Presentation1.pptx-kashmir university 2nd yr

Valuable for 2nd yr radiography students

1. introduction Lungs Antero-posterior – erect This projection is used as an alternative to the PA erect Projection for elucidation of an opacity seen on a PA Radiograph. Presented By :- Ahsaan Illahi Presented To :- Yehya Sir

2. Topics to be discussed Patient instructions Positioning of patient and image receptor/cassette Radiation protection for patient Direction and location of the X-ray beam Essential image characteristics

3. Patient instructions instruct the patient to remove any kind of jewellery from chest area. if the dress of the patient is having any metallic decorations over chest area,advice him to replace it by a hospital gown. Assist the patient upto the changing room. Give breathing instructions to patient for the procedure to be performed.

4. Positioning of the patient and image receptor NOTE :- A vertical bucky DDR system is employed or alternatively 14 x 17 inch(35 x 43 cm) film size,lengthwise is selected. The patient is positioned standing or sitting with their back against image receptor/cassette which is supported vertically with the upper edge of the receptor above the lung apices(2 inch above shoulders). Adjust the median sagittal plane at right angles to the middle of the receptor/cassette. instruct the patient to bring shoulders downward and forward,with backs of the hands below the hips and elbows well forward. in the unwell patient it may not be possible to perform this procedure,it is preferable that the patient’s arms are rotated laterally and supported with palms of hands facing forward.

5. Radiation protection for patient Restrict the radiation beam to the size of the receptor. Place lead shield over patient to protect gonads.

6. Direction and location of the x-ray beam The collimated horizontal beam is angled caudally until it is at right angles to the sternum and centred midway between the sternal notch and the xiphisternum. The degree of caudal angulation for the non kyphotic patient is dependent on the patient anatomy(5-10 degree).This will ensure maximum visualisation of the lung fields. The exposure is taken on normal full inspiration.

7. Essential image characteristics Entire lungs(from apices to costophrenic angles)should be included and seen without motion. Shadows of heart and great vessels will be magnified. Lungs will appear shorter due to magnified shadows of diaphragm. Trachea should be in midline and superimposed on vertebral column. Chest should be seen without rotation. Scapula are generally seen projected through lungs.

8. THANKS Source :- Clark’s positioning in radiography Radiographic positioning