Positioning Flashcards
How much should the femur be abducted for the Lauenstein method for hip?
40-45 degrees (with knee flexed 90 degress)
Where is the CR placed for unilateral frog leg projection
mid femoral neck
The Judet Method demostrates the
Acetabulum
Lateral of the hip is also called
Frog or Modified Cleaves or Lauenstein Method
How much should the femur be abducted for the Cleaves Method for the hip?
40-45 degrees
A male pelvis has a ________ angle while female pelvis has a _________
Male - Less than 90 degrees acute
Female - greater than 90 degrees obtuse
Trauma Hip most often used is called
Danellius - Miller or Cross- table lateral or Axiolateral (inferosuperior)
The AP Axial outlet projection for the pelvic ring requires the CR angle to be
20 - 35 degrees females
30 - 45 degrees males
The modified axiolateral trauma hip when both hips can’t be moved is called
Clements - Nakayama Method
Center of AP Hip (with hardware)
1-2” distal to neck of femur (all hardware must be demonstrated)
Three differences in a female and male pelvis are
Males have narrower, deeper and less flared
Angle of the pubic arch is less than 90 degrees
Shape of the inlet is more narrower and more oval or heart shape
The AP Inlet Projection for the pelvic ring requires the CR angle to be
40 degrees caudad
If the femoral neck is foreshortened and the lesser trochanter in profile medially on the radiograph. What is probable cause for positioning
External rotation of the leg and foot
What pathology is best demonstrated with the Judet Method
acetabular fractures
The ankle joint is formed by what 3 bones
Tibia, fibula, talus
The mortise position demonstrates the joint and should have even space over entire _____
Talar surface
When taking patient history for the hip xray, it is important to ask about the prosthesis or any hip surgery for what two reasons
So you can position patient without injuring the site
To make sure you center lower to include all the hardware
A 15 degrees internal rotation of the ankle in AP oblique projection is called the
Mortise Projection
What is the difference between the AP Mortise and AP oblique ankle projections for positioning?
AP Mortise - 15-20 degrees internal rotation
AP Oblique - 45 degrees internal rotation
Which malleolus is longer and is extension of the fibula
Lateral Malleolus
What are inversion/eversion of the ankle for?
Stress views that are used to demonstrate ligament damage
Positioning for the AP Mortise with how many degrees medial rotation
15-20 degrees medial rotation, centered to ankle (demonstrates ankle mortise)
The ankle is what type of joint, with what type of movement?
Synovial Joint, sellar or saddle type, movement is flexion, extension
How many tarsals are there?
Seven
Calcaneus, Cuboid, Talus, Navicular, and the medial, middle and lateral cuneiforms.
Where can you find sesamoid bones in the foot?
Embedded in tendons, near joints, plantar surface
Special projection for the foot to show longitudinal arches?
AP and Lateral weight-bearing, CR 15 degrees posterior to base of metatarsal
Does Lisfranc joint injury of the foot, requires a decrease or increase in technique?
Increase to penetrate tarsal region
What is the common trauma site for the foot that provide attachment of a tendon, and what is the projection for this
Tuberosity of the 5th metatarsal
Oblique Medial of the foot
Longest and strongest bone
Femur
Name three knee positions that are tunnel projections
Beclere, Camp-Coventry, Homblad
Name two tangential knee projections
Merchant, Sunrise
Difference between medial and lateral epicondyle of the knee is the presence of
Adductor tubercle on the posterior side of the medial condylethat receives the tendon of the adductor muscle
What do all tunnel view demostrate
Intercondylar Fossa
How do you position patient in Camp Coventry Method
Patient supine, flex knee 40-50 degrees, CR to knee joint or popliteal depression, perpendicular ti tib/fib, 40 SID
The Settegast Method is also called inferosuperior projection requires the knne flexed _____ degrees and the CR angle _____ to the lower legs
40-45 degrees, 10-15 degrees
The medial and lateral condyles of the femur articulate with
The tibia
Why must the CR angle for a lateral knee be 5-7 degrees cephalad
The medial femoral condyle extends lower than the lateral femoral condyle when the femoral shaft is vertical
What is the largest joint space of the human body
Cavity of the knee joint
Beclere Method (AP Axial) for tunnel knee requires ______ degree knee flexion, CR angle of ______ degrees and CR centered ______
40-45 degrees knee flexion
40-45 degrees cephalad
CR 1/2 inch distal to apex of patella
Holmblad Method (PA Axial) for tunnel knee requires _____ degree knee flexion, CR angle of ______ degrees.
