Lab final 2

Question 1

AP Projection-External Rotation: Shoulder (nontrauma)

AP Proximal Humerus

Answer 1

40”
10X12
75-85 Kv
1” inferior to the coracoid process

externally rotate arm

Question 2

AP Projection-Internal Rotation: Shoulder (nontrauma)

Lateral Proximal Humerus

Answer 2

40”
10x12
75-85 Kv
1” inferior to coracoid process

internally rotate arm

Question 3

Posterior Oblique Position –Glenoid Cavity:
Shoulder (nontrauma)
Grashey Method

Answer 3

40"
8x10
75-85
35-45 degrees toward affected side
centered to scapuloumeral joint, which is approximately 2 inches inferior and medial from the superolateral border of shoulder.

Question 4

AP Projection–Neutral Rotation: Shoulder (trauma)

Answer 4

40”
10x12
75-85
CR perpendicular to IR, directed to midscapulohumeral joint, which is approximately 3/4 inch inferior and slightly lateral to coracoid process.

Question 5

Scapular Y Lateral –Anterior Oblique Position:

Shoulder (Trauma)

Answer 5

40”
10x12
75-85
CR perpendicular to IR, directed to scapulohumeral joint (2 or 2 1/2” below top of shoulder)

Question 6

AP and AP Axial Projections: Clavicle

Answer 6

40"
10x12
75-85
AP 
Perpendicular to midclavicle
AP Axial
CR 15 to 30 degrees caphalad to midclavicle

Question 7

AP Projection: AC joints

Bilateal with and without weights

Answer 7

72”
14x17 or 10x12
70 to 80
CR perpendicular to midpoint between AC joints, 1 inch above jugular notch

Question 8

AP Projection: Scapula

Answer 8

40”
10x12
75-85
CR perpendicular to midscapula, 2 inches inferior to coracoid process, or to level of axilla, and approximately 2 inches medial from lateral border of patient.

Gently abduct arm 90 degrees (salute) and supinate hand.

Question 9

Lateral Position: Scapula

Patient Erect

Answer 9

40”
10x12
75 to 85
CR to midvertebral border of scapula

Lateral for body of scapula (approximately 45 degrees LAO)

Have patient reach across front of chest and grasp opposite shoulder.

Question 10

Lateral Position: Scapula

Patient Recumbent

Answer 10

40”
10x12
75-85
CR to midscapula lateral border.

Question 11

AP Pelvis Projection (bilateral hips): Hips

Answer 11

40”
14x17
80-85
CR perpendicular to IR, directed midway between level of ASIS and symphysis pubis.

Question 12

AP Bilateral Frog-Leg Projection: Pelvis

Modified Cleaves Method

Answer 12

40”
14x17
80-85
CR is perpendicular to IR, directed to a point 3 inches below level of ASIS (1 inch above sysmphysis pubis)

Place the plantar surfaces of feet together and abduct both femora 40 to 45 degrees from vertical. ensure that they are both abducted the same amount.

Question 13

Unilateral Frog-Leg Projection- Mediolateral:
Hip and Proximal Femur
Modified Cleaves Method

Answer 13

40”
10x12
80-85 Kv

CR perpendicular to IR. Directed to midfemoral neck.

Flex knee and hip on affected side, with sole of foot against inside of opposite leg, near knee if possible.
Abduct femur 45 degrees from vertical for general proximal femur region.

Question 14

AP Unilateral Hip Projection: Hip and Proximal Femur

Answer 14

40”
10x12
80-85
CR perpendicular to IR, directed to 1 to 2 inches distal to midfemoral neck.

Rotate affected leg internally 15 to 20 degrees.

Question 15

An “Open Mouth” Projection–C1 and C2: Cervical Spine

Answer 15

40”
8x10
75-85
Direct CR through center for open mouth

Adjust head so that, with mouth open, a line from lower margin of upper incisors to the base of the skull.

Question 16

AP Axial projection: Cervical Spine

Answer 16

40”
8x10
75-85

CR —Angle CR 15 to 20 degrees cephalad
Direct CR to enter at the level of the lower margin of thyroid cartilage to pass through C4

Question 17

Anterior and Posterior Oblique Positions: Cervical Spine

Answer 17

40" to 72"
10x12
  Anterior Oblique (RAO, LAO)
Direct CR 15 degrees caudad to C4 (level of upper margin of thyroid carilage)
  Posterior Oblique (RPO, LPO)
Direct CR 15 degrees cephalad to C4

Question 18

Lateral Position: Cervical Spine

Answer 18

60” to 72”
8 x 10
75-85
Direct CR Horizontally to C4 (level of upper margin of thyroid cartilage)
Ask patient to relax shoulders down and forward as far as possible.

