Podcast
Questions and Answers
What is the angle of the X-ray beam for the PA projection when centered over the 7th cervical spinous process?
What is the angle of the X-ray beam for the PA projection when centered over the 7th cervical spinous process?
In the Lordotic position, how is the patient's body positioned?
In the Lordotic position, how is the patient's body positioned?
How is the central ray directed for the AP projection?
How is the central ray directed for the AP projection?
What is the purpose of modifying the PA and AP projections in cases of apical opacities?
What is the purpose of modifying the PA and AP projections in cases of apical opacities?
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What condition may be demonstrated using the Lordotic technique?
What condition may be demonstrated using the Lordotic technique?
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What is the main advantage of adopting a semi-recumbent position for an X-ray projection?
What is the main advantage of adopting a semi-recumbent position for an X-ray projection?
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What is the degree of caudal angulation recommended for the X-ray beam in a semi-erect projection?
What is the degree of caudal angulation recommended for the X-ray beam in a semi-erect projection?
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In a lateral radiograph, why are the arms raised or folded over the head?
In a lateral radiograph, why are the arms raised or folded over the head?
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How should the median sagittal plane be oriented in relation to the image receptor during a semi-erect X-ray?
How should the median sagittal plane be oriented in relation to the image receptor during a semi-erect X-ray?
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Why is a lateral projection not taken routinely during lung examinations?
Why is a lateral projection not taken routinely during lung examinations?
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What is the typical size of the CR cassette used for the semi-erect and lateral X-ray projections?
What is the typical size of the CR cassette used for the semi-erect and lateral X-ray projections?
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What positioning adjustment is made to prevent rotation of the patient during a semi-erect projection?
What positioning adjustment is made to prevent rotation of the patient during a semi-erect projection?
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In what situation is a supplementary lateral projection particularly useful?
In what situation is a supplementary lateral projection particularly useful?
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What is the primary reason for using the antero-posterior erect projection instead of the PA erect projection?
What is the primary reason for using the antero-posterior erect projection instead of the PA erect projection?
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What adjustment is made to the median sagittal plane during antero-posterior positioning?
What adjustment is made to the median sagittal plane during antero-posterior positioning?
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In the antero-posterior erect view, how are the shoulders positioned to clear the lung fields?
In the antero-posterior erect view, how are the shoulders positioned to clear the lung fields?
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Where is the X-ray beam directed during the antero-posterior erect projection?
Where is the X-ray beam directed during the antero-posterior erect projection?
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What is a potential disadvantage of the antero-posterior erect projection in relation to heart size assessment?
What is a potential disadvantage of the antero-posterior erect projection in relation to heart size assessment?
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What position should the patient's arms be in during the antero-posterior supine projection?
What position should the patient's arms be in during the antero-posterior supine projection?
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In an antero-posterior supine position, what is the significance of positioning the upper edge of the cassette above the lung apices?
In an antero-posterior supine position, what is the significance of positioning the upper edge of the cassette above the lung apices?
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Study Notes
Radiographic Techniques
- Lungs: AP, lateral, and apical views are used to show lung structures, with the subject positioned in a lordotic posture.
- Technician: Ahmed Jasem, Abass, and others performed the procedure.
- Degree: Masters of Science (MSc) in Medical Imaging.
Antero-posterior – Erect
- Alternative: Used as an alternative to PA erect projection when a patient cannot stand or sit.
- Patient Support: Patient is supported sitting upright on a trolley against a Bucky.
- Positioning: Patient stands or sits, back against the image receptor (supported vertically). The median sagittal plane is adjusted perpendicular to the receptor center. Shoulders are lowered and forward, elbows forward, and hands below hips to clear the scapulae from the lung fields.
Antero-posterior – Erect (X-ray Beam)
- Beam Direction: Collimated horizontal beam positioned at a right angle to the sternum and centered midway between sternal notch and xiphisternum.
- Inspiration: Exposure is taken during normal full inspiration.
- Radiological Considerations: Projection moves the heart away from the image receptor plane, increasing magnification and reducing heart size assessment accuracy.
Antero-posterior – Supine
- Patient Position: Patient lies supine, cassette positioned under the chest, with the upper edge above lung apices (C7 prominence).
- Positioning: Median sagittal plane is adjusted at right angles to the receptor center. The patient's pelvis is checked for rotation, and arms are beside the body, chin slightly raised on pillow.
Antero-posterior – Semi-Erect
- Alternative: Used for patients too ill to stand or sit without support.
- Cassette Size: 35 x 43 cm cassette selected.
- Patient Position: Supported in semi-recumbent position, facing the X-ray tube.
- Body Positioning: Image receptor is supported against back, upper edge above lung fields. The median sagittal plane is adjusted perpendicular to the receptor center. Patient rotation is prevented by foam pads. The arms are rotated medially with shoulders forward to clear scapulae.
Antero-posterior – Semi-Erect (X-ray Beam)
- Beam Direction: Collimated horizontal beam first directed at right angles to image receptor, then angled caudally, centered midway between the sternal notch and the xiphisternum.
- Angulation: 5-10° caudal angulation, for lung field visualization, avoiding clavicle obscuring.
Lateral
- Supplementary: Used to localize lesions, particularly mediastinal masses, not visible on PA projections.
- **Procedure:**Erect patient, turned to bring affected side in contact with image receptor. Median sagittal plane is positioned parallel to the image receptor. Position arms folded over head or elevated on a support. The mid-axillary line should be positioned in line with the receptor center.
- Level: The receptor is adjusted to include the apices and the lower lobes to the level of the 1st lumbar vertebra.
Lateral (X-ray Beam)
- Beam Direction: Collimated horizontal beam directed at a right angle to the middle of the image receptor, coincident with the midaxillary line.
Apices
- Opacity Resolution: Used to demonstrate opacities obscured by overlying ribs or clavicles.
- PA Projection: Collimated beam angled 30° caudally for the PA position, centered over the 7th cervical spinous process and sternal angle.
- AP Projection: Collimated beam angled 30° cranially towards the sternal angle for the AP position.
Lordotic
- Application: Used for demonstrating right middle-lobe collapse or interlobar pleural effusion, positioning the middle-lobe fissure horizontally.
- Positioning Steps: Patient placed in a posteroanterior projection position, bends backwards at the waist (30-40 degree dorsiflexion) with the sides of the vertical Bucky clasped.
- X-ray Direction: Horizontal ray directed perpendicular to the cassette and towards the middle of the film.
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Description
This quiz covers advanced radiographic techniques used for imaging lung structures, including specific views like AP, lateral, and apical. It is aimed at students pursuing a Master's degree in Medical Imaging, detailing procedures and patient positioning techniques. Test your knowledge on the importance of proper positioning and beam direction in radiography.
