Introduction to Radiographic Positioning (Positioning Terminology ) IMG353 Lecture 1.

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Introduction to Radiographic PositioningIntroduction to Radiographic Positioning(Positioning Terminology )(Positioning Terminology )

IMG353Lecture 1

By the end of this Lecture the student will be able to:

Define the imaginary planes and body sections

Describe standard positioning terms.

List and identify the meaning of specific terms related to movement

Distinguish Between radiographic projection, position and view

List the four types of body habitus

Learning Objectives

References• Positioning in Radiography: By k.C.Clarke.• Text book of radiographic positioning and related anatomy; by Kenneth L.Bontrager, 5th edition

Websites

• http://www.e-radiography.net/ • http://www.theodora.com/anatomy/surface_anatomy_index.html• http://training.seer.cancer.gov/module_anatomy/unit1_3_terminology.html

Positioning Positioning TerminologyTerminology

A person in the anatomical position is

standing erect with the head, eyes and toes pointing

forward, feet together with arms by

the side. The palms of the hands are

also point forward.

Anatomic Anatomic PositionPosition

A plane is a flat surface passed through the body or a portion of the body

Body planes are divided into:-Longitudinal planes◦Coronal◦Sagittal

Horizontal plane◦Transverse

Positioning Positioning TerminologyTerminologyBody PlanesBody Planes

Body Body PlanesPlanes

Sagittal Plane (Lateral Plane)A vertical plane running from front to back; divides the body or any of its parts into right and left sides.

Median planeSagittal plane through the midline of the body; divides the body or any of its parts into right and left halves.

Body PlanesBody Planes

Coronal or (Frontal) A vertical plane

running from side to side; divides the body or any of its parts into anterior and posterior portions.

Axial Plane (Transverse Plane)A horizontal plane; divides the body or any of its parts into upper and lower parts.

Directional Directional TermsTermsLateral Vs. Medial

Away from the midline of the body (On the outer side of) e.g. the arms are lateral to the chest.

Lateral

Medial

Near to the midline of the body

(On the Inner side of) e.g. the chest is medial to the arms

MedialLateralLateral

Directional TermsDirectional TermsSuperior Vs. Inferior

Towards the head end or towards the upper part of a structure( above)

e.g. The head is superior to the chest.

Superior ( cephalic/ cranial)

Inferior (Caudal) Away from the head end or towards the lower part of a structure( Below) e.g. the abdomen is inferior to the chest.

Inferior

Superior

Directional TermsDirectional TermsAnterior Vs. Posterior Towards or at front of the body ( in front of)

e.g. The sternum is anterior to the spine.

Anterior ( ventral )

Posterior (Dorsal ) Towards or at the back of the body ( Behind)

e.g. The heart is posterior to the sternum. 8

Directional TermsDirectional TermsProximal Vs. Distal

Close to the origin of the body part or the point of attachment of a limb to the trunk

e.g. The knee is proximal to the ankle.

Proximal

Distal Farther or away from the origin of the body part or the attachment of a limb to the trunk

e.g. The forearm is distal to the arm.

Directional Directional TermsTermsSuperficial Vs. Deep

Towards or at the body surface

e.g. The skin is superficial to the skeletal muscles

Superficial

Deep Away from the body surface ( more internal)

e.g. The skeletal muscles are deep to the skin

anterior posterior lateral

cephalicsuperiorcranial

inferiorcaudal medial

lateral proximal

distal

Directional Directional TermsTerms

Abduction vs. Adduction

Joints Joints movement movement TermsTerms

Abduction : movement away from the midline of the body or body part.

Adduction: Movement toward the midline of the body or body part.

Flexion vs. Extension

Flexion : Decrease in the

angle of a joint by bending

Extension: Increase in the angle

of joint or straightening of a jointNote : Hyper flexion is over flexion while hyper

extension is extension beyond normal limits

Inversion vs. Eversion

Inversion : Turning of foot

inward at the ankle joint.

Eversion: Turning of the foot

outward at the ankle joint.

Pronation vs. Supination

Pronation : Turning the hand

so that the palm is down or onto one's stomach

Supination: Turning the hand

so the palm is facing upward or turning onto one's back.

