1 SKULL AP/LAT 8
2 PNS OM VIEW 15
3 C-SPINE AP/LAT 54
L/S SPINE AP/LAT 72
D/L SPINE AP/LAT 64
4 KUB AP 28
5 PELVIS AP 72
8 S I joint AP/LAT 9
S.N. Examination Requested Projection Total case Remarks
9 SHOULDER AP /AXIAL 51
10 SCAPULA AP 52
11 CLAVICLE AP 16
13 ELBOW AP/LAT 95
14 FOREARM AP/LAT 96
15 WEIST AP/LAT 99
1 SKULL AP/LAT 25
2 PNS OM VIEW 20
3 C-SPINE AP/LAT 54
L/S SPINE AP/LAT 65
D/L SPINE AP/LAT 34
4 KUB AP 52
5 PELVIS AP 33
8 S I joint AP/LAT 5
S.N. Examination Requested Projection Total case Remarks
9 SHOULDER AP /AXIAL 53
10 SCAPULA AP 15
11 CLAVICLE AP 13
13 ELBOW AP/LAT 36
14 FOREARM AP/LAT 25
15 WEIST AP/LAT 28
16 HAND AP/OBLIQUE 37
18 FEMUR AP/LAT 18
19 KNEE AP/LAT/SKYLINE 36
20 LEG AP/LAT 26
21 ANKLE AP/LAT 33
S.N. Examination Requested Projection Total case Remarks
22 FOOT AP/OBLIQUE 38
23 CALCANIUM AXIAL/LAT 25
24 IVU Control 12
Immediate
5min
15min
Full bladder
Post mict.
25 Lopogram Control 2
Injected after 100ml CM
Injected after again 200ml
CM
Injected after again 200ml
CM
Total 952
➢Critical
care(ICU
,NICU,PICU
and SICU)
➢Orthopedics and Trauma
care.
➢Radiology(CT scan ,USG
and Digital x-ray (CR
and DR) etc.
➢ This brand is
from Philips
➢ It is 16 slice CT
➢ Multi detector
➢ Supporting pads
➢ Philips computer
was conducted
S.N. Examination Requested Projection Total case Remarks
1 SKULL AP/LAT 12
2 PNS OM VIEW 8
3 C-SPINE AP/LAT 26
L/S SPINE AP/LAT 18
D/L SPINE AP/LAT 14
4 KUB AP 26
5 PELVIS AP 34
8 S I joint AP/LAT 2
S.N. Examination Requested Projection Total case Remarks
9 SHOULDER AP /AXIAL 15
10 SCAPULA AP 5
11 CLAVICLE AP 6
13 ELBOW AP/LAT 13
14 FOREARM AP/LAT 15
15 WEIST AP/LAT 12
16 HAND AP/OBLIQUE 10
20 LEG AP/LAT 16
21 ANKLE AP/LAT 13
22 FOOT AP/OBLIQUE 19
23 CALCANIUM AXIAL/LAT 14
24 IVU Control 9
Immediate
5min
15min
Full bladder
Post mict.
BA- ENEMA Control 8
Injected 50ml CM
Injected after 50ml CM
Injected after again
50ml CM
S.N. Examination Requested Projection Total case Remarks
BA-MEAL Control 5
Immediate
Supine Ap
RAO
LAO
Lateral
Tilted AP
Total 1180
NIRJALA GIRI
CERTIFICATE IN DIAGNOSTIC RADIOGRPHY
3rd YEAR
YHSA
22
The largest cavity of the body,
Bounded;
Anteriorly - by abdominal wall muscles
Posteriorly - by the vertebral column and posterior wall
muscles
Laterally - by lower ribs and parts of muscles of abdominal
wall
Superiorly - by the diaphragm
Inferiorly - by pelvic cavity
23
24
Occupied by the organs and glands of the digestive
which are listed below:;
The stomach , small intestine and most of the large
intestine.
The liver ,gall bladder , bile ducts and pancreases.
Other structures include:
The spleen
2 kidneys and the upper part of the ureters
2 adrenal(suprarenal) glands
Numerous blood vessels , lymph vessels, nerves
Lymph nodes
25
Fig: organs of anterior part of abdominal cavity
26
Fig: organs of posterior part of abdominal cavity
27
Divided into nine regions :
28
Careful preliminary patient preparation of the intestinal
and gastric contents is important for a clear view of all
the abdominal structures.
For non-acute conditions, patient preparation is as
follows:
(1) Patient placed on a low-residue diet for (2 days)
prior to x-ray examination to prevent formation of gas
due to excessive fermentation of the intestinal contents
(2) Patient should be instructed to take some laxative
the night before the examination.
29
One of the prime requisite in abdominal examinations
is the prevention of movement, both voluntary and
involuntary.
To prevent muscle contraction, the patient must be
adjusted in a comfortable position so that he can
relax.
A compression band may be applied across the
abdomen for immobilization but not compression.
The exposure should be made 1-2 sec after
suspension of respiration to allow involuntary
movement of viscera to subside.
30
In examinations of the abdomen without a contrast
medium, it is necessary to obtain maximum soft tissue
differentiation throughout its different regions.
