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Rt 124 – Spring Image Review pt 2. ABD & CHEST 2. Position & Projection. Look at blocker for PROJECTION Look at air/fluid levels for Upright vs Supine vs Decubitus Look at Pathology: Excessive Fluid or Air indicates pathology and may need adjustment in technique. Projection ? AP.

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Rt 124 spring image review pt 2

Rt 124 – Spring

Image Review pt 2

ABD & CHEST 2


Position projection
Position & Projection

  • Look at blocker for PROJECTION

  • Look at air/fluid levels for

  • Upright vs Supine vs Decubitus

  • Look at Pathology:

  • Excessive Fluid or Air indicates pathology and may need adjustment in technique



Projection ?AP –AXIAL (APICAL LORDOTIC


Projection ?PANote Pathology –Rt middle lobeLt lower lobeatelectasis


Projection ?APREMEMBER TO MOVE CARDIACMONITOR WIRES OUT OF THE WAYPathologynote bilateraleffusion both bases



LAT UPRIGHTON GURNEYNOTE AIR /FLUID LEVELSNote poor positioning ofCR to part(cr too low & too anterior – not at mcp


Position ?Projection?AP semi uprightnote – fluid levels in RT lung what else is needed?Decubs –for fluid levels


Position / Projection?Projection – cant’ tell because no blockerPosition – LLD1) look for the humerus that is raised2) look for fluid levels3) note: poor centering for upside of image


Position / Projection?Projection – AP

blocker lower RTPosition – RLD 1) look for the humerus that is raised2) look for fluid levels3) poor marker placement – label of image

look for fluid levels


Bilateral decub projection pa ap
BILATERAL DECUBProjection? PA AP

LLD RLD


Projection position go back and check previous slide
PROJECTION?POSITION?GO BACK AND CHECK PREVIOUS SLIDE


PROJECTION?POSITION?GO BACK AND CHECK PREVIOUS SLIDE


Abdomen

ABDOMEN-

SUPINE – UPRIGHT - LLD


Kub what is the critique to judge proper technique
KUBWHAT IS THE CRITIQUE TO JUDGE PROPER TECHNIQUE?




Supine kub what are the white dots residual barium
Supine KUB – – to keep out of diaphram areawhat are the white dots?Residual barium


KUB – – to keep out of diaphram areaPOST CT SCANRESIDUAL CONTRAST IN COLON AND KIDNEYSDARK LINE ACROSS ABDOMEN???FROM COMPRESSED SOFT TISSUE –TIGHT WAISTBAND OF CLOTHING


Case example of – to keep out of diaphram area

SUPINE – upper & KUB Upright

Should have collimated to upper abd – not exposed lower abd twice

(repeated – diaphram clipped)


Kub flat plate supine abd includes entire abd taken at 48 sid
KUB – to keep out of diaphram areaFLAT PLATESUPINE ABDINCLUDESENTIRE ABD(TAKEN AT 48” SID)


Position upright projection pa what else blocker placement clothing
POSITION? – to keep out of diaphram areaUPRIGHTPROJECTIONPA – WHAT ELSE?BLOCKER PLACEMENT & CLOTHING


Kub supine
KUB – to keep out of diaphram areaSUPINE


Upper abd supine note pathology gb stones
UPPER ABD – to keep out of diaphram areaSUPINENOTE PATHOLOGY (GB STONES)


UPRIGHT – to keep out of diaphram area ABDCRITIQUEWHAT IS THE DARK LINE IN THE CENTER


Pathology positioning

PATHOLOGY – to keep out of diaphram area&Positioning


Obstruction lg bowel
Obstruction – to keep out of diaphram arealg bowel


Example may need 4 films in quadrant to include all of abd structures obstruction
Example: – to keep out of diaphram areamay need4 films inquadrantto include allof abd structures(obstruction)


Free air in the abdomen
Free air in the abdomen – to keep out of diaphram area


Position look at air fluid levels
Position? – to keep out of diaphram areaLook at air/fluid levels


Left lat decub
LEFT LAT DECUB – to keep out of diaphram area


Need at least 2 crosswise films
Need at least 2 crosswise films – to keep out of diaphram area


Critique images for positioning collimation central ray placement

CRITIQUE IMAGES – to keep out of diaphram areaFOR POSITIONINGCOLLIMATION &CENTRAL RAY PLACEMENT


Critique if taken for ap chest cr is too cephalic moving clavicles above apex
Critique: If taken for AP chest – – to keep out of diaphram areaCR is < too cephalic – moving clavicles above apex


Ap chest cr too cephalic pt kyhphotic need to change cr direction to maintain to sternum
AP Chest – to keep out of diaphram areaCR – too cephalic PT kyhphotic –need to change CRdirection to maintain ┴ to sternum


Projection ap critique collimation not centered ekg wires over chest
Projection – AP – to keep out of diaphram areaCritique –collimation not centeredekg wires over chest


CRITIQUE – to keep out of diaphram areaSEE EARLIER IMAGES


Lat gurney chest prop arms up with sponges get st of arms off of chest
Lat gurney chest – to keep out of diaphram areaprop arms up withsponges get ST of arms off ofchest


Critique see earlier images
CRITIQUE – to keep out of diaphram areaSEE EARLIER IMAGES


Also review images on first presentation

Also review images on first presentation – to keep out of diaphram area

Written test on Tues

Lab on Thursday


More pathology positioning we will cover in more detail in gi section

More pathology – to keep out of diaphram area& positioningWe will cover in more detailin GI section


Cecal volvulus lg bowel obstruction critique for positioning and centering
Cecal volvulus – to keep out of diaphram areaLG bowel obstructioncritique forpositioningand centering


Toxic megacolon
Toxic – to keep out of diaphram areamegacolon


Projection postion
Projection? – to keep out of diaphram areaPostion?

PA – according to blocker

Supine – no air fluid levels


Projection
Projection? – to keep out of diaphram area

AP


Projection1
Projection? – to keep out of diaphram area

PA


What is this – to keep out of diaphram areastep laddersign indicate for pathology?Obstructionsee air-fluid levels Position?Upright!


Small bowel obstruction- – to keep out of diaphram arearemember toinclude all areas of the abdomenwhat could have improved this image?2 cross wise14 x 17


Critique for positioning projection
Critique for positioning& projection – to keep out of diaphram area


AP Chest – – to keep out of diaphram area

CR too low

Collimation too open

KVP too low – too short of contrast

Lat –

CR too forward –

Sit pt up more


Projection ap pathology copd
Projection – to keep out of diaphram areaAPPathology?COPD


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