Positioning

anterior

left

The heart lies (anterior/posterior) a little bit of the (left/right)

Reduce magnification

Chest x-rays are done in PA to _____________.

Move scapula more lateral

In a chest x-ray, the shoulders are moved forward the IR in order to?

10 ribs

For PA Chest x-ray, you must see at least ___ ribs above the diaphragm.

Heart is on left side so bringing that side closer to IR along with 72 inch SID will reduce magnification

Lateral chest x-rays are done left lateral because?

3-4 inches (8-10cm) INFERIOR to Jugular Notch

CR for PA and Lateral Chest x-rays?

15-20 degrees

For Lordotic chest x-rays, the patient will lean back _______ degrees from vertical IR

3 inches above the shoulders

For Lordotic chest, the top of the IR should be __ inches above the shoulders

Sternum or midsternum

For Lordotic chest, the CR should be __________

expose on 2nd inspiration

ALL chest x-rays are exposed on ________________.

Lordotic chest x-ray

Are done to show apices of the lungs

Side up

For a chest decubitus x-ray use the side (up/down) for the marker

72 inches for lateral soft tissue neck

For a lateral soft-tissue neck, the SID is

The laryngeal prominence (level of C4-5)

For a lateral and AP soft-tissue neck, the CR is directed at?

From Pharynx to midthoracic region

For the lateral soft tissue neck, you must be able to see from?

Expose on slow, deep inspiration

For the AP and lateral soft tissue neck, the exposure is done on?

No tube angulation

For AP soft tissue neck, what is the angle?

Superior

Vascular markings in a PA chest x-ray will appear thinner in the (superior/inferior) portions of the lungs.

40 inches SID

All skull x-rays are done in ______ SID

lateral

For _________ skull x-rays, both sides should be done.

IOML

For LATERAL SKULL, the ______ should be perpendicular to the front edge of IR.

IPL

For LATERAL SKULL, the ________ line should be perpendicular to the IR

2-2.5 inches above the EAM

The CR for the LATERAL SKULL is?

Lateral Skull X-ray

This position must have:

-Superimposed orbital roofs

-Greater sphenoid wings

-Sella turcica in profile

PA Skull

What skull x-ray?

-Nose and Forehead on the IR

-CR exits out the NASION

-No angulation

-ORBITS filled by PETROUS RIDGE

AP Axial Skull (Townes)

What skull x-ray?

-30 degrees caudal if using OML line

-37 degrees caudal if using IOML line

-CR 2 and ½ inches above GLABELLA

-Symmetrical Petrous Pyramids

-DORSUM SELLAE and POSTERIOR CLINOID PROCESS visible within the FORAMEN MAGNUM

CR is 2.5 inches above the GLABELLA

Where is the CR for the AP axial Skull (Townes)?

PA Axial Skull (Caldwell)

What skull x-ray?

-Nose and forehead on the IR

-CR Exits out the Nasion

-Symmetric Petrous Ridges

-PETROUS PYRAMIDS lying in the LOWER THIRD OF THE ORBIT.

Skull SMV (Basal view)

What skull x-ray?

-Neck hyperextended and vertex of head on IR.

-CR enters through SELLA TURCICA or ¾ inches ANTERIOR to EAM.

-Symmetrical MANDIBULAR CONDYLES

-Centered FORAMEN MAGNUM

IOML PARALLEL to IR

For SMV views, which line should be parallel to the IR?

CR between the OUTER CANTHUS and the EAM

What is the CR for LATERAL FACIAL BONES?

Lateral Facial Bones

Which facial bone x-ray?

-Affected side on the board

-IPL perpendicular to the IR

-IOML perpendicular to the edge of the IR

-Superimposed Mandibular Rami

-Superimposed Orbital Roofs

-Sella Turcica in Profile

IPL

For LATERAL skull, facial bones, and sinuses. Which line has to always be perpendicular to the IR?

Parietoacanathial Facial Bones (Waters view)

Which facial bone x-ray?

-No angulation

-CR exits through NASION

-Chin against the IR with 0.75” (2 cm) distance between the NOSE and IR.

