RAD 101 gerneral terminology and principles PDF.pdf

GENERAL TERMINOLOGY & PRINCIPLES REFERENCE: RADIOGRAPHIC POSITIONING & RELATED A N A T O M Y ( 1 1 TH E D I T I O N ) & B O N T R A G E R 1 0 TH E D I T I O N RAD 101 LEARNING OUTCOMES 1.00 Discuss the basic radiographic terms used in describing positioning and anatomy....

GENERAL TERMINOLOGY & PRINCIPLES REFERENCE: RADIOGRAPHIC POSITIONING & RELATED A N A T O M Y ( 1 1 TH E D I T I O N ) & B O N T R A G E R 1 0 TH E D I T I O N RAD 101 LEARNING OUTCOMES 1.00 Discuss the basic radiographic terms used in describing positioning and anatomy. 1.01 Define the following terms: 1. Anatomical Position 2. Median or Mid-Sagittal 3. Frontal or Coronal Plane 4. Transverse or Horizontal Plane 5. Longitudinal Plane 6. Section LEARNING OUTCOMES 1.02 Discuss the various terms that are used to describe opposites in anatomy. 1.03 Describe at least six terms that indicate bodily movement. 1.04 List three reasons for performing radiography examinations 90 degrees from each other.  LEARNING OUTCOMES 1.05 Define the following basic positioning terms: 1. Posterior (dorsal) 2. Interior 1. Longitudinal Plane 3. Anterior (ventral) 2. Ventral Decubitus 4. Exterior 3. Transverse 5. Posteroanterior (P.A.) 4. Position 6. Ipsilateral 5. Flexion 7. Anteroposterior (A.P.) 6. Projection 8. Contralateral 7. Extension 9. Supine 8. View 10. Axial 9. Hyperextension 11. Prone 10. Lateral 12. Semiaxial 11. Ulnar Flexion 13. Recumbent 12. Medial 14. Tangential 13. Radial Flexion 15. Trendelenburg 14. Proximal 16. Plantar 15. Eversion 17. Lateral 16. Distal 18. Dorsum 17. Inversion 19. Oblique 18. Cephalic (superior) 20. Palmar 19. Abduction 21. LPO/RPO 20. Caudal (inferior) 22. Median Plane 21. Adduction 23. Decubitus 22. Superficial 24. Coronal or Frontal Plane 23. Supination 25. Lateral Decubitus 24. Deep 26. Transverse or Horizontal Plane 25. Pronation 27. Dorsal Decubitus LEARNING OUTCOMES 1.06 Discuss the basic radiation protection principles to be observed by radiographers. 1.07 Discuss the major differences among the following terms: 1. Position 2. Projection 3. View LEARNING OUTCOMES 1.08 Discuss image evaluation in terms of: positioning accuracy, image markers and patient ID. 1.09 Identify the central ray (CR) as part of the radiation field. 1.10 Identify the collimator on the radiographic tube assembly. LEARNING OUTCOMES 2.00 Explain the function of the human skeletal system. 2.01 List at least three functions of the skeletal system. 2.06 Compare the axial and appendicular skeleton by discussing their major components.  TISSUES https://eduinput.com/wp-content/uploads/2023/03/21_11zon.jpg https://www.onlinebiologynotes.com/wp-content/uploads/2018/02/Nervous-tissue.jpg https://www.onlinebiologynotes.com/wp-content/uploads/2018/02/muscular-tissue.jpg https://eduinput.com/wp-content/uploads/2023/02/Connective-Tissues_11zon.jpg Epithelial Connective Muscular Nervous Cover internal and Supportive tissue Make up the Make up the external surfaces of Binds together substance of a substance of nerves the body muscle & nerve centers Supports Lining of vessels structures & organs General Terminology & Principles 2024 8  BODY SYSTEMS 1. Integumentary system 2. Skeletal system 3. Muscular system 4. Nervous system Sensory system 5. Endocrine system 6. Digestive system 7. Circulatory System Cardiovascular system Lymphatic system & immunity 8. Respiratory system 9. Urinary system 10. Reproductive system General Terminology & Principles 2024 9  INTEGUMENTARY SYSTEM Largest organ of the body COMPOSED OF: FIVE FUNCTIONS: Skin Regulate body temperature All structures derived from Protect the body the skin Eliminate waste products -Hair through perspiration -Nails Receive certain stimuli -Temperature -Sweat glands -Pressure -Oil glands -Pain Synthesize certain vitamins -Vitamin D Fig. 1.11 General Terminology & Principles 2024 10  SKELETAL SYSTEM 2 parts: 1) Axial 2) Appendicular COMPOSED OF: 4 FUNCTIONS: 206 separate bones Support & protect soft osteology tissues of the body Allow movement through Associated cartilages & joints interaction with the muscles to form a system of levers arthrology Produce blood cells Store calcium