Because of the wide range in thickness of the
abdomen and the delicate differences in physical
density between the contained viscera, it is necessary
to use a more critical exposure technique than is
required to demonstrate the difference in density
between an opacified organ and the structures adjacent
to it.
The exposure factors should thus be adjusted to
produce a radiograph with moderate gray tones and
less black and white contrast.
31
A sharply demonstrated outline of the psoas muscles,
lower border of liver, kidneys ribs and spinous
processes of the lumbar vertebra are the best criteria
for judging the quality of an abdominal radiograph.
32
Gonadal shields should often be used on males (upper
edge of the shield at the symphysis pubis). For
females, shields are used only where they could not
obscure essential anatomical structures (the lower
border of the shield should be at the symphysis pubis).
For potential early pregnancy, the ‘10-day Rule’ (the
LMP) must always be observed, unless permission has
been given by the medical specialist as to ‘ignore’ it,
e.g., in the case of an emergency (e.g., trauma), or in
case of a female with a removed uterus.
33
Basic : Antero-posterior – supine (KUB) (so named
because it includes the kidneys, ureters and bladder).
Alternative: Postero-anterior – prone
Supplementary: Antero-posterior –erect
Anteroposterior – left lateral
decubitus
Lateral
Lateral- dorsal decubitus
Anterior and posterior obliques ( for
contrast studies)
34
Bowel obstruction
Perforation
Renal pathology
Acute abdomen
Foreign body localization
Toxic megacolon
Aortic aneurysm
Control or preliminary films for contrast studies
Detection of calcification or abnormal gas collection
35
36
Patient position:
Patient supine, with the median sagittal plane at right angles
Pelvis adjusted so that the ASIS are equidistant from the table
Cassette placed longitudinally and positioned so that the symphysis pubis is
included
Arms placed alongside the trunk or above the head.
37
Centering of beam:
Vertical central ray directed approx. at the level of a point 1 cm
below the line joining the iliac crests.
Equipment setting: ( for screen film combination)
38
Picture criteria:
Whole of abdomen from upper abdomen to symphysis pubis.
Lateral abdominal wall and the properitoneal fat layer.
Psoas muscle, lower border of liver and the kidneys.
Ribs and spinous processes of the lumbar vertebra.
Whole of the urinary tract should be visualized.
Bowel gas pattern with minimal unsharpness.
39
40
When kidneys are not of primary interest, PA projection should be
used.
It reduces patient gonad dose compared to the AP projection
Patient position:
Patient prone, with median sagittal plane at right angles to the
table
Arms up beside the head and both legs extended
41
CR, equipment setting, picture criteria same as supine projection.
42
Position of patient:
Patient turned onto the side of examination,
with hands resting near the head. The hips and
knees are flexed for stability.
43
Centring of the beam:
Vertical central ray directed to the centre of the cassette
Equipment setting:
44
Picture criteria:
The prevertebral space along with abdominal aorta
Any other intra abdominal calcifications or tumour masses should
be clearly visible.
45
Patient position:
Patient stands with the back against the
vertical bucky.
Patient’s legs separated well apart to
maintain a comfortable position.
The median sagittal plane is adjusted at
right angles and coincident with the midline
of the table.
The pelvis is adjusted so that the anterior
superior iliac spines are equidistant.
46
Centring of beam:
The horizontal central ray is directed perpendicular to midpoint at
the level of iliac crests.
Equipment setting:
47
Picture criteria:
Both domes of diaphragm to ensure that any free air in the peritoneal
cavity is demonstrated.
Lateral abdominal wall and properitoneal fat
Psoas muscle, lower border of liver and kidney shadows
Vertebra in center of film.
Side identification marker placed properly.
48
Lateral decubitus is done instead of abdomen erect if
patient is unable to stand or sit.
Patient position:
Patient in lateral recumbent position
Elbows and arms flexed and hand resting near head
Cassette positioned in vertical bucky against the posterior aspect of the
trunk
49
Centring of beam:
The central ray is directed perpendicular to midpoint at the level
of iliac crest with x-ray tube horizontally.
Equipment setting:
50
Picture criteria:
Air fluid levels when an erect abdomen cannot be obtained.
Lung area above dome of diaphragm
Lateral abdominal wall and properitoneal fat
Psoas muscle, lower border of liver and kidney shadows
No rotation
51
52
Occasionally, the patient cannot sit or even be rolled on to the
side, in which case the patient remains supine and a lateral
projection is taken using a horizontal central ray.
Patient position:
Patient supine
Arms raised away from the abdomen and thorax.
Cassette positioned vertically against patient’s side
53
Centring of the beam:
The horizontal central ray is directed to the lateral aspect of the
trunk so that it is at right-angles to the cassette and centred to it.
Equipment setting:
54
Picture criteria:
Thorax to the level of mid-sternum and as much of the abdomen
as possible.
Pre-vertebral space for determining the air fluid levels in
abdomen.
Lung area above dome of diaphragm, without motion.
Patient elevated to demonstrate entire abdomen
55
Clark’s positioning in radiography, 12th
edition
Merrill’s atlas of radiographic positions and
radiologic procedures, 12th edition
Different other books and websites
56
THANK YOU
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