Question 19

Lateral Positions–Hyperflexion and Hyperextension:

Cervical Spine

Answer 19

40”
10 x 12
75 to 85

Direct CR horizontally to C4 (level of upper margin of thyroid cartilage).

Relax and depress shoulders as far as possible.
For hyperflexion: Depress chin until it touches the best or as much as patient can tolerate (do not allow the patient to move forward)
For hyperextension: raise chin and tilt head back as much as possible. do not allow patient to move backward to ensure entire cervical is included on IR.

Question 20

AP Projection: Thoracic Spine

Answer 20

40”
14 x 17
85-95

CR to T7 (3 to 4 inches below jugular notch or 1 to 2 inches below sternal angle)

Question 21

Lateral Position: Thoracic Spine

Answer 21

40”
14 x 17
85 - 95
CR perpendicular to long axis of thoracic spine
Direct CR to T 7 (3 to 4 inches below jugular notch or 7 to 8 inches below the vertebra prominens)
Raise patients arms to right angles (praying)

Question 22

AP or PA Projection: Lumbar Spine

Answer 22

40”
14x 17
85-95

Direct level of iliac crest (L4-L5)
Suspend breathing on expiration

Question 23

Obliques-Posterior or (anterior) Oblique Positions:

Lumbar Spine

Answer 23

40"
11 x 14
or 10 x 12 lengthwise
75-85
 Rotate body 45 degrees and align spinal column to midline of table

Direct CR to L3 at the level of lower costal margin (1 to 2 inches above the iliac crest and 2 inches medial to upside ASIS

Question 24

Lateral Position: Lumbar Spine

Answer 24

40"
14 x 17
11 x 14 lengthwise
90-100
CR perpendicular to IR
Center to level of iliac crest
Suspend breathing on expiration

Question 25

Lateral L5-S1 Position: Lumbar Spine

Answer 25

40" 8 x 10 90-100 Direct CR 1.5 inches inferior to iliac crest and 2 inches posterior to ASIS 5 to 8 degrees caudad

Question 26

AP Axial L5-SI Projection: Lumbar Spine

Answer 26

40" 8 x 10 90-100 Angle CR cephalad 30 degrees (males) 35 degrees (female)

Question 27

AP Axial Sacrum Projection: Sacrum

Answer 27

40" 10 x 12 85-80 Angle CR 15 degrees cephalad. Direct CR 2 inches superior to pubic symphysis

Question 28

AP Axial Coccyx Projection: Coccyx

Answer 28

40" 8 x 10 80 - 85 Kv Angle CR 10 degrees caudad. Direct CR 2 inches superior to symphysis pubis

Question 29

Lateral Sacrum and Coccyx Position: Sacrum and Coccyx

Answer 29

40" 10 x 12 90 to 100 Direct CR 3 to 4 inches posterior to ASIS (centering to for sacrum)

Question 30

Lateral Coccyx Position: Coccyx

Answer 30

40" 8 x 10 85-90 Direct Cr 3 to 4 inches posterior and 2 inches distal to ASIS

Question 31

AP Axial Projection: Sacroiliac Joints

Answer 31

40" 10 x 12 90 -100 Angle CR 30 to 35 degrees cephalad (generally, males require about 30 degrees and females 35 degrees. Direct midline about 2 inches below level of ASIS

