Podcast
Questions and Answers
What should you do if you need to expose radiation during your first lab session?
What should you do if you need to expose radiation during your first lab session?
- Make exposure without consultation to avoid delays.
- Ask the lab tutor to check before proceeding. (correct)
- Consult with a fellow classmate for their opinion.
- Wait until the end of the session to review the protocols.
What immediate action should you take before making an exposure in the lab?
What immediate action should you take before making an exposure in the lab?
- Ensure the lab supervisor is out of the room.
- Check that protective clothing is worn by all present.
- Conduct a quick briefing with classmates.
- Verify that the lab door is closed. (correct)
Which rule is NOT mentioned as part of the lab safety regulations?
Which rule is NOT mentioned as part of the lab safety regulations?
- Enclosed footwear with sturdy upper must be worn.
- TLD badges must be worn while attending labs.
- No unauthorised person is allowed in the lab.
- Students can consume food in reserved areas. (correct)
What is the intended purpose of wearing TLD badges in the lab?
What is the intended purpose of wearing TLD badges in the lab?
Why is imaging another classmate in the lab prohibited?
Why is imaging another classmate in the lab prohibited?
What is the central ray positioning for a lateral chest x-ray?
What is the central ray positioning for a lateral chest x-ray?
What is the required tube angle for both lateral chest and AP abdomen x-rays?
What is the required tube angle for both lateral chest and AP abdomen x-rays?
What is the optimal distance for performing a lateral chest x-ray?
What is the optimal distance for performing a lateral chest x-ray?
Which of the following is essential during patient preparation for a lateral chest x-ray?
Which of the following is essential during patient preparation for a lateral chest x-ray?
What kVp range should be used for adult AP abdomen imaging?
What kVp range should be used for adult AP abdomen imaging?
What anatomical structures should be displayed clearly in a lateral chest x-ray?
What anatomical structures should be displayed clearly in a lateral chest x-ray?
What is the required angle for the thumb side of the hand when positioning for a PA oblique hand x-ray?
What is the required angle for the thumb side of the hand when positioning for a PA oblique hand x-ray?
Which positioning detail is specific to the lateral hand x-ray technique?
Which positioning detail is specific to the lateral hand x-ray technique?
What is a recommended instruction to give the patient during a lateral chest x-ray?
What is a recommended instruction to give the patient during a lateral chest x-ray?
What is the primary reason for using a left lateral position in a lateral chest x-ray?
What is the primary reason for using a left lateral position in a lateral chest x-ray?
What is the central ray location for the PA oblique hand x-ray?
What is the central ray location for the PA oblique hand x-ray?
What is the appropriate collimation requirement for both PA oblique and lateral hand x-rays?
What is the appropriate collimation requirement for both PA oblique and lateral hand x-rays?
What is the recommended mAs setting for the lateral hand x-ray?
What is the recommended mAs setting for the lateral hand x-ray?
During a PA oblique hand x-ray, which part of the hand should not overlap as much?
During a PA oblique hand x-ray, which part of the hand should not overlap as much?
Which is NOT a key anatomical feature to visualize in the criteria for lateral hand x-ray?
Which is NOT a key anatomical feature to visualize in the criteria for lateral hand x-ray?
What is the required distance for the PA Hand imaging?
What is the required distance for the PA Hand imaging?
What main factor distinguishes the kVp settings between PA oblique and lateral hand x-rays?
What main factor distinguishes the kVp settings between PA oblique and lateral hand x-rays?
Which of the following factors is critical for ensuring appropriate density in abdominal imaging?
Which of the following factors is critical for ensuring appropriate density in abdominal imaging?
In the context of an PA Hand imaging, what is specifically required for proper alignment?
In the context of an PA Hand imaging, what is specifically required for proper alignment?
What anatomical areas should an abdominal X-ray adequately demonstrate?
What anatomical areas should an abdominal X-ray adequately demonstrate?
What should be included in the collimation for PA Hand imaging?
What should be included in the collimation for PA Hand imaging?
During abdominal imaging, what is a sign that could indicate the need for a repeat image?
During abdominal imaging, what is a sign that could indicate the need for a repeat image?
What is the typical kVp setting for a PA Hand imaging procedure?
What is the typical kVp setting for a PA Hand imaging procedure?
Which instruction is vital for achieving the correct posture while taking a PA Hand image?
Which instruction is vital for achieving the correct posture while taking a PA Hand image?