Fig 1.2 General Terminology & Principles 2024 11  AXIAL SKELETON Includes all bones that lie on or near the central axis of the body Adult Axial skeleton – 80 bones Skull Cranium – 8 bones Facial – 14 Bones Hyoid – 1 bone Auditory Ossicles – 6 bones (3 per ear) Vertebral Column Cervical – 7 bones Thoracic -12 bones Lumbar – 5 bones Sacral – 1 bone Coccyx – 1 bone Thorax Sternum – 1 bone Ribs – 24 bones (12 on each side) General Terminology & Principles 2024 12  APPENDICULAR SKELETON Bones of the upper and lower limbs (extremities), Shoulder, and pelvic Girdle Adult appendicular skeleton – 126 separate bones Shoulder Girdles Pelvic Girdle Clavicles - 2 Hip bones (innominate bones) - 2 Scapula (Scapulae) - 2 Lower Limbs Upper Limbs Femur (Femora) - 2 Humerus (Humeri) - 2 Tibia - 2 Ulna (Ulnae) - 2 Fibula (Fibulae) - 2 Radius (Radii) - 2 Patella (Patellae) - 2 Carpals - 16 Tarsals - 14 Metacarpals - 10 Metatarsals - 10 Phalanges - 28 Phalanges - 28 General Terminology & Principles 2024 13  MUSCULAR SYSTEM 3 MUSCLE TISSUE TYPES 3 FUNCTIONS: Skeletal Allow movement, such as -most of the muscle mass locomotion of the body or -striated -voluntary control movement of substances through the alimentary canal Smooth -involuntary control Maintain posture -Located in the walls of hollow internal organs such as blood vessels, stomach, & intestines Produce body heat Cardiac -found in the walls of the heart -striated https://cdn.medizzy.com/BFCluJpQcWP6vMeWhnEpv2H4zfc=/680x512/img/posts/5b2f697b-1ed7-47f8-af69-7b1ed757f890 -involuntary control General Terminology & Principles 2024 14  NERVOUS SYSTEM COMPOSED OF: FUNCTIONS: Brain Coordinate voluntary and Spinal cord involuntary body activities Transmit electrical impulses Nerves to various parts of the body Ganglia and brain Sensory organs: -eyes & ears Fig 1.8 General Terminology & Principles 2024 15  ENDOCRINE SYSTEM INCLUDES: FUNCTION: All the ductless glands Regulate bodily activities -testes, ovaries, pancreas, adrenals, through the various thymus, thyroid, parathyroid, pineal, hormones carried by the & pituitary cardiovascular system Placenta -acts as a temporary endocrine gland Fig 1.10 General Terminology & Principles 2024 16  DIGESTIVE SYSTEM INCLUDES: 2 FUNCTIONS: Alimentary canal Prepare food for absorption -mouth, pharynx, esophagus, -chemical and physical stomach, small intestines, large breakdown processes intestines, & anus Eliminate solid waste from Accessory organs the body -salivary glands, liver, GB, & pancreas https://upload.wikimedia.org/wikipedia/commons/1/14/Blausen_0316_DigestiveSystem.pn g General Terminology & Principles 2024 17  CIRCULATORY SYSTEM COMPOSED OF: SIX FUNCTIONS: Cardiovascular organs Distribute oxygen & nutrients to the body -heart, blood, & blood vessels Transport cell waste & carbon Lymphatic system dioxide from the cells -lymph nodes, lymph vessels, Transport water, electrolytes, lymph glands, & spleen hormones, & enzymes Protect against disease Prevent hemorrhage by forming blood clots Assist in regulating body temperature https://basicmedicalkey.com/wp-content/uploads/2016/06/B9780323260176000091_f009-001-9780323260176.jpg General Terminology & Principles 2024 18  RESPIRATORY SYSTEM COMPOSED OF: 3 PRIMARY FUNCTIONS: 2 lungs Supply oxygen to the blood & Series of passageways cells -nose, mouth, pharynx, larynx, Eliminate carbon dioxide trachea, & bronchial tree from the blood Assist in regulating the acid- base balance of the blood https://www.kenhub.com/thumbor/aYeiUDyWa3CQI1Ox3eJa6sR9Eng=/fit-in/800x1600/filters:watermark(/images/logo_url.png,-10,-10,0):backgrou nd_color(FFFFFF):format(jpeg)/images/library/13894/Respiratory_system.png General Terminology & Principles 2024 19  URINARY SYSTEM INCLUDES: 4 FUNCTIONS: Kidneys Regulate the chemical Ureters composition of the blood Eliminate many waste Bladder products Urethra Regulate fluid & electrolyte balance & volume Maintain the acid-base balance of the body https://www.news-medical.net/image.axd?picture=2018%2F9%2Fshutterstock_638539345.jpg General Terminology & Principles 2024 20  REPRODUCTIVE SYSTEM INCLUDES: FUNCTION: Males: To reproduce the organism -testes -vas deferens -prostate gland -penis