Rst Flashcards
1
Q
12:11 •
A
2
Q
6 Cervico-tho racic vertebrae
A
3
Q
178
A
4
Q
Lateral swimmers’
A
5
Q
In all trauma radiography
A
it is imperative that all of the cervical
6
Q
vertebrae and the cervico-thoracic junction are demonstrated.
A
7
Q
This is particularly important
A
as this area of the spine is particu-
8
Q
larly susceptible to injury. The superimposition of the shoulders
A
9
Q
over these vertebra and subsequent failure to produce an
A
10
Q
acceptable image is a familiar problem to all radiographers. In
A
11
Q
the majority of cases
A
the use of the swimmers’ lateral will pro-
12
Q
duce an image that reveals the alignment of these vertebrae and
A
13
Q
provides an image suitable for diagnosis.
A
14
Q
Position of patient and cassette
A
15
Q
• This projection is usually carried out with the patient supine
A
16
Q
on a trauma trolley. The trolley is positioned adjacent to the
A
17
Q
vertical Bucky
A
with the patient’s median sacit
18
Q
sagittal plane paral-
A
19
Q
lel with the cassette.
A
20
Q
The arm nearest the cassette is folded over the head
A
with the
21
Q
humerus as close to the trolley top as the patient can manage.
A
22
Q
The arm and shoulder nearest the X-ray tube are depressed
A
23
Q
as far as possible.
A
24
Q
• The shoulders are now separated vertically.
A
25
The Bucky should be raised or lowered
such that the line of
26
the vertebrae should coincide with the middle of the cassette
27
This project
28
jection can also be undertaken with the patient erect
29
either standing or sitting or supine.
30
Direction and centring of the X-ray beam
31
• The horizontal central ray is directed to the midline of the Bucky
32
at a level just above the shoulder remote from the cassette.
33
Essential image characteristics
34
• It is imperative to ensure that the C7/TI junction has been
35
included on the image. It is therefore useful to include an
36
anatomical landmark within the image
e.g. atypical CV2.
37
This will make it possible to count down the vertebrae and
38
ensure that the junction has been imaged.
39
Radiological considerations
40
See Right and left posterior oblique- supine (previous page).
41
Common faults and remedies
42
• Failure to ensure that the raised arm is as flat as possible
43
against the stretcher may result in the head of the humerus
44
obscuring the region of interest.
45
Notes
46
• For some patients
it may be useful to rotate the side further
47
from the cassette sufficiently forward to separate the shoulders
48
transversely. This positioning will produce a lateral oblique
49
projection of the vertebrae.
50
5th
51
Super
52
3 42%
53
dr of hent and
54
super- gt vessels also upper abdomen
55
Image quality will be increased if the erect Bucky is used in
56
preference to a stationary grid. This is due to the better scat-
57
ter attenuation properties of the grid within the Bucky.
58
193 ofp532of patient and cassette
59
Thoracic vertebrae 6
60
Antero-posterior - basic
61
The patien is positioned supine on the X-ray table
with
62
the median sagittal plane perpendicular to the tabletop and
63
coincident with the midline of the Bucky
64
The upper edge of a cassette
which should be at least 40 cm
65
long for an adult
should be at a level just below the promi-
66
nence of the thyroid cartilage to ensure that the upper thoracic
67
vertebrae are included.
68
• Make exposure on arrested inspiration. This will cause the
69
diaphragm to move down over the upper lumbar vertebra
70
thus reducing the chance of a large density difference appear-
71
ing on the image from superimposition of the lungs.
72
Direction and centring of the X-ray beam
73
177
74
• Direct the central ray at right-angles to the cassette and towards
75
anoint 25cmhelor tho cternl ane
76
12:11 •
77
6 Cervico-tho racic vertebrae
78
178
79
Lateral swimmers'
80
In all trauma radiography
it is imperative that all of the cervical
81
vertebrae and the cervico-thoracic junction are demonstrated.
82
This is particularly important
as this area of the spine is particu-
83
larly susceptible to injury. The superimposition of the shoulders
84
over these vertebra and subsequent failure to produce an
85
acceptable image is a familiar problem to all radiographers. In
86
the majority of cases
the use of the swimmers' lateral will pro-
87
duce an image that reveals the alignment of these vertebrae and
88
provides an image suitable for diagnosis.
89
Position of patient and cassette
90
• This projection is usually carried out with the patient supine
91
on a trauma trolley. The trolley is positioned adjacent to the
92
vertical Bucky
with the patient's median sacit
93
sagittal plane paral-
94
lel with the cassette.
95
The arm nearest the cassette is folded over the head
with the
96
humerus as close to the trolley top as the patient can manage.
97
The arm and shoulder nearest the X-ray tube are depressed
98
as far as possible.
99
• The shoulders are now separated vertically.
100
The Bucky should be raised or lowered
such that the line of
101
the vertebrae should coincide with the middle of the cassette
102
This project
103
jection can also be undertaken with the patient erect
104
either standing or sitting or supine.
105
Direction and centring of the X-ray beam
106
• The horizontal central ray is directed to the midline of the Bucky
107
at a level just above the shoulder remote from the cassette.
108
Essential image characteristics
109
• It is imperative to ensure that the C7/TI junction has been
110
included on the image. It is therefore useful to include an
111
anatomical landmark within the image
e.g. atypical CV2.
112
This will make it possible to count down the vertebrae and
113
ensure that the junction has been imaged.
114
Radiological considerations
115
See Right and left posterior oblique- supine (previous page).
116
Common faults and remedies
117
• Failure to ensure that the raised arm is as flat as possible
118
against the stretcher may result in the head of the humerus
119
obscuring the region of interest.
120
Notes
121
• For some patients
it may be useful to rotate the side further
122
from the cassette sufficiently forward to separate the shoulders
123
transversely. This positioning will produce a lateral oblique
124
projection of the vertebrae.
125
5th
126
Super
127
3 42%
128
dr of hent and
129
super- gt vessels also upper abdomen
130
Image quality will be increased if the erect Bucky is used in
131
preference to a stationary grid. This is due to the better scat-
132
ter attenuation properties of the grid within the Bucky.
133
193 ofp532of patient and cassette
134
Thoracic vertebrae 6
135
Antero-posterior - basic
136
The patien is positioned supine on the X-ray table
with
137
the median sagittal plane perpendicular to the tabletop and
138
coincident with the midline of the Bucky
139
The upper edge of a cassette
which should be at least 40 cm
140
long for an adult
should be at a level just below the promi-
141
nence of the thyroid cartilage to ensure that the upper thoracic
142
vertebrae are included.
143
• Make exposure on arrested inspiration. This will cause the
144
diaphragm to move down over the upper lumbar vertebra
145
thus reducing the chance of a large density difference appear-
146
ing on the image from superimposition of the lungs.
147
Direction and centring of the X-ray beam
148
177
149
• Direct the central ray at right-angles to the cassette and towards
150
anoint 25cmhelor tho cternl ane
