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27 Cards in this Set
- Front
- Back
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PA Chest: Explain Positioning of Patient |
-Place the patient with arms hanging at sides before the vertical grid device. - Center the midsagittal plane of the patient's body to the midline of the IR. - Extend the patients chin upwards - Flex elbows and rest the backs of the hands low on the hips, below the level of the costorphrenic angles. - Rotate the shoulders forward |
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Centering and Evaluation Criteria |
Centering: Perpendicular to the center of the IR. The central ray should enter at the level of T7 (inferior angle of the scapula) Criteria: - entire lung fields from the apices to the costophrenic angles - No rotation: sternal ends of the clavicles equal distance from the vertebral column trachea visible in the midline equal distance from the vertebral column to the lateral border of the ribs on each side - Scapula demonstrated outside of the lung field due to proper shoulder rotation. - proper inspiration demonstrated by 10 posterior ribs visible above the diaphragm. - sharp outlines of heart and diaphragm - lung markings visible |
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Lateral Chest: Positioning |
- Turn the patient into the true lateral position. - ensure the midsaggital plane of the body is parallel with the IR and the adjacent shoulder is touching the grid device - centre thorax to the grid - extend arms upwards, flex elbows, and with forearms resting on the head, hold arms into position. - adjust height of IR so that the upper border is 5cm above the shoulders. - Respiration: Full inspiration. |
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Centering and Evaluation Criteria |
Centering: perpendicular to the center of the IR. The central ray enters the patient on the midcoronal plane at the level of T7 or at the inferior aspect of the scapula. Criteria: - arm or its soft tissues not overlapping the superior lung field - costophrenic angles and the lower apices of the lungs - hilum in the approximate center of the radiograph - superimposition of the ribs posterior to the the vertebral column - lateral sternum with no rotation - no forward or backwards leaning - open thoracic intervertebral spaces and intervertebral foramina |
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AP Pelvis: Positioning |
- place patient on the table in the supine position - center the midsagittal plane of the body to the midline of the grid and adjust it in a true supine position. - medially the foot, if these no trauma or pathology detected, about 20 degrees to place the femoral necks parallel with the plane of the image receptor. |
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Centering and Evaluation Criteria: |
Centering: - midway between the ASIS and the pubic symphysis with the central ray perpendicular to the midpoint of the IR Criteria: - entire pelvis along with proximal femora - both ilia and greater trochanters equal distance to the edge of the radiograph - lower vertebral column centered to the middle of the radiograph - No rotation of the pelvis: both ilia symmetric in shape symmetric obturator foramina ischial spines equally seen sacrum and coccyx aligned with the pubic symphysis - femoral necks in full extent without superimposition - greater trochantors in profile with less trochantors visible on medial border of the femoral neck |
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AP shoulder: Positioning: |
- centre shoulder joint to the midline of the grid. - adjust position of IR so that the center is 2.5 cm inferior to the coracoid process - hand needs to be supinated with arm abducted slightly and rotated so epicondyles are parallel with plane of IR |
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Centring and Evaluation Criteria |
Centring: - perpendicular to a point 2.5cm inferior to the coracoid process, which can be palpated inferior to the clavicle and medial to the to the humeral head Criteria: - superior scapula, clavicle and proximal humerus - soft tissue - humeral head in profile - greater tubercle in profile on lateral aspect of humerus - scapulohumeral joint visualised with slight overlap of humeral head on glenoid cavity - outline of lesser tubercle between the humeral head and greater tubercle |
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Axial Shoulder: Positioning |
- seat patient at the end of the table with patient leaning laterally over IR until shoulder joint is positioned midpoint over the IR - flex patients elbow 90 degrees with hand in prone position. Lean head towards unaffected shoulder |
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Centring and Evaluation Criteria |
Centring: - angled 5 to 15 degrees through the shoulder joint and towards the elbow; to open up shoulder joint - this shows the joint relationship of the proximal end of the humerus and the glenoid cavity. Criteria: - scapulohumeral joint (not open on patients with limited flexibility) - coracoid process projected above the clavicle - lesser tubercle in profile - coracoid process projected above the clavicle |
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AP Elbow Positioning |
- shoulder joint, humerus and elbow joint in the same plane - extend the elbow, supinate the hand and center the IR to the elbow joint - lean laterally until the humeral epicondyles and anterior surface of elbow are parallel with the plane of the IR |
