Chapter 1 Radiology Technology

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Anatomic Position

• Palms forward

• Hands forward

• Standing up straight

• Facing us

• Arms slightly abducted from body

• Toes forward

How we position x-rays to be viewed?

We don’t take x-rays in anatomic position but we present the x-rays in anatomic position.

Splitting the body into left and right halves.

Sagittal plane

Splitting the body into Anterior and Posterior portions. (Mid-coronal: equal portions)

Coronal plane

Not parallel to Sagittal, Coronal, or Horizontal plane.

Oblique plane

• must also include a qualifying term that indicates which way it is rotated, such as medial or lateral rotation ( For projections )

Otherwise known as Axial. Transverse plane splitting the body into Superior and Inferior portions.

Horizontal plane

Radiograph

A processed image of a patient's anatomic part(s), as produced by the action of x-rays on an image receptor

Radiograph vs. X-ray film

Radiograph - includes the recording medium and the image.

X-ray Film - x-ray film specifically refers to the physical piece of

material on which a latent (non-processed) radiographic image

is stored.

Planes of Skull

• Base plane

• Occlusal plane

Base Plane

Connects Interorbital margin to External Auditory Meatus (ear canal) (EAM).

• Helps position the head

• sometimes is called the Frank-fort horizontal plane

Occlusal Plane

Plane when teeth are together .

• Positioning purposes for Cervical spine

Top of feet

Dorsum ( Dorsum Pedis )

• Anterior/Ventral

Bottom of feet

Plantar surface of foot

• Posterior/Dorsal

Front of hand surface called:

Palmar ( Anterior )

Back of hand surface called:

Dorsal

• Posterior

• “ Dorsal Manus “

General body position:

Laying on your back facing upward

Supine

General body position:

Laying on your belly

Prone

General body position: recumbent position with the body tilted with the head lower than the feet.

Head is slightly lower than feet

• important for patients feeling faint

Trendelenburg

General body position: recumbent position with the body tilted with the head higher than the feet.

Head is higher than feet

• Upper GI exams if patient can’t stand up

Fowler ( can be known as : Reverse Trendelenburg )

General body position: Patient is upright

Erect

General body position:

Lying down in any position

Recumbent

General body position:

Patient is Supine w/ hips and knees flexed. Thighs abducted and rotated externally. ( Position for a pap smear/urinary )

Lithotomy

General body position : recumbent oblique position with the patient lying on the left anterior side, with the right knee and thigh flexed and the left arm extended down behind the back.

• Position for Barium Enema

Modified Sims position

What position is this?

Right Lateral Erect

What position is this?

Right Lateral Recumbent

What position is this?

Left Posterior Oblique

What position is this?

Left Posterior Oblique

What position is this?

Right Anterior Oblique

What position is this?

Right Anterior Oblique

Body Position:

How is the body positioned? How is the patient positioned?

Projection:

Describes the path or direction of the central ray

Breakdown into two things (Body position)

• What part of the body is touching first? Is it Anterior or Posterior.

• Is it right or left side touching?

What position term is this?

• Patient lying down

• Horizontal beam

Decubitus (Decub) Position

Position : ?

Projection: ?

Position: Left Lateral Decubitus

Projection: AP projection

Position: ?

Projection: ?

Position: Right Lateral Decubitus

Projection: PA projection

What Position is this? ( Look how patient is with IR )

• Laying supine with Horizontal beam

Dorsal Decubitus

What Position is this? ( Look how patient is with IR)

• Laying Prone with Horizontal beam

Ventral Decubitus

Position: ?

Projection: ?

Position: Dorsal Decubitus

Projection: Left Lateral

( Left Lateral Dorsal Decubitus)

Position: ?

Projection: ?

Position: Ventral Decubitus

Projection: Right Lateral

( Right Lateral Ventral Decubitus )

How does x-ray beams come out of the x-ray tube?

Fan shaped and use the straightest portion of x-ray beam to the center of the body part.

Position: ?

Projection: ?

Position: Medial Oblique Foot

Projection: AP

-Always add what side ( Ex: Right AP Medial Oblique Foot)

Position: ?

Projection: ?

Position: Lateral Oblique Hand

Projection: PA

-Always add what side ( ex: Right PA Lateral Oblique Hand)

Tube angle or patient angle more than 10 degrees

Axial

Hand, foot or Limb turned or held so palm/sole facing downwards

Pronated

Position: ?

Projection: ?

Position: Oblique elbow

Projection: AP medial

( Right AP Medial Oblique Elbow )

Entering Lateral aspect ( the thumb side) and exiting the medial aspect

Lateromedial

Entering the Medial aspect of ankle and exiting the Lateral aspect of the ankle.

Mediolateral

Better example of Lateral and Medial . It’s based off of anatomic position

Special Projection Terms:

AP Axial (semiaxial) Projection

• 37 degree angle = Axial

• Enters Anterior exits Posterior

Special Projection terms:

Axial (superoinferior) Projection

• Tube is angled = Axial

• Enters Superior exits Inferior

Inferosuperior Axial Projection

• Enters Inferior exits Superior = Inferosuperior

• Angled more than 10 degrees = Axial

The beam (CR) is touching a curve or surface at only one point .

• Image shows Tangential projection of Zygomatic arches

• “Skims” Zygomatic arches

Projection: AP Axial

• Leaning shoulders back

• Angling the patient = Axial

Answer = AP Axial Lordotic Position

Answer = Trans Thoracic Lateral Projection

• Trans ( Across the thoracic)

• Thoracic Lateral ( Patient is in Lateral )

( if we want to add position it would be Right Lateral )

Name this projection?

