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Radiograph

An image of a patient's anatomic part(s), as produced by the action of X-rays on an image receptor.

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Radiography

The process and procedures of producing a radiograph.

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Radiograph vs X-ray film

X-ray film specifically refers to to physical piece of material on which a latent (non processed) radiographic image is stored. The term radiograph includes the recording medium *and* the image.

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IR

Image receptor. The device that captures the radiographic image that exits the patient.

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CR

Central ray. Refers to the center most portion of the X-ray beam emitted from the X-ray tube; the portion of the beam that has the least divergence.

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Five general functions of a radiographic examination.

1. Positioning the body part and alignment with the IR and CR.
2. Application of radiation protection measures and devices.
3. Selection of exposure factors (radiographic technique) on the control panel.
4. Instructions to the patient related to respiration & initiation of the x-ray exposure.
5. Processing of the IR.

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Anatomic position

Upright position with arms abducted slightly, palms forward, & head and feet directed straight ahead.

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What four devices can be considered IR's?

Cassette with film
Image plate (IP)
Solid-state detectors
Fluoroscopy screen

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What are the 4 fundamental body planes referred to in radiography?

Sagittal, oblique, horizontal, coronal

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Describe the sagittal plane.

Any longitudinal plane that divides the entire body (or part) into right and left segments.

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Coronal plane

Divides the entire body (or part) into anterior and posterior segments.

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Horizontal or axial plane

Plane that passes crosswise through the body or body part at right angles to the longitudinal plane, dividing the body into superior and inferior portions. Also referred to as transverse.

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Oblique plane

A longitudinal or transverse plane that is at an angle or slant and not parallel to the sagittal, coronal, or horizontal planes.

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What are planes used for in radiography?

To center a body part to the IR or CR and to ensure body part is properly orientated and aligned with the IR.

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What are planes used for in CT, MRI, and ultrasound?

To identify the orientation of anatomic cuts or slices demonstrated in the procedure.

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Describe the posterior body surface.

Refers to the back half of the patient. Also called dorsal. Includes the bottom of the feet and back of hands.

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Describe the anterior body surface.

Refers to the front half of the patient. Includes the top of the feet and the palms of the hands.

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Describe "plantar."

Refers to the sole or posterior surface of the foot.

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Describe "dorsum."

Refers to the anterior surface (top) of the foot.

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Describe the dorsal surface of the hand.

Refers to the back or posterior aspect of the hand.

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Describe the Palmer side of the hand.

Refers to the palm of the hand, or the anterior or ventral surface.

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Cephalad

Refers to parts toward the head of the body.

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Caudad

Refers to parts away from the head of the body.

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Superior

Refers to nearer the head or situated above.

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Inferior

Refers to nearer the feet or situated below.

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Medial

In the anatomic position, it is the "inside" part closest to the median and or midline of the body.

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Lateral

In the anatomic position, it is the part away from the center, or away from the median plane or midline of the body.

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Proximal

Near the source or beginning.

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Distal

Away from the source or beginning.

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Ipsilateral

Part or parts on the same side of the body.

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Contralateral

Part or parts on the opposite side of the body.

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Why are the four positioning terms used in radiology?

Projection, position, view*, and method.

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What is projection?

Path of the central ray.

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AP projection

A perpendicular central ray enters the anterior body surface and exits the posterior body surface.

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AP projection of the foot is also called:

Dorsoplantar projection

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PA projection

Posteroanterior projection. A perpendicular central ray enters the posterior surface of the body and exits the anterior surface.

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A true PA projection without rotation requires the CR to be:

Perpendicular to the coronal plane and parallel to the sagittal plane.

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Axial projection

Longitudinal angulation of the central ray with the long axis of the body or specific body part. Usually produced by angling the central ray cephalad or caudad though sometimes by angling the *body part* while maintaining a perpendicular central ray.

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What is the minimum longitudinal angle between the central ray and the long axis if the body to qualify as an axial projection?

10 degrees.

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Tangential projection

Means touching a curve or surface at only one point. Describes a projection that merely skims a body part to project that part into profile & away from other body structures.

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Lateral projection

A perpendicular CR enters one side of the body or body part, passes transversely along the coronal plane, and exits the opposite side.

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Lateral projection with right lateral position:

The CR enters the left side of the body, passes transversely along the coronal plane, and exits the right side (The right side is *closest to the IR.*)

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Lateral projection with left lateral position:

The CR enters the right side of the body, passes transversely along the coronal plane, and exits the left side (The left side is *closest to the IR.*)

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Lateral projections of the limbs are further clarified by:

the terms "lateromedial" or "mediolateral" to indicate the sides entered and exited by the central ray.

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Transthoracic lateral projection:

is a unique projection used for shoulder radiography.

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Oblique projections

the CR enters the body or body part from a side angle following an oblique plane.

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If he CR enters the anterior surface following an oblique plane,

it is an AP oblique projection.

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If the CR enters the posterior surface following an oblique plane,

it is a PA oblique projection.

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Right posterior oblique position:

place the right posterior surface of the body closest to the IR. Corresponds with the AP oblique projection.

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An AP or PA oblique projection of the upper or lower limbs must also include:

a qualifying term indicating which way it is rotated such a medial or lateral rotation.