60-70 degree knee flexion
CR perpendicular to IR (no angulation)
The term engorgement literally means
Distended or swollen with fluid
___________ is an excess of blood partially resulting to from a relaxation of the distal small blood vessels or arterioles.
Hyperemia
An _______ position in general tends to minimize the engorgement and hyperemia of pulmonary vessels, whereas ________ position will increase this, w/c can change the radiographic appearance of these vessel and the lungs in general.
Erect
Supine
Chest radiographs if taken AP instead of PA at 72 inches will cause
Increased magnification of the heart shadow
On a true PA chest, what is the evident that there is no rotation
Both the right and left sternal ends of the clavicles will be the same distance from the center of the spine
The seperation of the posterior ribs resulting from divergence of the xray beam at the commonly used 72inches (180cm) SID should only be _______, anymore seperation than this indicates rotation of the thorax from a true lateral position.
1/4 to 1/2 inches or about 1cm.
What is the evidence that a lateral chest have excessive rotation
Amount of separation of the right and left posterior ribs
Separation of two costiphrenic angles
Vertebra prominens corresponds to the level of ______ and the uppermost margin of the apex of the lungs.
T1
The CR for PA chest is at the
Level of T7 (midthorax)
Also near at the level of inferior angle of scapula on average px
3-4 inches below the jugular notch
____________ is an irreversible dilation or widening of the bronchi or bronchioles resulting from repeated pulmonary infection or obstruction.
Bronchiectasis
Increase exposure factor
___________ is a form of persistent obstruction of airway caused bu either emphysema or chronic bronchitis.
COPD (Chronic Obstructive Pulmonary Disease)
Decrease exposure factor
___________ irreversible and chronic lung dissease, in which alveoli air spaces become greatly enlarged as a result of alveolar wall destruction and loss of alveolar elasticity.
Emphysema
Decrease exposure factor depend on severity
________ shortness of breath which creates a sensation of difficulty in breathing, most common in older persons.
Dyspnea
For possible fluid in pleural cavity (pleural effusion), the suspected side should be ______.
Down
For possible small amounts of air in pleural cavity, the affected side should be ______.
UP
A ________ beam must be used to show air-fluid level or pneumothorax.
Horizontal beam
If patient is weak and unstable and/or not able to assume yhe lordotic position, an ___________ projection may be taken with the patient erect or supine position with back against table or IR.
AP Semi-Axial Projection
The central ray for AP Semi-Axial Projection is ________ degrees cephalad to the mid sternum
15-20
For anterior oblique of the chest, the side of interest is generally the side ________ from the IR. Thus the RAO will best visualize the ______ lung.
Farthest
Left Lung
Certain positions for studies of the heart require an LAO with an increase in rotation to ______ degrees.
60
Less rotation _______ degrees may be of value for better visualization of the various areas of the lungs for possible pulmonary disease.
15-20
Posterior obliques of the chest best visualize the side _______ to the IR.
Closest
Soft tissue lateral is frequently taken to rule out ________, which may be life threatening for a young child.
Epiglottitis
If the area of interest is primarily the larynx and upper trachea, the IR and CR should be
Laryngeal Prominence (C5)
If the are of interest is the distal larynx and upper and mid trachea, the IR and CR should be
At the upper jugular notch (T1)
Respiration for upper airway is during a _____________ to ensure filling trachea and upper airway with air.
