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ABD & CHEST 2

Rt 124 – Spring Image Review pt 2. ABD & CHEST 2. 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. Projection ? AP.

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ABD & CHEST 2

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  1. Rt 124 – Spring Image Review pt 2 ABD & CHEST 2

  2. 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

  3. Projection ?AP

  4. Projection ?AP –AXIAL (APICAL LORDOTIC

  5. Projection ?PANote Pathology –Rt middle lobeLt lower lobeatelectasis

  6. Projection ?APREMEMBER TO MOVE CARDIACMONITOR WIRES OUT OF THE WAYPathologynote bilateraleffusion both bases

  7. PROJECTION?AP

  8. LAT UPRIGHTON GURNEYNOTE AIR /FLUID LEVELSNote poor positioning ofCR to part(cr too low & too anterior – not at mcp

  9. Position ?Projection?AP semi uprightnote – fluid levels in RT lung what else is needed?Decubs –for fluid levels

  10. 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

  11. 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

  12. BILATERAL DECUBProjection? PA AP LLD RLD

  13. PROJECTION?POSITION?GO BACK AND CHECK PREVIOUS SLIDE

  14. PROJECTION?POSITION?GO BACK AND CHECK PREVIOUS SLIDE

  15. ABDOMEN- SUPINE – UPRIGHT - LLD

  16. KUBWHAT IS THE CRITIQUE TO JUDGE PROPER TECHNIQUE?

  17. Upper abd - should center higher to include more diaphram

  18. Centering better for upper abd – should put blocker down – to keep out of diaphram area

  19. Supine KUB –what are the white dots?Residual barium

  20. KUB –POST CT SCANRESIDUAL CONTRAST IN COLON AND KIDNEYSDARK LINE ACROSS ABDOMEN???FROM COMPRESSED SOFT TISSUE –TIGHT WAISTBAND OF CLOTHING

  21. Case example of SUPINE – upper & KUB Upright Should have collimated to upper abd – not exposed lower abd twice (repeated – diaphram clipped)

  22. KUBFLAT PLATESUPINE ABDINCLUDESENTIRE ABD(TAKEN AT 48” SID)

  23. POSITION?UPRIGHTPROJECTIONPA – WHAT ELSE?BLOCKER PLACEMENT & CLOTHING

  24. KUBSUPINE

  25. UPPER ABDSUPINENOTE PATHOLOGY (GB STONES)

  26. UPRIGHT ABDCRITIQUEWHAT IS THE DARK LINE IN THE CENTER

  27. PATHOLOGY&Positioning

  28. Obstructionlg bowel

  29. Example:may need4 films inquadrantto include allof abd structures(obstruction)

  30. Free air in the abdomen

  31. Position?Look at air/fluid levels

  32. LEFT LAT DECUB

  33. Need at least 2 crosswise films

  34. CRITIQUE IMAGESFOR POSITIONINGCOLLIMATION &CENTRAL RAY PLACEMENT

  35. Critique: If taken for AP chest –CR is < too cephalic – moving clavicles above apex

  36. AP ChestCR – too cephalic PT kyhphotic –need to change CRdirection to maintain ┴ to sternum

  37. Projection – APCritique –collimation not centeredekg wires over chest

  38. CRITIQUESEE EARLIER IMAGES

  39. Lat gurney chest prop arms up withsponges get ST of arms off ofchest

  40. CRITIQUESEE EARLIER IMAGES

  41. Also review images on first presentation Written test on Tues Lab on Thursday

  42. More pathology& positioningWe will cover in more detailin GI section

  43. Cecal volvulusLG bowel obstructioncritique forpositioningand centering

  44. Toxicmegacolon

  45. Projection?Postion? PA – according to blocker Supine – no air fluid levels

  46. Projection? AP

  47. Projection? PA

  48. What is thisstep laddersign indicate for pathology?Obstructionsee air-fluid levels Position?Upright!

  49. Small bowel obstruction-remember toinclude all areas of the abdomenwhat could have improved this image?2 cross wise14 x 17

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