image analysis Flashcards
for ribs AP and PA projections above the diaphragm what should be seen? (expiration)
scapula off the lung fields by placing back of hands on the hips, rotating the elbows and shoulders anteriorly (AP)
scapula off the lungs fields by abducting and internally rotating patients arms forcing the shoulders to rotate anteriorly (PA)
-chin is elevated
-9th posterior ribs are demonstrated above the diaphragm indicating full lung aeration (upright 10ribs)
-7th posterior rib in the center of the exposure of the affected side
for ribs AP and PA projections below the diapharm what should be seen? (inspiration)
- 8-12 posterior ribs below the diapharm
- 10th posterior rib in the center of the exposure
- part of the thoracic & lumbar vertebral column
for a hyperstenic patient with a short wide throax where should the centering be placed for ribs below the diapharm
slightly higher place the IR 5cm above the iliac crest
if the ribs below the diapharm only show 3 posterior ribs below the diapharm what happened?
the image was exposed after the patient had taken a deep breathe.
to fix: show more posterior ribs below the diapharm and the image is exposed after the patient exhales
when the posterior ribs are affected how is the image taken
in AP to place the posterior ribs closer to the IR with the 7th rib in the middle of the exposure field
what should AP Axial C-spine look like
spinous processes aligned down the center open intervertebral disk spaces vertebral bodies without distoration c4 in the center see C4-C7
how can you detect rotation on the AP Axial C-spine
if the side of the patient is positioned closer to the table or upright IR its the side toward which the mandible is rotated and also side that is demonstrated
if the patient has a large lordotic curve…..
the vertebral bodies slant upward anteriorly to posteriorly
why do we angle for the cspine?
so the angle is in the same direction oas the slope of the vertebral bodies to open the intervertebral disk spaces
if the patient is in a upright position then the cervical vertebrae show?
more lordotic curve than if supine (more straight in the supine position)
if the patient is very kyphotic there will be
excessive lordotic curvature and you will need to increase the degree of central ray angulation
if on a cspine the spinous processes are not aligned in the middle and pedicles are not symmetrical, the mandible is rotated towards the patients left side and the medial end of the left clavicle shows no vertebral column superimposition what happened
the patient was rotated toward the left side LPO position
- rotate the patient towards the right side until the shoulders are at equal distances and turn the patients head toward the right side till mandible angles and mastoid tips are at equal distances
what is the criteria for AP open mouth?
atlas is symmetrical, lateral masses at equal distances from the dens, spinous process in the middle, upper incisors and base of skull seen superior to the dens and atlantoaxial jt, dens in the center
most patients in a c-collar for a ap open mouth need
10 degree caudal angle, CR is parallel with the IOML
to project the upper incisors superiorly you need
5 degree cephalic angle
for a ap open mouth the dens is superimposed over the posterior occipital bone. the upper incisors are demonstrated approx. 1.5” superior to the base of the skull so the patient s head was not accurately positioned how can you fix
tuck the chin toward the chest until the line of the upper occulsal plane and the base of skull are aligned perpendicular to the IR. so tuck in the chin 2cm
for a ap open mouth the upper incisors are superimposed over the dens. the base of skull is 1.25cm superior to the upper incisors and 0.6cm superior to the dens so the upper occlusal plane was positioned inferior to the base of the skull how can you fix
elevate the upper jaw until the upper occulsal plane and the base of the skull is aligned perpendicular to the IR
for lateral c-spine what is the criteria
see the prevertebral fat stripe
see spinous processes, left and right zygopopyseal jts , c4 in the center, see the c7 & T1 intervertebral jt space
for a lateral c-spine the vertebral body of c7 is not demonstrated in its entirety and the superior body of t1 is not demonstrated so the shoulders were not adequately depressed so how would you fix
have the patient hold weights on each arm to depress the shoulders if the patient cannot then do the swimmers projection
how should the patient be positioned for a cspine obliques?
