POSITIONING TERMINOLOGY Learning a new language!

THE ANATOMIC POSITION

THE ANATOMIC POSITION Standing erect with the face and eyes directed forward. Arms extended by the sides with the palms facing forward (anteriorly). Heels together and toes pointed forward. All positioning terms refer to the anatomic position.

Body Planes

BODY PLANES - Imaginary lines passing through the body in the anatomic position. Midsagittal Plane (median plane) is a longitudinal plane. Divides body into equal right and left portions Abbreviated MSP A sagittal plane divides the body into right and left sections, but not equally. These planes run parallel with the midsagittal plane.

BODY PLANES Midcoronal plane is a longitudinal plane. Divides the body into equal front (anterior) and back (posterior) sections. Abbreviated MCP Coronal planes divide the body into front and back sections, but not equally. These planes run parallel with the midcoronal plane.

BODY PLANES Horizontal, Transverse, or Axial Planes Any transverse plane dividing the body into upper (superior) and lower (inferior) sections.

Body Surfaces

BODY SURFACES (OPPOSITES) Anterior (ventral) Front half of the body that includes the top of the feet and the palms of the hands. Refers also to the forward part of an organ. Posterior (dorsal) Back half of the body that includes the bottom of the feet and the back of the hands. Refers also to the back part of an organ.

SURFACES OF THE FEET & HANDS Plantar – soles of feet (posterior) Dorsum – top of the foot (anterior) “dorsum pedis” Palmar – palm of hand that is known also as the anterior or ventral surface

GENERAL BODY POSITIOINS Supine – lying on the back, face up. Prone – Lying face down. Recumbent – Lying down in any position. Trendelenburg’s position – Supine with the head lower than the feet. Fowler’s position – Supine with the head higher than the feet Erect – (includes seated erect position) Upright position.

SUPINE AND RECUMBENT

PRONE AND RECUMBENT

Trendelenburg

Fowler’s (Reverse Trendelenburg)

SPECIFIC BODY POSITIONS Always described by the side or sides closest to the image receptor! Erect or recumbent lateral position: Right lateral – right side closest to IR. Left lateral – left side closest to the IR Demonstrates a side view.

DESCRIBE THIS PATIENT’S POSITION.

ANSWER If you answered the right lateral, erect position, you are correct.

DESCRIBE THIS PATIENT’S POSITION.

ANSWER If you answered right lateral, recumbent position, you are correct.

OBLIQUE POSITIONS The chest, abdomen, or pelvis is rotated from the supine, prone or lateral positions. A limb is rotated from the AP, PA or lateral positions.

SPECIFIC OBLIQUE BODY POSITIONS Anterior Obliques – as laterals are descibed by the body surfaces closest to the IR. RAO – right anterior oblique position – right and anterior surfaces closest to image receptor. LAO – left anterior oblique – left and anterior surfaces closest to IR.

IN WHAT POSITION IS THIS PATIENT POSITIONED?

ANSWER If you answered the erect, right anterior oblique position, you are correct.

In what position is this patient?

ANSWER If you answered recumbent, right anterior oblique, you are correct.

SPECIFIC OBLIQUE BODY POSITIONS Posterior Obliques –As laterals and anterior oblique positions are always described by the surfaces closest to the IR RPO – right posterior oblique position- right and posterior surfaces closest to IR. LPO – left posterior oblique position- left and posterior surfaces closest to IR.

IN WHAT POSITION IS THIS PATIENT POSITIONED ?

ANSWER If you answer erect, left posterior oblique you are correct.

In what oblique position is this patient?

ANSWER If you answered recumbent, left posterior oblique, you are correct.

An image taken in the RAO position will correspond with an image taken in the LPO position An image takes in the LAO position will correspond with an image taken in the RPO position.

OBLIQUE PROJECTIONS OF THE EXTREMITIES Require quantifying terms: Medial or internal rotation – The limb is turned in toward the median plane or midline of the patient. Lateral or external rotation – The limb is turned away from the median plane or midline of the patient.

