INSTRUCTION. Course Package RAD 110 RADIOGRAPHIC POSITIONING I APPROVED 12/02/2011 EFFECTIVE FALL MCC Form EDU 0007 (rev.

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1 RAD 110 RADIOGRAPHIC POSITIONING I APPROVED 12/02/2011 EFFECTIVE FALL

2 Prefix & Number RAD 110 Course Title: Radiographic Positioning I & Lab Purpose of this submission: New Change/Updated Retire If this is a change, what is being changed? Update Prefix Course Description Title Format Change Prerequisite Course Number Credits Competencies Textbook/Reviewed Competencies-no changes needed Does this course require additional fees? No Yes If so, please explain. Is there a similar course in the course bank? No Yes (Please identify) Articulation: Is this course or an equivalent offered at other two and four-year universities in Arizona? No Yes (Identify the college, subject, prefix, number and title: This course is offered in radiography programs in the state. Is this course identified as a Writing Across the Curriculum course? No Yes Course Textbook, Materials and Equipment Textbook(s) Title Radiographic Positioning and Related Anatomy Author(s) Bontrager, Kenneth L.; Lampignano, John P. Publisher Mosby Elsevier Barnes & Noble Price New Used Title Radiographic Positioning and Related Anatomy Workbook Volume One and Two. Author(s) Bontrager, Kenneth L.; Lampignano, John P. Publisher Mosby Elsevier Barnes & Noble Price New Used Title Radiographic Image Analysis Author(s) McQuillen Martensen, Kathy Publisher Saunders Elsevier Barnes & Noble Price New Used Software/ Equipment Course Assessments Description of Possible Course Assessments Exams and quizzes; Demonstrations, perform phantom positioning in radiographic procedures, image analysis, discussions, corrective actions of images, mid-term and final exams

3 Exams standardized for this course? Midterm Final Other Where can faculty members locate or access the required standardized exams for this course? Student Outcomes: Identify the general education goals for student learning that is a component of this course. Check all that apply: 1. Communicate effectively. a. Read and comprehend at a college level. b. Write effectively in a college setting. Are exams required by the department? No Yes If Yes, please specify: Final exam with multiple choice and fill in the blanks Pilot course exams: multiple choice from Registry Director of Radiologic Technology Office The ability to offer compassionate, clinically competent and professional care, applying the skills of positioning and technique; the student radiographer will be able to evaluate the resulting radiographic image for quality technical factors and collimation. Method of Assessment Mid-term and Final exam, blanks, multiple choice and matching 2. Demonstrate effective quantitative reasoning and problem solving skills. Demonstrations, simulations, sharing content, case studies, quizzes, exams; pilot exams from the Registry; group discussions in image analysis, film critique presentations, simulations, practice sessions 3. Demonstrate effective qualitative reasoning skills. Demonstrations, simulations, sharing content, case studies, quizzes, exams; pilot exams from the Registry; group discussions in image analysis, film critique presentations, simulations, practice sessions 4. Apply effective methods of inquiry. a. Generate research paper by gathering information from varied sources, analyzing data and organizing information into a coherent structure. b. Employ the scientific method. 5. Demonstrate sensitivity to diversity a. Experience the creative products of humanity. b. Describe alternate historical, cultural, global perspectives. The student listens attentively to the patient s concerns; and, professionally explains and helps the patient through the procedure with an understanding of cultural diversity, age-specific care, and a compassionate approach to patients with disabilities. In performance of the procedure in simulations and phantom positioning, the student demonstrates critical thinking, positioning skills, and professional competence.

