ANLS 2620 Lecture and Lab Notes

ANLS 2620 Lecture and Lab Notes - Full Spine X-Ray...

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Full Spine X-Ray Positioning RADD 2303 November 1996/ Revised December 06
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AP LUMBOPELVIC VIEW (APP) Demonstrates: L1- 5, pelvis (do not cut off the ischial tuberosities), 5 lumbar vertebrae, coccyx, femur heads, and acetabulum. Measure: At the thickest part of the abdomen or at the level of the ASIS Film Size: 14 x 17. Name blocker up. SID: 40” (they just started doing them at 40” (used to be 60”) in the clinic recently) TEXTBOOK is 40”. Central Ray Angle : none Patient / Part Position: Upright, standing, touching lightly against Bucky (not leaning). 1. Gowned and shielded. Shield filters 60% (aluminum and copper) for female, 85% (lead) on males. Female shield: The apex of the heart placed 1/4” below the top of the pubic bone, covering the ovaries. Crests of the heart at the level of the ASIS. Male shield: The top of the shield placed just below the bottom of the pubic bone and base of penis, covering the testicles not necessarily the entire penis. The patient will not typically know where their pubic bone is so a careful explanation is in order, especially in the case of a pendulous abdomen. New LUCC Radiology Handbook states that you should assist the patient in the placement of the gonadal shield. 2. Feet comfortably apart for a steady base. Feet internally rotated 15 degrees (rotate on axis through the heels) to obtain a true AP view of the proximal femur. 3. Patient may hold onto Bucky if it does not change posture. Otherwise abduct arms. 4. View may be taken PA especially with obese patients. CR: Horizontal- 2 1/2” below the top of the iliac crest at approximately the level of the ASIS. Vertical through the midline of the body Center film to CR Collimation: Show unexposed borders. Side Marker: Upper film corner Breathing Instructions: Suspended expiration. “Take a big breath in, blow it all the way out, and hold it.” This procedure raises the diaphragm for uniform density and to see lower thoracic vertebrae. 2
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AP Thoracic Demonstrates: T1-12 Measure: Across the shoulder from sternum to spinous processes. Caliper should be at approximately mid thoracic area. Film Size: 14 x 17. Name blocker up. SID: 40” SID according to textbooks Central Ray Angle: None Patient / Part Position: Upright, standing, touching lightly against Bucky. Gowned, shielding is optional. The Patient’s feet should be comfortably apart. Arms slightly abducted to clear the area. CR: Central ray should be located at approximately T6 (Yochum and Rowe states place top of cassette 2” above C-7 Spinous Process). Vertical: Midline of the body Horizontal: To the center of 14 x 17” film Collimation: Show unexposed borders, collimate to the spine, laterally . Approximately 7 -10 “ Side Marker: Upper film corner Breathing Instructions: Full inspiration. This will lower the diaphragm for uniform density. Extras:
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ANLS 2620 Lecture and Lab Notes - Full Spine X-Ray...

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