearm

What is the positioning for an AP elbow?

Arm fully extended; hand supinated; shoulder dropped & entire limb on same plane; epicondyles parallel to IR*2 AP projections done if arm cannot be extended: 1 with humerus parallel to IR & 1 with forearm parallel to IR

What is the CR for an AP elbow?

Enters mid elbow joint - 3/4" distal to epicondyles

What is the the positioning for an AP external oblique elbow?

Arm fully extended; hand supinated; shoulder dropped & entire limb on same plane; arm rotated externally until epicondyles 45° to IR

What is the CR for an AP external oblique elbow?

Enters mid elbow joint - 3/4" distal to epicondyles

What is the positioning for an AP internal oblique elbow?

Arm fully extended; hand pronated; shoulder dropped & entire limb on same plane; arm rotated internally until epicondyles 45° to IR

What is the CR for an AP internal oblique elbow?

Enters mid elbow joint - 3/4" distal to epicondyles

What is the positioning for a lateral elbow?

Elbow flexed 90°; hand & wrist lateral; shoulder dropped & entire limb on same plane; epicondyles perpendicular to IR

What is the CR for a lateral elbow?

Enters mid elbow joint - 1.5" medial to posterior surface of olecranon process

What is the anatomy on a lateral elbow?

3 concentric arcs, olecranon in profile, epicondyles superimposed

What is the positioning for an Axial lateromedial elbow for the radial head?

Elbow flexed 90°; hand pronated; shoulder dropped & entire limb on same plane; epicondyles perpendicular to IR (for radial head)

What is the CR for an Axial lateromedial elbow for the radial head?

To mid elbow joint:45° angle toward shoulder (for radial head)

What is the positioning for an Axial lateromedial for the coronoid process?

Elbow flexed 80°; hand pronated; shoulder dropped & entire limb on same plane; epicondyles perpendicular to IR (for coronoid process)

What is the CR for an Axial lateromedial elbow for the coronoid process?

45° angle away from shoulder (for coronoid process)

What is the positioning for an AP humerus?

Pt. facing tube; arm fully extended; hand supinated; arm abducted slightly; body slightly rotated to bring arm closer to IR; epicondyles parallel to IR

What is the CR for an AP humerus?

Enters mid humerus

What is the positioning for a rotational lateral (lateromedial) humerus?

Pt. facing tube; arm fully extended & elbow partially flexed; arm internally rotated until back of hand against thigh; body slightly rotated to bring arm closer to IR; epicondyles perpendicular to IR

What is the CR for a rotational lateral (lateromedial) humerus?

Enters mid humerus

What is the positioning for a Rotational Lateral (mediolateral) humerus?

Pt. facing Bucky; body rotated 20°-30°; arm flexed 90°; epicondyles perpendicular to IR