4 COURSE INFORMATION Initiator: Maryann Shepherd Date of proposal to Curriculum Sub-Committee: December 2, 2011 Effective Semester/Year Prefix & Number: RAD Fall st Program Semester Full Title: Radiographic Positioning I and Lab Short Title: Positioning I and Lab Catalog Course Description: The student radiographer will be introduced to the principles of body planes and general positions to independently perform quality radiographs of the skeletal system for adult, pediatric and trauma patients; in the lab, the student radiographer will apply and integrate positioning skills, technical factors, and tube alignment for quality images. Credit Hours: 4 Lecture Hours: 3 Lab Hours: 3 Prerequisite: Admission to the Radiologic Technology Program Corequisite: RAD are in the same cohort and must be taken during the same semester. Intended Course Goals By the end of the semester, students will be able to: 1. Exercise the positioning principles of body planes and general positions to independently perform quality radiographs of the skeletal system 2. Competently and judiciously employ the principles of image quality, digital technology and radiation protection 3. Adapt to the patient s immobility and creatively reposition the equipment to achieve a quality radiograph 4. Assist in adapting interactions to meet cultural/psychological needs of people and function as a public-minded individual 5. Communicate effectively with the adult and pediatric patients 6. Use problem-solving and critical thinking skills for the exams learned 7. Comprehend the characteristics of an acceptable image, the necessity of detail, optimal procedural factors, and corrective actions 8. Apply and integrate positioning skills, technical factors, patient protection and tube alignment for quality images 9. Evaluate and demonstrate critical thinking skills and professional competency in employing alternative methods and procedural modifications for patients who are unable to be positioned according to standards 10. Adapt procedures, technical factors and tube angulation for trauma patients to obtain quality radiographs 11. Competently perform chest, abdomen, upper and lower extremity, shoulder girdle, pelvic girdle, pediatric x-rays and full spine radiographs

5 Course Competencies and Objectives By the end of the semester, students will be able to: Competency 1 Competently use the positioning principles of body planes and general positions Objective 1.1 Explain the concepts of general anatomy from cell structure to systems Objective 1.2 Identify the systems, the appropriate anatomy and physiology Objective 1.3 State the bone classifications along with bone composition and function Objective 1.4 Define the classification of joints Objective 1.5 Demonstrate the radiographic Objective 1.6 Communicate using the specific body positions and terminology Objective 1.7 Mark the radiographic image with the correct patient identification and positioning Competency 2 Competently and judiciously employ the principles of image quality, digital technology and radiation protection Objective 2.1 Evaluate image quality factors of density, contrast, resolution and distortion Objective 2.2 Critically apply corrective measures to acquire a quality radiographic image Objective 2.3 Apply anode heel effect and explain the purpose Objective 2.4 Explain the difference between density and contrast, along with the function of each Objective 2.5 Explain the correct use of grids and recognize grid cutoff Objective 2.6 Recognize motion on the radiograph, and evaluate the options for correction Objective 2.7 Employ effectively the controlling factors of SID, OID, OI receptor alignment, central ray alignment Objective 2.8 Apply exposure factors of milliamperage and kilovoltage effectively and produce an acceptable image Objective 2.9 Explain signal-to-noise ratio Objective 2.10 Accurately position the body part and effective apply the technical details of collimation, 30% rule, accurate centering, use of grids and exposure factors Objective 2.11 Competently apply ALARA principles and radiation protection Objective 2.12 Verify if any female patient s over the age of 12 are pregnant; follow appropriate clinical procedures if non-pregnancy cannot be confirmed Competency 3 Independently perform a quality radiograph involving the thorax Objective 3.1 State the radiographic anatomy and physiology of the bony thorax and respiratory system Objective 3.2 Position the patient for the posteroanterior (PA) chest x-ray, integrating technical factors, collimation, central ray (CR) and respiration Objective 3.