done AP or PA
- see 2nd-7th intervertebral foramina open
- open intervertebral disk spaces
- see down to the c7-t1 intervertebral disk space
if for the c-spine oblqiues if the pedicles appear forshortened and the intervertebral foramina are peanuts what happened
rotated not enough
if for the cspine oblqiues the one side of the pedicles are partially foreshortened but the other side is aligned with the midline of the vertebral bodies what happened
rotated more than 45degrees
for a lateral t-spine T8-T12 intervertebral disk spaces are obscured and the vertebral bodies area distorted the veretebral column was not parallel with the table how would you fix
place a sponge under the iliac crest to make the column parallel or angle cepahlad until the column is perpendicular to the t spine (3-5)
ap lumbar spine T12 to L3 intervertebral disk spaces are closed and the lumbar bodies are distorted. the ischial spines are demonstrated without pelvic brim superimposition so there was a lordotic curvature in the spine how to fix
flex the hips and knees until the lower back is placed against the table
for a lateral lumbar spine the posterior surfaces of the 1st through 4th vertebral bodies and the posterior ribs are demonstrated one anterior to the other, the posterior ribs demonstrate greater mag and were positioned posteriorly how can you fix
rotate the side positioned farther from the IR anteriorly until the posterior ribs are superimposed
for a lateral lumbar spine l4-l5 and l5-s1 intervertebral disl spaces are closed and the 3rd through 5th vertebral bodies are distorted so the lumbar vertebral column was not aligned parallel with the IR how would you fix it
place a sponge under the lateral surface just superior to the iliac crest to the align the column parallel with the table
for a ap coccyx the pubic symphysis is superimposed over the coccyx and the 2nd through 3rd coccygeal vertebrae are foreshortened so the CR was not angled caudally how can you fix it
angle the CR 10 caudad to project the pubic symphysis off
for a PA chest the manubrium is at the level of the 5th t spine and more than 1” of apices superior to the clavicles so the upper midcoronal place was tilted anteriorly how can you fix
move the patients upper thorax posteriorly until the midcoronal plane is vertical
for a PA chest the manubrium is at the level of 2nd t spine and less than 1” of apices above superior the clavicles. the upper MCP was tilted away from the IR
move the patients upper throax twd the IR until the MCP is vertical
for a lateral chest the right and left posterior ribs are separated by more than 0.5” indicating that the chest was rotated and the gastric bubble is not seen but the superior heart shadow is extending beyond the sternum and into the anterior lung the left lung, the left throax is rotated anterior and the right thorax is rotated posteriorly
position right throax anteriorly half the distance between the posterior ribs about 1”
for the lateral chest the right and left posterior ribs are more than a 0.5 inch space so the chest is rotated the superior heart shadow does not extend beyond the sternum and the gastric air bubble is posterior the lung so the right lung is anterior to the sternum and left lung posterior the right throax was rotated anterior and left posterior
postiotion the right throax posterior
for an abdomen the sacrum is not aligned with the pubic symphysis and is closer to the left and the distance of the spinous processes is less on the right indicating the patient was rotated toward the right side how should you fix
rotate the patient to the left side until the shoulder and ASIS are at equal distances
for an abdomen the sacrum is not aligned with the pubic symphysis and is closer to the left and the distance of the spinous processes is less on the right indicating the patient was rotated toward the right side how should you fix
rotate the patient to the left side until the shoulder and ASIS are at equal distances
the vertebral column is deviated laterally at the level of the 2nd thru 4th Lspiine and the sacrum is centered within the inlet of the pelvis indicating scoliosis how to fix
nothing is needed
the vertebral column is deviated laterally at the level of the 2nd thru 4th Lspiine and the sacrum is centered within the inlet of the pelvis indicating scoliosis how to fix
nothing is needed
upright abdomen and the domes of the diapharm are not included and the CR was centered to inferiorly how can you fix
center the CR and IR 5cm superiorly from the crest
upright abdomen and the domes of the diapharm are not included and the CR was centered to inferiorly how can you fix
center the CR and IR 5cm superiorly from the crest
the pubic symphysis is not included on the image and the centering was to superiorly
center higher
the pubic symphysis is not included on the image and the centering was to superiorly
center higher
