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CHAPTER 1
PART 1
TERMINOLOGY AND
POSITIONING
1
GENERAL, SYSTEMIC,
AND SKELETAL
ANATOMY AND
ARTHROLOGY
2
Levels of Human Structural
Organization
3
Skeletal System
206 separate bones
Osteology-study of
bones
Arthrology-study of
joints
4
Circulatory System
Composed of:
 Cardiovascular Organs- heart, blood, and
blood vessels
 Lymphatic system- lymph nodes, lymph
vessels, lymph glands, and spleen
Functions:
1. Distribute oxygen and nutrients to cells
2. Transport cell waste and CO2
3. Transport water, electrolytes, hormones,
and enzymes
4. Protect against disease
5. Prevent hemorrhage by forming blood clots
6. Regulate body temperature
5
Digestive System
Composed of:
Alimentary Canal- mouth,
pharynx, esophagus, stomach,
small intestine, large intestine,
and anus
Accessory organs- salivary
glands, liver, gallbladder, and
pancreas
Functions:
1. Prepare food for absorption
by cells.
2. Eliminate waste.
6
Respiratory and Urinary Systems
Composed of:
 Nose, mouth, pharynx, larynx,
trachea, and bronchial tree
Functions:
1. Supply oxygen to blood and cells
2. Eliminate CO2 from blood
3. Regulate acid-base balance of
blood
Composed of:
 Kidneys, ureters, bladder, and urethra
Functions:
1. Regulate chemical composition
2. Eliminate many wastes
3. Regulate fluid and electrolyte balance and
volume
4. Maintain acid-base balance
7
Reproductive System
Male- testes, vas
deferens, prostate
gland, and penis
Female- ovaries,
uterine tubes,
uterus, and vagina
Make babies
8
Nervous and Muscular Systems
Composed of:
 Brain, spinal cord, nerves, ganglia, and
special sense organs (eyes, ears)
Functions:
1. Regulates body activities
Composed of:
 Skeletal, smooth, and cardiac muscles
Functions:
1. Allows movement
2. Maintains posture
3. Produces body heat
9
Endocrine and Integumentary Systems
Composed of:
Ductless glands of body (testes,
ovaries, pancreas, adrenals,
thymus, thyroid, pituitary)
Functions:
1. Regulates body via hormones
Composed of:
Skin, and all structure derived from skin
(hair, nails, sweat, and oil glands)
Functions:
1. Protects the body
2. Eliminates waste through
perspiration
10
Axial and Appendicular Skeletons
Total Adult Skeleton—206 Separate Bones
Axial skeleton (80 bones)
• Central axis of body
• Skull, vertebral column, ribs, and
sternum
Appendicular (*appendages*) skeleton
(126 bones)
• Limbs
• Shoulder and pelvic girdles
11
• Small, oval shaped bone
embedded in tendons
• Not part of axial or appendicular
skeleton, except for patellae
(largest sesamoids)
Sesamoid bones
12
Classification of bones (Osteology)
13
Long bone
Short bone
Flat bone
Irregular bone
Bone Development
14
Ossification- bone formation
• Intramembranous- replaces membranes
• Endochondral- replaces cartilage
Classification of Joints (Arthrology)
Functional-
• Synarthrosis- immovable joint
• Amphiarthrosis- joint with limited movement
• Diarthrosis- freely moveable joint
Structural-
• Fibrous joints- fibrous connective tissue, no cavity
• Cartilaginous- cartilage, no cavity
• Synovial- synovial fluid capsule, cavity
Fibrous Joints
(3Types)
16
Cartilaginous Joints
(2Types)
17
Synovial Joints
(7Types)
 Generally freely movable or
diarthrodial
18
Synovial Joints
MovementTypes
1. Plane (gliding)
2. Ginglymus
(hinge)
19
Synovial Joints
MovementTypes
3. Trochoid (pivot)
4. Ellipsoid
(condyloid)
20
Rotational movement
Flexion, extension, abduction,
adduction, circumduction
Synovial Joints
MovementTypes
5. Sellar (saddle)
6. Spheroidal (ball
and socket)
21
Flexion, extension, abduction,
adduction, circumduction
Flexion, extension, abduction,
adduction, circumduction, medial
and lateral rotation
Synovial Joints
Bicondylar
22
Single direction movement
with limited rotation
Quiz Me
Which of the following joints is classified as trochoidal?
A. Wrist joint
B. Metacarpophalangeal
C. Distal radioulnar
D. Shoulder
23
Quiz Me
Which of the following joints is classified as ellipsoidal?
A. Wrist
B. Interphalangeal
C. Ankle
D. Hip
24
Quiz Me
Which of the following joints is classified as bicondylar?
A. Metacarpophalangeal
B. First carpometacarpal joint
C. Proximal radioulnar joint
D. Knee
25
POSITIONING AND
TERMINOLOGY
26
GeneralTerms
 Radiography- process and procedures
to produce a radiograph
 Radiograph- image of patient anatomy
by x-ray
Radiograph vs. x-ray film
27
Radiographic procedure (examination)
1. Positioning w/IR
&CR
2. Apply protection
3. Select exposure
factors
4. Instruct patient
breathing
5. Processing IR
^you
Anatomic Position
28
Body Planes
Sagittal
(midsagittal)
Coronal
(midcoronal)
Oblique
Horizontal (axial)
29
Body Planes- Sectional Images
•Longitudinal- lengthwise
regardless of position of
body, may be taken in
either sagittal, coronal,