Females: -ovaries -uterine (fallopian) tubes https://dubaivfm.com/wp-content/uploads/2019/11/facts-about-reproductive-system-1.jpg -uterus -vagina General Terminology & Principles 2024 21  ANATOMIC POSITION The anatomic position is an upright position with arms abducted slightly (down), hands by sides with palms forward, and head and feet together and directed straight ahead General Terminology & Principles 2024 22  BODY PLANES Sagittal Plane Any longitudinal plane that divides the body into right and left parts Any plane parallel to midsagittal plane Midsagittal or Median Plane (MSP) Divides the body into equal right and left parts Passes approximately through the sagittal suture of the skull Coronal Plane Any longitudinal plane that divides the body into anterior and posterior parts Any plane parallel to the frontal or midcoronal plane Frontal or Midcoronal Divides the body into approximately equal anterior and posterior parts Passes approximately through the coronal suture of the skull Fig. 1.43 copyright 2025 by Elsevier, Inc. General Terminology & Principles 2024 23  BODY PLANES CONTINUED… Oblique Plane Longitudinal or transverse plane that is at an angle or slant Not parallel to the sagittal, coronal, or horizontal plane Horizontal (Axial) Plane Any transverse plane that passes through the body at right angles to a longitudinal plane Divides the body into superior and inferior portions Fig. 1.43 copyright 2025 by Elsevier, Inc. General Terminology & Principles 2024 24  PLANES OF THE SKULL Base Plane Formed by connecting the lines from the infraorbital margins (inferior edge of bony orbits) to the superior margin of the external auditory meatus (EAM), the external opening of the ear AKA Frankfort Horizontal Plane Occlusal Plane Formed by the biting surfaces of the upper and lower teeth with jaws closed Fig. 1.48 copyright 2025 by Elsevier General Terminology & Principles 2024 25  BODY SURFACES & PARTS Posterior or Dorsal Refers to the back half of the patient Includes bottom of feet and the backs of the hands Anterior or Ventral Refers to the front half of the patient Includes tops of feet and the fronts or palms of the hands Fig. 1.49 copyright 2025 by Elsevier General Terminology & Principles 2024 26  BODY SURFACES AND PARTS (HANDS AND FEET) Plantar Sole or Posterior surface of the foot Dorsal Foot https://i.stack.imgur.com/7O07i.png Top or Anterior surface of the foot Dorsum pedis Hand Back or posterior aspect of hand Dorsum Manus Palmar Palm of the hand, anterior or ventral surface of hand Fig. 1.50 copyright 2021 by Elsevier General Terminology & Principles 2024 27  TERMS RELATED TO MOVEMENT Flexion vs. Extension Flexion Decreases the angle of the joint Extension Increases the angle of the joint Fig. 1.90 Copyright 2025 by Elsevier General Terminology & Principles 2024 28  TERMS RELATED TO MOVEMENT CONTINUED… Hyperextension Extending a joint beyond the straight or neutral position Abnormal Hyperextension When an elbow or knee is hyperextended beyond the straightened or neutral position This is not a natural movement for these 2 joints and results in injury or trauma https://www.knee-pain-explained.com/images/hyperextended-knee.jpg General Terminology & Principles 2024 29  TERMS RELATED TO MOVEMENT CONTINUED… Normal Flexion of the spine Bending forward Normal Hyperextension of the spine Backward bending beyond the neutral position Neutral (Extension) Straight neutral position Fig. 1.91 copyright 2025 by Elsevier General Terminology & Principles 2024 30  TERMS RELATED TO MOVEMENT CONTINUED… Normal hyperextension of the wrist Wrist is extended beyond neutral position Dorsiflexion (backward or posterior flexion) Acute flexion of the wrist Wrist is flexed beyond neutral position This is required for a special tangential projection of the wrist - carpal bridge projection Fig. 1.92 copyright 2025 by Elsevier General Terminology & Principles 2024 31  TERMS RELATED TO MOVEMENT CONTINUED… Ulnar Deviation Is to turn or bend the hand and wrist from the natural position toward the ulnar side Radial Deviation Is toward the radial side of the wrist Fig. 1.93 copyright 2025 by Elsevier General Terminology & Principles 2024 32  DORSIFLEXION