What is the correct tube angle for a PA Oblique Thumb positioning?
What is the correct tube angle for a PA Oblique Thumb positioning?
Which of the following is NOT part of the criteria for the AP Thumb imaging?
Which of the following is NOT part of the criteria for the AP Thumb imaging?
What is the correct central ray location for both AP and PA Oblique Thumb images?
What is the correct central ray location for both AP and PA Oblique Thumb images?
What distance should be maintained from the tube to the image receptor for Thumb imaging?
What distance should be maintained from the tube to the image receptor for Thumb imaging?
Which of the following is crucial for ensuring that joint spaces are open in Thumb imaging?
Which of the following is crucial for ensuring that joint spaces are open in Thumb imaging?
Which density characteristic should be demonstrated in the final image of the Thumb?
Which density characteristic should be demonstrated in the final image of the Thumb?
What preparation should be done on the patient before Thumb imaging?
What preparation should be done on the patient before Thumb imaging?
What is the maximum kVp recommended for Thumb imaging?
What is the maximum kVp recommended for Thumb imaging?
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Study Notes
Introduction
- The text is a guide for x-ray protocols at the University of Newcastle (UON), the guidelines may vary depending on the site.
- The UON laboratory has a Philips DigitalDiagnost C90 digital radiography system
- The UON laboratory uses a Philips 35x43cm IR (Image Receptor)
- Body habitus, patient presentations and equipment will affect exposures
Lab Rules
- Students must wear TLD badges while attending labs, failure to do so will result in limitations, including lab exclusion.
- UON placement uniform, enclosed footwear, must be worn
- Eating, drinking, or smoking is not permitted in the diagnostic radiography laboratory
- Unauthorised people cannot be in the lab
- School of Health Science OH&S regulations must always be adhered to
Radiation Rules
- Students should confirm with a tutor before using radiation in a lab for the first time.
- Imaging classmates is prohibited.
- The door must be closed before taking an exposure.
- Students must ensure there are no other people in the room.
- The guidance of a supervisor must be followed.
Lateral Chest
- Positioning: Left side to upright bucky, hands on head
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: Mid-coronal plane at level of T7 (inferior angle of scapulae)
- Distance: 180cm
- Collimation: Include lung apices to costophrenic angles, laterally to skin border.
- IR (Receptor): 35x43cm Portrait
- kVp: 90-110 kVp
- mAs: Central cell of AEC Estimate: 4 mAs
- Grid: Yes
- Breathing: Suspended (inspiration)
- Notes: Remove any artifacts before taking an image, patient should wear a gown.
Lateral Chest Criteria
- Collimation: From the apices to costophrenic angles. Include the anterior and posterior soft tissues
- Alignment: No rotation. Posterior ribs superimposed
- Anatomy: Lungs, trachea, heart, great vessels, diaphragm, posterior costophrenic angles, bony thorax
- Density: Vertebral bodies of thoracic spine just visible through cardiac shadow
- Contrast: Lung detail clearly visualised. Soft tissue borders should be seen
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Left lateral position reduces cardiac magnification as the heart is close to the image receptor.
AP Abdomen
- Posture: Supine
- Positioning: Patient on back, on xray table or trolley. No rotation, with shoulders and hips equidistant from table/trolley.
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: Mid-sagittal plane at level of iliac crests
- Distance: 100-110cm
- Collimation: Include lung apices to costophrenic angles, laterally to skin border.
- IR (Receptor): 35x43cm Portrait (landscape may be required in bariatric patients to include all relevant anatomy)
- kVp: Adult 75-80 kVp
- mAs: Lateral cells of AEC Estimate: 30-35+ mAs
- Grid: Yes
- Breathing: Suspended (expiration)
- Notes: Remove any artifacts before taking an image, patient should wear a gown.
AP Abdomen Criteria
- Collimation: Superior to the diaphragm, inferiorly to the inferior pubic rami, laterally to the abdominal skin edge
- Alignment: No rotation. Ribs, crests and obturator foramen symmetrical
- Anatomy: Abdomen from diaphragm to inferior pubic rami. Liver, spleen, kidneys, gastric bubble, bowel gas, bladder, bony anatomy of the lumbar spine and pelvis
- Density: Gas, soft tissue and bone adequately demonstrated.
