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Unit 5B – Standard terms for positioning and projection

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1 Unit 5B – Standard terms for positioning and projection

2 Chapter 3 General Anatomy and Radiographic Positioning Terminology

3 Introduction Radiographers must possess a thorough knowledge of anatomy and medical terminology

4 General Anatomy Definitions of terms Body planes Body cavities
Divisions of the abdomens Surface landmarks Body habitus

5 Definition of Terms Anatomy Physiology Osteology
The term applied to the science of the structure of the body Physiology The study of the function of the body organs Osteology The detailed study of the body of knowledge relating to the bones of the body

6 Anatomic Position

7 Body Planes Imaginary planes that subdivide the body in reference to anatomic position Planes “slice” the body in all directions at designated levels Fundamental planes Sagittal Coronal Horizontal Oblique

8 Body Planes Sagittal planes divide the body into right and left segments, passing vertically from front to back

9 Body Planes Midsagittal plane (MSP) is a specific sagittal plane that passes through midline and divides the body into equal right and left halves

10 Body Planes Coronal planes pass through the body vertically from side to side, dividing the body into anterior and posterior parts

11 Body Planes Midcoronal plane (MCP), also called midaxillary plane, is the specific plane that passes through midline and divides the body into equal anterior and posterior halves

12 Body Planes Horizontal planes pass crosswise through the body or body part at right angles to the longitudinal axis Positioned at right angle to sagittal and coronal planes Divides the body into superior (top) and inferior (bottom) portions Also called transverse, axial, or cross-sectional planes

13 Body Planes Oblique planes pass through a body part at any angle between previous three planes Planes are used in radiographic positioning to center a body part to the IR or CR

14 Body Cavities Two great cavities
Thoracic cavity Abdominal cavity Abdominal cavity has no lower partition, but the lower portion is called the pelvic cavity Often referred to as the abdominopelvic cavity

15 Body Cavities Thoracic cavity contains Pleural membranes Lungs Trachea
Esophagus Pericardium Heart and great vessels

16 Body Cavities Abdominal cavity contains Peritoneum - Stomach
Liver - Intestines Gallbladder - Kidneys Pancreas - Ureters Spleen - Major blood vessels

17 Body Cavities Pelvic portion contains Rectum Urinary bladder
Part of the reproductive system

18 Divisions of the Abdomen
Bordered superiorly by diaphragm Bordered inferiorly by the superior pelvic aperture (pelvic inlet) Abdomen divided in two methods Quadrants Regions

19 Divisions of the Abdomen
Four quadrants Right upper quadrant (RUQ) Right lower quadrant (RLQ) Left upper quadrant (LUQ) Left lower quadrant (LLQ) Quadrants are useful for describing the location of various abdominal organs

20 Divisions of the Abdomen
Abdomen divided into nine regions by four planes, two horizontal and two vertical Not used as often as quadrants Superior regions Right hypochondrium Epigastrium Left hypochondrium

21 Divisions of the Abdomen
Middle regions Right lateral Umbilical Left lateral Inferior regions Right inguinal Hypogastrium Left inguinal

22 Surface Landmarks Most anatomic structures cannot be seen or palpated
To accurately position, radiographers rely on palpable external landmarks to locate unseen anatomy Table 3-1 on p. 63 summarizes these external landmarks Practice is needed to use surface landmarks accurately

23 Surface Landmarks - Cervical
Mastoid Tip C1 Gonion C2-3 Hyoid Bone C3-4 Thyroid cartilage C5 Vertebra prominens C7-T1

24 Surface Landmarks - Thoracic
2” above Jugular notch T1 Jugular notch T2-3 Sternal angle T4-5 Inferior angles Of Scapula T7 Xiphoid Process T9-10

25 Surface Landmarks-Lumbar/Pelvic
Inferior costal Margin L2-3 Iliac Crest L4-5 ASIS (anterior superior iliac spine) S1-2 Symphysis pubis or Greater trochanter of femur Coccyx

26 Body Habitus Defined as the common variations in the shape of the human body Important in radiography because habitus determines size, shape, and position of organs of the thoracic and abdominal cavities

27 Body Habitus Organs affected by body habitus Heart Lungs Diaphragm
Stomach Colon Gallbladder

28 Body Habitus Four major types of body habitus Sthenic – average
Hyposthenic – thinner and taller than average Asthenic – petite, frail Hypersthenic - large frame, broad

29 Body Habitus Sthenic and hyposthenic are considered average
Hypersthenic and asthenic are the extremes


31 Sthenic Hyposthenic

32 Asthenic Hypersthenic

33 Osteology Skeletal divisions General bone features Bone development
Classification of bones

34 Bone Functions Attachment for muscles Mechanical basis for movement
Protection of internal organs Support frame for body Storage for calcium, phosphorous, and other salts Production of red and white blood cells

35 Skeletal Divisions Total of 206 bones in the body
Divided into two main groups Axial skeleton (80 bones - blue) Appendicular skeleton (126 bones – yellow) Axial skeleton supports and protects the head and trunk Appendicular skeleton provides means for movement

