here's a quick review on important positioning terminology that we'll be using throughout all of our positioning courses position versus projection these two words my students often kind of flip back and forth and mistake on a test or if it's asking you radiographic position that is specific to the position that the patient's body is in so supine prone recumbent erect trendelenburg something like that okay when it says projection this is the path of the central array so where the beam is entering and where the beam is exiting is the projection so here's some examples so pa posterior anterior the beam enters the posterior part of the body exits the anterior ap is the reverse enters anterior exit posterior axial it's going longitudinally along the long axis of the body and tangential is skimming between the body part or surface lying down positions if you see the word recumbent that simply means the patient is lying down it's not specifying um if they're on their back on their stomach that's where supine and prone comes in supine uh on your back looking up at the sun if you will supine prone face down on your stomach lying down with a tilt will either be your trendelenburg or your fowler so trendelenburg head is lower than feet and fowler's feet lower than head standing up these are pretty easy upright or erect your patient is vertical an anterior position means the anterior is touching the board in a posterior position posterior against the board do not confuse these with projection those are different terms lateral position so lateral can be recumbent or it can be upright the lateral is named by the side closest to the image receptor for position okay so we'll take this first picture here she's standing up her right side is against the wall stand here so this is a right lateral the patient lying down on the table here their left side is against the table this is a left lateral because it's on the table the image receptor is under the table so that's closest to the ir okay in these bucky trays is where your imaging plate will be so whatever side of the body is closest to the board that is the name of the lateral if it's asking you a lateral projection for an extremity watch the term projection right it's asking you traveling beam so for this ankle the beam is entering the medial part exiting the lateral so that's a medial lateral for the wrist or the hand they're doing a lateral hand here they're entering the lateral part of the hand exiting the medial oblique positions these can sometimes be a little confusing but let's keep it basic oblique simply means your patient is not facing straight on or they're not laying flat on their back they are turned to a certain degree sometimes it's going to be 15 degree turn sometimes it's going to be 45 all right but that oblique simply means they're not straight okay you can have anterior or posterior oblique options these images here i'm showing you anterior obliques and similar to that of a lateral the anterior oblique is named by whichever part is closer to the board so our young man here standing up against the wall stand his right shoulder the anterior part of his right shoulder is touching the imaging plate this is a right anterior oblique okay same with this young lady here she is laying down but her right side is closest to the table remember the imaging plate is under the table so again this is a right anterior oblique she's just laying down this image here is showing a left anterior oblique so the left shoulder is closer in the anterior is touching so left anterior oblique right anterior obliques okay whatever is closest to the image receptor the reverse is the posterior okay again they can be laying down they can be upright but a posterior oblique part of the back will be touching either left or the right okay she's laying down here the left side is closer than the right because she's rolled up to a certain degree here so left posture oblique again his left posterior part of his body is closer than the right here so this is an lpo again and over here this image is an rpo because the right side the right posterior is closer decubitus decubitus anytime you see this term uh usually match it up with the term horizontal beam what does that mean it means your beam isn't coming from the top anymore the patient most likely couldn't turn into a position that you need or we're looking for an air fluid level all right so the patient's either going to be supine or prone here for these dorsal and ventral decubitus so dorsal decubitus and remember the posterior part of the patient also can be referred to referred to as the dorsum all right so this is a dorsal decubitus because the back is down ventral's up there see the beam here is coming across as the horizontal beam this is a ventral decubitus the anterior portion is down horizontal beam ventral decubitus there's also lateral to cube and lateral decubitus is named by whichever side is down so your patient's either going to be ap or pa it actually doesn't matter there's going to be a horizontal beam so remember anytime you see that term horizontal beam it's going to be at a cube okay this lady right here is laying on her left side and there's a horizontal beam this is a left lateral decubitus okay we talk about side down for decubitus position most of the time we're looking for either air or fluid levels so for the abdomen here we look for free air and we'll see that on the right side of the abdomen so we want air to rise and we want to look at the right we'll get to that later on in the semester okay the position here he's pa his right side is down this is a right lateral decubitus this is for a chest and for chest we look for fluid so we would look side down but again we'll get there later in the semester okay so if it says your patient's in a lateral position there's a horizontal beam your answer is going to be decubitus okay and where anytime you see decubitus we're looking for an air fluid level okay projection remember this is the path of the beam so where is the beam entering where is it exiting um we talked about anterior and ap and pa okay so this is your pa entering pa exiting anterior hitting your image receptor ap hitting the anterior exiting posterior image receptor here this is an axial image here it's called it's also called an inferior superior because it's entering the inferior part of the shoulder it's going to exit the superior it's going longitudinal along the long axis of the body this patella image here is a tangential image because the central ray is skimming between the body part or surface it's trying to skim here and we're looking right through to this patella so that's standard tangential anatomical position every position uh that you'll talk about in radiology is reference back to this original anterior position or anatomical position where your patient is looking directly at you palms out facing front one thing i'd like you to go back and look over and this will be back from a and p for you guys is your body planes so know your sagittal mid sagittal coronal mid coronal transverse horizontal and oblique planes basic terminology right anterior ventral posterior dorsal we went through that a little bit but just remember anterior can also be termed ventral posterior can be dorsal proximal and distal um these will come into play a lot you'll hear this terminology especially in the or so proximal is closest to the midpoint of the body distal i always just think it's out closer to the digits it's out towards my finger so see in this picture here here's proximal out towards the fingers is distal so if your surgeon tells you to move more distal and you're doing a humerus you're going to move down towards the elbow you're going to move in this direction if they ask you to move more proximal you're going to move closer to the midline surface landmarks these you're going to see a lot of over our entire program and they're going to be on your board exam so do me a favor i would make a flash card or a list of these to practice and these are a memorization okay memorize the landmark and sort of the level so where's the mastoid tip it's at c1 where is the iliac crest is that l45 those okay go for go through those for me body habitus body habitus can sort of make adjustments on where the anatomy will be found right depending on the shape of the stomach the location of the gallbladder you know those kind of things so most the ones you're going to hear are aesthetic or hypothetic or hyper aesthetic so i'd like you to know the difference between these okay those could be a flash card too two bangles if we're angling our tube towards the head we're gonna be a cephalad angle so you can see this arrow was coming up towards the head this one here up towards the head of cephalad down towards the feet is a coddle angle or caudad you might see both you might see that in the or2 they ask you to angle your c arm cephalad or caudad okay more terms internal rotation external well wherever the part is normally rotated out to the outside is external and is internal those aren't too hard for the hand pronation supination the only way i remember this is um someone once told me to pretend you're holding a cup of soup and that is supination with your palm up see if that helps anybody abduction versus adduction abduction is a way adduction towards and i was i was always told think of adduction you're adding to add add bringing in towards the body again if that helps anybody these were some terms that i just um wanted to collect for you too and i'm sure you um sell almost all of these as part of your a p one or two um but you're gonna wanna review these terms because you're gonna see these a lot over positioning time together