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

30. Body Habitus
STHENIC
HYPOSTHENIC
ASTHENIC
HYPERSTHENIC

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

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