-OML forms the a 37-degree to the IR

-MML Perpendicular to the IR

-EAM and OML aligned to form that 37 degree angle

-PETROUS RIDGES projected BELOW the MAXILLARY SINUSES.

MML

For WATERS views, which line should be perpendicular to the IR?

PA Axial Facial Bones (Caldwell)

Which facial bone x-ray?

-15-degree caudal angle

-Nose and forehead on the IR

-EAM and OML aligned

-Symmetric PETROUS RIDGES lying in LOWER THIRD OF THE ORBIT

Waters and Lateral

Which x-ray views are done to see the Maxillary sinuses?

MODIFIED Parietoacanthial facial bones (Modified waters)

Which facial bone x-ray?

-Great for BLOWOUT Fractures

-JUST THE CHIN against the IR

-CR exits out the acanthion

-OML 55 degree angle to the IR

-Petrous Ridges projected BELOW THE MAXILLARY SINUSES.

Parietoacanthial waters nasal view

Which Nasal x-ray?

-CR Exits out the acanthion

-Chin on the board

-3/4 inch (0.75 inch) from the tip of nose to board

-OML forms 37-degree angle to the IR

-MML perpendicular to IR

-Nasal bones centered

Lateral nasal bones

Which nasal x-ray?

-Recommended to do both sides

-IPL perpendicular to IR

-CR ½ inch to the inferior nasal bone

-see Nasal bone

-see frontal nasal suture

-see anterior nasal spine

erect

Sinuses must always be done ______ to show air and fluid levels

Lateral sinus

Which Sinus x-ray?

-Affected side against the board

-IOML perpendicular to front edge of IR

-IPL perpendicular to IR

-CR halfway between outer canthus and EAM

-Sella turcica in profile

-Air fluid levels of ALL sinuses seen

Nasal Parietoacanthial view (waters)

Which Sinus x-ray?

-CR exits through Acanthion

-Chin on board

-3/4 inch distance from nose to the board

-OML forms 37-degree angle to the IR

-MML perpendicular to IR

-Maxillary sinuses seen

-Petrous pyramids lying inferior to the floor of the maxillary sinuses,

Inferosuperior SMV Sinus projection (full basal)

Which sinus view?

-Neck hyper extended and vertex of the head on IR.

-CR directly through SELLA TURCICA perpendicular to IOML.

-CR ¾ inch anterior to EAM.

-See Ethmoid and Sphenoid sinuses.

-Superimposition of ANTERIOR FRONTAL BONE by MENTAL PROTUBERANCE AIR FLUID LEVELS

-IOML Parallel to IR

Open-Mouth Parietoacanthial Sinuses (Waters)

What sinus x-ray?

-OML forms a 37-degree angle to IR

-Chin on board and open mouth on instruction

-With mouth open, the MML line DOES NOT form a perpendicular plane to IR.

-SPHENOIDAL SINUSES projected through OPEN MOUTH.

-Maxillary sinuses can also be seen.

-Petrous pyramids lying immediately inferior to the floor of maxillary sinuses.

Right lateral

For lateral sternum, you should do the _____ lateral to move heart shadow out.

72 inches SID

What SID should a lateral sternum be done in?

CR at lateral border of the sternum

Where is the CR for the a LATERAL STERNUM?

Upper Ribs

For a lateral sternum, it should be free of superimposition of the _________

PT HOLDS breathe on inspiration

For a LATERAL STERNUM, what is the breathing instructions?

30-40 inch SID

What is the SID for an RAO Sternum?

15-20 degrees

How many degrees of rotation for RAO sternum?

CR on left or upside of the midline of T7

Where is the CR for an RAO sternum?

Slow respiration

What is the breathing technique for RAO sternum?

Heart

Slow inspiration breathing technique for RAO Sternum as it will show BLURRED PULMONARY MARKINGS to see visiblity of STERNUM superimposed over the __________.

Put affected or injured side closest to IR so Patient will be in PA position.

For ribs, if the injury is in the ANTERIOR, put that injured side (closest/farthest) from IR,

Put affected or injured side away from IR . Remeber PA =AWAY for ribs

For ribs, if the injury is in the POSTERIOR, put that injured side (closest/farthest) from IR,

72 inches SID

What is the SID for AP UPPER ribs?

