Chapter 4 procedures and hand positioning
What should be removed from the anatomy of interest Artifacts such as watches, rings, and bracelets.
before an x-ray?
How should patient possessions be handled during x-ray They should be secured in a designated manner and location.
procedures?
What is the general position for ambulatory patients during Seated at the end of the x-ray table with the affected limb resting on the IR placed
x-ray? on the tabletop.
What should be done to maximize comfort for Alter their positioning as needed.
nonambulatory patients?
Why is collimation critical in x-ray procedures? It ensures ethical radiation protection, optimum image quality, and allows accurate
exposure indicator information.
What is the recommended SID for x-ray procedures? 40 inches (102 cm).
Are breathing instructions required for digit, hand, and No, breathing instructions are not required.
wrist procedures?
What must be visible on the x-ray for proper identification? Patient ID and side marker; within collimated field
What should be avoided when using digital x-ray systems Avoid using annotation to place side markers.
regarding side markers?
What is the protocol for radiation protection during x-ray Shield patients according to local regulations and department policy.
procedures?
What are two radiation protection measures? Close collimation and optimum technique.
What are the key exposure factors for trauma patients? Part parallel to IR, CR 90° to part and IR, low to medium kVp (60-80), short
exposure time, small focal spot, adequate mAs, and evaluate the exposure.
Image receptors for upper extremities? typically non-grid for body part smaller than 10cm
Biggest concern for pediatric patient? reducing motion; use immobilization devices
Biggest concern for geriatric patients? not understanding, use clear and complete instructions; cognitive reflexes are
slower with age
, Chapter 4 procedures and hand positioning
What do we do if a mom wants to stay in room with child? Ask if pregnant; if so try and substitute person, ask her to fill out a pregnancy form
and screen for pregnancy
Minimum number of trauma views? AP and Lateral view
What is the recommended IR size for finger projections? 8 x 10 inches.
What are the three positioning principles for imaging? Part should be parallel to the plane of IR, CR should be 90 degrees to the part and
IR, and CR should be directed to the correct centering point.
What is the purpose of accurate centering in imaging? It avoids size and shape distortion, helps demonstrate joint spaces, and assists with
image processing.
Acceptable S-number 100-300
Overexposed S-number under 100
Underexposed S-number over 300
Deviation index a value that reflects the difference between the desired or target exposure to the IR
and the actual exposure to the IR
Perfect deviation index 0
Accurate centering -avoid size and shape distortion
-help demonstrate joint spaces
-also assist with the ways the computer processes images
shape distortion elongation and foreshortening
size distortion magnification
Three positioning principles 1. Part should be parallel to plane of IR
2. CR should be 90 degrees to part and IR
3. CR should be directed to correct centering point
Finger projections for digits 2-5 PA, Lateral, PA oblique
What should be removed from the anatomy of interest Artifacts such as watches, rings, and bracelets.
before an x-ray?
How should patient possessions be handled during x-ray They should be secured in a designated manner and location.
procedures?
What is the general position for ambulatory patients during Seated at the end of the x-ray table with the affected limb resting on the IR placed
x-ray? on the tabletop.
What should be done to maximize comfort for Alter their positioning as needed.
nonambulatory patients?
Why is collimation critical in x-ray procedures? It ensures ethical radiation protection, optimum image quality, and allows accurate
exposure indicator information.
What is the recommended SID for x-ray procedures? 40 inches (102 cm).
Are breathing instructions required for digit, hand, and No, breathing instructions are not required.
wrist procedures?
What must be visible on the x-ray for proper identification? Patient ID and side marker; within collimated field
What should be avoided when using digital x-ray systems Avoid using annotation to place side markers.
regarding side markers?
What is the protocol for radiation protection during x-ray Shield patients according to local regulations and department policy.
procedures?
What are two radiation protection measures? Close collimation and optimum technique.
What are the key exposure factors for trauma patients? Part parallel to IR, CR 90° to part and IR, low to medium kVp (60-80), short
exposure time, small focal spot, adequate mAs, and evaluate the exposure.
Image receptors for upper extremities? typically non-grid for body part smaller than 10cm
Biggest concern for pediatric patient? reducing motion; use immobilization devices
Biggest concern for geriatric patients? not understanding, use clear and complete instructions; cognitive reflexes are
slower with age
, Chapter 4 procedures and hand positioning
What do we do if a mom wants to stay in room with child? Ask if pregnant; if so try and substitute person, ask her to fill out a pregnancy form
and screen for pregnancy
Minimum number of trauma views? AP and Lateral view
What is the recommended IR size for finger projections? 8 x 10 inches.
What are the three positioning principles for imaging? Part should be parallel to the plane of IR, CR should be 90 degrees to the part and
IR, and CR should be directed to the correct centering point.
What is the purpose of accurate centering in imaging? It avoids size and shape distortion, helps demonstrate joint spaces, and assists with
image processing.
Acceptable S-number 100-300
Overexposed S-number under 100
Underexposed S-number over 300
Deviation index a value that reflects the difference between the desired or target exposure to the IR
and the actual exposure to the IR
Perfect deviation index 0
Accurate centering -avoid size and shape distortion
-help demonstrate joint spaces
-also assist with the ways the computer processes images
shape distortion elongation and foreshortening
size distortion magnification
Three positioning principles 1. Part should be parallel to plane of IR
2. CR should be 90 degrees to part and IR
3. CR should be directed to correct centering point
Finger projections for digits 2-5 PA, Lateral, PA oblique
