Rad Procedures Chapters 1&2

supine position

lying on the back, face upward

prone position

lying face down, head can be turned to side

erect position

upright, standing or sitting vertically

recumbent position

lying down in any position (dorsal, ventral, or lateral recumbent)

Trendelenburg position

supine with feet elevated higher than head

Fowler's position

Reverse trendelenburg.

supine with head and torso elevated above the feet (typically 45 degrees to 60 degrees)

Sim's position AKA left lateral recumbent

recumbent oblique position, lying on left anterior side with right knee and thigh flexed. (used for barium enemas)

Anteroposterior (AP) projection

CR enters the anterior (front) surface and exits the posterior (back) surface

Posteroanterior (PA) projection

CR enters at posterior surface and exits at anterior surface

Lateral projection

CR passes perpendicularly through the coronal plane from one side of the body to the other.

Oblique projection

CR enters at an angle relative to the coronal or sagittal plane

Axial projection

CR is angled longitudinally along, or parallel to, the long axis of the body part

Tangential projection

CR skims a body part profile to project it free of superimposition

Decubitus

patient is lying down (recumbent) while the x-ray beam is directed HORIZONTALLY. critical for detecting air-fluid levels.

Cephalad

CR angled toward the head

Caudad

CR angled toward the feet

Eversion

turning the foot outward, away from the midline

Inversion

turning the foot inward, toward the midline

Pronation

rotating the forearm so the palm faces posteriorly/downward

Supination

rotating the forearm so that the palm faces anteriorly/upward in anatomical position

midsagittal plane

anatomical plane that cuts body into equal right and left halves

transverse plane

anatomical plane that cuts body into top and bottom halves

coronal plane

anatomical plane that cuts body into front and back halves

midsagittal plane at level of T7.

the central ray for a PA chest is centered to what?

2nd full inspiration

exposure for the PA chest is done on what respiration?

minimum of 10

how many posterior ribs should you see on a PA chest?

to get the scapula out of the way

Why do you roll the shoulders forward on a PA chest?

because PA chest puts the heart closer to the board, reducing the shadow of the heart and putting the heart further away from the x-ray beam.

Why do you do PA chest instead of AP chest?

PA and lateral

What 2 views do you always do for the chest?

Vertebra Prominens (C7)

CR is centered roughly 7-8 inches inferior to C7 for an average adult.

What is the most prominent landmark for centering a PA chest?

(Spinous process at the base of the neck)

Jugular Notch

CR is directed 3-4 inches inferior to the jugular notch.

What is the key landmark for centering an AP chest?

(Deep depression on superior border of the manubrium)

Sternal Angle (level of T4-T5)

Junction between manubrium and body of sternum, marks carina and aortic arch level.

Xiphoid Tip (level of T9-T10)

Distal cartilaginous tip of the sternum, approximates the anterior/inferior lung border.

Inferior Angle of Scapula (level of T7)

Lowest point of scapular body, corresponds to midthorax/CR entry point.

Clavicles and SC Joints

Anterior shoulder girdle, used to evaluate patient rotation (symmetric spacing from spinous processes)

Costal Margins (Level of L2-L3)

Inferior lower edge of the rib cage, ensures exposure does not cut off deep costophrenic angles.

Body Habitus

the build, physique, and general shape of the body.

Sthenic

What body habitus makes up 50% of the population?

Left Posterior Oblique

Patient is erect with back to the IR, left side of body is turned 45 degrees toward IR.

Right Anterior Oblique

Patient is recumbent facing the IR, right side of body is turned 15 degrees toward IR.

Dorsal Decubitus (L Lateral)

Patient is lying on back. X-ray beam is directed horizontally and enters right side of the body, exits left side. IR is placed against left side of patient.

Right Lateral

Patient erect with right side of body against IR. X-ray beam enters left side and exits right side of body.

Left Lateral Decubitus (PA)

Patient lying on left side. X-ray beam is directed horizontally and enters the posterior surface of body and exits anteriorly. The IR is against the anterior surface.

Axial Projection

CR directed parallel along the long axis of the body or body part.

Lordotic Position

Position that demonstrates the apices of the lungs, without superimposition of the clavicles.

LR marker and patient info

Which two types of information should be on every radiographic image?

Where is the level of T4 or T5 when looking at the trachea?

parietal pleura

the outer layer of the pleural sac, lining the inner surface of the chest wall.

visceral pleura

the inner layer of the pleura that covers the surface of the lungs.

Apex of the Lung

What is B on the image?

Trachea

What is A on the image?

Carina

What is C on the image?

point of bifurcation of the trachea

Costophrenic angle

F on the image

outermost lower corner of the lung

Hilum

G on the image

aka root region. central area of each lung where bronchi, blood vessels, lymph vessels, and nerves enter and leave the lungs.

Mediastinum

medial portion of the thoracic cavity between the lungs

1. thymus gland

2. heart and great vessels

3. trachea

4. esophagus

What are the 4 radiographically important structures located in the mediastinum?