Question 32

Posterior Oblique Positions (LPO and RPO): Sacrioliac Joints

Answer 32

``` 40" 10 x 12 85-95 CR 1 inch medial to upside ASIS Rotate body into 25 to 30 degrees posterior oblique with side of interest elevated (LPO for right joint and RPO for left joint). ```

Question 33

AP Axial Projection: Skull Series | Towne Method

Answer 33

40" 10 x 12 80 to 85 Angle CR 30 degrees caudad to OML or 37 degrees caudad to IOML. Center at MSP 2 1/2" above the glabella to pass through the foramen magnum at the level of the base of the occiput.

Question 34

Lateral Position--Right or Left Lateral: Skull Series

Answer 34

40" 10 x 12 80 to 85 Kv Align IPL perpendiuclar to IR Adjust neck flexion to align IOML perpendicular to front edge of IR (GAL) is parallel to front edge of IR center to a point 2 inches superior to EAM or halfway between the glabella and the inion for other types of skull morphologies.

Question 35

PA Axial Projection: Skull Series | 15 degrees CR (Caldwell Method) or 25 to 30 degrees CR

Answer 35

40" 10 x 12 80 to 85 Rest patient's nose and forehead against table/imaging device. Flex neck to align OML perpendicular to IR Align MSP perpendicular to midline of the gird Angle CR 15 degrees caudad and center to exit at naison Angle CR 25 to 30 degrees caudad, and center to exit at naison.

Question 36

PA Projection: Skull Series | 0 degrees

Answer 36

40" 10 x 12 80 to 85 Rest patient's nose and forehead against table/imaging surface. Flex neck, aligning OML perpendicular to IR Align MSP perpendicular to midline of table. CR is perpendicular to IR (parallel to OML) and is centered to exit at glabella.

Question 37

Lateral Position---Right or Left Lateral: Facial Bones

Answer 37

40" 8 x 10 70 to 80 Center CR to zygoma (prominence of cheek) midway between outer canthus and EAM Rest lateral aspect of head against table or upright imaging device surface, with side of interest closest to IR. Adjust head in a true lateral position and oblique body. Align MSP parallel Align IPL perpendicular to IR Adjust chin to bring IOML perpendicular

Question 38

Parietoacanthial Projection: Facial Bones | Waters Method

Answer 38

40" 8 x 10 or 10 x 12 75 to 85 Extend neck, resting chin against table. Adjust head until MML is perpendicular to plane of IR. OML forms a 37 degree angle with table. Position MSP perpendicular to midline of grid or table. Align CR perpendicular to IR, exit at Acanthion

Question 39

PA Axial Projection: Facial Bones | Calwell Method

Answer 39

40" 8 x 10 or 10 x 12 75 to 85 angle CR 15 degrees caudad, to exit at naisn. Rest patient's nose and forehead against tabletop. Tuck Chin, bringing OML perpendicular to IR. Align MSP perpendicular to midline of grid or table

Question 40

Lateral Position: Nasal Bones

Answer 40

40" 8 x 10 60 to 70 Rest lateral aspect of head against the table. Position nasal bones to center. Adjust head into a true lateral position and oblique body. Align MSP parallel with table Align IPL perpendicular to table Position IOML perpendicular to front edge center CR to 1/2 inch inferior to naison

Question 41

SMV Projection: Zygomatic Arches

Answer 41

40" 8 x 10 70 to 80 Raise chin hyperextend neck until IOML is parallel to IR Rest head on vertex of skull. Align MSP perpendicular to midline of the grid or the table. Center CR midway between zygomatic arches, at a level 1 1/2 inches inferior to mandibular symphysis.

Question 42

Oblique Inferosuperior (tangential) projection: zygomatic arches

Answer 42

40" 8 x 10 70 to 80 Raise chin, hyperextending neck until IOML is parallel to IR Rest head on vertex of skull Rotate head 15 degrees toward side to be examined; also tilt chin 15 degrees toward side of interest. Align CR prpendicular to IR and IOML Center CR to zygomatic arch of interest.

Question 43

AP Axial Projection: Zygomatic Arches: | Modified Towne Method

Answer 43

40" 8 x 10 70 to 80 Tuck chin, bringing OML (or IOML) perpendicular to IR Align MSP perpendicular to midline of grid or table. Angle CR 30 caudad to OML or 37 degrees to IOML Center CR to 1 inch superior to glabella to pass through midarches at level of gonion.

Question 44

Lateral Position --Right or Left Lateral: Sinuses

Answer 44

40" 8 x 10 75 to 85 Align Cr to a point midway between outer canthus and EAM Adjust head until a true lateral position, align IPL perpendicular to IRr

Question 45

PA projection: sinuses | Caldwell method

Answer 45

