Technique Summary(331)

8/3/2019 Technique Summary(331)

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Radiographic Positioning Summary (Basic Projections RAD 331)

(Cervical Spine):Projection SID

(FFD)

Filament size Pat. and part Position Central ray and

center point

Grid Breathing instructions Remarks

AP C3-C7 40 inches

Small

focal spot

Seated or standing

line from the Occlusal plane to the

mastoid tips must be 90 to the couch

15 - 20 . Cephalic

Level of th e thyroid

cartilage (C4)

Yes

( Rested Respiration)

C3 to T1 = visualized

Lateral

Cervical

C1-C7

72 inches Seated or standing / no rotation / relax

shoulder

90 to IR center

Through C4 -

( Rested Expiration) C1 to C7 = visualized

Mandibular rami should be superimposed

over each other

R or LOblique

C1-C7

40 inches Center spine to midline of table orBucky Pt. angled 45 / shoulder touching

Bucky

For PO :15 - 20 cephalic

For AO :

15 - 20 Caudal

Through C4

Yes( Rested Expiration) C1 to C7 = visualized

RPO show L foramina

LPO show R foramina

(Thoracic spine):Projection SID

(FFD)


center point


A-PThoracic

40 inches

largefocal spot

Pt. is standing or supine facing the x-ray

tube with the midsagittal plane centered

to the Center of Bucky or IR and central

ray 90 to IR center

Level of T.7 Yes

( Rested Inspiration) C7 to T12 = centered in the midline

Lateral

Thoracic

Small

focal spot

Pt. is standing or lying down in la teral

position with mid-coronal planecentered to the Bucky / have pt. place

hands on top of the head.

A lead blocker sheet near patients back

helps minimize scattered rays

(expose duringexhalation)

C7 to T12 = centered in the midline

(Lumbar Spine):Projection SID

(FFD)

Filament size Pat. and part Position Central ray Grid Breathing instructions Remarks

A-P

Lumbar

Supine

40 inches Smallfocal spot

Pt. is supine with midsagittal plane

centered to Bucky with arms hang

comfortably at side

Flex knees partially with support under

knees

90 to IR center

Large IR L4 L5

(Level of iliac crest).

Small IR L3 (level

of lower costal

Margins).

Yes

( Rested Expiration)

T11 through sacrum should be visible

Collimation through spine

Transverse processes should be visualized

Lateral

Lumbar

Pt. is lying down recumbent with

Midcoronal plane centered to Bucky,arms folded on chest, elevate elbow

T1 through sacrum should be visible

A-P

L5/S1

Spot Shot

Pt. is supine with midsagittal plane

centered to table, place arms at side or

folded upon chest.

Flex knees partially with support

Cephalic (30 males),

(35 females).

to mid line at level of

ASIS

L5 / S1 joint space should be clearly seen

R or L

Posterior

Oblique

Or

Anterior

Oblique

Pt. is standing or lying down at 45 angle

with supporting shoulder and pelvis that

are off the table place arm across chestout of collimated field /

90 to IR center

L3 (level of lower

costal margin)

spinal column from T11 - S1 should be

visible / Scotty Dogs should be seen on all

5 L/S vertebra

LPO has L side closest

RPO has R side closest


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Chest:

Projection SID

(FFD)


center point


P-A Chest

Erect

72

inches

Large

focal spot

Patient erect with feet separated slightly

Align MSP to center and midline of IR

Elbows partially flexed

Shoulders rotated forward against IR

( to allow scapulae to move laterally

clear of lung fields)

90 to IR center

Level of T7(Inferiorangle of scapula

Yes End of second full

inspiration

The lung apices, Costophrenic angles,

and lateral margin of the ribs should beincluded in the film.

The scapulae should be moved lateral to

the lung fields

The spine should be centered on the

film

Sternoclavicular joints should be equal

in both sides.

10 posterior ribs should be demonstrated

above the diaphragm.

Lateral

ChestPatient erect left side against Bucky unlesspatient complaint is on right side.

