RadPos

5/25/99

Pillar view

• mandible blocks so not able to get both sides on one film

• have to take one on each side
• crush fracture on the pillar of the cervical spine
• 35° angle when lying on the table

Thoracic Spine

• 7x17 film—do not use necessarily if have scoliosis
• A-P—collimate to the area (T1-where traps meet the neck)
• middle of sternum is middle of thoracic spine—central ray
• filter the top of the beam
• thickest part to upper thoracic spine
• thinner part to lower part to mid thoracic spine
• filter will block part of the beam

• breathing—take a deep breath and hold it—enables to see all of thoracics
• lateral—same height—just have pt rotate
• broaden beam to account for kyphosis
• spine is in the back half of the body—don't need the entire chest cavity
• mid-axillary line to the posterior of the soft tissue
• try to get the shoulders out of the way—put hands palm to palm straight out and drop them down
• filter the bottom half of the beam
• use 90 kVp (supertech says 80)
• take deep breath and hold it

Lumbar

• L1-L5
• lie down and bring up their knees—done in hospitals
• lumbo-pelvic
• 14x17—collimate to entire film
• palpate to top of iliac crest
• cross ray one inch below—w/normal lordosis
• have no lordosis and pelvis tucked up—central ray at the crest
• heart shield should be placed in the beam w/a little light below the point of the heart
• male shield should be below the light to protect the testes
• 95% of chiropractic x-rays should use the shields because not looking for fractures tumors, dislocations, and such—looking for subluxations
• works for people up to about 6ft 2
• include ischial tuberosity and take the chance of cutting off L1 and maybe L2
• if cut off the top take a spot shot on the top
• exhale completely and don't breathe in

• 14x17 for hyperlordosis or obese
• 7x17 for thin pt's
• central ray an inch above the iliac crest
• not looking for ischial tuberosity
• very small amount of light going through the lumbar lordosis
• cross arms in front of chest so they are not near the abdomen
• use filter to cut off one upper corner
• spinous filter to cover light beyound the lordosis—match to skin surface
• compensate for the fact that L5 sits b/w the two ilium—filter to protect L1-L4