procedures

how should the patient’s arms be positioned for the swimmers projection?

* position the arm farthest from the IR down along the patient’s side with the shoulder depressed


* the arm closest to the IR should be elevated with the elbow flexed and the forearm resting on the patient’s head

(if supine, rest head on arm closest to the IR so that it is still out of the way)

two ways the CR can be directed in a swimmers technique

* perpendicular if the shoulder away from the IR is well depressed
* if not well depressed, 3-5° caudal angle

Why would you flex the patient's hips for a T-spine AP projection?

to reduce the kyphotic curvature of the spine

respiration for an AP T-spine

suspended respiration at the end of full expiration

* this minimizes the air in the lungs, which results in less attenuation differences and more uniform exposure of the thoracic anatomy

centering point for a T-spine AP projection?

* Perpendicular
* Midway between the jugular notch and xiphoid process (T7)

How would you take advantage of the anode heel affect when taking an image of a chest or T-spine?

Put the cathode end of the tube toward the feet- so that the greatest percentage of radiation goes through the thickest part of the thorax

T7 landmark

level of the inferior angle of the scapula

Central ray centering for a T-spine lateral

perpendicular to T7 on the posterior half of the thorax

when positioning for a lateral T-spine, what should you do if the the thorax is not in a horizontal plane? (WM)

* women- 10° cephalad


* men- 15° cephalad -→ men have more broad shoulders. this is the reason for the larger angle

For a T-spine AP projection in the supine position, Why should the patient's head rest directly on the table or on a thin pillow instead of on a thick pillow/foam

To avoid accentuating the thoracic kyphosis

Why is it preferable to place the patient in the left lateral position instead of the right lateral position for a T-spine

To place the heart closer to the IR - minimizing superimposition of vertebrae by the heart

For the lateral recumbent position, what is the purpose of placing a firm pillow under the patient's head

To keep the long axis of the vertical column horizontal

Where do you Center for an AP projection of the L-spine

* Perpendicular to L4 (Level of the iliac crest) To view lumbosacral (Both the spine and the sacrum)
* Perpendicular to 1 1/2 inches above the iliac crest for just the spine itself

Why would you ask the patient to flex their knees for the lumbar spine AP projection

to reduce the lordotic curvature

Where would you Center for a lateral projection of a L-spine

* Perpendicular to L4 (Level of the iliac crest) To view lumbosacral (Both the spine and the sacrum)
* Perpendicular to 1 1/2 inches above the iliac crest for just the spine itself

centering for the lateral lumbar spine projection

(L5/S1 junction)

2 inches posterior to the ASIS and 1 1/2 inch inferior to the iliac crest

why should the patient empty the urinary bladder before the AP projection of the lumbar spine is performed

To eliminate superimposition caused by the secondary radiation generated with the filled bladder

lumbar articular facets for vertebrae L1-L4 form an angle of ______ __to__________

30 to 60 degrees

What is the importance of seeing the Scottie dog in an image

To show that the patient is properly positioned in an oblique

What is the ear of the Scottie dog

Superior articular process

What is the nose of the Scottie dog

Transverse process

What is the eye of the Scottie dog

pedicle

What is the neck of the Scottie dog

Pars interarticularis

What is the body of the spottie dog

lamina

What makes the feet of the Scottie dog

Inferior Articular process

What positioning error most likely occurred if the lumber zygapophyseal joint is not well demonstrated and the pedicle is quite anterior on the vertebral body

The patient was not rotated enough

What positioning error mostly likely occurred if the lumber zygapophyseal joint is not well demonstrated and the pedicle is quite posterior on the vertebral body

The patient is overrotated

How many degrees and in what direction should the central Ray be directed for a man and for females for the AP axial projection ( Ferguson method ) of the lumbosacral junction?

30° cephalad-men

35° cephalad- females

What is the one a central projection for the SI joints

AP oblique

What is the angle of the body for the AP oblique of the SI joint

* The side of interest is elevated 25 to 30°
* the side being examined is furthest from the IR