Anatomical Terminology • Anatomic position is a specific body position in which an individual stands upright with the feet parallel and flat on the floor. • The head is level, and the eyes look forward toward the observer. • The arms are at either side of the body with the palms facing forward and the thumbs pointing away from the body. Relative and Directional Terms of the Body

Relative to front (belly side) or back (back side) of the body : Anterior = In front of; toward the front surface Posterior = In back of; toward the back surface Dorsal =At the back side of the human body Ventral = At the belly side of the human body Relative and Directional Terms of the Body Relative to the head or tail of the body: Superior = Toward the head or above Inferior = Toward feet not head Caudal = At the rear or tail end Cranial = At the head end Relative and Directional Terms of the Body Relative to the midline or center of the body: Medial = Toward the midline of the body Lateral = Away from the midline of the body Deep = On the inside, underneath another structure Superficial = On the outside Relative and Directional Terms of the Body Relative to point of attachment of the appendage: Proximal = Closest to point of attachment to trunk Distal = Furthest from point of attachment to trunk Planes of the Body

• Three planes of the body are used extensively for descriptions of positioning both in plain X- ray imaging as well as other cross-sectional imaging techniques. Planes of the Body

• Three planes of the body are used extensively for descriptions of positioning both in plain X- ray imaging as well as other cross-sectional imaging techniques. Sections and Planes

•A coronal plane, also called a frontal plane, is a vertical plane that divides the body into anterior (front) and posterior (back) parts. Sections and Planes • A transverse plane, also called a cross-sectional plane or horizontal plane, cuts perpendicularly along the long axis of the body or organ separating it into both superior (upper) and inferior (lower) parts. • Median sagittal plane (MSP) divides the body into right and left halves con

• A sagittal plane in the body midline is a midsagittal plane. • A plane that is parallel to the midsagittal plane, but either to the left or the right of it, is termed a parasagittal (or sagittal) plane. • A minor plane, called the oblique plane, passes through at an angle. Body Regions • The human body is divided into two main regions, called the axial and appendicular regions. – the axial region includes the head, neck, and trunk which comprise the main vertical axis of our body – our limbs, or appendages, attach to the body’s axis and make up the appendicular region. POSITIONING TERMINOLOGY

• This section describes how the patient is positioned for the various radiographic projections POSITIONING TERMINOLOGY

• This section describes how the patient is positioned for the various radiographic projections Erect

• the projection is taken with the patient sitting or standing:. • supine (dorsal decubitus):patient lying on their back. • prone (ventral decubitus):lying face down. • lateral decubitus:lying on the side: right lateral decubitus – lying • on right side; left lateral decubitus – lying on left side. • Semi-recumbent:the patient is reclining, part way between supine and sitting erect. Trendelenburg* (tren-del′-en-berg)position

• A recumbent position with the body tilted with the head lower than the feet. Fowler’s† (fow′-lerz)position

• A recumbent position with the body tilted with the head higher than the feet. Lithotomy (li-thot′-o-me) position

• A recumbent (supine) position with knees and hip flexed and thighs abducted and rotated externally, supported by ankle supports Sims’ position (semiprone position) • A recumbent oblique position with the patient lying on the left anterior side, with the right knee and thigh flexed and the left arm extended down behind the back • All the positions may be more described by reference to the planes of the body. • For example, ‘the patient is supine with the median sagittal plane at right-angles to the table top’ or ‘the patient is erect with the left side in contact with the image receptor and the coronal plane perpendicular to the image receptor’. Terminology used to describe the limb position • Positioning for limb radiography may include: a description of the aspect of the limb in contact with the cassette; the direction of rotation of the limb in relation to the anatomical position, e.g. medial (internal) rotation towards the midline, or lateral (external) rotation away from the midline; the final angle to the cassette of a line joining two imaginary landmarks; the movements, and degree of movement, of the various joints concerned. • Extension: when the angle of the joint increases. •Flexion: when the angle of the joint decreases. • Abduction:refers to a movement away from the midline. • Adduction:refers to a movement towards the midline • Pronation:movement of the hand and forearm in which the palm is moved from facing anteriorly (as per anatomical position) to posteriorly. Supinationis the reverse of this. • Rotation:movement of the body part around its own axis,e.g. • medial (internal) rotation towards the midline, or • lateral(external) rotation away from the midline. Common Positioning orbitomeatal line

Landmarks coracoid process

manubrial notch

iliac crest symphysis

patella Common Projection Terminology

PA AP

LAT Oblique

A = Anterior (front) P = Posterior (back) Radiographic Projections

• Projection is a positioning term that describes the direction or path of the CR of the x-ray beam as it passes through the patient, projecting an image onto the IR. PROJECTION TERMINOLOGY

• Antero-posterior (AP)The central ray is incident on the anterior aspect, passes along or parallel to the median sagittal plane and emerges from the posterior aspect of the body.

AP • Postero-anterior (PA)The central ray is incident on the posterior aspect, passes along or parallel to the median sagittal plane and emerges from the anterior aspect of the body. PA • LateralThe central ray passes from one side of the body to the other along a coronal and transverse plane

LAT

Oblique • The central ray passes through the body along a transverse plane at some angle between the median sagittal and coronal planes. • Anterior ObliqueThe central ray enters the posterior aspect, passes along a transverse plane at some angle to the median sagittal plane and emerges from the anterior aspect. • Posterior ObliqueThe central ray enters the anterior aspect, passes along a transverse plane at some angle to the median sagittal plane and emerges from the posterior aspect.

• Beam angulation: Radiographic projections are often modified by directing the central ray at some angle to a transverse plane, i.e. either • caudally(angled towards the feet) or • cranially/cephalic (angled towards the head). • Lateral Oblique:The central ray enters one lateral aspect, passes along a transverse plane at an angle to the coronal plane and emerges from the opposite lateral aspect. Positioning aids: immobiliztion devices Positioning aids • Sandbags- compression bands Sandbag and head holder Gonadal shield Lead maker lead aprons Sponges- sandbages Summary of Potentially Misused Positioning Terms • The three terms position, projection, and view are sometimes confusing and may be used incorrectly in practice. These terms should be understood and used correctly. • Position Position is a term that is used to indicate the patient’s general physical position, such as supine, prone, recumbent, or erect. Position also is used to describe specific body positions by the body part closest to the IR, • Projection Projection is a correct positioning term that describes or refers to the path or direction of the central ray (CR), projecting an image onto an image receptor (IR). • View .View describes the body part as seen by the IR or other recording medium, such as a fluoroscopic screen

RADIATION PROTECTION

• minimize dose to patients and staff at various stages of the radiological examination. Patient ■ Explain the procedure to the patient and the need to keep still. ■ Make the patient comfortable. Other Staff and Carers ■ Only required staff in the X-ray room. ■ If supporting the patient, use lead protection Thank you