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 3.2 Objective 3.4 Ability to adapt the objectives 3.2 and 3.3 for a sitting patient on a stretcher or in a wheelchair. Objective 3.5 Position the patient for the lateral chest x-ray, integrating technical factors, collimation, central ray (CR) and respiration Objective 3.6 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 3.5 Objective 3.7 Ability to adapt the objectives 3.5 and 3.6 for a sitting patient on a stretcher or in a wheelchair Objective 3.8 Ability to adapt PA and lateral radiographic skills to the anteroposterior (AP) projection, lateral decubitus position, AP lordotic projection, right anterior oblique (RAO) position, left anterior oblique (LAO) position, right posterior oblique (RPO position, left posterior oblique (LPO) position Objective 3.9 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 3.8 Objective 3.10 Position the patient for the AP and lateral upper airway, integrating technical factors, collimation, central ray (CR) and respiration Objective 3.11 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 3.10 Competency 4 Competently and independently perform quality radiographs involving the upper extremity to include the hand, wrist, forearm, elbow Objective 4.1 State the radiographic anatomy and physiology of the upper extremity Objective 4.2 Position the patient for the PA, oblique and lateral views for each finger, the hand, the wrist, forearm, elbow and distal humerus, integrating technical factors, collimation, central ray (CR) and respiration

6 Objective 4.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 4.2 Objective 4.4. Position the patient for the special views of the hand, thumb, wrist and elbow: Modified Robert s Method for the thumb, PA stress projection; extension and flexion lateromedial projection of the hand; AP oblique bilateral projection of the hand; PA scaphoid-hand elevated with ulnar deviation of the wrist; PA projection with radial deviation of the wrist; carpal canal views and carpal bridge views of the wrist; acute flexion and lateral views of the elbow. Objective 4.5 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 4.4 Competency 5 Competently and independently perform quality radiographs involving the humerus and shoulder girdle Objective 5.1 State the radiographic anatomy and physiology of the humerus and shoulder girdle Objective 5.2 Position the patient for the AP/PA, oblique, lateral, axial and tangential views for the humerus, shoulder girdle, clavicle, and scapula Objective 5.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 5.2 Objective 5.4 Position the patient for the special, nontrauma views of the humerus, shoulder girdle, clavicle and scapula: Lawrence Method and Clements Modification - inferosuperior axial projection of the shoulder (2); Hobbs modification - superoinferior PA transaxillary projection of the shoulder; Grashey Method for glenoid cavity; Fisk Modification for bicipital groove Objective 5.5 Position the patient for the trauma views of the humerus, shoulder girdle, clavicle and scapula: transthoracic lateral projection of humerus and shoulder; Neer Method for supraspinatus outlet; Garth Method for the shoulder. Objective 5.6 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 5.5 Competency 6 Competently and independently perform quality radiographs involving the toes, foot, ankle, lower leg, and knee Objective 6.1 State the radiographic anatomy and physiology of the lower extremity Objective 6.2 Position the patient for the AP< PA, oblique, lateral, axial and tangential views of the toes, foot, ankle, lower leg, and knee Objective 6.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 6.2 Objective 6.4 Position the patient for special views: sesamoids, weight-bearing of the foot; stress of inversion and eversion positions; Rosenberg Method PA axial weight-bearing bilateral knee projection; Camp-Coventry Method and Holmblad method; Beclere Method for intercondylar fossa; Merchant bilateral method for tangential patella; Hughston and Settegast Method for tangential patella. Objective 6.5: Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 6.4. Competency 7 Competently and independently perform quality radiographs involving the femur, and pelvic girdle. Objective 7.1 State the radiographic anatomy and physiology of the femur and pelvis girdle Objective 7.2 Position the patient for the AP, PA, oblique, lateral, axial and tangential views of the femur and pelvic girdle Objective 7.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 7.2 Objection 7.4 Position the patient for special views: Modified Cleaves Method of the pelvis; Taylor Method of the pelvis; Judet method of the pelvis; Teufel Method for the acetabulum; Danelius-Miller Method for the hip; modified Cleaves Method for the hip; Clements-Nakayama Method for the hip. Objective 7.5 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 7.4. Competency 8 Competently and independently perform quality radiographs involving the sternum and ribs Objective 8.1 State the radiographic anatomy and physiology of the sternum and ribs Objective 8.2 Position the patient for the AP, PA, oblique, and lateral views of the sternum and ribs Objective 8.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 8.2 Competency 9 Competently and independently perform quality radiographs of the abdomen Objective 9.1 State the radiographic anatomy and physiology of the abdomen, digestive system, and urinary system

