CENTRAL RAY (CR):
the center of a radiographic beam
will be demonstrated by a shadow created by the collimator light when positioning a patient
will be directed at particular anatomical structures to obtain accurate placement
PART POSITION:
the position of the body part being exposed Example: on a Cervical Flexion view the head is in complete flexion
PATIENT POSITION:
the postural attitude of the patient’s body during the exposure of the film Example: recumbent, seated, standing
most chiropractic films are
weight bearing (standing or seated)
TUBE:
the portion of the machine where x-ray radiation is produced and directed towards the patient
TUBE TILT:
the angle of the x-ray machine tube
TUBE/FILM DISTANCE
AKA Focal/Film Distance
distance between the tube and the film
BUCKY:
the portion of the x-ray machine which houses the grid and the cassette will be placed during the exposure of a film
COLLIMATION:
a mechanism (inside the tube) utilized to limit the exposure field required to be seen on the film in some states
CEPHALAD
towards the head or I-S
CAUDAL
towards the feet or S-I
SINGLE LETTER MARKERS:
the single letter marker indicates the patient’s appropriate side of the body part closest to the film during exposure
MULTIPLE LETTER MARKERS:
the marker will indicate the body part closest to the film during the exposure Example: RAO, RPO
PLACEMENT OF MARKER
Never obstruct any anatomical structure with a marker
Carefully place markers so that they are not collimated out of the exposed area of the film
Do not place markers in the area of the nameplate
MITCHELL MARKERS
markers with mercury balls inside a small dome or bubble
when the bucky is upright the balls will be located at the bottom of the dome
when the bucky is parallel to the floor, the balls will be centrally located
LATERAL CERVICAL VIEW:
CR?
CR: left to right or right to left (doctor’s choice except for scoliosis)
LATERAL CERVICAL VIEW: PATIENT POSITION
patient’s coronal plane is perpendicular to the bucky
LATERAL CERVICAL VIEW TUBE TILT
NONE
LATERAL CERVICAL VIEW DEMONSTRATES:
body heights and widths,
disc height,
cervical curve,
ADI
(less than 3 mm for adults, less than 5 mm for children),
SELLA TURCICA
A-P NORMAL RANGE
5-16mm
Sella Turcica S-I normal range
4-12mm
average: 8 mm
Retropharyngeal Interspace
C1-3 levels
Retrolaryngeal Interspace
C4-5 levels
Retrotracheal Interspace
C6-7 levels
ANTEROPOSTERIOR CERVICAL VIEW: (aka LOWER CERVICAL)
CENTRAL RAY?
A-P
Lower Cervical View patient position
patient’s coronal plane is parallel to the bucky with midsagittal plane aligned with the vertical midline of the bucky
lower cervical TUBE TILT
15 degrees cephalad
LOWER CERV. DEMONSTRATES
Joints of Luschka, bony structures, soft tissue (trachea in the midline), air space (apex of the lungs)
ANTEROPOSTERIOR OPEN MOUTH VIEW
CR?
A-P
OPEN MOUTH PATIENT POSITION
patient’s coronal plane is parallel to the bucky with the patient’s midsagittal plane aligned with the vertical midline of the bucky. The patient’s mouth is open and the head is extended 15 degrees (with CR parallel to the floor) or hard palate is parallel to the floor (with CR cephalad 15 degrees)
OPEN MOUTH DEMONSTRATES
atlas, axis and joints spaces
FLEXION AND EXTENSION CR?
left to right or right to left
FLEXION AND EXTENSION PATIENT POSITION?
PATIENT POSITION: the patient’s coronal plane is perpendicular to the bucky with full flexion or full extension of the head
FLEXION AND EXTENSION DEMONSTRATES
ADI (should not deviate more than 1 mm from neutral lateral view), cervical curve, mobility of cervical spine
In a cervical LPO, what side is the IVF on?
Right
In a lateral cervical view, what portion of the segment is posterior to the vertebral body?
Articular pillar
In an A-P lower cervical, what parts make up the Joint of VonLuscka
Uncinate process and uncinate fossa
in a cervical RPO, is the marker closer to the body, or the SP?
Body
In a cervical LPO, which IV are we looking at?
Right IVF
CR for POSTERIOR OBLIQUES?
A-P
CR for anterior obliques?
P-A
CERVICAL OBLIQUES
PATIENT POS.?
the patient’s coronal plane is angled 45 degrees to the bucky
POSTERIOR OBL. TUBE TILT?
CEPHALAD 15
ANTERIOR OBL. TUBE TILT?
CAUDAL 15
TUBE/FILM DISTANCE
AKA Focal/Film Distance
distance
-Distance between the tube and the film
In a cervical RAO, is the right pedile a bar or a circle?
R pedicle is a bar
In a cervical RAO, where is the name plate?
Upper R/lower left (don’t flip it)
Marker closer to the SP
in a cervical RAO, is the marker closer to the body or the SP?