Slow, deep inspiration
Vertebra prominence is at level of
C7
Xiphoid tip is at level of
Level of T9-T10
Inferior costal rib margin
Level of L2-L3
__________ a chronic inflammation of the intestinal wall that can result in bowel obstruction (most common in young adults, from unknown cause)
Crohn’s Disease
Patient should be on side for a minimum of ______ minutes before exposure( to allow air to rise or abnormal fluids to accumulate, ______ minutes is preferred, if possible to beat demonstrate potential small amounts of intraperitoneal air.
5 minutes
10-20 minutes
_________________best visualizes free intraperitoneal air in the area of liver in the right upper abdomen away from the gastric bubble.
Left Lateral Decubitus
_____________ replaces erect position of the abdomen, if the patient is too ill to stand
Left Lateral decubitus
Open ups and best demonstrates the carpals on the opposite side (radial side) of the wrist, namely scaphoid, trapezium and trapezoid.
Ulnar Deviation (Special Scaphoid Projection)
Opens and best demonstrates the carpals on the ulnar side of the wrist, namely hamate, pisiform, triquetrum and lunate.
Radial Deviation
On AP Projection of the elbow, _________ rotation separate the radius and ulna and ________ rotaion superimposes.
Lateral Rotation
Medial Rotation
Fracture and dislocation of the posterior lip of the radius involving the wrist joint.
Barton’s Fracture
Fracture of the base of the first metacarpal bone, extenting into the CMJ, complicated by subluxation with some posterior displacement.
Bennett’s Fracture
A transverse fracture extending through the metacarpal neck; most commonly seen in the fifth metacarpal
Boxer’s Fracture
A transverse fracture of the distal radius with the distal fragment being displaced posteriorly; an associated ulnar styloid fracture seen in 50-60% of cases.
Colles’ Fracture
Reverse of Colle’s fracture, or a transverse fracture of the distal radius with the distal fragment displaced anteriorly
Smith’s Fracture
Demostrates fractures and/or dislocation of the first carpometacarpal joint. Base of 1st metacarpal is demonstrated for ruling out Bennett’s Fracture
AP Projection (Modified Robert’s Method) Thumb
For Modified Roberts Method, CR directed _____________(toward wrist), entering the first CM joint
15 degrees proximally
This position is performed commonly to evaluate for early evidence of rheumatoid arthritis at the 2nd through 5th proximal phalanges.
Norgaard Method or Ball-Cather’s Position
For Pa Scaphoid, angle CR ____________, along long axis of forearm and toward elbow, Center CR to _________.
10-15 degrees proximally
Scaphoid
Modified Stecher Method of the wrist indicates that elevation of the hand ______ degrees rather than angling the CR places the scaphoid parallel to IR.
20 degrees
This projection is performed most commonly to rule out abnormal calcification and bony changes in the carpal sulcus that may create impingement on the median nerve, as with carpal tunnel syndrome.
Gaynor-Hart Method
For Gaynor-Hart Method angle CR ____________ to the long axis of the hand.
25-30 degrees
When elbow cannot be fully extended, obtain two AP Projections, one with _________ parallel to IR, one with __________ parallel to IR.
Forearm
Humerus
Of patient cannot partially extend elbow and elbow remains flexed near 90 degrees, take the two AP Projections as described but angle CR to _________ into elbow joint or if flexed more than 90degrees, take the ________ position.
10-15 degrees
Jones Position
_____________ rotation of the elbow best visualizes radial head, neck and capitulum of humerus.
External Oblique
____________ rotaion of the elbow best visualizes coronoid process of ulna and trochlea in profile.
Internal Oblique
For Jones Method, acute flexion, there are two projections required to visualize both the distal humerus and proximal radius and ulna. What are these?
CR perpendicular to humerus
CR angled so that it is perpendicular to the forearm
Best demonstrate fracture of the elbow, particularly the radial head and coronoid process. Effective projections when patient cannot extend elbow fully for medial or lateral obliques of the elbow.
Coyle Method (Trauma Axial Lateral)
In AP Projection of the humerus, what is the evidence that it’s in True AP projection.
Greater tubercle is seen in profile laterally
Humeral head is partially seen in profile medially with minimal superimposition of the glenoid cavity
Lateral and Medial epicondyles are both visualized in profile
___________ is a fracture of the anterior glenoid rim
Bankart Lesion
Is a compression fracture of the articular surface of the humeral head often associated with an anterior dislocation of the humeral head.
