1

PA -anterior side BEST SEEN AP -posterior side BEST SEEN

Ribs 2012- pt 2POSITIOINING (review)

2 RIBS (Projections & Positions)

• AP

• OBLIQUES• LPO

• RPO

• (May also include PA CHEST for lungs)

• PA

• OBLIQUES• RAO

• LAO

Exam done : UNILATERAL or BILATERAL AD (above diaphram) & BD – (below diaphram)

3 BEST SEEN - RIBS

• AP - posterior ribs (AD/BD)

• PA - anterior ribs (AD/BD)

• OBLIQUES– RAO / LPO :

• LT axillary ribs + RT post rib art w/spine

– LAO / RPO • RT axillary ribs + LT post rib art w/spine

4UNIT 3 RT 122

TECHNIQUE CONSIDERATION

RIBS : UNILATERAL OR BILATERAL SHORT SCALE CONTRAST NEEDED

BONY DETAIL

• AD – above diaphram– 60 – 70 KVP – INSPIRATION

• BD – below diaphram– 70 KVP + 3-4 x more mAs (ABD)

• EXPIRATION

5 Routine: Bilateral RIBS

• AP or PA

• OBLIQUES• LPO (RAO)

• RPO (LAO) • (May also include PA CHEST for lungs)

↑ kVp for lungs (90-120)vs kVp bony ribs (60-80)

Must include : BOTH sides (RT & LT) TOP & Bottom (AED & BD)

6

PA for Chest or Bilat RIBS (AD)

7BILAT – AD (upright)

14 x 17 LW CW

Centering – same as CXR MSP + T 7

8

(AP) BILATERAL - AD

9 Deep Inspiration

Why?

10 INSPIRATION vs EXPIRATION

11Why do AP vs PA projection?

PA AP

12

BILAT (BD)

11X14 CW OR 14 x 17 LW Centering – (similar to upper ABD) MSP + L-1 (Bend of Rib)

Top of light 1 – 2 “ above xyphoid Bottom of light 1 – 2 “ below IC

13

OR Upright

14 SUPINE AP BILATERAL RIBS AD BD

15 AD – INSP BD - EXP

16 AP Bilat – OBLIQUE (AD)Position?

Demonstrates?

CR ~ ½ way between MSP/MCP (side up) or ~ 2” lat to MSP (side up)

& T7 (AD)

17

LAO VS RPO

18 Taken “AP”

Position? Demonstrates?

19 PA Bilat – OBLIQUE (AD)

Move both arms out of the way

This position not tested in lab

20

BILATERAL OBLIQUES (bd)

21 OBL – BDBILAT VS UNILAT

22 AP- UNILATERALAD(LEFT) RIBS

23AP UNILATERAL (LT RIBS) AD BD

24 UNILATERAL – LT RIBSAP AD BD

25LAO/RPO for the RT RIBSUPSIDE = PA AWAY DOWNSIDE = AP TOWARD (SIDE OF PAIN)

26

LAO VS RPO

27

LPO/RAO – For LEFT Ribs

RAO

28 UNILATERAL (LEFT RIBS) – ADLPO –AXILLARY RPO –LT POST ART

29LPO vs RAO AD/BD

30

31

UNILAT – LEFT(LPO) (BD)

32

LPO/RAO – For LEFT Ribs

RAO

33LPO vs RAO AD/BD