Lab final

Question 1

AP Pelvis Projection (Bilateral Hips): Pelvis

Answer 1

40 SID
80 KV
Midway between level of ASIS and Symphysis Pubis

Question 2

AP Bilateral Frog-Leg Projection: Pelvis

Answer 2

40 SID
80 KV
Abduct both femora 40 to 45 degrees from vertical
3 inches below level of ASIS

Question 3

AP Axial Outlet Projection
For Anterior -Inferior Pelvic Bones: Pelvis
Taylor Method

Answer 3

40 SID
80 KV
Cephalad 20 to 35 degrees for males and 30 to 45 degrees for femals
2 inches dista to the superior border of the symphysis pubis or greater trochanters.

Question 4

AP Axial Inlet Projection: Pelvis

Answer 4

40 SID
80 KV
Caudad 40
Midline point at level of ASIS

Question 5

Posterior Oblique pelvis-Acetabulum

Judet Method

Answer 5

patient in 45 degree posterior oblique
When anatomy is downside, center 2 inches distal and 2 inches medial to downside ASIS
When anatomy is upside, center 2 inches directly distal to upside
40 SID
80 KV

Question 6

PA Axial Oblique Projection–Acetabulum

Teufel Method

Answer 6

Place patient in 35 to 40 degrees anterior oblique with both pelvis and thorax 35 to 40 degrees from tabletop.
When anatomy of interest is downside, center to 1 inch superior to the level of the greater trochanter, approximately 2 inches lateral to midsagittal plane.
Angle CR 12 degrees cephalad
40 SID
80 KV

Question 7

AP Unilateral Hip Projection: Hip and Proximal Femur

Answer 7

1 to 2 inches distal to midfemoral neck 
Femoral neck can be located about 1 to 2 inches medial
and 3 to 4 inches distal to ASIS
40 SID
80 KV

Question 8

Axiolateral Inferorsuperior Projection: Hip and Proximal Femur–Trauma
Danelius-Miller Method

Answer 8

40 SID
80 KV

internally rotate affected leg 15 to 20 degrees
CR is perpenicular to femoral neck

Question 9

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

Answer 9

SID 40 inches
KV 80
Abduct femur 45 degree from vertical
CR is perpendicular and directed to midfemoral neck

Question 10

Modified Axiolateral –Possible Trauma Projection:
Hip and Proximal Femur
Clements-Nakayama Method

Answer 10

40 SID
80 KV
Tilt IR 15 degrees from vertical
Angle CR mediolaterally as needed so that it is perpendicular to and centered to femoral neck. it should be angled posteriorly 15 degrees to 20 degrees from horizontal

Question 11

AP “open mouth” Projection -C1 and C2: Cervical Spine

Answer 11

40 SID
75-85 KV
lower margin of upper incisors to the base of the skull (mastoid tips) is perpendicular to table
Center to open mouth

Question 12

AP Axial Projection: Cervical Spine

Answer 12

40 SID
75 to 85 KV
Angle CR 15 to 20 Cephalad
Direct CR to enter at the level of the lower margin of thyroid cartilage to pass through C4

Question 13

Anterior and posterior Oblique Positions: Cervical Spine

Answer 13

40 SID
75 to 80 KV
Rotate body and head into 45 degree oblique
Anterior oblique (RAO, LAO)
Direct CR 15 degrees caudad to C4 (level of upper margin of thyroid cartilage)
Posterior Oblique (RPO, LPO)
Direct CR 15 degrees Cephalad to C4

Question 14

Lateral Position: Cervical Spine

Answer 14

60 to 72 SID
75 to 85 KV
Direct patient to relax and drop shoulder down and foward as far as possible.
CR horizontally to C4 (level of upper margin of thyroid cartilage)

Question 15

Lateral Position, Horizontal Beam:
Cervical Spine (Trauma Patient)

Answer 15

SID 60 to 72 inches
75 to 85 KV
Direct CR horizontally to C4 (level of upper margin of thyroid cartilage)

Question 16

Cervicothoracic (swimmer’s) Lateral Position: Cervical Spine
Twining Method for C5-T3 Region

Answer 16

60-72 SID
KV 80 to 95
Direct CR to T1, which is approximately 1 inch above level of jugular notch anteriorly and at level of vertebra prominens posteriorly

Question 17

Lateral Positions —Hyperflexion and Hyperextension:

Cervical Spine

Answer 17

SID 60 to 72 inches
75 to 85 KV
Relax and depress shoulders
For hyperflexion: depress chin until it touches the chest or as much as possible.
For hyperextension: Raise chin and tilt head back as much as possible.
Direct CR horizontaly to C4 (level of upper margin of thyroid cartilge)

Question 18

AP or Posteroanterior (PA) Projection for C!-C2 (Dens):
Cervical Spine
Fuchs Method (AP) or Judd Method (PA)

Answer 18

SID 40
75 to 85 KV
AP Fuchs—Elevate chin as needed to bring MML (mentomeatal line) near perpendicular to tabletop (Adjust CR angle as needed to be parallel to MML).
Ensure that no rotation of head exists (angles of mandible equidistant to tabletop.
PA Judd —This is reverse than AP, Chin is resting on tabletop (may adjust CR as needed to be parallel to MML).
tabletop (adjust CR angle as needed to be parallel to MML)
Ensure CR is parallel to MML, through midoccipital bone, about 1 inch inferoposterior to mastoid tips and angles of mandible.