or oblique planes
•Transverse or Axial
Sections (Cross-
sections)- right angles
along the longitudinal
axis
30
SECTIONAL IMAGES
31
Sagittal Transverse (Axial) Coronal
Planes of Skull
32
Base plane aka Frankfort horizontal plane- infraorbital margins
to superior EAM; used in orthodontics and carnial topography
Occlusal plane- between closed jaw, c-spine and skull radiography
Posterior vs. Anterior
33
*Anatomic
position
views anterior
surface* Palmar Plantar
Dorsal Dorsal
PA (posterior to anterior)
Radiographic Projections
AP (anterior to posterior)
34
AP and PA Oblique Projections
35
Why?
DescribeThis Oblique
Projection
36
Mediolateral
Lateral Projections
Lateromedial
37
Why?
General Body Positions
38
Supine (dorsal recumbent) Prone (ventral recumbent)
General Body Positions
39
Trendelenburg Fowler
General Body Positions
40
Erect R lateral Recumbent L lateral
Modified Sims’ Position
41
Used for barium enemas, we’ll talk more about that later..
Oblique Positions
(Part of Body Closest to IR)
42
Decubitus (Decub) Positions
43
AP Left lateral decubitus
Dorsal andVentral Decubitus Positions
44
Left lateral dorsal decubitus
Axial (superoinferior)
projection
Special ProjectionTerms
AP axial (semiaxial)
projection
45
Which Projection IsThis?
46
Tangential Projections
47
Touches a curve
or surface at only
one point; skims
AP Lordotic
48
Ordered by doctor’s when TB cannot be ruled out
Right transthoracic lateral shoulder position
49
RelationshipTerms
Medial vs.
lateral
Proximal vs.
distal
50
Caudad and Cephalad CR Angles
51
RelationshipTerms
Superficial vs. deep
52
MovementTerms
Flexion vs.
extension
53
MovementTerms
Hyperextension vs. extension
54
MovementTerms
55
MovementTerms
Radial vs. ulnar deviation
56
Pee yuu
Dorsiflexion vs. Plantar Flexion
57
Stress Movements of Ankle Joint
Medial vs. Lateral Rotation
58
Abduction vs. Adduction
Supination vs. Pronation
MovementTerms
59
Rotation
TiltCircumduction
Terminology Review
Identify Position/Projection
60
Terminology Review
Identify Projection/Position
61
Terminology Review
1. A projection that merely skims a body part?
2. A projection in which the hand is pronated, then is rotated
laterally 45?
3. Cr directed towards the head?
62
Terminology Review
4. A specific oblique position in which the right anterior aspect of the
body is closest to the IR?
5. A body position in which the patient is lying on the abdomen with
the x-ray beam directed horizontally?
6. A general body position in which the head is lower than the feet?
63
64
Commonly Misused PositioningTerms
•RadiographicView- Describes the body part as seen by
the image receptor or other recording medium, such as a
fluoroscopic screen. Restricted to the discussion of a
radiograph or image.
•Radiographic position- Refers to a specific body position,
such as supine, prone, recumbent, erect, or
Trendelenburg. Restricted to the discussion of the
patient’s physical position.
•Radiographic Projection- Restricted to the discussion of
the path of the central ray.
ARRT, (2016). Radiographic examination content specifications, p.12
POSITIONING
PRINCIPLES
65
Positioning Accuracy
All pertinent anatomy
demonstrated
Multiple images aligned on
IR
Collimation
Rotation
Central ray (CR)
Goal is to not repeat, take
your time
66
Evaluation Criteria (Lateral
Forearm)
Anatomy demonstrated:
elbow and wrist joints
both included
Position: no rotation at
wrist and at elbow joints
Exposure: optimal
exposure factors
Image markers: “R”
marker visible
67
Essential IR Markers
68
Sample Procedure Markers
69
Positioning Rules and Principles
1. Minimum of two projections
• Anatomic structures superimposed
• Localization of lesions or foreign bodies
• Determination of alignment of fractures
70
Positioning Rules and Principles
2. Minimum of three projections when joints are in prime interest area
• AP or PA
• Lateral
• Oblique
71
Long Bones RequireTwo
Projections
72
Exceptions to Positioning Rules
Postreduction upper and lower limbs
Pelvis study projection unless a hip injury is suspected
Abdomen (KUB)
73
Placing Radiographs forViewing
 Patient facing the viewer
 Patient’s right to the viewer’s left
 Lateral projections
 Decubitus projections
74
Viewing Radiographs
 Limbs
• Anatomic position
 Hands and feet
• Digits up
75
PA chest (L appears reversed)
Viewing Radiographs
AP chest (L appears right-side-
up)
76
Left lateral decubitus chest
Viewing Radiographs
Left lateral chest
77
Viewing CT and/or MRI Images
Viewed as radiographs, patient’s right to viewer’s left
78Coronal Sagittal Transverse

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Procedures Ch 1(1)

Editor's Notes

  1. C. Distal radiolunar
  2. B. Interphalangeal
  3. D. Knee
  4. Image on right is Courtesy Joss Wertz, DO.