In a cervical LPO, is the marker closer to the body or the SP?
Marker closer to the body
In a cervical LPO, where is the name plate?
Upper left, lower R
In a cervical LPO, is the L pedicle a bar or a circle?
L pedicle = circle
In a cervical RPO, is the L pedicle a bar or a circle?
L pedicle = bar
A-P THORACIC CR?
A-P
A-P THORACIC PATIENT POS?
coronal plane parallel to the bucky (the patient will be x-rayed supine if they are extremely obese)
A-P DEMONSTRATES
thoracic spine, ribs, lung fields, sternum
LATERAL CERVICOTHORACIC
AKA
SWIMMER’S VIEW
LATERAL CERVICOTHORACIC
CR?
obliquely left to right or obliquely right to left
LATERAL CERVICOTHORACIC
PATIENT POSITION?
the patient’s coronal plane is rotated 10-20 degrees off of perpendicular to the bucky with the arm next to the bucky flexed and the arm next to the tube extended
SWIMMER’S VIEW TUBE TILT?
caudal 5 degrees
SWIMMER’S VIEW DEMONSTRATES
lower cervical spine, upper thoracic spine
ANTEROPOSTERIOR LUMBAR
CR
A-P
AP LUMBAR PATIENT POSITION?
the patient’s coronal plane is parallel to the bucky with their midsagittal plane aligned with the midline
AP LUMBAR DEMONSTRATES
lumbar, pelvis, soft abdominal tissues, sacrum, hips
LATERAL LUMBOSACRAL CR?
right to left, left to right
LAT. LUMBAR PATIENT POS?
the patient’s coronal plane is perpendicular to the bucky
LAT. LUMBAR DEMONSTRATES?
lumbar spine, sacrum, coccyx, soft tissue
POSTERIOR LUMBAR OBLIQUE CR?
A-P
ANTERIOR LUMBAR OBL. CR?
P-A
LUMBAR OBLIQUES
PATIENT POS?
coronal plane angled 45 degrees
LUMBAR OBLIQUES
DEMONSTRATE
Scotty dog to observe integrity of the pars interarticularis
ANTEROPOSTERIOR PELVIS
A-P
A-P- PELVIS PAT. POS?
the patient’s coronal plane is parallel to the bucky with their midsagittal plane aligned with the midline
A-P PELVIS DEMONSTRATES?
both inominates, sacrum, proximal femur heads, coccyx, soft tissue
A-P SACRUM
CR: A-P
A-P SACRUM PAT. POS?
the patient’s coronal plane is parallel to the bucky and their midsagittal plane is aligned with the midline
A-P SACRUM TUBE TILT?
15 degrees cephalad (perpendicular to the sacrum)
A-P SACRUM
sacrum, S-I joints, coccyx, lumbosacral joint
LATERAL SACRUM
CR?
left to right or right to left
A-P SACRUM PAT. POS?
the patient’s coronal plane is perpendicular to the bucky
A-P SACRUM DEMONSTRATES?
sacrum, lumbosacral joint, coccyx
A-P OPEN MOUTH VIEW
Taken A-P
Read P-A
A-P OPEN MOUTH VIEW NAMEPLATE??
upper left/lower right
A-P OPEN MOUTH VIEW
DEMONSTRATES?
Atlas, Axis, Atlanto-occipital joint, Atlanto-Axial jointtext
In an A-P thoracic view, what is it called when the diaphragm meets the ribs?
Costophrenic angle
An an A-P lumbopelvic view, what is lateral to the obturator foramen
Ishial tube
In an A-P lumbopelvic view, what is lateral to the apoposeal joint?
Superior arti. Process of inferior segment
In a lateral lumbosacrao view, which process is closer to vertebral bodies?
Sup. Art. Facet
In an A-P lumbopelvic view, what makes up the sideways ‘v’ shpae?
Ischial spine
In an A-P lower cervical view, what is tube tilt?
15 cephalad
In an A-P thoracic view, what is the white density in the middle cavity that looks like
pulled cotton?
Hilus of the lung
In a lateral cervical view, what is posterior to the vertebral body
Articular pilar
In an A-P thoracic view, are the name plate and the heart shadow on the same
side?
YES
Name 5 things an A-P lower cervical view demonstrates:
Bony tissue , lower cervical
spine , soft tissue-tracheal air shadow , air-apex of lungs , jts : IVD & Von Luschka
In an A-P thoracic view, what is tube tilt?
NONE
In an A-P thoracic view, what is it called where the heart meets the diaphragm?
Cardiophrenic angle
What is the tube tilt for an A-P lower cervical?
15⁰ cephalad
Name three things that an APOM shows? D
Dens, C1\C2 capsule , Foramen magnum
In a cervical RAO, is the right pedicle a bar or a circle?
R pedicle is a bar
In a cervical LPO, is the L pedicle a bar or a circle?
L pedicle = circle
In a cervical RPO, is the L pedicle a bar or a circle?
L pedicle = bar