Medial Rotation of the Foot

SPECIFIC BODY POSITIONS Decubitus positions always require a horizontal central ray and vertical placement of the image receptor (IR). Decubitus means to lie down.

SPECIFIC DECUBITUS POSITIONS LLD – Left lateral decubitus position – Patient lying on left side with the IR placed vertically and the x-ray beam horizontal. RLD – right lateral decubitus position –Patient lying on their right side with the IR placed vertically and the x-ray beam horizontal.

Left Lateral Decubitus Position (LLD)

SPECIFIC DECUBITUS POSITIONS Dorsal decubitus position – Patient lying on back with the IR placed vertically adjacent to a side of the patient, and the x-ray beam horizontal. Ventral decubitus position – Patient lying face down with the IR placed vertically adjacent to a side of the patient, and the x-ray beam horizontal. Both the dorsal and ventral decubitus positions ALWAYS DEMONSTRATE A SIDE OR LATERAL IMAGE!

Dorsal Decubitus Position

Ventral Decubitus Position

RADIOGRAPHIC PROJECTIONS Projections are different from positions in that they describe the path of the central ray (CR) or x-ray beam as it passes through the patient. The term projection always refers to the path of the central ray as it exits the x-ray tube, traverses the patient and reaches the IR, regardless of the body position.

AP (ANTEROPOSTERIOR) PROJECTION CR enters the anterior body surface and exits the posterior body surface. IR closest to the posterior surface of the patient. Produces a posterior view. A view is the opposite of a projection. When viewing a radiograph the term view represents a position. For example, if the patient is radiographed in the lateral position then the image is said to be a lateral view.

AP Projection

PA (POSTEROANTERIOR) PROJECTION The CR enters the posterior surface of the body and exits the anterior surface. IR closest to the anterior surface of the patient.

PA Projection

OBLIQUE BODY PROJECTIONS Includes the thorax (chest), abdomen, and pelvis. RAO and LAO positions are posterior oblique projections, because the central ray will enter the posterior surface of the patient and exit the anterior surface. RPO or LPO positions are anterior oblique projections.

Projections of the Feet The feet are commonly imaged so that the CR enters the top or superior surface of the foot (dorsum) and exits the bottom or inferior surface of the foot (plantar). Thus the projection is referred to as the dorsoplantar projection.

AXIAL PROJECTIONS Longitudinal angulations of the central ray x-ray tube) toward the head (cephalad) or the feet (caudad).

Cephalad CR Angulation – Axial Projection

TANGENTIAL PROJECTION The CR is directed toward the outer margin of a curved body surface to profile a body part just under the surface or a surface lesion and project it free of superimposition.

TANGENTIAL PROJECTON OF THE CHEEK BONE OR ZYGOMA

TANGENTIAL PROJECTION OF THE KNEE CAP OR PATELLA

RELATIONSHIP TERMS Medial - “inside part” – closest to median plane or midline of the body Lateral – away from median plane or midline of body. Proximal – near the source or beginning. In regards to extremities, the part closest to the trunk of the body. Distal – away from the source. In regards to extremities, the part furthest from the trunk of the body.

RELATIONSHIP TERMS

RELATIONSHIP TERMS Cephalad – toward the head Caudad – toward the feet Superior – nearer the head or situated above Inferior – nearer the feet or situated below Ipsolateral - part or parts on the same side of the body Contralateral – Part or parts on the opposite side of the body

BODY MOVEMENT TERMINOLOGY Abduction – lateral movement of arm or leg away from the body Adduction – movement of arm or leg toward the body Flexion – bending or decreasing the angle of a joint Extension – Straightening or increasing the angle of a joint

BODY MOVEMENT TERMINOLOGY Eversion – outward turning of the foot at the ankle Inversion – inward turning of the foot at the ankle Pronation – Tuning the palm of the hand down Supination – Turning the palm of the hand up

Eversion

Inversion