ANTERIOR OBLIQUE POSITION - RAO AND LAO: CHEST

Tuesday, December 6, 2011

Pathology Demonstrated:

  • Pathology involving the lungs fields, trachea, and mediastinal structures, including the size and contours of the heart and great vessels.

Technical Factors:
  • IR size - 35 x 43cm (14 x 17 inches), lengthwise
  • Moving or stationary grid
  • 110 to 125 kV range

Shielding:

  • Secure lead shield around waist to shield gonads.


Patient Positions:

  • Patient erect, rotated 45degrees with left anterior shoulder against IR for the LAO and 45degrees with right anterior shoulder against IR for the RAO (see note below for 60degrees LAO)
  • Patient's arm flexed nearest IR and hand placed on hip, palm out
  • Opposite arm raised to clear lung field and hand rested on head or on chest unit for support, keeping arm raised as high as possible
  • Patient looking straight ahead; chin raised


Part Position:

  • As viewed from the x-ray tube, center the patient to CR and to IR, with top of IR about 1inch (2.5cm) above vertebral prominens.


Central Ray:

  • CR perpendicular, directed to level  of T7 (7 to 8 inches [8 to 10cm] below level of vertebral prominens)
  • SID of 72 inches (180cm)


Collimation:

  • Collimate to area of lungs.


Respiration:

  • Make exposure at end of second full inspiration.


Note:

  • For anterior obliques, the side of interest generally is the side farthest from the IR. Thus the RAO will provide best visualization of the left lung.
  • Certain positions for studies of the heart require an LAO with an increase in rotation to 60degrees.
  • Less rotation (15 to 20degrees) may of value for better visualization of the various areas of the lungs for possible pulmonary disease.


Exception:

  • Either erect or recumbent posterior obliques can be taken if the patient cannot assume an erect position for anterior obliques, or if supplementary projections are required.

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