VS. PLANTAR FLEXION Dorsiflexion Means to decrease the angle (flex) between the dorsum and the lower leg Moving the foot and toes upward Plantar flexion Extending the ankle joint Moving the foot and toes downward Fig. 1.94 copyright 2025 by Elsevier General Terminology & Principles 2024 33  INVERSION VS. EVERSION Inversion Eversion Inward stress movement of the outward stress movement of the foot at the foot without rotation of the leg ankle joint Varus Valgus Abnormal position in which a part Abnormal position in which a part or limb is or limb is forced inward toward MSP forced outward from MSP Can be used to describe inversion stress Can be used to describe eversion stress of of the ankle joint ankle joint General Terminology & Principles 2024 34 Fig. 1.96 copyright 2025 by Elsevier Fig. 1.95 copyright 2025 by Elsevier  MEDIAL VS LATERAL ROTATION Medial (Internal) Rotation A rotation or turning of a body part with movement of the anterior aspect of the part toward the inside or median plane Lateral (External) Rotation A rotation or turning of a body part with movement of the anterior body part toward the outside, or away from the median plane Fig. 1.97 copyright 2025 by Elsevier General Terminology & Principles 2024 35  Tip: Adduction = “adding” back ABDUCTION VS. to the body ADDUCTION Abduction Is the lateral movement of the arm or leg away from the body Abduction of the fingers and toes means to spread them apart Adduction Is a movement of the arm or leg toward the body Adduction of the fingers and toes means to move them together or toward each other Fig. 1.98 Copyright 2025 by Elsevier General Terminology & Principles 2024 36  SUPINATION VS. PRONATION Supination Is a rotational movement of the hand into the anatomic position (palm up) Pronation Is a rotation of the hand into the opposite of the anatomic position (palm down) Fig. 1.99 Copyright 2025 by Elsevier General Terminology & Principles 2024 37  PROTRACTION VS. RETRACTION Protraction Is a movement forward from a normal position Example: moving the jaw forward or drawing the shoulders forward Retraction Is a movement backward or the condition Fig. 1.100 Copyright 2025 by Elsevier of being drawn back Example: moving the jaw backward or squaring the shoulders General Terminology & Principles 2024 38  ELEVATION VS. DEPRESSION Elevation Is a lifting, rising, or moving of a part superiorly Depression Is a letting down, lowering, or moving of a part inferiorly Fig. 1.101 Copyright 2025 by Elsevier General Terminology & Principles 2024 39  CIRCUMDUCTION Circumduction: Means to move around in the form of a circle Fig. 1.102 Copyright 2025 by Elsevier General Terminology & Principles 2024 40  ROTATION VS. TILT Rotation: Fig. 1.104 Copyright 2025 by Elsevier Is to turn or rotate a bod part on its axis Tilt Tilt: Is a slanting or tilting movement with respect to the long axis Fig. 1.103 Copyright 2025 by Elsevier General Terminology & Principles Rotation 2024 41  RELATIONSHIP TERMS Medial vs. Lateral Medial: refers to toward median plane or center Lateral: refers to away from center or median plane Fig. 1.85 Copyright 2025 by Elsevier General Terminology & Principles 2024 42  RELATIONSHIP TERMS Proximal vs. Distal Proximal: Near the source or beginning Ex. Upper and lower limb: the closer to the trunk = Proximal Distal: Away from the source or beginning Ex. Upper and lower limb: the further from the trunk = Distal Fig. 1.85 Copyright 2025 by Elsevier General Terminology & Principles 2024 43  Cephalad vs. Caudad RELATIONS Cephalad (cephalic): Means toward the head end of the body HIP TERMS Caudad (caudal): Means away from the head end of the body Angle? Angle? General Terminology & Principles 2024 44 Fig. 1.87 Copyright 2025 by Elsevier Fig. 1.86 Copyright 2025 by Elsevier  CEPHALAD VS CAUDAD Fig. 1.88 Copyright 2025 by Elsevier General Terminology & Principles 2024 45  RELATIONSHIP TERMS Interior (Internal, Inside) vs Exterior (External, Outer) Prefix Intra: Means within or inside Example: Intravenous Prefix Inter: Means between things Example: Intercostal Prefix Exo: Means outside or outward Example: Exocardial https://i.redd.it/4dypn4rppvn41.jpg General Terminology & Principles 