7 Objective 9.2 Describe the four abdominal quadrants, nine abdominal regions and seven landmarks of the abdomen Objective 9.3 Evaluating whether to perform the abdominal series or the acute abdominal series Objective 9.4 Position the patient for the Abdominal series, acute abdominal series, AP upright and supine views, oblique, and lateral views of the abdomen and abdominal procedures Objective 9.5 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 9.3 and 9.4 Objective 9.6 Position the patient for special views: dorsal and lateral decubitus position Objective 9.7 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and stated in objective 9.6 Competency 10 Competently perform a mobile radiography exam bedside Objective 10.1 Drive the portable radiography unit and manipulate the locks and tube for positioning Objective 10.2 Inform the attending nurse of x-ray s arrival, and verify whether the patient can sit for the x-ray (chest) Objective 10.3 Verify the correct patient, and the correct radiographic examination Objective 10.4 If applicable, apply grid, markers and plastic cover Objective 10.5 Place the cassette under the correct body part, checking positioning and shadows for a quality radiograph Objective 10.6 Set the correct techniques and apply the inverse square law if necessary Objective 10.7 Shield the patient if applicable Objective 10.8 Put the lead apron on self Objective 10.9 Assess whether the patient can follow breathing instructions or observe the patient s breathing in order to perform the exposure during inspiration Objective Utilize the principles of time, distance and shielding during the exposure Objective Shield the patient appropriately and also alert other members in the vicinity of an x-ray exposure Objective Remove the cassette, attach the requisition to maintain the identity of the cassette, and return to the department to process the cassette Objective Prepare the radiograph for image control and PACS Objective Document and complete the exam Competency 11 Competently approach the pediatric patient with care and understanding before performing the appropriate pediatric radiographic series Objective 11.1 Apply superior performance in putting the child and family at ease through communication, explanation of the exam, and a pleasant attitude Objective 11.2 Explain radiographic procedures, special positions to patients/family members Objective 11.3 Modify directions to patients with various communication problems Objective 11.4 Self-initiate the proper immobilization techniques and invite the support of the parents Objective 11.5 Evaluate the proper positions and exposure adjustment according to pathologic indications Objective 11.6 Secure and place lead shield over the pelvic area, while shielding the parents with aprons and gloves Objective 11.7 Verify whether the mother or adult female holding the child is pregnant Objective 11.8 Verify if fasting procedures were followed before contrast studies Objective 11.9 Adapt radiographic and fluoroscopic procedures for special considerations Objective Explain the purpose for using contrast media Objective Name the type, dosage and route of administration of contrast media commonly used to perform radiographic contrast and special studies Objective Locate the anatomical structures demonstrated on routine radiographic and fluoroscopic images Objective Dismiss the patient, explaining the postprocedural indications and follow up Competency 12 Creatively radiograph trauma patients and adapt to their immobility Objective 12.1 Transform the routine positioning methods into procedures that adapt to the patient s immobility, by angling the tube, propping the cassette, and using immobilization tools Objective 12.2 Adjusting the technique for plaster and fiberglass casts Objective 12.3 Shield the patient appropriately and also alert other members in the vicinity of an x-ray exposure Objective 12.3 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and Competency 13 Understand the special considerations involved in mobile examinations Objective 13.1 Determine factors that contribute to the difficulty of mobile radiography Objective 13.2 Explain appropriate communications methods for mobile examinations

