ABD

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ABD CHEST 2

• Rt 124 Spring
• Image Review pt 2

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Position Projection

• Look at blocker for PROJECTION
• Look at air/fluid levels for
• Upright vs Supine vs Decubitus
• Look at Pathology
• Excessive Fluid or Air indicates pathology and
  may need adjustment in technique

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Projection ?AP
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Projection ?AP AXIAL (APICAL LORDOTIC
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Projection ?PANote Pathology Rt middle
lobeLt lower lobeatelectasis
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Projection ?APREMEMBER TO MOVE
CARDIACMONITOR WIRES OUT OF THE
WAYPathologynote bilateraleffusion both
bases
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PROJECTION?AP
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LAT UPRIGHTON GURNEYNOTE AIR /FLUID
LEVELSNote poor positioning ofCR to part(cr
too low too anterior not at mcp
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Position ?Projection?AP semi upright note
fluid levels in RT lung what else is
needed?Decubs for fluid levels
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Position / Projection?Projection cant tell
because no blockerPosition LLD1) look for
the humerus that is raised2) look for fluid
levels3) note poor centering for upside of image
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Position / Projection?Projection AP blocker
lower RTPosition RLD 1) look for the humerus
that is raised2) look for fluid levels3) poor
marker placement label of image
look for fluid levels
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BILATERAL DECUBProjection?
PA AP
LLD RLD
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PROJECTION?POSITION?GO BACK AND CHECK PREVIOUS
SLIDE
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PROJECTION?POSITION?GO BACK AND CHECK PREVIOUS
SLIDE
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ABDOMEN -

• SUPINE UPRIGHT - LLD

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KUBWHAT IS THE CRITIQUE TO JUDGE PROPER
TECHNIQUE?
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Upper abd - should center higher to include more
diaphram
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Centering better for upper abd should put
blocker down to keep out of diaphram area
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Supine KUB what are the white
dots?Residual barium
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KUB POST CT SCANRESIDUAL CONTRAST IN COLON
AND KIDNEYSDARK LINE ACROSS ABDOMEN???FROM
COMPRESSED SOFT TISSUE TIGHT WAISTBAND OF
CLOTHING
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Case example of SUPINE upper KUB
Upright
Should have collimated to upper abd not exposed
lower abd twice
(repeated diaphram clipped)
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KUBFLAT PLATESUPINE ABDINCLUDESENTIRE
ABD(TAKEN AT 48 SID)
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POSITION?UPRIGHTPROJECTIONPA WHAT
ELSE?BLOCKER PLACEMENT CLOTHING
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KUBSUPINE
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UPPER ABDSUPINENOTE PATHOLOGY (GB STONES)
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UPRIGHT ABDCRITIQUEWHAT IS THE DARK LINE IN
THE CENTER
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PATHOLOGYPositioning
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Obstructionlg bowel
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Examplemay need4 films inquadrantto include
allof abd structures(obstruction)
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Free air in the abdomen
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(No Transcript)
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Position?Look at air/fluid levels
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LEFT LAT DECUB
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Need at least 2 crosswise films
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CRITIQUE IMAGESFOR POSITIONINGCOLLIMATION
CENTRAL RAY PLACEMENT
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Critique If taken for AP chest CR is lt too
cephalic moving clavicles above apex
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AP ChestCR too cephalic PT kyhphotic
need to change CRdirection to maintain - to
sternum
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Projection APCritique collimation not
centeredekg wires over chest
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CRITIQUESEE EARLIER IMAGES
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Lat gurney chest prop arms up withsponges get
ST of arms off ofchest
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CRITIQUESEE EARLIER IMAGES
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Also review images on first presentation

• Written test on Tues
• Lab on Thursday

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More pathology positioningWe will cover in
more detailin GI section
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Cecal volvulusLG bowel obstructioncritique
forpositioningand centering
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Toxicmegacolon
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Projection?Postion?
PA according to blocker Supine no air fluid
levels
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Projection?
AP
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Projection?
PA
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What is thisstep laddersign indicate for
pathology?Obstructionsee air-fluid levels
Position?Upright!
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Small bowel obstruction-remember toinclude all
areas of the abdomenwhat could have improved
this image?2 cross wise14 x 17
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Critique for positioning projection
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• AP Chest
• CR too low
• Collimation too open
• KVP too low too short of contrast

• Lat
• CR too forward
• Sit pt up more

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ProjectionAPPathology?COPD