- Contrast: Soft tissue and bony contrast visualised.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Carefully observe the patient to catch full breathing expiration. Blurring of bowel gas indicates respiratory movement (repeat may be required)
PA Hand
- Posture: Seated
- Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: 3rd MCP joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of hand
- kVp: 50kVp
- mAs: 2mAs
- Grid: No
- Breathing: N/A
- Notes: Remove any artifacts before taking an image (watch, jewellery)
PA Hand Criteria
- Collimation: Include all of required anatomy including skin edges
- Alignment: No rotation. Symmetry of phalanges and metacarpals
- Anatomy: Tips of digits to distal radius and ulna
- Density: Cortical outline and bony trabecular pattern adequately demonstrated
- Contrast: Soft tissue and bony interfaces visualised.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Ensure all fingers are in contact with the image detector to ensure joint spaces are open.
PA Oblique Hand
- Posture: Seated
- Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor. Thumb side of hand raised 45 degrees.
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: 3rd MCP joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of hand
- kVp: 50kVp
- mAs: 2mAs
- Grid: No
- Breathing: N/A
- Notes: Remove any artifacts before taking an image (watch, jewellery)
PA Oblique Hand Criteria
- Collimation: Include all of required anatomy including skin edges
- Alignment: 45 degrees rotation with elevation of radial aspect of hand elevated (thumb up). Midshafts of third, fourth and fifth metacarpals should not overlap, however some overlap of distal metacarpal heads
- Anatomy: Tips of digits to distal radius and ulna
- Density: Cortical outline and bony trabecular pattern adequately demonstrated
- Contrast: Soft tissue and bony interfaces visualised.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Ensure all fingers are in parallel with the image detector to ensure joint spaces are open.
Lateral Hand
- Posture: Seated
- Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor. From oblique position, rotate hand to 90 degrees. Thumb is parallel to image receptor. Fingers can be superimposed or fanned to see each digit.
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: Level of MCP joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of hand
- kVp: 55kVp
- mAs: 2.5mAs
- Grid: No
- Breathing: N/A
- Notes: Remove any artifacts before taking an image (watch, jewellery)
Lateral Hand Criteria
- Collimation: Include all of required anatomy including skin edges
- Anatomy: Tips of digits to distal radius and ulna
- Density: Cortical outline and bony trabecular pattern adequately demonstrated
- Contrast: Soft tissue and bony interfaces visualised. Internal rotation of hand so that thumb is AP and in contact with the image receptor.
AP Thumb
- Posture: Seated
- Positioning: Patient seated at end of xray table with legs at right angle to table, hand on image receptor. Rotate hand to 90 degrees. Fingers are superimposed or fanned to see each digit.
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: 1st MCP Joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of thumb
- kVp: 50kVp
- mAs: 2mAs
- Grid: No
- Breathing: N/A
- Notes: Remove any artifacts before taking an image (jewellery)
AP Thumb Criteria
- Collimation: Include all of digit of interest including skin edges
- Anatomy: Tip of thumb to trapezium
- Density: Cortical outline and bony trabecular pattern adequately demonstrated
- Contrast: Soft tissue and bony interfaces visualised.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Ensure finger is parallel to the image detector to ensure joint spaces are open. Hand is free of motion artifact.
PA Oblique Thumb
- Posture: Seated
- Positioning: Patient seated at end of xray table. Hand flat on image receptor, thumb slightly abducted.
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: 1st MCP Joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of thumb
- kVp: 50kVp
- mAs: 2mAs
- Grid: No
- Breathing: N/A
- Notes: Remove any artifacts before taking an image (jewellery)
PA Oblique Thumb Criteria
- Collimation: Include all of digit of interest including skin edges
- Anatomy: Tip of thumb to trapezium
- Density: Cortical outline and bony trabecular pattern adequately demonstrated
- Contrast: Soft tissue and bony interfaces visualised.
- Markers: Side marker evident
- Identity: Image has appropriate identification or deliberately anonymised
- Hints: Ensure finger is parallel to the image detector to ensure joint spaces are open. Hand is free of motion artifact.
Lateral Thumb
- Posture: Seated
- Positioning: Patient seated at end of xray table.
- Tube Angle: Straight tube (perpendicular to anatomy)
- Central Ray: 1st MCP Joint
- Distance: 100-110cm
- Collimation: Four sides of collimation seen to include skin edges of thumb
- kVp: 50kVp
- mAs: 2mAs
- Grid: No
- Breathing: N/A
- Notes: Remove any artifacts before taking an image (jewellery)
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