8 Objective 13.3 Describe items that must be considered when arranging a patient room for a mobile examination Objective 13.4 Recommend methods for accomplishing acceptable variations of standard radiographic, especially chest examinations, for air-fluid levels Objective 13.5 Assess the radiation protection rules for mobile radiography Objective 13.6 Differentiate light-duty portable x-ray units from full-power mobile units Objective 13.7 Evaluate the advantages of capacitor-discharge and battery-powered mobile units Objective 13.8 Explain why technical factor selection is more difficult during mobile radiography Objective 13.9 Describe the effect of various generator waveforms on kvp Objective Identify advantages of standardizing mobile SID to one of 40, 56 or 72 Objective Determine appropriate grids for mobile examinations Objective Appraise various image receptor systems for mobile applications Competency 14 Comprehend the characteristics of an acceptable image, the necessity of detail, optimal procedural factors, and corrective actions Objective 14.1 State the characteristics of an optimal projection Objective 14.2 Properly display of all body structures Objective 14.3 State the demographic requirements for and explain why this information is needed Objective 14.4 Discuss how to mark accurately and explain the procedure to be followed if a has been mismarked or the marker is only faintly seen Objective 14.5 Discuss why good collimation practices are necessary, and list the guidelines to follow to ensure good collimation Objective 14.6 Describe how positioning of anatomic structures in reference to the x-ray beam and image receptor affects how they are visualized on the image Objective 14.7 State how similarly appearing structures can be identified on images Objective 14.8 Determine the amount of patient or central ray adjustment required when poorly positioned projection are obtained Objective 14.9 Explain the procedural factors that affect the recorded detail sharpness of an image and how they are identified on the resulting image Objective Describe the radiation protection practices that are followed to limit patient does and discuss how to identify whether adequate shielding was used Objective Discuss the factors that affect radiographic density and contrast and state how they should be adjusted, and to what degree, when an image is produced that demonstrates poor density or contrast Objective List and describe the different artifact categories and discuss how they can be prevented Objective State the procedures to follow after an examination has been completed Objective Discuss the difference between an optimal and acceptable projection Objective List the guidelines for obtaining mobile and trauma and state how technical factors should be adjusted to adapt for different mobile and trauma-related conditions Objective Describe the differences to consider when performing procedures and evaluating images of pediatric and obese patients Competency 15 Utilize evidenced-based practice principles to improve image quality Objective 15.1 Explain the difference between screen-film radiography and digital imaging Objective 15.2 Describe the processing steps completed in computed radiography (CR) and direct-indirect digital radiography (DR) Objective 15.3 State why the exposure field recognition process is completed in CR and is not needed in DR Objective 15.4 Identify the areas of an image histogram and list the guidelines to follow to produce an optimal histogram Objective 15.5 Explain the relationship between the image histogram and the chosen lookup table in the automatic rescaling process Objective 15.6 List the CR exposure indicator parameters and discuss what they are and when they are useful to improve image quality Objective 15.7 State how the CR exposure indicators and the DR dose area product differ Objective 15.8 Compare the factors that affect spatial resolution between CR and DR systems Objective 15.9 Discuss how radiation dose is reduced using digital radiography Objective State the causes of overexposure and underexposure in digital radiography and the effect that each has on image quality

9 Objective Discuss the causes of a histogram analysis error Objective Describe the factors that affect contrast resolution in digital radiography Competency 16 Produce quality radiographs, problem-solve and analyze radiographs of the chest Objective 16.1Identify the required anatomy and describe the proper setup procedures for adult and pediatric chest and abdomen ; explain why each procedural step is required Objective 16.2 State the technical data, marking and displaying requirements for chest images Objective 16.3 List the image analysis requirements for accurately positioned adult and pediatric chest images Objective 16.4 State how to reposition the patient properly when chest with poor positioning are produced Objective 16.5 State how to position the patient and central ray to demonstrate air and fluid levels within the pleural cavity and when to expose chest images when the patient is unconscious or on a ventilator to obtain a fully aerated lung Objective 16.6 State the purpose and proper location of the internal devices, tubes, and catheters demonstrated on adult and pediatric chest images Objective 16.7 Describe how the chest dimensions change when the patient breaths and discuss how to