CR is between Jugular notch and Xiphoid

Where is the CR for AP UPPER RIBS?

move scapula more lateral

For AP UPPER ribs, put hands on hips and elbow slightly forward to _______________.

Expose on SUSPENDED INSPIRATION

When do you expose on AP UPPER and UPPER OBLIQUE RIBS?

10 posterior ribs

How many ribs should be seen on AP Upper ribs?

40 inch SID

What is the SID for AP LOWER Ribs?

Between xiphoid and lower ribs

What is the CR for for AP LOWER Ribs?

Expose on EXPIRATION

When should exposure be done on AP LOWER Ribs?

Ribs 8-12

Which ribs must be seen on AP Lower Ribs?

40-45 degrees

How much rotation for an oblique upper and lower ribs?

72 inches SID

What is the SID for AP oblique upper ribs?

1 to 10 posterior ribs

How many ribs on AP UPPER OBLIQUE RIBS?

40 SID

What is the SID for AP LOWER RIBS?

Expose on respiration and ribs 8-12 must be seen

When do you expose on AP LOWER RIBS?

PA projection of affected side

RAO

Which 2 views will best demonstrate a patient experiencing LEFT ANTERIOR RIB PAIN?

Suspend on RESPIRATION

What is the breathing technique for pelvis and hip x-rays?

Will help elongate neck of femur and PUT GREATER TROCHANTER IN PROFILE

Why do you INVERT the heels 15-20 degrees medially when doing pelvis and hip x-rays?

Approximately 2.5 cm (1 inch) distal on a line drawn perpendicular from the midpoint of a line between the ASIS and the pubic symphysis

Which is used to locate the central ray entrance point for the AP projection of the hip?

Clements-Nakayama View and Danelius-Miller View

What are the two inferosuperior trauma hip views?

15 degrees POSTERIOR and perpendicular to the femoral neck?

What is the angle for the Clements-Nakayama View?

No tube angulation

What is the angle for the Danelius-Miller view?

Perpendicular to long-axis of femoral neck

What is the CR for the Danelius-Miller view?

2 inches superior from the pubic symphysis

or

2 inch inferior to the ASIS

What is the CR for an AP Pelvis?

1 inch above the iliac crest

The IR margin for an AP Pelvis should be?

20-35 degree cephalic angulation for men

What is the angulation for males for an AP Axial Pelvis Outlet view?

30-45 degree cephalic angulation for women

What is the angulation for females for an AP Axial Pelvis Outlet view?

1-2 inches distal to the superior border of the pubic symphysis

What is the CR for an AP Axial Pelvis Outlet view?

30 degrees caudal tube angulation

What is the angle for an AP Pelvis Outlet view?

At the ASIS for Inlet view

What is the CR for an AP Pelvis Outlet view?

AP Pelvis Inlet

AP Pelvis Inlet or Outlet?

AP Pelvis Inlet

AP Pelvis Inlet or Outlet?

AP supine and prone KUB

The only 2 x-ray views where the CR for KUB is at the iliac crest are:

(every other KUB CR is 2 inches superior to the Iliac Crest.)

Lateral decubitus KUB (Pt must be in position for at least 5 minutes before x-ray is shot)

Which KUB x-ray is done to check for air-fluid levels?

Put the side that is up in the air so if patient’s left side (left lateral position) is on the table, you will use a right marker since it is the side that is up in the air. *position is still called LEFT LATERAL DECUBITUS

For a lateral decubitus KUB, which marker would you use to mark patient side position?

Liver

Which part of the abdomen?

Gallbladder

Which part of the abdomen?

Stomach

Which part of the abdomen? (pink portion)

Pancreas

Which part of the abdomen? (yellow portion)

Duodenum

Which part of the small intestine is the blue arrow?

Jejenum

Which part of the small intestine is the red arrow?

Ileum

Which part of the small intestine is the purple arrow?

Add a 15-degree cephalic angle to view joint spaces

When you are doing the AP projection of the toes and want to capture the joint spaces, what should you do with the CR?

30-45 degrees towards the other knee

For the oblique projection of the toes, how much degree should your roll the knee towards the other knee?