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Introduction to Radiographic PositioningIntroduction to Radiographic Positioning(Positioning Terminology )(Positioning Terminology )
IMG353Lecture 1
2
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
3
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.
2
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
3
Body Body PlanesPlanes
4
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.
5
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
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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
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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.
9
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
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anterior posterior lateral
an
teri
or
po
ste
rio
r
cephalicsuperiorcranial
inferiorcaudal medial
lateral proximal
distal
Directional Directional TermsTerms
11
Abduction vs. Adduction
12
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
13
Joints Joints movement movement TermsTerms
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
14
Joints Joints movement movement TermsTerms
Inversion : Turning of foot
inward at the ankle joint.
Eversion: Turning of the foot
outward at the ankle joint.
Pronation vs. Supination
15
Joints Joints movement movement TermsTerms
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
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Describe the overall placement of the body in the desired position.
Recumbent Recumbent PositionsPositionsSupine
(posterior recumbent position)
◦Lying down on the back
Body Position Body Position TermsTerms
17
xx lateral recumbent◦lying down on the xx side
Prone
(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
Body Position Body Position TermsTerms
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Decubitus Decubitus PositionsPositionsVentral decubituspatient is prone ,Cassette (IR) is vertical & a horizontal beam is used
Body Position Body Position TermsTerms
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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
Body Position Body Position TermsTerms
19
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
Body Position Body Position TermsTerms
21
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
Body Position Body Position TermsTerms
22
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.
Body Position Body Position TermsTerms
23
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
24
• 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
X-ray
25
• 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
26
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
27
Classification of Body HabitusClassification of Body Habitus
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.
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Classification of Body HabitusClassification of Body Habitus
Hyposthenic
Thorax longerDiaphragm lowerStomach and GB lower and close to midline.
Colon lower and close to midline of abdomen
Unit III
28
Classification of Body HabitusClassification of Body Habitus
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.
28
Unit III
Classification of Body HabitusClassification of Body Habitus
Hypersthenic 5% Sthenic 50% Hyposthenic 35%Sthenic 10%
Unit III 34