2024 46  RELATIONSHIP TERMS Superficial vs. Deep Superficial: nearer the skin Deep: farther away from the skin Fig. 1.89 Copyright 2025 by Elsevier General Terminology & Principles 2024 47  RELATIONSHIP TERMS Ipsilateral vs Contralateral Ipsilateral: is on the same side of the body or part Contralateral: is on the opposite side of the body or part *Example: the right knee and the left hand are contralateral General Terminology & Principles 2024 48  GENERAL TERMS An image of a patient’s anatomic part(s), as produced by the Radiograph: action of x-rays on an image receptor Refers to both the recording medium and the image Radiography: The process and procedures of producing a radiograph The device that responds to the ionizing radiation to create Image Receptor (IR): the radiographic image after it exits the patient Refers to both analog (film-screen) cassettes and digital acquisition devices Refers to the centermost portion of the x-ray beam emitted Central ray (CR): from the x-ray tube This is the portion of the beam that has the least divergence https://cdn.3d4medical.com/media/blog/snippet-radiograph/radiograph1.jpg https://upload.wikimedia.org/wikipedia/commons/thumb/d/db/Projectional_radiography_components.jpg/250px-Projectional_radiography_components.jpg https://whitemountainimaging.com/wp-content/uploads/innocare-dr-panel-3-300x300.jpg https://www.glaciermedicaled.com/courses/301/08_Image_Production_files/image023.jpg  BODY HABITUS Sthenic – 50% of population Average shape & internal organ structure Hyposthenic - 35% of population Slenderer than the sthenic Hypersthenic – 5% of the population Broad frame compared to sthenic Asthenic – 10% of the population Very thin or slender with a long & narrow body build Shorter in stature than hyposthenic Bariatric Patient (Obesity) “abnormal or excessive fat accumulation that may impair health” Clinical Application: Centering & IR Placement General Terminology & Principles 2024 50  BMI Ranges/Classification General Terminology & Principles 2024 51  Fig. 1.37 copyright 2021 by Elsevier IMAGE RECEPTOR (IR) POSITIONING/ALIGNMENT Portrait (Lengthwise) Example: Hyposthenic and asthenic patients for chest x-ray Lungs are generally longer Landscape (Crosswise) Example: Hypersthenic and obese patients for a chest x-ray Lungs are shorter in length and broader in width Fig. 1.36 copyright 2021 by Elsevier GENERAL BODY POSITIONS Supine – lying on back Prone –lying on abdomen (head may be turned to one side) Erect –upright position (stand or sit) Recumbent –lying down in any position Dorsal Recumbent –lying on back (supine) Ventral Recumbent –lying face down (prone) Lateral Recumbent –lying on side (right or left lateral)  Fig. 1.57 Copyright 2025 by Elsevier Fig. 1.58 Copyright 2025 by Elsevier Fig. 1.63 Copyright 2025 by Elsevier Fig. 1.65 Copyright 2025 by Elsevier QUIZ ME: GENERAL BODY POSITIONS Trendelenburg – A recumbent position with the body tilted with the head lower than the feet Reverse Trendelenburg – Patient is flat with table tilted with head higher than the feet Fowler – head is raised 18-20 inches above the flat position, with knees bent Sims (semiprone) – A recumbent oblique position with the patient lying on the left anterior side, with the right knee and thigh flexed and the left arm extended down behind the back Modified Sims (left lateral recumbent position) – Upper torso stays more lateral, and patient brings right leg up Used for insertion of the rectal tube for a barium enema Lithotomy – A recumbent supine position with knees and hip flexed and thighs abducted and rotated externally, supported by ankle supports Frequently used in the surgical suite for certain urinary studies  Quiz Me! Fig. 1.58 Copyright 2025 by Elsevier Fig. 1.57 Copyright 2025 by Elsevier  Quiz Me! Fig. 1.59 Copyright 2025 by Elsevier Fig. 1.60 Copyright 2025 by Elsevier  Quiz Me! Fig. 1.61 Copyright 2025 by Elsevier Fig. 1.62 Copyright 2025 by Elsevier  SPECIFIC BODY POSITIONS Lateral Position (right or left lateral) Side view Described by side of the body closest to the IR or the body part from which the CR exits Oblique Position An angled position in which neither the sagittal nor the coronal