Hill-Sachs Defect
Is a traumatic injury to one or more muscles, teres minor, supraspinous, infraspinous and subspularis. It limits the range of motion to the shoulder.
Rotator Cuff Tear
Full external rotation of the shoulder is evidenced by the ______________ visualize in full profile on the lateral aspect of the proximal humerus.
Greater Tubercle
What projection in which px abduct arm 90 degrees from body, palm up in external rotation, CR medially 25-30 degrees, centered horizontally to axilla and humeral head.
Lawrence Method (Inferosuperior Axial Projection)
The external oblique position of the elbow, require how many rotation of the arm
40-45 degrees
What is the angle of the tube in the carpal canal projection?
20-25 degrees
On a true AP Projection of the proximal humerus, note that the lesser tubercle is located ___________ and the greater tubercle is located _____________.
Anteriorly
Laterally
AP shoulder in external position places the _________ in a true AP or frontal projection.
Humerus
Scapulohumeral (glenohumeral) jt is what kind of movement, which allows greater freedom of movement.
Spheroidal or ball and socket joint
Sternoclavicular joint is what kind of movent? Acromioclavicular joint?
Plane or gliding
The internal rotation of the shoulder places the humerus in what position?
Lateral position
The neutral AP projection of the shoulder places the epocondyles of the distal humerus at an approximate how many degrees to the IR.
45 degrees to the IR, and results in 45degrees oblique position of the humerus when palm of the hand facing inward against the thigh.
Is commonly used to image soft-tissue parhologies such as rotator cuff tears associated with shoulder girdle.
Arthrography
A projection wherein the patient is in prone position, elbow flexed and forearm hanging down, CR directed 25degrees anterior and 25 degrees medially passing theoigh midscapulohumeral joint. Performed for specific pathology such as Hill-Sachs defects and Bankart Lesions.
West Point Method
Inferosuperior Axial Projection
In Grashey method, how many degrees body rotation and what should be seen in profile in this projection.
35-45 degrees body rotation
Glenoid Cavity
Demonstrate pathologies of the intertubercular groove, such as bony projection of the humeral tubercles.
Fisk Method, Tangential Projection: Intertubercular (Bicipital) Groove
Patient standing, leaning over end of table with elbow flexed and posterior surface of forearm resting on table, hand supinated holding casette, head turned away from affected side, is what position?
Fisk Method
In Fisk Method, a correct CR angle of 10-15 degrees to the long axis of humerus will demostrate ____________ and __________ in profile without superimposition of acromion process.
Intertubercular groove and Tubercles
What breathing technique is preferred in Transthoracic (Lawrence Method) if patient can cooperate, and this will best visualize the proximal humerus by blurring out ribs and lung structures.
Breathe slow, shallow breaths
If patient is in too much pain to drop injured shoulder and elevate uninjured arm and shoulder high enough to prevent superimposition of shoulders, angle CR __________.
CR 10-15 degrees cephalad
This projection specifically demostrates the coracoacromial arch for possible outlet region for possible shoulder impingement. CR 10-15 degrees caudal angle
Neer Method
Tangential Projection-Supraspinatus Outlet
Patient erect or supine, rotate body 45 degrees toward affected side, posterior surface against IR, flexed elbow and placed arm across chest. CR 45 degrees caudad centered to SHJ.
Garth Method, AP Apical Oblique Axial Projection
Patient should not be asked to hold on to the weights with their hands, rather the weights should be attached to the _______ so that the hands, arms and shoulders are relaxed to determine possible AC joint separation.
Wrists
Patient reach across front of chest and grasp opposite shoulder, this demonstrates
Body of scapula
Px drop affected arm, flex elbow and place arm behind lower back with arm partially abducted, or just let arm hang down at patients side, this demonstrates
Acromion and coracoid process
Is an inflammation of the bone and cartilage involving the anterior proximal tibia and is most common in boys ages 10-15.