40" 8 x 10 75 to 85 Place patient's nose and forehead against upright imaging device or table with neck extended to elevate OML 15 degrees from horizontal. Center CR to exit at naison.

Question 46

Parietoacanthia Projection: Sinuses | Waters method

Answer 46

40" 8 x 10 75 to 85 Extend neck, placing chin and nose against table/upright imaging surface. Adjust head until MML is perpendicular to IR; OML forms a 37 degrees angle with plane. Position MSP perpendicular to midline of grid or table. Align horizontal CR perpendicular to IR centered to exit at acanthion.

Question 47

RAO Position: Esophagogram

Answer 47

40" 14 x 17 100-125 Rotate Body 35 to 45 degrees from prone position, with the right anterior body against the table. Place right arm down with left arm flexed at elbow and up by the patient's head, holding cup of barium, with a straw in patient's mouth. Flex knee for support. Place top of IR about 2 inches above the shoulders. CR perpendicular to IR CR to center of IR at level of T5 or T6 (2 to 3 inches inferior to jugular notch)

Question 48

Lateral Position: Esohagogram

Answer 48

40" 14 x 17 100-125 Place patient's arms over the head, with the elbows flexed and superimposed. align midcoronal plane to midline place shoulders and hips in a true lateral position. place top of IR about 2 inches above level of shoulders, to place center of IR at CR. CR to level of T5 or T6 (2 to 3 inches above level of shoulders, to place center of IR at CR. CR perpendicular to IR CR to level of T5 or T6 (2 to 3 inches inferior to jugular notch)

Question 49

AP (PA) Projection: Esophagogram

Answer 49

72" 14 x 17 100 - 125 Align MSP to midline Place right arm up to hold cup of barium Place top of IR about 2 inches above top of shoulders to place CR at center. CR to MSP, 1 inch inferior to sternal angle (T5-T6) or approximately 3 inches inferior to jugular notch.

Question 50

LAO Position: Esophagogram

Answer 50

40" 14 x 17 100-125 Rotate 35 to 40 degrees from a PA, with the left anterior body against IR or table Place left arm down by patient's side, with right arm flexed at elbow and up by patient's head. Flex right knee for support Place top of IR about 2 inches above level of shoulders to place CR at center of IR. CR to level of T5 to T6 (2 to 3 inches inferior to jugular notch)

Question 51

RAO Position: Upper GI Series

Answer 51

40" 10 x 12 90 to 100 From a prone position, rotate 40 to 70 degrees, with right anterior body against IR or table (more rotation needed for heavier patients and less for thinner patients) Place right arm down and left arm flexed at elbow and up by the patient's head. flex left knee for support. Hypersthenic (heavy) center about 2 inches above level of L1 and nearer midline, 70 degrees oblique Asthenic (thin): center about 2 inches below level of L1 , 40 degrees oblique

Question 52

PA projection: Upper GI Series

Answer 52

40" 10 x 12 or 11 x14 90 to 100 Kv Align MSP to CR and to table Hypersthenic (Heavy) center about 2 inches above level of L1 and nearer midline. Asthenic (thin) center about 2 inches below level of L1

Question 53

Right Lateral Position: Upper GI Series

Answer 53

40" 10 x 12 or 11 x 14 100 - 125 Direct CR perpendicular to IR Hypersthenic (heavy) center about 2 inches above L1 Asthenic (thin) center about 2 inches below L1

Question 54

LPO Position: Upper GI Series

Answer 54

40" 10 x 12 or 11 x 14 90 to 100 Rotate 30 to 60 degrees from supine position with left posterior against IR or table. (more rotation may be required for heavy hypersthenic patients and less may be required for thin asthenic patients.) Flex right knee for support Extend arm from body and raise right arm high across chest to grasp end of table for support. Sthenic type(skinny)-center CR and IR to level of L1 (about midway between xiphoid tip and lower lateral margin of ribs) and midway between midline of body and left lateral margin of abdomen, 45 degrees oblique. Hypersthenic (heavier): center about 2 inches above L1 (about midway between midline of body and left lateral margin of abdomen, 45 degree oblique.

Question 55

AP Projection: upper GI Series

Answer 55

40" 11 x 14 90 to 100 Sthenic type (skinny)--center to level of L1 (about midway between xiophoid tip and lower margin of ribs), midway between midline and left lateral margin of abdomen.

Question 56

PA Projection: Small Bowel Series

Answer 56

40" 14 x 17 100 to 125 1. 15 or 30 minutes: center to about 2 inches above iliac crest. 2. Hourly: center CR and midpoint to IR to iliac crest

Question 57

PA or AP projection: Barum Enema

Answer 57