Planodorso projection of foot or PA proj. of foot

• more specific “Axial Planodorso projection of the Calcaneus ”

• Bottom of foot= Plantar

• 40 degree angle = Axial

Name this projection?

Dorsoplantar or AP proj. of foot

• Top of foot: Dorsum

Caudad Angle

• Towards the feet

• image 1

Cephalic Angle

• Towards the head

• image 2

Flexion

• Flexion decreases the angle of the joint

Flexion for legs

• Bend leg

Flexion for arms

• Bend Elbow

Extension

• Extension increases the angle

Extension for legs

• Straighten leg

Extension for arms

• Straighten arm

Image 1 : Hyper-extension beyond the straight or neutral position

Image 2 : Extension ( Neutral )

Image 3 : Flexion ( chin to chest )

Image 1 : Hyperextension or Dorsiflexion

• lifting up hand to the air

Image 2: Acute Flexion

• Moving Fingers downwards wrist

Movement term

Ulna Deviation

• Moving hand towards Ulna (Pinky side)

Movement term

Radius Deviation

• Moving hand towards Radius ( Thumb side)

Movement term for foot

Dorsiflexion

• 90 degrees

• Toes up

Movement term for foot

Plantar flexion

• 180 degrees

• Toes hanging down

Stress movement of ankle joint

Inversion ( Varus ) inward stress movement

• Big toe up , pinky toe down

Stress movement of ankle joint

Eversion (Valgus) outward stress movement

• Big toe down , pinky toe up

What type of rotation ?

Medial rotation

is a rotation or turning of a body part with movement of the anterior aspect of the part toward the inside, or median plane.

What type of rotation?

Lateral rotation

• is a rotation of an anterior body part toward the

outside, or away from the median plane.

Movement term

Abduction

• Away from

Movement term

Adduction

• towards

Movement term

Pronation

Movement term

Supination

Movement term

Protraction

• movement forward from a normal position

Movement term

Retraction

• movement backward or the condition of being drawn bac k.

Movement term

Elevation

• lifting, raising, or moving of a part superiorly.

Movement term

Depression

• letting down, lowering, or moving of a part

  inferiorly.

Movement term

Circumduction movement

• Circular movement at a joint

• Combines flexion, extension, abduction, and adduction

Difference b/w Rotation and Tilt

Rotation: Stays parallel with IR

Tilt: Midsagittal plane is no longer parallel to IR

• Midsagittal has a slant to it

Relationship terms

Superficial vs Deep

Superficial - nearer the skin surface

Deep - The more interior you get to the body part (arrow points at Humerus compared to Skin)

Radiographic view definition

View as describes body part as seen by IR or other recording medium such as Fluoroscopic screen.

Positioning accuracy

• All pertinent anatomy demonstrated

• Multiple images aligned on IR

• Collimation ( only want light field on anatomy you want)

• Rotation ( depends on what you want to create)

• Central Ray ( CR) ( Want the straightest beam at body part)

Evaluation criteria

Anatomy demonstrated: Elbow and wrist joints both included

Position: No rotation at wrist and elbow joints

Exposure: Optimal exposure factors

Image markers: “R” marker visible

Positioning Rules and Principles

MINIMUM TWO VIEWS/PROJECTIONS

• Anatomic structures superimposed ( Placed or laid on top of each other)

• Localization of lesions or foreign bodies ( For example the nail near the knee)

• Determination of alignment of fractures ( For example: the alignment of the tibia )

1 x-ray done straight on ( PA or AP) → Nail seems deep

1 x-ray 90 degree from that projection for true lateral → Nail adjacent to knee after true lateral

Positioning Rules and Principles

MINIMUM THREE PROJECTIONS/VIEWS

when joints are in prime interest area

• AP or PA

• Lateral

• Oblique

Long bones are required how many projections?

Two

• AP

• Lateral

Joints in a prime interest area how many projections?

Three

• AP or PA

• Lateral

• Oblique

Exceptions to Positioning Rules

• Postreduction upper and lower limbs ( Ex: Wrist in a cast usually three views but it’s fractured. Only 2 views (PA and lateral ) to check alignment.

• Pelvis study projection unless hip injury is suspected ( Ex: Usually 1 view unless trauma which you want 2 views.)

• Abdomen (KUB) One x ray supine when usually 2 x-rays 90 degrees from each other.

Viewing radiographs?

• patient is facing the viewer, with the patient in the anatomic position

• Limbs in anatomic position

• Hands & feet are digits up.

Human body 10 systems

(l) skeletal
(2) circulatory

(3) digestive

(4) respiratory

(5) urinary

(6) reproductive

(7) nervous

(8) muscular

(9) endocrine

( l0) integumentary

Skeletal system

includes the 206 separate bones of the body and their associated cartilages and joints

structures that make up the passageway from the exterior to the

alveoli of the lung interior include

• nose

• mouth

• pharynx

• larynx

• trachea

• bronchial tree.

urinary system includes

organs that produce, collect, and eliminate urine.

• kidneys

• ureters

• bladder

• urethra
  

function of the nervous system

regulate body activities with electrical impulses that travel along various nerves

muscular system, which includes all muscle tissues of the body,

is subdivided into three types of muscles:

• Skeletal

• smooth

• cardiac

Most of the muscle mass of the body is skeletal muscle

striated and under voluntary control

Smooth muscle

• involuntary

• is located in the walls of hollow internal organs such as blood vessels, the stomach , and intestines.