NEW YORK CITY COLLEGE OF TECHNOLOGY THE CITY UNIVERSITY OF NEW YORK. Department of Radiologic Technology & Medical Imaging

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1 NEW YORK CITY COLLEGE OF TECHNOLOGY THE CITY UNIVERSITY OF NEW YORK Department of Radiologic Technology & Medical Imaging RAD 1125 (REVISED 9/1/15) Section D806: Monday, 10:00am to 11:15am Radiographic Procedures I Course Outline / Outcomes Semester: Fall, 2015 Professor Jennett M. Ingrassia, MSRS, RT(R) Room: P jingrassia@citytech.cuny.edu Office hours: Tuesday, 10:00am to 11:00am Wednesday, 9:00am to 10:00am Note: All other course related documents can be found on Blackboard.

2 New York City College of Technology / CUNY Department of Radiologic Technology and Medical Imaging Fall, 2015 COURSE: RAD 1125, Section D806 (1.5 cl. hrs., 1.5 lab hrs, 2 crs.) Monday, 10:00am to 11:15am INSTRUCTOR: Jennett M. Ingrassia, MSRS, RT(R) jingrassia@citytech.cuny.edu OFFICE: P513 PHONE: OFFICE HOURS: Tuesday, 10:00am to 11:00am Wednesday, 1:00pm to 2:00pm (or by appointment) COURSE DESCRIPTION: This course introduces the student to basic radiographic positioning and related anatomy with emphasis on the skeletal system and extremities. In the laboratory, students develop positioning skills needed for clinical practices. PREREQUESITES: None COREQUESITES: RAD 1124, RAD 1126, RAD 1127, RAD 1128, BIO 2311 GENERAL COURSE OBJECTIVES: Upon completion of RAD 1125 the student should be able to: 1. Describe the responsibility of the radiographer in obtaining optimal radiographic images. 2. Explain standard positioning terms 3. Differentiate between position, projection and view 3. Summarize all general considerations concerning patient care needed to obtain a radiographic image. 4. Identify all pertinent anatomy for chest, abdomen, upper and lower extremities, pelvis, hip and and bony thorax. 5. List and describe positions for obtaining images chest, abdomen, upper and lower extremities, pelvis, hip and pelvis. 6. Demonstrate positioning for the chest, abdomen, upper and lower extremities, pelvis, hip and ribs to include proper collimation, central ray, marker use and placement and radiation protection. 7. List and identify structures to be demonstrated on each view of the chest, abdomen, upper and lower extremities, pelvis, hip and ribs. 8. List image evaluation criteria and critique routine views for the chest, abdomen, upper and lower extremities, pelvis, hip and ribs for proper positioning.

3 REQUIRED TEXTBOOKS: NOTE: It is imperative that you purchase all required textbooks with the most up to date edition. ***ALL CURRENT TEXTBOOKS FOR THIS COURSE ARE IN THE 13TH EDITION*** 1. Long, Rollins and Smith, Merrill s Atlas of Radiographic Positioning & Procedures, Volume I, 13th edition. Mosby, St. Louis, MO, ISBN# Long, Curtis and Smith, Workbook for Merrill s Atlas of Radiographic Positioning & Procedures, Volume I, 13th edition. Mosby, St. Louis, MO, ISBN# Long, Curtis and Smith, Merrill s Pocket Guide to Radiographic Positioning & Procedures, 13th edition. Mosby, St. Louis, MO, ISBN# COURSE REQUIREMENTS: This course includes lecture and laboratory practice in addition to required reading assignments. Students must participate in all scheduled quizzes and examinations. COURSE GRADING: Coursework will be weighted as follows: 1. Quizzes 20% (includes both lecture and laboratory quizzes and mandatory 1 hour per week open lab attendance, and additional assignments) 2. Midterm 30% 3. Final Exam 50% Total 100% Quizzes There will be a total of five quizzes, both on lecture and laboratory material given as noted on the schedule. Quizzes will be related to the information given in the previous classes. There will be no make-up quizzes. Students who arrive late to class will only be given the remaining allotted time to complete the quiz. Open Lab Requirement Open lab attendance is mandatory and will count as one (1) quiz grade. All students are required to attend the open lab to practice procedures taught in the lab, at least 1 hour per week. Students MUST sign in to be recorded as present. There will be ABOLUTLEY NO EXCEPTION to this policy. Open lab sessions will be announced and posted by the third week of the semester. It is strongly recommended that students attend sessions in excess of the minimum required one hour per week amount. For clarification of this requirement: 1. All students are required as part of their grade to attend the open lab at least one hour per week to receive full credit for the semester. For example, if you only attend the open lab for 45 minutes, your grade for the week is 75% and attend for the full hour, your grade will be 100% for the week. All weeks' grades will be averaged at the end of the semester and the final grade will count as one quiz grade. It will average in with lecture and lab quizzes which overall, count for 20% of your grade. There will be no deviations from this requirement for any reasons, whatsoever. 2. Although it is extremely beneficial to do so, additional time spent in the lab in excess of one hour per week will not count toward your overall grade. For example, if you did not spend any time in the open lab for Week 4, yet spent two hours in the lab for Week 5, your requirement for Week 4 would still not have been met and would result in a grade of zero for week 4, yet you would have received full credit for 1 hour for week 5. In other words, you can not make up time in the open lab for missed minutes or the full hour.