Pronation vs. Supination

Body Position Body Position TermsTerms

Erect "upright" Position when the Sagittal and

coronal planes of the body are perpendicular to the horizon

Recumbent "lying down"

Position when the transverse plane of the body

is perpendicular to the horizon

Describe the overall placement of the body in the desired position.

Recumbent Recumbent PositionsPositionsSupine

(posterior recumbent position)

◦Lying down on the back

xx lateral recumbent◦lying down on the xx side

(anterior recumbent position)

◦Lying face down

Decubitus vs. Recumbent◦general meanings are the same "LYING DOWN"◦but in radiography, decubitus has a special meaning

◦DECUBITUS patient is lying down & the x-ray beam is parallel to the horizon

Decubitus Decubitus PositionsPositionsVentral decubituspatient is prone ,Cassette (IR) is vertical & a horizontal beam is used

Lateral decubitus ( Right or Left)

patient lying on the left lateral side ,Cassette (IR) is vertical & a horizontal beam is used

Dorsal decubituspatient is supine ,Cassette (IR) is vertical & a horizontal beam is used

Oblique (Erect Oblique (Erect or Recumbent)or Recumbent)Position when the body is

rotated so that the MS plane is neither nor to the film but at an angle

Exact position is indicated by the surface closest to the film and the angle of rotation

May be erect or recumbent

abbreviations:◦RPO, LPO, RAO, LAO

45 RPO

Erect PositionsErect PositionsSurface of body closest to the film used to give a more specific description

Examples:Posterior erect -- patient is standing with the posterior surface of the body next to the cassette

Left lateral erect -- patient is standing with the left side of the body next to the cassette

Unit III

Left lateral erect

position

Fowler's Position

A person in the Fowler's position is sitting leaning slightly back 45o - 90o.legs may either be straight or bent.

Trendelenburg Position

A person in the Trendelenburg position is lying supine with head slightly lower than their feet.

Unit III

Sim's Position A near lateral Left anterior oblique ( Left

Sim's ) OR right anterior oblique with the top leg in front the lower leg.

ProjectionProjection Refers to the path the x-ray beam takes through partAnteroposterior projection (AP)

Beam enters the front surface and exits the back surface of the part

Posteroanterior projection (PA) Beam enters the back and exits the front of the part

AP projection in supine position

Positioning Positioning TermsTerms

• Lateral Lateral ProjectionsProjections

◦Torso (Trunk) and headRight to left lateral projection

Left to right lateral projection

◦Extremities (Limbs)Mediolateral projectionLateromedial projectionNote: Normally the positioning terminology is used rather than projection.

Left lateral erect positionR to L lateral projection

Positioning Positioning TermsTerms

• Special Special ProjectionsProjections

Axial ProjectionAxial Projection

Right to left lateral projection

Left to right lateral projection

Tangential projectionTangential projection

Mediolateral projectionLateromedial projectionNote: Normally the positioning terminology is used rather than projection.

Positioning TermsPositioning TermsX-ray beam

AP axial with 40° caudal angle X-ray beamX-ray beam

Classification of Body HabitusClassification of Body Habitus

Hypersthenic

Deep broad thorax Short thoracic cavityShort wide heart Elevated diaphragm Stomach and GB very high

Colon high and wide

Unit III

Sthenic

Lightly longer and shallow thorax

Ribs more vertical

Heart narrow and longer

Thoracic cavity longer

Diaphragm is not as high

Colon slightly lower and more centrally located.

Hyposthenic

Thorax longerDiaphragm lowerStomach and GB lower and close to midline.

Colon lower and close to midline of abdomen

Unit III

Asthenic

Exaggeration of Hyposthenic type Thorax narrow and shallow Heart longer and narrow Thoracic cavity longer Diaphragm is very low Stomach and GB very lower ,vertical and near midline.

Unit III

Hypersthenic 5% Sthenic 50% Hyposthenic 35%Sthenic 10%

Unit III 34

Introduction to Radiographic Positioning (Positioning Terminology ) IMG353 Lecture 1.

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