Osgood Schlatter Disease
Also called osteochondroma, is a benign, neoplastic bone lesion caused by consolidated overproduction of bone at a joint (usually knee).
Exostosis
The external oblique position of the elbow, require how many rotation of the arm
40-45 degrees
What is the angle of the tube in the carpal canal projection?
20-25 degrees
For AP Mortise Projection, how many degrees internal rotation should be done?
15 to 20 degrees
Demonstrate pathology involving ankle joint separation due to ligament tear or rupture
AP stress projection of the ankle: inversion and eversion positions
What is the position for Camp Coventry Method?
Patient in prone position, knee flexed 40-50 degrees (provide support)
What is the position for Homblad Method?
Patient in kneeling position, ask patient to lean forward 20-30 degrees and hold that position, results in 60-70 degrees knee flexion
Pleural effusion, Tech must increase
MAS by 35%
Trochlea articulates with the
Ulna
Capitulum articulates with the
Radius
Cartilaginous joints are called:
Amphiarthroses
synarthroses are
fibrous joints
diarthroses are
synovial joints
The bulge at the upper end of the stomach is called the:
Fundus
For the right PA oblique projection (RAO) for the sternum, the body should be rotated how many degrees?
15-20 degrees
A skull that is short from front to back and broad from side to side would be described as:
Brachycephalic
Cavity within a bone is described as a:
Sinus
fossa is a
pit and a groove
sulcus is a
Furrow
The carpometacarpal joint of the thumb has what type of movement?
Saddle
- A saddle joint permits flexion, extension, adduction, and abduction and has opposing surfaces that are concavoconvex, such as the carpometacarpal joint of the thumb.
For an axial projection of the calcaneus, the central ray enters at the:
Base of the third metatarsal, 40 degrees cephalic
For the lateral projection of the chest, the central ray is directed:
2 inches anterior to the midaxillary plane at the level
The portion of the small bowel in which the greatest amount absorption takes place.
Jejunum
A large rounded projection is called a:
Tuberosity
The serous membrane surrounding the visceral and parietal layers of each lung is called the:
Pleura
For the AP oblique projection (LPO and RPO) for the colon, the patient is rotated how many degrees from the supine position?
35-45
Directing the central ray 5 to 7 degrees cephalic is done for what projection?
AP Knee
The pelvocalyceal system will visualize approximately how many minutes after injection?
2-8 mins
For a lateral L5 -S1 projection of the lumbar spine, the central ray is directed:
Perpendicular to L5 at a point 1.5 inches anterior to the palpated spinous process of L5 and 1.5 inches inferior to the iliac crest
This bone is located in the wrist on the medial side of the proximal row:
Pisiform
For the lateral projection for the sinuses, the central ray enters:
0.5 to 1.0 inch posterior to the outer canthus
For an AP projection of the thoracic spine, the central ray is directed:
3 to 4 inches distal to the jugular
Which of the following is (are) located just below the head of the humerus?
Greater and lesser tubercles
This bone is located beneath the talus:
Calcaneus
The inner part of the kidney is called the:
Medulla
The cardiac portion is where the:
Esophagus enter the stomach
For what projection does the OML form and angle of 37 degrees with the cassette?
Parietoacanthial (Waters) for sinuses
Which of the following bones has a coronoid process?
Mandible
Which of the following bones has (have) costal facets?
Thoracic Vertebra
The patient’s body is rotated 30 degrees for what projection?
RPO and LPO of kidneys
The functional part of the kidney is called the:
Nephron
For a lateral projection of the ankle, the central ray is directed perpendicular to the:
Medial Malleolus
This bone is located in the wrist on the lateral side of the proximal row:
Scaphoid
The wrist and ankle have what type of movement?
Gliding
The elbow has what type of movement?
Hinge
- The elbow permits motion in only one plane; therefore, it functions as a hinge.
To demonstrate foramen rotundum in the PA Axial projection, it is necessary to:
Direct the CR at 25 to 30 degrees caudad
In the Supero-inferior (axial) of the shoulder,when the patient can’t abduct his arm due to trauma, the part below will not appear…
Glenoid cavity
