Chapter 15 part 2 trauma positioning
To ensure that the joints are open for an AP projection of the foot, how is the CR aligned?
10 posteriorly from perpendicular to the plantar surface
What projection of the ribs can be taken for the supine immobile patient who cannot be rotated into an oblique position?
30-40 degree cross angled mediolateral projection
T/F: a grid must be used with the AP axial trauma oblique projection of the C spine to reduce scatter radiation reaching the IR.
False
T/F: the CR should not exceed a 30 degree caudad angle for the AP axial projection of the cranium to avoid excessive distortion of the cranial bones.
False
What projection demonstrates the odontiod process for a trauma patient who is unable to open his/her mouth yet can extend the skull and neck?
Fuchs method
What are the two CR angles for the AP axial trauma oblique C spine?
45 degrees lateromedial and 15 degrees cephalad
Where is CR angled for trauma axiolateral elbow for radial head?
45 degrees toward shoulder
Which projections are taken for a post reduction study (casted) of the wrist?
PA and lateral
A patient with a possible potts fx enters er. Which positioning routine is performed?
AP and horizontal beam lateral lower leg
A patient with a possible dislocation of the patella enters er. What type of positioning routine should the tech do?
AP and horizontal beam lateral with no flextion of the knee
Which of the following is required for a postreduction study of the ankle?
AP and lateral
Which position will best demonstrate the pedicles of C2 on a severely injured patient?
AP axial trauma oblique
A patient with a possible barton fracture comes to radiology. Which positioning routine should be performed?
AP or PA and lateral wrist
Which projections of the skull will project the petrous ridges in the lower one third of the orbits on a supine trauma patient?
AP skull, CR 15 degrees cephalad to OML
A patient with a possible fracture of the proximal humerus enters the emergency room. Patient is unable to stand or sit. What positioning routine should be performed?
AP, horizontal beam transthoracic lateral or scap Y
A patient with a monteggia fracture enters the er. What positioning routine is performed?
PA or AP and horizontal beam lateral forearm
What can the tech do to demonstrate the dens of the cervical spine when the patient cannot open the mouth?
Align CR parallel to MML
An ortho surgeon orders a mortise projection of ankle, but patient cannot rotate ankle medially. What can the tech do?
Angle CR 15-20 lateromedially to the long axis of the foot
Patient with injuries from a motor vehicle accident comes to er. Physician orders a lateral C spine to rule out fracture or dislocation but c6-c7 is not visualized what additional projections can be taken?
Swimmers lateral
Patients enters er with possible radial head dislocation. The arm is immobilized with the elbow flexed at 90 degrees. Which projection best demonstrates the radial head free of superimposition of the ulna without having to extend the elbow?
Trauma axiolateral projection
T/F: AP projections of the skull and facial bones will increase exposure to the thyroid gland as compared with PA.
True
T/F: a PA horizontal beam projection of the elbow can be taken for a patient with multiple injuries.
True
T/F: for a trauma lateral projection of the elbow, the CR must be kept parallel to the interepicondylar plane.
True
What type of CR angle is required for the reverse caldwell projection of the cranium?
15 cephalad to OML
How much CR angulation should be used for an AP axial clavicle on a hypersthenic patient?
15 degrees
Which position can be used to replace the RAO sternum for the patient who cannot lie prone but can rotate into semi prone?
15-20 degree LPO
Patient with a crushing injury to the thorax enters the er on a backboard. What projection can be done to determine whether the sternum is fractured?
15-20 mediolateral angle and horizontal beam lateral
Minimum number of projections required for a postreduction study of the wrist?
2
A scap Y projection taken AP supine for trauma patient usually requires a ________ degree of rotation of the body away from the IR.
25-30
How much rotation of the body is required for a lateral scapula Y, AP oblique projection taken on a trauma patient?
25-30
What type of CR angulation is required for the trauma version of an axiolateral projection of the mandible?
25-30 cephalad, possibly 5-10 posterior to clear the shoulder
How much rotation of the body is required for a lateromedial scapula trauma patient?
25-30 or until CR can be projected parallel to the scapular blade
How is the CR centered and aligned in relationship to the sternum for an AP portable chest?
3-4 in below jugular notch perpendicular to sternum
Patient with possible C2 fx enters the er on a back board. The AP does not demonstrate C2. The patient cannot open his mouth. Which projection can be safely performed to demonstrate this region?
35-40 degree cephalad axial projection
Patient with a proximal fracture of the tib fib enters er. What position can be performed that would provide an unobstructed view of the fibular head and neck?
45 degree lateromedial cross angle AP
Where is CR angled for trauma axiolateral elbow for coronoid process?
45 degrees away from shoulder
To provide a lateral view of the proximal femur, what projection would be performed on a trauma patient?
Dan miller method
Which projection of the abdomen most effectively demonstrates a possible abdominal aneurysm?
Dorsal decub
Which projection will best demonstrate air fluid levels in the sinuses for a patient who cannot sit or stand?
Horizontal beam lateral
Patient with a possible basilar fracture enters er. Er physician wants a projection that best demonstrates sphenoid effusion. Which would achieve this goal?
Horizontal beam lateral skull
Which lateral projection would best demonstrate the mid to distal humerus without rotation the limb?
Horizontal beam lateromedial
Patient with possible dislocation of proximal humerus enters er. Patient is unable to stand or sit. What position demonstrates whether the condition is an anterior or posterior dislocation?
Horizontal beam transthoracic lateral
What is the disadvantage of performing a PA thumb rather than an AP thumb?
Increased OID of thumb
A 14x17 IR should be placed ___________________ for an AP portable chest on the average or large patient.
Landscape
How must the grid be aligned to prevent grid cutoff when angling the CR mediolaterally for an oblique projection of the sternum when the patient cannot be rotated or moved at all?
Landscape
On a horizontal beam lateral trauma skull projection the IR should be placed _____________________.
Landscape
How do we best visualize a compression fracture of the lumbar spine?
Lateral
How should the grid be for AP axial clavicle?
Lengthwise
Patient with possible ascites enters er. Patient cannot sit or stand. Which projection can be performed?
Left lateral decub
Which position or projection best demonstrates free intra abdominal air for the patient who cannot stand or sit erect?
Left lateral decub
Lateral elbow CR is ____________ to interepicondylar plane.
Parallel
Lateral humerus CR is __________ to epicondyles.
Parallel
How is the CR angled and where is it centered for the AP acanthioparietal (reverse waters) projection of the facial bones?
Parallel to mml CR @ acanthion
How is the CR aligned for a trauma lateral elbow?
Parallel to the interepicondylar plane
A patient with a possible greenstick fx enters er. What age group does this fx usually effect?
Pediatric
AP humerus CR is __________ to epicondyles.
Perpendicular
PA elbow CR is __________ to interepicondylar plane.
Perpendicular
How must the IR and grid be positioned for the inferosuperior axiolateral projection for the hip?
Perpendicular to the neck
A patient with a possible pleural effusion of the right lung enters the er. Patient cannot stand or sit. Which projection must be performed?
Right lateral decub
Which projection will best diagnose a hemothorax of right lung for patient who is unable to stand?
Right lateral decub
A patient is struck directly on the patella with a heavy object and the patella is shattered. The resultant fx would most likely be described as a?
Stellate fx
Why do we do landscape for AP chest?
To prevent the sides of the lungs from being cut off
What is the name of the device on the x-ray tube mount that permits compound angles of the x-ray tube?
Trunnion
Which technical factor does not apply to an AP axial trauma oblique projection of the C spine?
Use a grid