36 General Bone Features Compact bone Spongy bone
Strong, dense outer layer Spongy bone Inner, less dense layer Contains a spiculated network called trabeculae Trabeculae filled with red and yellow marrow

37 General Bone Features Red marrow produces red and white blood cells
Yellow marrow stores fat cells Medullary cavity Central cavity of long bones Contains trabeculae filled with yellow marrow Red marrow found in ends of long bones

38 General Bone Features Periosteum Endosteum
Tough, fibrous connective tissue that covers bone, except at articular ends Endosteum Lines marrow cavity

39 Bone Development Ossification is the term that applies to the development and formation of bones Begins in the second month of embryonic life Two processes Intermembranous Endochondral

40 Bone Development Flat bones are formed by intramembranous ossification
Short, irregular, and long bones are created by endochondral ossification Endochondral ossification occurs from two distinct centers of development Primary Secondary

41 Bone Development Primary ossification begins before birth and forms long central shaft in long bones (diaphysis)

42 Bone Development Secondary ossification occurs after birth when separate bones begin to develop at both ends of long bones Ends are called epiphyses

43 Classification of Bones
Classified by shape Long Short Flat Irregular Sesamoid

44 Classification of Bones
Long bones found only in limbs Consist of body and two enlarged articular ends Examples: femur and humerus Short bones Consist mainly of cancellous bone with a thin outer layer of compact bone Example: carpal bones

45 Classification of Bones
Flat bones consist of two plates of compact bones Middle layer of cancellous bone called diploë Examples: sternum and cranium Irregular bones are peculiarly shaped Examples: vertebrae and facial bones

46 Classification of Bones
Sesamoid bones Very small and oval Develop inside and beside tendons Protect the tendon from excessive wear Largest is patella (knee cap)

47 Arthrology Defined as the study of joints, or articulations, between bones Classified two ways Functional Structural

48 Functional Classification
Three subdivisions based on mobility of joint Synarthroses = immoveable Amphiarthroses = slightly moveable Diarthroses = freely moveable

49 Structural Classification
Three distinct groups based on connective tissues Fibrous Cartilaginous Synovial 11 specific types of joints fall within the above broad categories

50 Synovial Joints Six types Gliding Hinge Pivot Ellipsoid Saddle
Ball and socket

51 Gliding Joint Simplest synovial joint
Examples: intercarpal and intertarsal joints

52 Hinge Joint Permits flexion and extension only
Examples: elbow and knee

53 Pivot Joint Allows rotation around a single axis
Example: atlantoaxial joint (C1-C2 joint)

54 Ellipsoid Joint Allows flexion, extension, abduction, adduction, and circumduction Example: radiocarpal (wrist) joint

55 Saddle joint Allows movement similar to ellipsoid
Difference is in the shape of the articular surfaces Example: carpometacarpal joint between trapezium and first metacarpal

56 Ball and Socket Joint Permits widest range of motion
Examples: hip and shoulder

57 Bone Markings and Features
Processes or Projections Extend beyond or project out from the main body of a bone Depressions Hollow or depressed areas Fractures A break in bone

58 Processes and Projections
Condyle Rounded process at an articular end Crest Ridgelike process Epicondyle Projection above a condyle Head Expanded (usually rounded) end of a long bone

59 Processes and Projections
Line Linear elevation; not as prominent as a crest Malleolus Club-shaped process Protuberance Projecting prominence Spine Sharp process

60 Processes and Projections
Trochanter Either of the two large, rounded, and elevated processes of the proximal femur Tubercle Small, rounded, and elevated process Tuberosity Large, rounded, and elevated process

61 Depressions Fissure Foramen Fossa Groove Cleft or deep groove
Hole in a bone for transmission of vessels and nerves Fossa Pit, fovea, or hollow space Groove Shallow linear channel

62 Depressions Meatus Notch Sinus Sulcus Tubelike passageway
Indentation in the border of a bone Sinus Recess, groove, cavity, or hollow space Sulcus Furrow or trench

63 Anatomic Relationship Terms
Anterior (ventral) Forward or front part of the body or of a part Posterior (dorsal) Back part of body or part

64 Anatomic Relationship Terms
Caudad (Caudal) Parts away from the head of the body Cephalad (Cephalic) Parts toward the head

65 Anatomic Relationship Terms
Superior Nearer the head or situated above Inferior Nearer the feet or situated below Central Mid area or main part of an organ Peripheral At or near the surface, edge, or outside of another body part

66 Anatomic Relationship Terms
Medial Toward the median plane of the body or toward the middle of a body part Lateral Away from the median plane or away from the middle of a part Superficial Near the skin or surface Deep Far from the surface

67 Anatomic Relationship Terms
Distal Farthest from the point of attachment or origin Proximal Nearer to the point of attachment or origin External Outside the body or part Internal Inside the body or part