determine whether full lung expansion is obtained on chest images Objective 16.8 Describe methods of identifying hemidiaphragms on chest images Objective 16.9 State why the kilovoltage peak (kvp) level used for mobile chest images is lower than that for routine chest images; discuss why a different kvp level is used when an image is taken to evaluate the patient s lung field versus the mediastinal region Objective Discuss how the patient is specifically positioned to rule out pneumothorax and pleural effusion on chest images Objective Explain how neonates lungs develop and change as they grow Competency 17 Integrate positioning, technical factors, and tube alignment for quality images of the upper extremity Objective 17.1 Identify the required anatomy on upper extremity Objective 17.2 Describe how to properly position the patient, image receptor (IR), and central ray on upper extremity Objective 17.3 List the image analysis requirements for upper extremity with accurate positioning Objective 17.4 State how to reposition the patient properly when upper extremity with poor positioning are produced Objective 17.5 State the kilovoltage that is routinely used for upper extremity, and describe which anatomic structures will be visible when the correct technique factors are used. Objective 17.6 Explain how a joint space is aligned with the central ray and IR to be demonstrated as an open space on an images Objective 17.7 List the soft tissue structures that are of interest and should be demonstrated on upper extremity ; state where they are located and describe why their visualization is important Objective 17.8 Explain how wrist and elbow rotations affect the placement of the radial and ulnar styloids, and radial tuberosity on upper extremity Objective 17.9 Describe the slant of the distal radial articulating surface Objective Discuss how a patient with large, muscular, or think proximal forearms should be positioned for good posteroanterior (PA) and lateral wrist to be obtained Objective State the carpal bone changes that occur when the wrist is extended, flexed, or ulnar- and radialdeviated in hand and wrist Objective Discuss how the degree of central ray angulation needs to be adjusted for the PA ulnar-deviated scaphoid position if a proximal or distal scaphoid fracture is in question Objective Describe what effect the anode heel effect has on forearm and humeral and discuss how to position the arm to take advantage of the anode heel effect Objective Explain how to position the patient to ensure that appropriate joints are included on forearm and humerus Objective State why the patient s humerus is never rotated if a humeral fracture is suspected Objective Explain when a grid is needed for humeral images and how the technique factors are adjusted when a grid is added Competency 18 Evaluate and process information of anatomy, positioning, technical factors and tube alignment for quality images on the lower extremity Objective 18.1 Identify the required anatomy on lower extremity images Objective 18.2 Describe how to properly position the patient, image receptor (IR), and central ray for lower extremity

10 images Objective 18.3 State how to properly mark and display lower extremity images Objective 18.4 List the image analysis criteria used to determine the accuracy of lower extremity images and state how to improve images when the criteria are not met Objective 18.5 List the image requirements for accurate positioning for lower extremity images Objective 18.6 Discuss how the degree of central ray angulation is adjusted for an AP axial foot projection and how the degree of obliquity is adjusted for an AP oblique foot projection in patients with high and low longitudinal arches Objective 18.7 Describe how the central ray angulation is adjusted when a patient is unable to dorsiflex the foot for an axial calcaneal projection Objective 18.8 Describe what effect the anode heel effect has on lower leg and femoral images and how the leg should be positioned to take advantage of it Objective 18.9 Explain how the central ray angulation used for AP and AP oblique knee is determined by the thickness of the patient s upper thigh and buttocks, and discuss why this adjustment is required Objective State how to determine what central ray angulation to use for an AP knee projection in a patient who cannot fully extend the knee Objective State which anatomic structures are placed in profile on AP oblique knee with accurate positioning Objective List the soft tissue structures of interest found on lower extremity images; state where they are located and why their visualization is important Objective State how the patient s knee is positioned for a lateral knee projection if a patella fracture is suspected Objective State the relationship of the medial and lateral femoral condyles, and describe the degree of femoral inclination demonstrated in a patient in an erect