1. Rt 124 – Spring Image Review pt 2
ABD & CHEST 2
Rt 124 – Spring
Image Review pt 2

2. Position & Projection Look at blocker for PROJECTION
Look at air/fluid levels for
Upright vs Supine vs Decubitus
Look at Pathology:
Excessive Fluid or Air indicates pathology and may need adjustment in technique

3. Projection ? AP

4. Projection ? AP –AXIAL (APICAL LORDOTIC

5. Projection ? PA Note Pathology – Rt middle lobe Lt lower lobe atelectasis

6. Projection ? AP REMEMBER TO MOVE CARDIAC MONITOR WIRES OUT OF THE WAY Pathology note bilateral effusion both bases

7. PROJECTION? AP

8. LAT UPRIGHT ON GURNEY NOTE AIR /FLUID LEVELS Note poor positioning of CR to part (cr too low & too anterior – not at mcp

9. Position ? Projection? AP semi upright note – fluid levels in RT lung what else is needed? Decubs –for fluid levels

10. Position / Projection? Projection – cant’ tell because no blocker Position – LLD 1) look for the humerus that is raised 2) look for fluid levels 3) note: poor centering for upside of image

11. Position / Projection? Projection – AP
blocker lower RT Position – RLD 1) look for the humerus that is raised 2) look for fluid levels 3) poor marker placement – label of image
look for fluid levels

12. BILATERAL DECUB Projection? PA AP
LLD RLD

13. PROJECTION? POSITION? GO BACK AND CHECK PREVIOUS SLIDE

14. PROJECTION? POSITION? GO BACK AND CHECK PREVIOUS SLIDE

15. ABDOMEN -
SUPINE – UPRIGHT - LLD

16. KUB WHAT IS THE CRITIQUE TO JUDGE PROPER TECHNIQUE?

17. Upper abd - should center higher to include more diaphram

18. Centering better for upper abd – should put blocker down – to keep out of diaphram area

19. Supine KUB – what are the white dots? Residual barium

20. KUB – POST CT SCAN RESIDUAL CONTRAST IN COLON AND KIDNEYS DARK LINE ACROSS ABDOMEN??? FROM COMPRESSED SOFT TISSUE – TIGHT WAISTBAND OF CLOTHING

21. Case example of
SUPINE – upper & KUB Upright
Should have collimated to upper abd – not exposed lower abd twice
(repeated – diaphram clipped)

22. KUB FLAT PLATE SUPINE ABD INCLUDES ENTIRE ABD (TAKEN AT 48” SID)

23. POSITION. UPRIGHT PROJECTION PA – WHAT ELSE
POSITION? UPRIGHT PROJECTION PA – WHAT ELSE? BLOCKER PLACEMENT & CLOTHING

24. KUB SUPINE

25. UPPER ABD SUPINE NOTE PATHOLOGY (GB STONES)

26. UPRIGHT ABD CRITIQUE WHAT IS THE DARK LINE IN THE CENTER

27. PATHOLOGY & Positioning

28. Obstruction lg bowel

29. Example: may need 4 films in quadrant to include all of abd structures (obstruction)

30. Free air in the abdomen

32. Position? Look at air/fluid levels

33. LEFT LAT DECUB

34. Need at least 2 crosswise films

35. CRITIQUE IMAGES FOR POSITIONING COLLIMATION & CENTRAL RAY PLACEMENT

36. Critique: If taken for AP chest – CR is < too cephalic – moving clavicles above apex

37. AP Chest CR – too cephalic PT kyhphotic – need to change CR direction to maintain ┴ to sternum

38. Projection – AP Critique – collimation not centered ekg wires over chest

39. CRITIQUE SEE EARLIER IMAGES

40. Lat gurney chest prop arms up with sponges get ST of arms off of chest

41. CRITIQUE SEE EARLIER IMAGES

42. Also review images on first presentation
Written test on Tues
Lab on Thursday

43. More pathology & positioning We will cover in more detail in GI section

44. Cecal volvulus LG bowel obstruction critique for positioning and centering

45. Toxic megacolon

46. Projection? Postion? PA – according to blocker
Supine – no air fluid levels

47. Projection? AP

48. Projection? PA

49. What is this step ladder sign indicate for pathology
What is this step ladder sign indicate for pathology? Obstruction see air-fluid levels Position? Upright!

50. Small bowel obstruction- remember to include all areas of the abdomen what could have improved this image? 2 cross wise 14 x 17

51. Critique for positioning& projection

52. AP Chest –
CR too low
Collimation too open
KVP too low – too short of contrast
Lat –
CR too forward –
Sit pt up more

53. Projection AP Pathology? COPD