68 Anatomic Relationship Terms
Parietal The wall or lining of a body cavity Visceral The covering of an organ Ipsilateral Parts on the same side of the body Contralateral Parts on the opposite side of the body

69 Anatomic Relationship Terms
Palmar Palm of the hand Plantar Sole of the foot Dorsum Anterior, or top, of the foot or the back of the hand

70 Radiographic Positioning Terminology
Projection Defined as the path of the CR as it exits the x-ray tube, passes through the patient to the IR Identified by the entrance and exit points of the body Position Overall posture of the patient or general body position Also refers to the specific placement of the body or part in relation to the table or IR

71 Radiographic Positioning Terminology
View Used to describe the body part as seen by the IR Exact opposite of projection, the preferred term in the United States Method Refers to a specific radiographic projection developed by an individual

72 Essential Projections
AP (Anterior-Posterior) CR enters the anterior surface and exits the posterior

73 Essential Projections
PA (Posterior-Anterior) CR enters the posterior surface and exits the anterior

74 Essential Projections
Axial Longitudinal angle of the CR of 10 degrees or more

75 Essential Projections
Tangential CR directed along the outer margin of a curved body surface

76 Essential Projections
Lateral CR enters one side of the body, passing transversely along the coronal plane

77 Essential Projections
Oblique CR enters from side angle Entrance and exit surfaces still specified, e.g., AP oblique

78 General Body Positions
Upright – erect or vertical Seated – upright, but sitting on a stool Recumbent – lying down in any position Supine – lying on the back Prone – lying face down Lateral – lying on the side

79 General Body Positions
Supine – lying on the back Prone – lying face down

80 Positions General body positions
Trendelenburg’s position – supine with the head lower than the feet

81 Positions General body positions
Fowler’s position – supine with the head elevated

82 Positions General body positions
Sims’ position – recumbent with patient lying on left anterior side with left leg extended and right knee and thigh partially flexed

83 Positions General body positions
Lithotomy position – supine with knees and hips flexed and thighs abducted and rotated externally, supported by ankle supports

84 Positions General body positions Lateral position
Named according to the side of the patient that is placed closer to the IR

85 Positions Oblique position
Body is rotated so that the coronal plane is not parallel with the table or IR Angle of rotation is specific for anatomy of interest Named according to side and surface of body closer to table or IR Abbreviations: RPO, LPO, RAO, and LAO

86 Positions Right Anterior Oblique (RAO) Position
Body is rotated so that the right anterior side of the patient is closest to the table or IR Angle of rotation is specific for anatomy of interest

87 Positions Left Anterior Oblique (LAO) Position
Body is rotated so that the left anterior side of the patient is closest to the table or IR Angle of rotation is specific for anatomy of interest

88 Positions Right Posterior Oblique (RPO) Position
Body is rotated so that the right posterior side of the patient is closest to the table or IR Angle of rotation is specific for anatomy of interest

89 Positions Left Posterior Oblique (LPO) Position
Body is rotated so that the left posterior side of the patient is closest to the table or IR Angle of rotation is specific for anatomy of interest

90 Positioning Aids

91 Positions Decubitus position Recumbent position with a horizontal CR
Named according to the body surface on which the patient is lying and the side of the patient closest to the IR

92 Positions Left Lateral Decubitus position
Left Lateral Recumbent position with a horizontal CR (AP projection) A Right Lateral Decubitus position would be with the right side down

93 Positions Right Dorsal Decubitus position
Supine Recumbent position with a horizontal CR (Lateral projection)

94 Positions Left Ventral Decubitus position
Prone Recumbent position with a horizontal CR (Lateral projection)

95 Positions Lordotic position
Upright position in which the patient is leaning backward

96 Body Movement Terminology
Abduct or abduction Movement of a part away from the central axis of the body Adduct or adduction Movement of a part toward the central axis of the body

97 Body Movement Terminology
Extension Straightening of a joint Flexion Bending of a joint

98 Body Movement Terminology
Hyperextension Forced or excessive extension Hyperflexion Forced overflexion

99 Body Movement Terminology
Evert/eversion Outward turning of the foot at the ankle Invert/inversion Inward turning of the foot at the ankle

100 Body Movement Terminology
Pronate/pronation Rotation of forearm so that the palm is down Supinate/supination Rotation of forearm so that the palm is up

101 Body Movement Terminology
Rotate/rotation Turning of the body or part around its axis Rotation of a limb is either medial (toward midline) or lateral (away from midline) medial (toward midline) lateral (away from midline

102 Body Movement Terminology
Circumduction Circular movement of a limb Tilt Tipping or slanting a body part slightly

103 Body Movement Terminology
Deviation A turning away from the regular or standard course

104 Sponsored by: This workforce solution was funded by a grant awarded under the President’s Community-Based Job Training Grants as implemented by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or it’s completeness, timeliness, usefulness, adequacy, continued availability, or ownership. This solution is copyrighted by the institution that created it. Internal use by an organization and/or personal use by an individual for non-commercial purposes is permissible. All other uses require the prior authorization of the copyright owner.

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