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What are the two ways the term "position" is used in radiology?

One way identifies overall posture of patient or the general body position. The other way refers to the specific placement of the body part in relation to the radiographic table or IR *during imaging.*

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Supine

Lying on back, facing upward.

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Prone

Lying on abdomen, facing downward.

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Erect (upright)

An upright position marked by a vertical position.

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Recumbent position.

General term referring to lying down in any position.

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Dorsal recumbent

lying on back supine.

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Ventral recumbent

lying face down prone.

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lateral recumbent

lying on side---right or left.

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Trendelenburg position

Supine position with the head tilted downward. Whole body tilted so that the head is lower than the feet.

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Fowler's position

A recumbent position with the body tilted so that the head is higher than the feet.

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Sim's position

A recumbent position with the patient lying on the left anterior side (semi prone) with the left leg extended and the right knee and thigh partially flexed.

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Lithotomy position

A supine position with the knees and hip flexed and thighs abducted and rotated externally, supported by ankle supports.

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Lateral radiographic positions are always named according to:

side of the patient that is closest to the IR.

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What is the resulting projection of a left lateral position?

A lateral projection.

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What is the resulting projection of a right lateral position?

A lateral projection.

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An oblique radiographic position is achieved when:

the entire body or body part is rotated so that the coronal plane is not parallel with the radiographic table or IR.

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Oblique positions are aways named according to:

the side of the patient that is placed closest to the IR.

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Right posterior oblique position (RPO)

The right posterior body surface is in contact with the radiographic table.

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Left posterior oblique position (LPO)

The patient's left posterior surface is in contact with the radiographic table.

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Posterior oblique positions result in what type of projection?

AP oblique projections.

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Right anterior oblique position (RAO)

The right anterior body surface is in contact with the radiographic table.

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Left anterior oblique position (LAO)

The left anterior body surface is in contact with the radiographic table.

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Anterior oblique positions of the chest result in what projection?

PA oblique projection.

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For oblique positions of the limbs, what terms have been standardized to designate the direction in which the limbs have been turned from the anatomic position?

Medial rotation and lateral rotation.

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Decubitus position

This term indicates that the patient is lying down and that the central ray is horizontal and parallel with the floor.

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Which position is most often used to demonstrate the presence of air-fluid levels or free air in the chest and abdomen?

Lateral decubitus position.

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What is the resulting projection of a left lateral decubitus position with the back closest to the IR?

AP projection.

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What is the resulting projection of a left lateral decubitus position with the anterior surface closest to the IR?

PA projection.

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What is the resulting projection when the patient is in a dorsal decubitus position with the right side of the body next to the IR?

Right lateral projection.

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What is the resulting projection when the patient is in a ventral decubitus position with the left side of the body next to the IR?

Left lateral projection

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Lordotic position is achieved by

having the patient lean backward while in the upright body position so that only the shoulders are in contact with the IR.

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What type of projection results from the Lordotic position and what is it used for?

AP axial and it is used for the visualization of the pulmonary apices.

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The term, "view,"

Is not an accepted positioning term. (seen from vantage of IR)

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The term, "method," refers to:

some projections and procedures that are named after individuals.

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A specific oblique position in which the right anterior aspect of the body is closest to the IR:

Right anterior oblique (RAO)

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A body position in which the patient is lying on the abdomen with the X-ray beam directed horizontally:

Ventral decubitus position.

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A general body position in which the head is lower than the feet:

Trandelenburg postion.

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Interior:

internal, inside

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Exterior

external, outer

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The prefix inter- means:

situated between things. As in intercostal.

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The prefix intra- means:

within or inside. As in intravenous.

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The prefix exo- means:

outside or outward. As in exocardial.

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Superficial

refers to parts near the skin or surface

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Deep

refers to parts far from the surface.

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Extension

straightening of a joint; increases the angle as the body part moves from a flexed to a straightened position.

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Flexion

Act of bending a joint; decreases the angle of the joint.

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Hyperextension

Extending a joint beyond the straight or neutral position.

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Abnormal hyperextension

results when the joint is extended beyond the straightened or neutral position.

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Normal flexion of the spine

bending forward

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Normal extension of the spine

returning to the straight or neutral position.

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Hyperextension of the spine

backward bending beyond the neutral position.

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Hyperextended wrist

When wrist is extended beyond the neutral position

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Acute flexion of the wrist

Bending the wrist so that the fingers move up and towards the anterior aspect of the forearm.

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Deviation

A turning away from the regular standard or course.

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Ulnar deviation

turn hand and wrist away from natural position *toward* the *ulnar* side.

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Radial deviation

turn hand and wrist away from natural position *toward* the *radial* side.

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Dorsiflexion of the foot

decrease the angle between dorsum of foot and lower leg, moving foot and toes upward.

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Plantar flexion

extending joint, moving foot and toes downward from the normal position.

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Evert/eversion

outward turning of the foot at the ankle.

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Invert/inversion

inward turning of the foot at the ankle

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Valgus

bending of part outward or away from midline of body. Also used to describe eversion stress of ankle joint.

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Varus

Bending of a part inward or toward the midline. Also describes inversion stress applied at the ankle joint.