Robert Trager (Cervical): patient <12cm no grid…………72040(3), 72050(5), 72052(7) View (series films)

Technique always exhale, hold

position & collimation Clinical

APLoC (3/5/7)

80 kVp, 100mA, 40” FFD, 15° cephalad tube tilt M: C3, CR: C3/C4 (thyroid cartilage) . 8x10 or 10x12 for cervicals. flash ↑ (away from lung apices)

APOM (transoral / peg/AP dens view) (3/5/7)

70 kVp, 100 mA, 40” FFD. M: C3, CR: C1/C2, uvula, midpoint of open mouth. ADD 30% to mAs due collimation. Open mouth variation: 3-5° cephalad tube tilt if incisors superimposed.

Otonello (wagging) add 2-4 kVp. Fuch’s method close mouth, elevate chin. Judd’s: PA mouth closed.Kasabach’s: rotate head. AA rotation fixation: lateral flexion, rotation, b/l (4 exposures)

Neutral Lateral Cervical (grandy) (3/5/7)

70kVp, 200 mA, 72” FFD, M: C7, CR: C3 just inf. to mandible. must see all seven! marker posterior

R/L Anterior Oblique (AO), (PO) (foraminal views) (5/7)

70 kVp, 200 mA, 72” FFD. 15° caudad (AO) 15° cephalad(PO) M: C7, CR: C3. marker under chin for AO, behind spine for PO

Flexion & Extension Lateral cervical (sagittal functional view, dynamic view, stress view) (7)

70 kVp, 200 mA, 72” FFD, M: C7, CR: C3 marker posterior to spine non-grid if possible. do NOT perform if fracture suspected!

Pillar (vertebral/neural arch projection)

70 kVp, 100 mA, 40”FFD, 35° tilt caudad (AP), 35° cephalad (PA) M: CR: C3. grid

(Thoracic): 72070(2): AP & lat. T-spine ,72072(3) w/ CT spot., 71010(1*): PA CXR, 71020(2*): PA& lat CXR, 71021(3*) = w/apical lordotic, 71022: w/obliques, 71030(>4): complete X-Ray view

Cassette, attentuation

Technique position & collimation Clinical

A-P Thoracic (spine) (2, 3) (scoliosis: do P-A to ↓ dose)

7x17 or 14x17” if scoliosis (V) compensating filter/upper ½ thorax

80 kVp, 300 mA, 40” FFD, anode towards head,. M: T6, CR: T6. inhale, hold. lateral view is MANDATORY if AP obtained

Lateral Thoracic spine (2, 3)

7x17 or 14x17” if ↑ kyphosis (V) compensating filter/lower thoracic

70-80 kVp (breathing), 90 kVp (not breathing) and w/ filtration .low mA (long time) high mA (short time). 40” FFD . M: axilla (arms raised). CR: T6 inhale, hold

PA Chest (1*, 2*) & expiration view

14x17 insight, (H) or (V) ½ lead apron (waist down)

110 kVp. 72” FFD (♥ mag!). exposure <0.1 sec (heart) . M: greatest diameter of chest. CR: film inhale, inhale hold

Lateral Chest (1*, 2*)

14x17” (V) insight grid ½ lead apron

110 kVp, 72” (♥ mag!) M: axilla, T6, CR: film inhale, inhale, hold

Chest: Lordotic (apical lordotic) (1*, 2*, 3*)

10x12 (apices) 14x17 (RML)

same as PA chest

Lateral C-T spot – Swimmer (3) (twining)

8x10 (V) compensating filter @ cervical

80 kVp, 300 mA, 40” FFD, none or 10° caudal, M: neck and shoulder, CR: sternal notch. Same Tx as lateral lumbar on Supertech

Ribs above diaphragm (AP, PA, obliques)

14x17” (V)

70 kVp 40” FFD M: AP chest @ CR. CR: area of complaint full inspiration. collimate to area of interest

ribs below diaphragm

10x12” (H) 90 kVp, 40” FFD full expiration

71100 ribs, unilateral, two views. 71101 includes PA chest, minimum 3 views, 71110 = ribs, bilateral, 3 views. 71111 includes posteroanterior chest, minimum 4 views

(Lumbar): 72100 (2):lumbosacral (AP and lateral), 72110 (>4) (AP, lateral, b/l obliques), 72114(6) including bending views (and AP, lateral, b/l obliques), 72120 (4*) lumbosacral, bending only X-Ray view Technique: all @ 40” position & collimation clinical/anatomical P-A Lumbar (2, 4, 6)

80 kVp, 300 mA, 40” FFD, M: @ L5-S1, CR: 2” superior to iliac crests, close to belly button. do NOT expose gonads. Film: 10x12”. Exhale and hold to raise diaphragm

Lateral Lumbar (2, 4, 6) & flexion extension, traction-compression

90 kVp, 40” FFD, 300 mA, M: @ L5-S1, CR: 2” superior to iliac crests, space btw. iliac crests & ribs Film: 10x12”. filter superior to diaphragm, SPs. Gonad Shield. Exhale, hold.

Lumbar Oblique (4, 6) (and angled spot oblique)

80 kVp, 40” FFD, M: @ L3, CR: L3, halfway between umbilicus & ASIS. Film: 10 x 12. don’t expose beyond umbilicus. exhale, hold.

lateral lumbosacral spot

80 kVp,300 mA, 40” FFD, M: 1” inferior to iliac crest, CR: 1 ½” inf. to iliac crest, @ mid-axillary line. Film: 8x10 or 10x12”

PA lumbosacral spot (ferguson)

80 kVp, 300 mA, 40” FFD 35° caudal (PA view) 35° cephalad (AP view) PA: M: CR: L4 SP (crest). M: CR: btw ASIS, pubic symphysis. Film 8x10, 10x12”. add 30-50% mAs due to collimation. subtract 10 from disc angle if lying down

AP Abdomen (KUB) Kidneys-Urinary Bladder

100 kVp standing ↑ mA, ↓ time, ↓ contrast, 40” FFD 70 kVp recumbent, ↓ mA, ↑ time, ↑ contrast, 40” FFD M: CR: iliac crest level gonad shield, filter for males exhale, hold. inhale if tall pt. Film 14x17”

standing-assess air-fluid levels or free intraperitoneal air

recumbent-small kidney stones

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