``` 40 SID 14 x 17 100 to 125 (single contrast) 80 to 90 (iodinated, water soluble contrast media) Center to level of iliac crest ```

Question 58

RAO Position: Barium Enema

Answer 58

40" 14 x 17 100-125 single contrast 80 to 90 iodinated, water soluble contrast media pelvis and trunk for 35 to 45 rotation. Direct CR perpendicular to IR to a point about 1 inch to the left of the MSP. Center CR and IR to level of iliac crest.

Question 59

LAO Position: Barium Enema

Answer 59

40" 14 x 17 90-100 single contrast 80 to 90 iodinated, water soluble contrast media place right arm up, with left arm down behind patient and right knee partially flexed. check posterior pelvis and trunk for 35 to 45 degree rotation. CR is perpendicular to IR, directed to a point about 1 inch to the right of MSP. center CR and IR to 1 to 2 inches above iliac crest.

Question 60

LPO and RPO Positions: Barium Enema

Answer 60

40" 100 to 125 digital 90 to 100 single contrast 80 to 90 iodinated water soluble contrast media Flex elevated side elbow and place in front of head; place opposite arm down by patient's side. Partially flex elevated side knee to remain in this position. Direct CR perpendicular to level of iliac crest and about 1 inchlateral to elevated side of MSP.

Question 61

Lateral Rectum Position or Ventral Decubitus Lateral: | Barium Enema

Answer 61

40" 10 x 12 100 to 125 flex and superimpose knees; place arms up in front of the head. CR is perpendicular to IR and center to level of anterior superior iliac spine (ASIS) and posterior sacrum.

Question 62

Right Lateral Decubitus position (AP or PA): Barium Enema-Double Contrast

Answer 62

40" 14 x 17 90 to 100 Patient is lateral recumbent position, with a pillow for head and lying on the right side on a radiolucent pad, with a portable grid placed behind the patient's back for an AP projection. The patient also can be facing the portable grid or vertical table for a PA projection. Direct CR horizontal, perpendicular to IR center at level of iliac crest and MSP.

Question 63

Left Lateral Decubitus Position (AP or PA Projection): | Barium Enema

Answer 63

40" 90 to 100 14 x 17 Direct CR horizontal, perpendicular to IR Center CR to level of iliac crest and MSP

Question 64

PA (AP) Projection: pstevacuation: Barium Enema

Answer 64

40" 14 x 17 90 to 100 Center Cr and center of IR to iliac crest

Question 65

AP Projection (Scout and Series): Intravenous (excretory) Urography

Answer 65

40" 14 x 17 75-80 Center Cr and IR to level of iliac crest and to midsagittal plane. Nephrogram: Center CR midway between xiphoid process and iliac crest.

Question 66

Nephrotomography and nephrography: | Intravenous (excretory) urography

Answer 66

40" 11 x 14 75 to 80 midway between xiphoid process and iliac crest

Question 67

RPO and LPO Positins: Intravenous (excretory) Urography

Answer 67

40" 14 x 17 or 11 x 14 crosswise 75 to 80 Rotate body 30 degrees for both right and left posterior oblqiue postions. flex elevated side for support of lower body. raise arm on elevated side and place across upper chest center vertebral column to midline of table or grid center CR and IR to level of iliac crest and vertebral column.

Question 68

AP projection: Intravenous (excretory) urography | Postvoid

Answer 68

40" 14 x 17 75 to 80 center to level of iliac crest and midsagittal plane, or for larger patients, 1 inch lower to ensure that the bladder area is included.

Question 69

AP Projection--LPO and RPO Positions--Lateral Position: Cystography

Answer 69

``` 40" 14 x 17 75 to 80 Posterior oblique 45 to 60 degrees body rotation center perpendicular --2 inches superior to symphysis pubis and 2 inches to anterior superior iliac spine (ASIS) AP patient is supine, with legs extended and midsagittal plane to center of table. center 2 inches superior to symphysis pubis, with 10 to 15 degrees caudad. ```

Question 70

RPO (30 degrees) position --Male---APO Projection --Female: Voiding Cystourethrography

Answer 70

``` 40" 10 x 12 75 to 80 Male oblique body 30 degrees into the RPO Female supine or erect into the AP postion ``` Center to symphysis pubis