Matching Pairs Radiologic PositioningOnline version Central Ray and Topographic Landmarks by Jenna Rose 1 Nasal Bones 2 Thoracic Spine 3 Retrograde Urography 4 Forearm 5 Barium Enema 6 Free 7 Femur 8 Calcaneus (Os Calcis) 9 Scapula 10 Sacroiliac Joints Items needed for study: Urethral catheter tray 1 catheter tip syringe 1 60 cc Luer LOC syringe 2 bottles of Conray 43 50 cc's sterile saline (to dilute 1 of the bottles of Conray 43) 19 gauge Angio catheter double balloon catheter The catheter has two balloons, the upper balloon is fixed and the lower balloon is a sliding balloon. Before placing the catheter in the urethra, put a very small amount of water soluble lubricant near the lower sliding balloon and slide it down to approximately the middle of the catheter. Place as small amount of water soluble lubricant needed on the end of the catheter for insertion (too much could possibly "clog" the side holes of the catheter or "fill in" the diverticula). After the catheter is placed into the bladder, fill the upper balloon with 30 cc's of 50% Conray - 50% saline mixture. After that is completed, slide the lower uninflated balloon up (while pulling down on the catheter to pull the upper balloon against the bladder) until the lower balloon is against the outside of the urethra. Using the "soft" part of the Angio catheter, inflate the lower balloon with 30 cc's of the diluted Conray mixture. Insert the catheter tip syringe into the end of the catheter. It is not unusual that the contrast will go up into the bladder. If this happens, the catheter will need to be pulled down tighter against the bladder. If the contrast leaks out distally, the lower balloon will need to be slid up even more. Waters 1. 8 x 10 cassette 2. Patient prone or upright 3. Patient positioned with chin on table, O.M.L. forms 37 degree angle with plane of cassette 4. 40" SID 5. Central Ray: passes through acanthion PA 1. 8 x 10 cassette 2. Patient prone 3. Patient positioned with forehead on table, O.M.L. perpendicular to plane of film 4. Angle 15 degrees caudal 5. Central Ray: exits nasion 6. 40" SID Right and Left Lateral 1. 8 x 10 cassette divided in half for each side 2. Head in true lateral position, interpupillary line is perpendicular to the film 3. 40" SID 4. Central Ray: perpendicular to film and centered to bridge of nose AP 1. 10 x 12 cassette 2. Patient supine 3. 40" SID 4. Central Ray: 15 degree cephalic angle, enter halfway between A.S.I.S. and symphysis pubis Obliques (RPO and LPO) 1. 10 x 12 cassette 2. Patient recumbent 3. Patient rotated 30 degrees from AP position 4. 40" SID 5. Central Ray: enters 1" medial A.S.I.S. of side up. AP 1. 14 X 17 cassette 2. Patient Standing 3. 40" SID 4. Central Ray: perpendicular to film 5. Place top of cassette 2" above shoulder LATERAL 1. 14 X 17 cassette 2. Patient placed in left lateral position 3. 40" SID 4. Central Ray: perpendicular to film 5. Center at T7 "Y" View 1. 10 x 12 cassette 2. Patient supine or upright 3. Palpate the borders of the scapula and rotate the patient until in true lateral position 4. 40" SID 5. Central Ray: direct to midvertebral border of scapula, cassette placed 2 inches above shoulder, raise affected arm out of the field of view. 6. Expiration True AP 1. 10 x 12 cassette 2. Patient supine or upright 3. Rotate body approximately 15 degrees toward side of interest, posterior aspect of arm and shoulder 4. 40" SID 5. Expiration Plantodorsal (Axial) 1. 8x10 cassette 2. Patient supine or seated, dosiflex foot 3. CR 40 degrees to long axis of plantar surface 4. Center to base of 3rd metatarsal 5. SID 40" Lateral 1. 8x10 cassette 2. patient recumbent 3. Dorsiflex foot 4. CR perpendicular, to midcalcaneus, 1" inferior to medial malleolus 5. SID 40" Scout K.U.B. 1. Patient supine\ 2. 40" SID 3. Center at iliac crest 4. Include Symphysis Pubis RPO 45 degree 1. Patient recumbent, rotated 45 degrees with right side down 2. 40" SID 3. Center iliac crest 4. To demonstrate splenic flexure L.P.O. 45 degree 1. Patient recumbent, rotated 45 degrees with left side down 2. 40" SID 3. Center iliac crest Left Lateral for Flexures 1. Patient recumbent in left lateral position 2. 40" SID 3. Center at iliac crest. Left Lateral Rectum 1. Patient recumbent in left lateral position 2. 40" SID 3. Deflate tip, midaxillary plane between ASIS and posterior sacrum PA 1. Patient prone 2.. 40" SID 3. Center to include flexures as well as rectum 4. Center at iliac crest PA Sigmoid (Can be done A.P. due to patient condition) 1. Patient prone or supine 2. 40" SID 3. Center to include sigmoid colon, PA exits ASIS, AP enters ASIS 4. Central Ray: PA 30 degrees caudally, AP 30 degrees cephalic Post Evac Position the same as the scout. *110 KVP should be used on adults. *90 KVP should be used on infants. AP 1. 14x 17 Cassette 2. Patient seated 3. Affected arm extended with palm facing up 4. Central Ray: perpendicular to film 5. 40" SID 6. Center midshaft LATERAL 1. 11 x 17 cassette 2. Patient seated 3. Affected arm positioned on cassette so that if forms a 90 degree angle with the hand and wrist in a lateral position. 4. 40" SID 5. Central Ray: perpendicular to film 6. Center midshaft MUST INCLUDE BOTH JOINTS ON BOTH VIEWS Free AP 1. 14 x 17 cassette 2. Patient supine 3. Leg centered to cassette 4. Central Ray: mid shaft LATERAL 1. 14 x 17 cassette 2. Patient positioned with affected side closest to film 3. 40" SID 4. Central Ray: mid shaft
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