body plane is perpendicular to the IR Thorax, abdomen, or pelvis are described by the side of the body closest to the IR or the body part from which the CR exits Left and Right Posterior Oblique (LPO & RPO) Positions Specific oblique positions in which the left or right posterior aspect of the body is closest to the IR Left and Right Anterior Oblique (LAO & RAO) Specific oblique position in which the left or right anterior aspect of the body is closest to the IR *Obliques of Upper and Lower limbs are described correctly as medial or lateral rotation  Quiz Me! Fig. 1.66 Copyright 2025 by Elsevier Fig. 1.65 Copyright 2025 by Elsevier Fig. 1.64 Copyright 2025 by Elsevier Fig. 1.67 Copyright 2025 by Elsevier Fig. 1.68 Copyright 2025 by Elsevier Fig. 1.63 Copyright 2025 by Elsevier SPECIFIC BODY POSITIONS Decubitus (Decub) Position Decubitus means to lie down, or the position assumed is lying down on a horizontal surface Which surface is the body resting on? Back (Dorsal) – also need to indicate what side is closest to IR (Right or Left) Front (Ventral) – also need to indicate what side is closest to IR (Right or Left) Side (Right or Left) – Lateral Decubitus – Can be done AP or PA Always preformed with the CR horizontal (used for detecting air-fluid levels or free air in the body cavity) Where will air settle? Where will Fluid settle? WHAT CAN WE SEE? WHAT POSITION IS THIS? Air = Black https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/8484545d-34c5-4009-aad9-7f5f8009bb99/gr2.jpg Fluid = White  Quiz Me Fig. 1.70 Copyright 2025 by Elsevier Fig. 1.72 Copyright 2025 by Elsevier Fig. 1.71 Copyright 2025 by Elsevier Fig. 1.69 Copyright 2025 by Elsevier  PALPATION OF TOPOGRAPHIC POSITIONING LANDMARKS Positioning requires location of specific structures or organs within the body Not visible from the exterior This is why technologist rely on bony landmarks Referred to as topographic landmarks Landmarks are located by a process called palpation Applying light pressure with the fingertips directly on the patient to locate landmarks Should be done gently Always inform the patient of the purpose before you begin, and you should check with the patient Fig. 1.117 Copyright 2025 by Elsevier first RADIOGRAPHIC PROJECTIONS Projection: Is a positioning term Describes the direction or path of the CR of the x-ray beam as it passes through the patient to the IR * The term Position is used in the clinical setting, but the most accurate term for describing how the procedure is preformed is Projection Fig. 1.52 Copyright 2025 by Elsevier  Posteroanterior (PA): PA VS AP Travels from the back of the patient and exits the front Anteroposterior (AP): Travels from the front of the patient and exits the back Fig. 1.51 Copyright 2025 by Elsevier Fig. 1.52 Copyright 2025 by Elsevier  What type of AP OBLIQUE VS AP Oblique: rotation is PA OBLIQUE PA Oblique: happening? Fig. 1.54 Copyright 2025 by Elsevier Fig. 1.53 Copyright 2025 by Elsevier MEDIOLATERAL AND LATEROMEDIAL PROJECTIONS Lateromedial Mediolateral Fig. 1.56 Copyright 2025 by Elsevier Fig. 1.55 Copyright 2025 by Elsevier  ADDITIONAL SPECIAL-USE PROJECTION TERMS Axial Projections: AP or PA axial “Axial” – refers to the long axis of a structure or part In radiographic positioning it is used to describe Fig. 1.76 Copyright 2021 by Elsevier any angle of the CR of 10˚ or more along the long axis of the body or body part Inferosuperior and Superoinferior axial projections Inferosuperior views frequently performed for the should and hip CR enters inferiorly and exits superiorly Superoinferior axial is a special nasal bone projection Opposite of inferosuperior Fig. 1.75 Copyright 2025 by Elsevier AP axial chest projection (lordotic) Used to demonstrate apices of the lungs Fig. 1.74 Copyright 2025 by Elsevier Fig. 6.52 Copyright 2021 by Elsevier ADDITIONAL SPECIAL-USE PROJECTION TERMS Tangential Projection Tangential means touching a curve or surface at only one point This is a special use of the term projection to describe the CR that skims a body part to project the anatomy into profile and free of superimposition or surrounding body structures Examples: Tangential projection of sesamoid bones Tangential