Question 19

AP “Wagging Jaw” Projection: Cervical Spine

Ottonello Method

Answer 19

40 SID
KV 75 to 85
Direct CR to C4 (upper margin of thyroid cartilage).

Question 20

AP Axial Projection–Vertebral Arch (pillars): Cervical Spine

Answer 20

SID 40
75 to 85 KV
Angle CR 20 to 30 Caudal
CR to the lower margin of the thyroid cartilage and pass through C5

Question 21

AP Projection: Thoracic Spine

Answer 21

SID 40
85 to 95 KV
Flex knees and hips to reduce thoracic curvature
Direct CR to T7 (3 to 4 inches below jugular notch or 1 to 2 inches below sternal angle.

Question 22

Lateral Position: Thoracic Spine

Answer 22

40 SID
85 to 95 KV
CR perpendicular to long axis of thoracic spine
Direct CR to T7 (3 to 4 inches below jugular notch or 7 to 8 inches below the vertebra prominens)

Question 23

Oblique Position –Anterior or posterior Oblique:

Thoracic Spine

Answer 23

40 SID
85 to 95 KV
Posterior Oblique Position (Recumbent)
LPO or RPO: place arm nearest table up and forward; arm nearest tube down and posterior
Anterior Oblique Position (Recumbent)
LAO or RAO: Place arm nearest table down and posterior; arm nearest tube up and forward
CR is perpendicular to IR
Direct CR to T7 (3 to 4 inches below jugular notch) or 2 inches below sternal angle.

Question 24

AP (or PA) Projection: Lumbar Spine

Answer 24

SID 40
KV 85 to 95
Flex knees and hips to reduce lordotic curvature
CR Large IR level of iliac crest (L4-L5) larger IR will include lumbar vertebrae, sacrum, and possibly coccyx.
Small IR level of L3, which may be localized by palpation of lower costal margin (1.5 inches above iliac crest)

Question 25

Obliques--Posterior (or Anterior) Oblique Positions: | Lumbar Spine

Answer 25

SID 40 KV 85 to 95 Rotate body 45 degrees and align Ensure equal rotation of shoulders and pelvis. Flex knee for stability and bring arm furthest from IR across chest Direct CR to L3 at the level of the lower costal margin (1 to 2 inches above iliac crest and 2 inches medial to upside ASIS.

Question 26

Lateral Position: Lumbar Spine

Answer 26

SID 40 KV 80 to 90 Large IR center to iliac crest (L4-L5). This projection al includes lumbar vertebrae, sacrum, and possibly coccyx. Smaller IR center to L2-L3 at the level of the lower costal margin (1.5 inches above iliac crest). This includes the five lumbar vertebrae.

Question 27

Lateral L5-S1 Position: Lumbar Spine

Answer 27

SID 40 90 to 100 KV CR perpendicular to IR with sufficient waist support, or angle 5 to 8 caudad with less support Direct CR 1.5 inches inferior to iliac crest and 2 inches posterior to ASIS

Question 28

AP Axial L5-S1 Projection: Lumbar Spine

Answer 28

40 SID 90 to 100 KV Angle CR cephalad 30 (males) and 35 (females) Direct CR to level of ASIS at the midline of the body

Question 29

AP Axial Sacram Projection: Sacrum

Answer 29

40 SID 85 to 90 KV CR 15 degree cephalad: Direct 2 inches superior to symphysis pubis

Question 30

AP Axial Coccyx Projection: Coccyx

Answer 30

SID 40 80 to 85 KV Angle CR 10 degree caudad Direct 2 inches superior to symphysis pubis