and recumbent lateral projection Objective State the femoral length and pelvic width that demonstrate the least amount of femoral inclination Objective Describe how patellar subluxation is demonstrated on a tangential knee projection Objective State the importance of securing the legs and instructing the patient to relax the quadriceps femoris muscles for a tangential knee projection Objective Explain how the positioning setup for a tangential knee projection is adjusted for a patient with large posterior calves Competency 19 Evaluate and demonstrate knowledge of anatomy, positioning, technical factors and tube alignment for quality images of the hip and pelvis Objective 19.1 Identify the required anatomy on hip, pelvis and sacroiliac joint Objective 19.2 Describe how to properly position the patient, image receptor (IR) and central ray for hip, pelvic, and sacroiliac Objective 19.3 List the requirements for accurate positioning for hip, pelvis and sacroiliac joint and state how to properly reposition the patient when less than optimal are produced Objective 19.4 List the soft tissue fat planes demonstrated on AP hip and pelvis, describe their locations, and discuss the importance of using a technique that adequately demonstrates them Objective 19.5 Explain how leg rotation affects which anatomic structures of the proximal femur are demonstrated on AP hip and pelvis Objective 19.6 Discuss why the leg of a patient with a proximal femoral fracture should never be rotated to obtain AP ad lateral, and state how these should be taken Objective 19.7 Define the differences demonstrated between the pelvic bones of female and those of male patients Objective 19.8 Describe how the anatomic structures of the proximal femur are demonstrated differently for AP oblique hip and pelvis when the distal femur is elevated at different angles to the imaging table Objective 19.9 Describe how to localize the femoral neck for an axiolateral hip projection Objective State which sacroiliac joint is of interest when the patient is rotated for AP oblique sacroiliac joint Competency 20 Evaluate and demonstrate knowledge of anatomy, positioning, technical factors and tube alignment for quality images of the sternum and ribs Objective 20.1 Identify the required anatomy on sternal and rib Objective 20.2 Describe how to properly position the patient, image receptor (IR), and central ray on sternal and rib Objective 20.3 State how to properly mark and display sternal and rib Objective 20.4 List the image analysis requirements for sternal and rib with accurate positioning and state

11 how to reposition the patient when less than optima are produced Objective 20.5 Describe how the patient is positioned to achieve homogeneous density on PA oblique sternal Objective 20.6 Explain why a 30-inch (76 cm) source-image receptor distance (SID) is used on PA oblique sternal Objective 20.7 Define costal breathing, and discuss the advantages of using it for PA oblique sternal Objective 20.8 Describe how thoracic thickness affects how far the sternum is positioned from the vertebral column when the patient is rotated Objective 20.9 List ways of reducing the amount of scatter radiation that reaches the IR when the sternum is imaged in the lateral projection Objective Discuss when it is appropriate to take an AP projection of the ribs rather than a PA projection and why the AP oblique projection is preferred over the PA oblique projection when the axillary ribs are imaged Competency 21 Evaluate and demonstrate knowledge of anatomy, positioning, technical factors and tube alignment for quality images of the abdomen Objective 21.1 Identify the required anatomy of the abdomen Objective 21.2 Describe how to properly position the patient, image receptor (IR), and central ray for abdominal Objective 21.3 State how to properly mark and display abdominal images Objective 21.4 List the image analysis requirements for abdominal with accurate positioning and state how to reposition the patient when less than optima are produced Objective 21.5 Analyze reasons for adjusting technique for specific conditions Objective 21.6 Explain the positioning, purpose and film quality of the left lateral decubitus projection Competency 22 Competently perform mobile radiographic images and trauma procedures Objective 22.1 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and Competency 23 Evaluate and demonstrate knowledge of anatomy, positioning, technical factors and tube alignment for quality images of children Objective 23.1 Describe how to properly position the pediatric patient, image receptor (IR), and central ray for Objective 23.2 Analyze reasons for adjusting technique for pediatric images Objective 23.3 Expend considerable effort in attempting to achieve optimal positioning Objective 23.4 Analyze the radiographic image for structures shown, positioning, collimation, CR, and exposure criteria for views and