projection of patella Fig. 1.77 Copyright 2025 by Elsevier  ADDITIONAL SPECIAL-USE PROJECTION TERMS Transthoracic Lateral Projection A lateral projection through the thorax Requires you to use positioning term Right or Left This tells us what shoulder is closest to IR and being examined Example: Right Transthoracic Shoulder Fig. 1.79 Copyright 2025 by Elsevier  Fig. 1.81 Copyright 2025 by Elsevier ADDITIONAL SPECIAL-USE PROJECTION TERMS Dorsoplantar and Plantodorsal Projections Dorsoplantar: describes the path of the CR from the dorsal (anterior) surface to the plantar (posterior) surface of the foot Axial Plantodorsal Projection: for the heel bone (calcaneus or os calcis) angled CR enters the plantar surface and exits the dorsal surface Fig. 1.80 Copyright 2025 by Elsevier  ADDITIONAL SPECIAL-USE PROJECTION TERMS Parietoacanthial and Acanthioparietal Projections Fig. 1.82 Copyright 2025 by Elsevier Parietoacanthial (PA Waters): CR enters at the cranial parietal bone and exits at the acanthion (junction of nose and upper lip) Acanthioparietal (AP Reverse Waters): CR will be the opposite or parietoacanthial projection Fig. 1.83 Copyright 2025 by Elsevier Fig. 1. 82 copyright 2021 by Elsevier ADDITIONAL SPECIAL-USE PROJECTION TERMS Submentovertical (SMV) and Verticosubmental (VSM) SMV: Used for the skull and mandible CR enters below the chin, or mentum, and exits at the vertex or top of the skull VSM: Opposite of SMV CR enters the top of skull and exits below mandible PATIENT ASSESSMENT AND CLINICAL HISTORY “ACE” Campaign (ASRT) Introduce yourself By name and role Patient identification by two means Verbally, arm band, patient chart, and/or examination requisition EXAMPLE: Ask name then check wrist band Verification of procedure(s) ordered Correct exam for Correct patient? Check chart and examination requisition https://online.ahu.edu/wp-content/uploads/2017/04/What-Does-a-Radiographer-Do_-Job-Duties-Requirements.png PATIENT ASSESSMENT AND CLINICAL HISTORY Acquire clinical history Interview patient Chief complaints, allergy history, symptoms (duration and frequency) Pregnancy status Ask females if any chance of pregnancy (Childbearing age – 10- 60yrs old) If patient states “yes” “maybe” or “I don’t know” – inform physician or supervisor before proceeding Explain procedure Use terms and language patient can understand Provide opportunity for patient to ask questions Encourage patients to ask questions about the procedure or other concerns before beginning the procedure https://online.ahu.edu/wp-content/uploads/2017/04/What-Does-a-Radiographer-Do_-Job-Duties-Requirements.png RADIOGRAPHIC PROCEDURE OR EXAMINATION Involves 5 general functions 1. Position of body part and alignment with the IR and CR 2. Application of radiation protection measures and devices 3. Selection of exposure factors (radiographic technique) 4. Instructions to the patient related to respiration (breathing) and initiation of the x-ray exposure 5. Processing of the IR (analog) [chemical processing] or digital processing systems IMAGE MARKERS & PATIENT IDENTIFICATION Minimum of 2 types of markers should be imprinted on every radiographic image 1. Patient Identification and Date (Patient name or ID number, institutional name) Age/DOB is optional 2. Anatomic Side Markers IMAGE MARKERS & PATIENT IDENTIFICATION 1. Patient Identification and Date Digital Systems – annotated through the system – input patient information before exam Digital systems with photostimulable storage phosphor (PSP) cassette-based systems (CR) Bar code system imprints the patient information before or after exposure Patient identification is entered during registration and prior to exposure Fig. 1.109 Copyright 2025 by Elsevier IMAGE MARKERS & PATIENT IDENTIFICATION 1. Anatomic Side Markers Radiopaque – White on an image – made of lead (Pb) Right (R) or Left (L) marker - correctly identifying patient’s side or which limb is being radiographed Don’t superimpose over essential anatomy Needs to be placed within the collimator field *Digital imaging – unacceptable practice to annotate digitally (legal and liability problems) Images typically must be repeated to be marked correctly causing excessive