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Centring, Collimation and Evaluation Criteria |
Centring: - perpendicular to the elbow joint Collimation: - 8cm proximal and distal to the elbow joint and 2.5cm either side Criteria: - radial head, neck and tuberosity slightly superimposed over proximal ulna - elbow joint open and centred to the central ray - no rotation of humeral epicondyles (coronoid and olecranon fossa approx equal distant to epicondyles) |
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Lateral Elbow Positioning |
- shoulder, elbow and humerus lie in the same plane - flex patients elbow 90 degrees and place medial aspect of the forearm against the IR - to obtain lateral projection: adjust hand in the lateral position and ensure humeral epicondyles are perpendicular to the IR |
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Centring, collimation and evaluation criteria |
Centring: - perpendicular to the elbow joint Collimation: - 8cm proximal and distal to the elbow joint Criteria: - elbow joint open and centred to the central ray - elbow in true lateral position: superimposed humeral epicondyles, radial tuberosity facing anteriorly , radial head partially superimposing the coronoid process, oloecranon process in profile - elbow flexed 90 degrees |
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AP Knee Positioning |
- patient in supine position - place IR under patients knee and centre 1cm below apex to the IR - ensure femoral epicondyles are parralel with the IR |
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Centring and Evaluation Criteria |
Centring: - directed to a point 1.3cm inferior to the patella apex - angle depending on measurement between the anterior superior iliac spine (ASIS) and tabletop (if its a really small person slight 5 degree caudad and if really large slight 5 degree cephalic) Criteria: - knee fully extended if patients condition permits - entire knee without rotation: femoral condyles symmetric and tibia intercondylar eminence centred, slight superimposition of the fibular head if the tibia is normal, patella completely superimposed on the femur - open femorotibial joint space, with interspaces of equal width on both sides if the knee is normal |
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Lateral Knee Positioning |
- turn onto affected side with affected knee forward and extend other limb behind it - flexion of 20 to 30 degrees - place support under ankle - ensure epicondyles are perpendicular (superimposed) on the IR. The patella shoulder be perpendicular to IR |
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Centring, Evaluation Criteria |
Centring: - directed at knee joint 2.5cm distal to the medial epicondyle Criteria: - true lateral position which can be demonstrated by femoral condyles being superimposed. Superimposition will not occur IF - fibular head and tibia slightly superimposed - patella in lateral profile - open patellofemoral joint space - open joint space between formal condyles and tibia |
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PA Knee - Rosenberg Method Positioning |
- patient in standing position with anterior aspect of knees centred to the vertical grid device - flex knees to place femora at angle of 45 degrees |
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Centring and Evaluation Crtieria |
Centring: - horizontal and perpendicular to the IR. perpendicular to the tibia and fibula, a 10 degree caudal angulation is used Criteria: - both knees without rotation - knee joints centred to exposure area - tibial plateaus in profile - intercondylar fossa visible |
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Intercondylar Views |
- demonstrates subtle fractures of the tibial plateaus and femoral condyles - open intercondylar fossa - good visualisation of tibio-femoral joint and intercondylar eminences - no superimposition of patella over fossa - no rotation |
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Lipohaemarthrosis |
- casued by intra-articular fracture leaking fat from the bone marrow and blood into the supra patellar bursa - only demonstrated on a projection that has horizontal beam as you can see the layers of fat and blood |
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Tibial Plateau Fractures |
- associated with damage to cruciate ligaments and medial collateral ligaments - perpendicular line drawn at the most lateral margin of the femur should not have more than 5mm of the adjacent tibia beyond it |
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Supine Abdomen |
- supine on table - beam perpendicular to the IR - midsagittal plane at level of iliac crests |
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Why is Respiration Important? |
Inspiration - diaphragm flattens - abdominal length reduced - easier to include whole abdomen - contents compressed - may need higher exposure to penetrate Expiration - diaphragm raised - abdomenal contents not as compressed - slightly lower exposure to penetrate |
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Erect Abdomen |
- useful for demonstrating intraperitoneal air under diagram - Pt erect against upright bucky - centre in midline approx 5cm superior to iliac crests - arrested repiration |
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Penetration For Chest |
- lung markings - thoracic vertebrae and ribs through the heart - wont be able to see trabecular detail on bone, as kV will be lower - diaphragm and heart sharply outlined |
