RAD111 CH10 Projections

Routine projections for sternum

RAO and lateral

Routine projections for SC joints

PA, RAO, LAO

Routine projections for posterior ribs

Erect:

AP + RPO or LPO

Recumbent:

AP + RPO or LPO

Routine projections for anterior ribs

Erect:

PA + RAO or LAO

Recumbent:

PA + RAO or LAO

SID for RAO Sternum

40 inches

Breathing technique for RAO sternum

orthostatic breathing

PT oblique degree for RAO sternum

15 to 20

CR for RAO sternum

Midsternum, between jugular notch and xiphoid process

1 inch left of midline

If the PTs condition does not allow for an RAO sternum, what position can you do

LPO

If the PT cannot be rotated for an RAO sternum, how should you angle the CR

15-20º across the RIGHT side of the PT to project the sternum lateromedial

SID for lateral sternum

72 inches bc of OID

For the lateral sternum should it be right or left

Preferably left bc of the heart

In a lateral sternum, the top of IR is how many inches above the jugular notch

1.5 inches

Respiration for lateral sternum

Suspend on deep inspiration

For lateral sternum if the PT is in lateral recumbent, where should the hands be and how is the CR positioned

Up above head, horizontal CR

SID for PA SC joints

40 in

IR position for PA SC joints

Landscape (horizontal)

CR of PA SC joints

Center at jugular notch, then turn PT around to PA

OR

3 inches below the vertebrae prominens

Respiration for PA SC joints

suspend on expiration

SID for RAO and LAO SC Joints

40in

PT rotation for RAO and LAO SC joints

10-15º toward side of interest

CR for RAO and LAO SC joints

Center to the level of T2-T3 and 1 to 2" lateral (towards the upside) of the spine

(Same as PA)

Respiration for RAO and LAO SC joints

Suspend on expiration

What does the 10-15º rotation of the SC joints do

Moves the spine across to the opposite lung field

RAO SC joint best shows which joint? Right or left

Right joint in the left lung field

LAO SC joint best shows which joint? Right or left

Left joint in the right lung field

With what degree obliquity, the opposite SC Joint (upside joint) would be visualized NEXT to the center real column

5-10º

If the PTs condition requires, oblique images of the SC joints can be obtained by

Posterior oblique with 10-15º rotation away from side of interest (PA away), CR is 1-2 inches lateral to midsag. The Upside SC joint would be best seen in this projection

Upper ribs require more or less kVp

Less (70-75)

Lower ribs require more or less kVp

More (75-85)

For above diaphragm ribs, how many ribs should you see

1-9

For below diaphragm ribs, how many ribs should you see

10-12

Above diaphragm ribs are preformed erect or recumbent

Erect

Below diaphragm ribs are preformed erect or recumbent

Recumbent

What should you tell the PT to do to their shoulders to rib studies

Roll them forward

For above diaphragm ribs, where is the CR

T7

AP - 3-4 inches below jugular notch

PA - 7-8 inches below vertebrae prominens

For below diaphragm ribs, where is the CR

Midway between the xiphoid process and lower rib margin

Respiration for above diaphragm ribs

Suspend on inspiration

Respiration for below diaphragm ribs

Suspend on expiration

For posterior pain of the ribs the patient is AP or PA

AP

For anterior pain of the ribs the patient is AP or PA

PA

What studies may be added aside from rib projections to rule out respiratory truama or dysfunctions like pneumothorax or hemothorax

PA erect and lateral chest studies

How should you rotate the patient for the oblique axillary ribs

45º,

AP - affected side towards board

PA - affect side away from board

What should you do with the patients arm for oblique axillary ribs

Raise up the arm

CR for oblique axillary ribs above diaphragm

T7

AP - 3-4inches below jugular notch

PA - 7-8 inches below the vertebrae prominens

CR for oblique axillary ribs below diaphragm

Midway between xiphoid process and lwoer rib margin (bottom of light/IR at iliac crest)

A PT has right anterior rib pain

Upper rib:

Erect PA + LAO

Lower rib:

Recumbent PA + LAO

A PT has left anterior rib pain

Upper rib:

PA + RAO

Lower rib:

PA + RAO

A PT has right posterior rib pain

Upper rib:

AP + RPO

Lower rib:

AP + RPO

A PT has left posterior rib pain

Upper rib:

AP + LPO

Lower rib:

AP + LPO