radiation to patient  ADDITIONAL MARKERS OR IDENTIFICATION Technologist initials Who is responsible for taking the radiograph Time indicators For elapsed time series (small bowel series) Arrow identifying which side is up Decubitus positioning Fig. 1.108 Copyright 2021 by Elsevier https://shop.mxrimaging.com/pub/media/catalog/product/cache/688c6f35fdb9f37ebbbea2dca73824e7/e/l/elite-word-4ez_2.png https://www.magicxraymarker.com/image/data/demo/891165535238792535aluminum-arrow-markers-500x522.png  ESSENTIAL PROJECTIONS Routine Projections Projections commonly taken on patients who can cooperate fully *Varies depending on radiologist and department preference and on geographic differences Special Projections Projections most commonly taken to demonstrate better specific anatomic parts or certain pathologic conditions or projections that may be necessary for patients who cannot cooperate fully Fig. 2.72 Copyright 2021 by Elsevier  ORTHOGONAL VIEWS Fig. 1.109 Copyright 2021 by Elsevier Must have minimum of 2 images 90˚ from each other – orthogonal views Exceptions: portable (AP) chest, single AP abdomen(KUB), and AP Pelvis 3 reasons why: 1. Superimposition of anatomic structures 2. Localization of lesions or foreign bodies 3. Determination of alignment of fractures General Terminology & Principles 2023 83  Fig. 1.113 Copyright 2021 by Elsevier Fig. 1.114 Copyright 2021 by Elsevier MINIMUM OF THREE PROJECTIONS WHEN JOINTS ARE IN AREA OF INTEREST AP or PA, Oblique, and Lateral Projections More information is needed Small oblique chip fractures can be missed on only AP(PA) and Lateral views Typically require 3 projections Fingers Toes Hand Wrist Ankle Foot Knee Typically, only require 2 projections Forearm Humerus Femur Hips Tibia-fibula Chest Fig. 1.112 Copyright 2021 by Elsevier VIEWING RADIOGRAPHS General rule in viewing radiographs is to display them so that the https://images.squarespace-cdn.com/content/v1/5e48489da899cd09424943db/1598832212389-WPVDDGWAAJXQP1IV5037/Austin.Kosier.38B.png patient is facing the viewer, with the patient in the anatomic position https://images.squarespace-cdn.com/content/v1/53c1a2cce4b0e88e61f99b70/1464954924986-ZQIYF60K44VODCTQO11U/image-asset.png VIEWING RADIOGRAPHIC IMAGES AP (PA) Projections Typically, images are displayed so that the patient is facing the viewer This always places the patients left to the viewers right Lateral Positions Typically, image is placed so that the viewer is seeing the image from the same perspective as the tube *Can vary based on site – radiologist discretion PA(AP) Oblique projections Same as PA or AP (patients right to viewers left) Decubitus Chest and abdomen projections Viewed generally as the x-ray tube sees them Fig. 1.123 Copyright 2021 by Elsevier  Fig. 1.124 Copyright 2025 by Elsevier Fig. 1.121 Copyright 2025 by Elsevier Fig. 1.122 Copyright 2025 by Elsevier Fig. 1.123 Copyright 2025 by Elsevier General Terminology & Principles 2024 87 EVALUATION CRITERIA Goal Take optimal radiographs that can be evaluated by definable standard Don’t just take passable radiographs Evaluation Criteria Format – 3 parts Anatomy demonstrated Position (4 issues) Body placement in relationship to IR Positioning factors that are important for the projection Correct centering of anatomy collimation Fig. 1.103 Copyright 2021 by Elsevier Exposure How exposure factors or technique (kVp, mA, and time) can be evaluated for optimum exposure of that body part No motion – (exposure time is the primary controlling factor for motion)  REMEMBER ALARA Time Distance Shielding General Terminology & Principles 2023 89  Fig. 1.126 Copyright 2025 by Elsevier VIEWING CT Axial images OR Patient’s right is to the viewer’s left MRI IMAGES General Terminology & Principles 2024 90  Coronal Image Sagittal Image SECTIONAL IMAGES (CT OR MRI) Longitudinal Sections Fig. 1.44 Copyright 2021 by Elsevier Fig. 1.43 Copyright 2021 by Elsevier Run lengthwise in the direction of the long axis of the body or any of its parts Sagittal, Coronal, and Oblique Transverse or Axial Sections (Cross-Sections) At right angles along any point of the longitudinal axis of the body or its parts General Terminology & Principles 2024 91