Hands raised above head with chin up

coronal plane is perpendicular and sagittal

plane is parallel to IR

The lung apices, Costophrenic angles,

spine and sternum should be included inthe film.

The heart should adequately penetrate

showing sharp outlines, with vascularmarkings behind the sternum and heart.

ObliqueChest

Patient erect, rotated 45 (left anterior

shoulder against film for LAO, and rightanterior shoulder against film for RAO).Hands raised above head with chin up

The heart should adequately penetrateshowing sharp outlines

Abdomen:

Projection SID

(FFD)


center point


Abdomen

SupineOr Erect

40

inches

Large

focal spot

Patient Supine or erect with arms placed at

sides away from body or above head

For supine position Legs extended with

support under knees to keep patient back

close contact with table

MSP centered to midline of IRCenter of IR to level of iliac crest

No rotation of pelvis or Shoulders

90 to IR center

L4-5 (Level of iliac

crest) for supine

Level of lowercostal margin (5

cm above Level

of iliac crest) forerect position

Yes End of second full

Expiration

Appropriate markers should beplaced

indicating R and L

The image should include the area fromthe upper border of the pubic symphysis to

the diaphragm.

No rotation Spinous processes in the center

of the vertebral column Symmetric iliac

wingsNo motion The diaphragm should appear

sharp in an upright film.

Soft tissues visualization :faintly visualize

the lower liver margin, and kidneys outline,

The lateral borders of psoas muscles

Transverse processes of L. vertebrae.

*Note about AP Abdomens:-Standing film taken at high KVp to shorten exposure time, to look for air-fluid levels or free intraperitoneal air

-Patient should be standing for at least 5 minutes, if possible

-Recumbent film taken at low KVp (70) for higher contrast to find small kidney stones


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Skull Radiography:

ProjectionSID

(FFD)Filament size Pat. and part Position Central ray and

center pointGrid Breathing

instructionsRemarks

PA Skull 0

Occipital

frontal

projection

40 inches

Small

focal spot

Patient nose and forehead against the

table (IR) center

OML is 90 to the couch,

MSP 90 to IR center, head not rotated

EAMS equidistant from the couch top.

90 to IR center

Exits at the glabella

Yes N/A

Best demonstrate the frontal bone

PA Skull 15Caldwellprojection

90 to IR centerExits at nasion

Best demonstrate the petrous ridges

AP AxialTownes

projection

Patient supine, or AP sitting,

Chin is depressed (OML 90 to film),

No rotation of the head

30 caudad to OML

2 cm superior to level

of EAMs

Best demonstrate the occipital bone

Submentove

rtex (SMV)Patient supine or sitting,

chin raised, and neck hyper extended till

IOML is parallel to film,

MSP 90 to couch top.

A pillow under patients back allows for

sufficient extension

90 to IOML

Midway betweenangles of mandible

Best demonstrate the skull base

LateralSkull

cranium

Patient in a semi prone or sitting.

Head in a true lateral.

MSP parallel and IPL 90 to couch top.

Required side close to the film.

90 to IOML2 inches superior to

EAM

Best demonstrate superimposed cranialbones

Vertex-occipital and frontal bones should be

included

Mandibles should be superimposed

Lateral

Skull

Facial

90 to IOML

Zygoma

Best demonstrate superimposed Facial

bones

All facial bones should be included

Mandibles should be superimposed

(OM)

Waters forsinuses

Patient erect or seated.

Chin and nose against couch

MML is 90 to the film,

OML makes 37 with film.(Open mouth) patient drops his jaw

without moving the head).

90 to IOML

Exit at achanthion Best demonstrate maxillary , frontal sinusesand nasal Fossa.

*Note about skull:

Lateral skull with patient seated is essential for PNS to show fluid level

Lateral Sella require:-

- Examining both sides ( Rand L)- A long narrow cone should be used- C.P 2 cm anterior and 2 cm superior to EAM

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Technique Summary(331)