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L 2 HVV

This document discusses different chest x-ray projections including apical lordotic, AP supine, lateral decubitus, anterior oblique, and posterior oblique views. It describes the positioning, central ray placement, and indications for each projection. Key details provided include leaning back 30 degrees for the apical lordotic, using a 5 degree caudal angled tube for AP supine to prevent clavicle obstruction, and rotating the body 45 degrees with arms positioned overhead or at the hip for the oblique views.

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Mohammad Dawaghreh
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52 views25 pages

L 2 HVV

This document discusses different chest x-ray projections including apical lordotic, AP supine, lateral decubitus, anterior oblique, and posterior oblique views. It describes the positioning, central ray placement, and indications for each projection. Key details provided include leaning back 30 degrees for the apical lordotic, using a 5 degree caudal angled tube for AP supine to prevent clavicle obstruction, and rotating the body 45 degrees with arms positioned overhead or at the hip for the oblique views.

Uploaded by

Mohammad Dawaghreh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Apical (lordotic)

•Pathologic indications
•To rule out Calcifications,
infection and masses
beneath the clavicles
•Anatomy
• Demonstrated
Lung apices and the
medial ends of the first 4
ribs
Basic Patient Position

•Horizontal central ray


patient's coronal plane
angled, (lordotic)
The patient stands AP erect
approximately 30 cm from
the film then leans back so
the coronal plane is 30
degrees to the film, the head
and dorsal skin surface in
contact with the cassette, the
backs of the hands are placed
on the lateral aspects of the
waist and the shoulders
rolled forward. Exposure is
made on suspended
inspiration.
Central Ray
• The horizontal central ray is centered in the
midline midway between the sternal notch
and the xiphisternum, the top of the cassette
needs to be approximately 10 cm above the
apical skin surface
Evaluation of the Image

 ID and markers must be present and correct in the


appropriate area of the film.
Limits of anatomy, superiorly the skin margins of the
apices, inferiorly the T4, laterally the ribcage.
No rotation, The apices should be symmetrical about
he midline.
Centering, T6
The medial ends of the clavicles should be projected
above the lung apices.
scapulae should be clear of the lung fields.
Penetration the vertebral outlines should be visible
AP supine or Semi erect

• Image indication: pathology involving lungs


and diaphragm.
• Performed when patient is unable to stand.
• Also performed on pediatrics usually <5years that are unable to stand or
stay still standing.
• It can be completed erect or supine depending on the mobility of the
patient.
CXR

•Position: patient supine or


setting up, shoulders are
rolled forward and the
cassette is placed under or
behind the patient and
above the shoulders
CXR
• Central ray: the tube is angled 5 degrees
caudal to be perpendicular to the sternum to
prevent clavicles from obscuring the apices
• CR is T7 ( 3 inches from the jugular notch)
CXR
• Image evaluation:
• Heart is magnified due to shorter SID (100 cm)
and longer OID
Lateral Decubitus

Image indication
Pneumothorax and haemothorax (air fluid level)
Position

•Patient lying down on


either side with knee
flexed and both arms
elevated beside the head
and horizontal beam is
used.
•Central ray: CR is T7 (3
inches from the jugular
notch)
Anterior Oblique AO Chest

• Image indication: pathology involving lungs,


size and contours of the heart and great
vessels
Position

•Patient in erect position, the


anterior aspect of the left side
will be against the cassette for
LAO and the right side for RAO
with the body rotated 45
degrees, the hand of the
closest side to IR is placed over
the hip and the arm of the
remote side is placed over the
head
• Central ray : mid way between the skin surface
of the remote side and the spine at the level
of T7
• Anterior oblique is best to demonstrate the
farthest side from the IR. For Example, RAO is
best to visualize the left lung.
RAO position
LAO position
Posterior Oblique PO Chest

• Image indication: pathology involving lungs,


size and contours of the heart and great
vessels
Position

•Patient in erect position, the


posterior aspect of the left
side will be against the
cassette for LPO and the right
side for RPO with the body
rotated 45 degrees, the hand
of the remote side is placed
over the hip and the arm of
the closest side to IR side is
placed over the head
• Central ray: mid way between the skin surface
of the remote side the spine at the level of T7
• Posterior oblique is best to demonstrate the
nearest side from the IR. For Example, RPO is
best to visualize the right lung.
RPO LPO

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