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8Quinnipiac University Diagnostic Imaging

RS 211 Radiographic Positioning Laboratory

Lab One Chest Positioning


Identify and perform proper positioning for Chest radiography

including the following routine and additional views:


Postero-Anterior Projection (PA) routine view

PT placed PA against upright bucky

Shoulders rolled forward and depressed
Central Ray at MSP and T6/7
72 SID

Antero-Posterior projection (AP)

Done supine or semi-erect for patients who cant stand

Can be done portable or in department
Central ray 3-4 below jugular notch
Utilize 5 degree caudal angle

Lateral Projection (LAT) routine view

Left side against the bucky

Arms elevated above head
Patients feet shoulder with apart for balance
Can be performed with patient sitting

Apical Region 2 Methods:

1. Apical Region (AP Axial)
Patient AP
Tube angled 25-30 degrees cephalic
Central Ray at MSP and 2 inferior to Jugular notch
Increased collimation
2. Lindblom Method AP Lordotic
Instruct Patient to stand 6 away from upright unit
Assist patient to lean back until shoulders touch
Central Ray at MSP and 2 inferior to Jugular notch

Decubitus views

Alternate to erect when looking for air/fluid

Patient lies on side
Same centering as PA
If looking for air place the side of interest up
If looking for fluid place side of interest down

Oblique Views RAO/LAO

10-15 degree rotation (most common)

45 degree rotation
55-60 degree rotation

QUESTIONS: Be thorough in your answers

1. Why do we use 72 SID for Chest radiography?
-We use 72 SID for Chest radiography because we want to minimize magnification
of the heart.
2. What are the breathing instructions? Why do we use them?
-The patient should take in a full inspiration, exhale and then take another full
inspiration and suspend breathing on expiration. Radiograph should be taken on
second full inspiration. We use this technique to show the lungs as they appear fully
expanded and move the diaphragm down.
3. Why are the shoulders rolled forward and depressed for the PA projection? Be
-The shoulders are rolled forward to allow scapulae to move laterally clear of the
lung fields and the shoulders are depressed downward to move the clavicles below
the apices.
4. Give an example of a patient who would not be able to perform the Lindblom

-A patient that is weak and unstable would not be able to perform the Lindblom
5. Give an example of a pathology that would be best demonstrated on an AP
-A pathology that would best be demonstrated on an AP Axial would be a fracture or
dislocation of the clavicle.
6. An LAO would demonstrate which side of the thorax?
-An LAO would demonstrate the right side of the thorax
7. Suspicion of left sided pneumothorax. Patient unable to stand. Which
decubitus would best demonstrate the pathology?
-A right lateral decubitus would best demonstrate a possible left sided
pneumothorax because for a possible pneumothorax the affected side should be up.
8. Give two reasons why a physician may order a chest exam on a patient.
-A physician may order a chest exam on a patient to rule out possible pathologies,
such as Tuberculosis or a Pleural effusion. A physician may also order a chest exam
on a patient as a follow up exam, such as patients with Pneumonia.