Question 31

Lateral Sacrum and Coccyx Position: Sacrum and Coccyx

Answer 31

SID 40 90 to 100 KV Direct CR 3 to 4 inches posterior to ASIS

Question 32

Lateral Coccyx Position: Coccyx

Answer 32

40 SID 85 to 90 KV Direct CR 3 to 4 inches posterior and 2 inches distal to ASIS

Question 33

AP Axial Projection: Sacroiliac Joints

Answer 33

``` 40 SID 90 to 100 KV Angle CR 30 to 35 Cephalad 30 degrees for males 35 degrees for femlaes Direct CR to midline about 2 inches below level of ASIS ```

Question 34

Posterior Oblique Positions (LPO and RPO): Sacroiliac Joints

Answer 34

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

Question 35

AP Projection: External Rotation: Shoulder (nontrauma) | AP Proximal Humerus

Answer 35

SID 40 75 to 85 KV 1 inch inferior to coracoid process

Question 36

AP Projection--Internal Rotation: Shoulder (nontrauma) | Lateral Proximal Humerus

Answer 36

SID 40 75 to 85 KV 1 inch inferior to coracoid process

Question 37

Inferosuperior Axial Projection: Shoulder (nontrauma) | Lawrence Method

Answer 37

40 SID 75 to 80 Kv Position patient supine with shoulder raised about 2 inches from tabletop by placing support under arm and shoulder to place body part near center of IR. Direct CR medially 25 to 30 degrees, centered horizontally to axilla and humeral head. If abduction of arm is less than 90 degrees the CR medial angle also should be decreased to 15 to 20 degrees if possible.

Question 38

PA Transaxillary Projection: Shoulder (Nontrauma) | Hobbs Modification

Answer 38

40 SID 75 to 85 KV Arm is raised suppiorly as much as the patient can tolerate and head is turned away from the affected arm. CR directed perpendicular to axilla and the humeral head to pass through the glenohumeral joint.

Question 39

Inferosuperior Axial Projection: Shoulder (nontrauma) | Clements Modification

Answer 39

``` SID 40 KV 75 to 85 Abduct arm 90 degrees from body Direct horizontal CR perpendicular to IR If patient cannot abduct the arm 90 degrees, angle the tube 5 to 15 degrees toward the axilla. ```

Question 40

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

Answer 40

Rotate body 35 to 45 degrees toward affected side CR: perpendicular to IR, centered to scapulohumeral joint, which is approximately 2 inches inferior and medial from the superolateral border of shoulder

Question 41

Tangential Projection--Intertubercular (Bicipital) Groove: Shoulder (nontrauma) Fisk Modification

Answer 41

40 SID 65 to 75 KV Patient leaning forward slightly to place humerus 10 to 15 degrees from vertical. CR perpendicular to IR, directed to groove area at midanterior margin of humeral head

Question 42

AP Projection-Neutral Rotation: Shoulder (Trauma)

Answer 42

SID 40 75 to 85 Kv CR perpendicular to IR, directed to midscapulohumeral joint, which is approximately 3/4 inch inferior and slightly lateral to coracoid process

Question 43

Transthoracic Lateral Projection: Proximal Humerus (Trauma) | Lawrence Method

Answer 43

SID 40 Kv 75 to 85 Affected arm at patient's side in neutral rotation; drop shoulder if possible Raise opposite arm and place hand over top of head; elevate shoulder as much as possible to prevent superimpostion of affected shoulder. CR perpendicular to IR, directed through thorax to level of affected surgical neck.

Question 44

Scapular Y Lateral--Anterior Oblique Position: | Shoulder (Trauma)

Answer 44

40 SID 75 to 85 Kv Obliquity may range from 45 to 60 degrees. Center scapulohumeral joint to CR and center to IR CR perpendicular to IR, directed to scapulohumeral joint (2 or 21/2 inches below top of shoulder)

Question 45

Tangential Projection--Supraspinatus Outlet: Shoulder (Trauma) Neer Method

Answer 45

40 SID Kv 75 to 85 10 to 15 degrees caudal angle centered posteriorly to pass through superior margin of humeral head with patient facing IR, rotate into anterior oblique position as for lateral scapula.

Question 46

AP Apical Oblique Axial Projection: Shoulder (Trauma) | Garth Method

Answer 46

SID 40 Kv 75k to 85 Adjust IR so that 45 degree toward affected side (posterior surface of affected shoulder against IR. Center 45 degrees caudad, scapulohumeral joint to CR

Question 47

AP and AP Axial Projections: Clavicle

Answer 47

``` 40 SID 75 to 85 Kv AP CR perpendicular to midclavicle AP Axial CR 15 to 30 degrees cephalad to midclavicle ```

Question 48

AP Projection: AC joints

Answer 48

SID 72 70 to 80 Kv CR perpendicular to midpoint between AC joints, 1 inch above jugular notch Alternative AP Axial Projection (Alexander method) A 15 cephalic angle centered at the level of the AC joints projects the AC joint superior to the acromion

Question 49

AP Projection: Scapula

Answer 49

SID 40 75 to 85 Kv Gently abduct from 90 degrees, and supinate hand. (abduction moves scapula laterally to clear more of the thoracic structures.) 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.

Question 50

Lateral Position: Scapula | Patient Erect

Answer 50

SID 40 75 to 85 Kv This best demonstrates acromion and coracoid processes. CR to midvertebral border of scapula

Question 51

Lateral Position: Scapula | Patient Recumbent

Answer 51

SID 40 75 to 85 Kv CR to midscapula lateral border