4 3. As stated in the Syllabus, to receive any credit at all, you must sign in by placing your initials next to your name. Failure to do so, will result in non-attendance. 4. When signing up initially, please write both your first and last name and please write legibly. The reason for this course requirement is for you to be consistent in your practice of procedures taught in this course. Students should do the best that you can to not only meet the minimum requirements for Open Lab, but to exceed them, if at all possible. The more practice obtained in a simulated environment, the more improved the clinical experience will be next semester. The goal is for students to be knowledgeable about procedures, and comfortable with equipment and communication skills for proper patient care. Midterm Examination and Final Examination Both the midterm and final examinations will be comprehensive and completely in multiple choice format. Testing Policy Students will be given one hour for all lecture quizzes and the midterm. All scantrons must be completely filled out within that time period. STUDENTS WILL NOT BE GIVEN EXTRA TIME TO TRANSFER ANSWERS FROM THE TEST FORM ONTO THE SCANTRON ANSWER SHEET. ALL ANSWERS NOT COMPLETED ON THE SCANTRON, REGARDLESS OF COMPLETION ON THE TEST FORM, WILL BE COUNTED AS AN INCORRECT ANSWER AND THE QUIZ/MIDTERM WILL BE GRADED ACCORDINGLY. THERE WILL BE NO EXCEPTIONS TO THIS POLICY. ATTENDANCE POLICY: Maximum 2 absences per semester. Detailed college attendance policy may be found in the college catalog. LATENESS: As per department policy, arriving 10 minutes after the scheduled start of class time will be counted as late. Arriving 20 minutes after the start of class will count as an absence. Two late arrivals to class will be counted as one absence. Note that all of the above can and will affect the final course grade CLASSROOM CONDUCT: CELL PHONE POLICY: Cell phones are not permitted in the classroom or lab for this course. This means that at no time, whatsoever, is a cell phone to be visualized in either location. If this rule is violated, students will be removed from the classroom and will still be responsible for all material missed. There will be no deviation from this classroom/lab requirement. Attendance of students in violation will be recorded as absent for the day and this may be reflected in the final grade for the course. Cell phones must be TURNED OFF, not just placed in silent mode. Ringing or vibrating phones heard during class may result, at the instructor's discretion, in the student being removed from class. Unnecessary talking is not permitted during instructor s lectures or when another student is speaking. Food and drinks are not allowed in the classroom at any time. Students are not permitted to leave the classroom and return during scheduled class sessions. (See Student Conduct Policy in the College Student Handbook). Students are not permitted to leave the classroom and return at any time during the class period. This includes during testing.

5 ACADEMIC INTEGRITY: NEW YORK CITY COLLEGE OF TECHNOLOGY POLICY ON ACADEMIC INTEGRITY: Students and all others who work with information, ideas, texts, images, music, inventions, and other intellectual property owe their audience and sources accuracy and honesty in using, crediting, and citing sources. As a community of intellectual and professional workers, the College recognizes its responsibility for providing instruction in information literacy and academic integrity, offering models of good practice, and responding vigilantly and appropriately to infractions of academic integrity. Accordingly, academic dishonesty is prohibited in The City University of New York and at New York City College of Technology and is punishable by penalties, including failing grades, suspension, and expulsion. The complete text of the College policy on Academic Integrity may be found in the catalog. Schedule of Lectures, Quizzes, Examination and Readings (Referred chapters are to be read prior to class.) Sessions Dates Topic 1 August 31 Introduction to course, imaging systems, terminology and positions --- September 7 No Class (Labor Day) 2 September 10 (THURSDAY) Chapter Note: Exact pages will be noted on Blackboard Chapters 1 & 3 Chest and Abdomen Chest: Chapter 10 Abdomen: Chapter 16 (Volume II) Exam/Quiz 3 September 21 Hand, Wrist, Digit & Thumb Chapter 4 4 September 28 Quiz 1 Quiz 1 5 October 5 Forearm & Elbow & Humerus Chapter 4 Chapter 5: Humerus --- October 12 No class (Columbus Day) 6 October 19 Image Evaluation Review Chapters 4, 5 10 & 16 (V.II) 7 October 26 Midterm Examination 50 Questions Comprehensive 8 November 2 Shoulder Chapter 5 9 November 9 Foot, Ankle, Toes and Os Calcis Chapter 6 10 November 16 Quiz 2 Quiz 2 11 November 23 Lower Leg, Knee & Chapter 6 Patella 12 November 30 Femur, Hip and Pelvis Femur & Hip: 6, Pelvis: 7 13 December 7 Ribs 14 December 14 Quiz 3 (Anatomy Only) All above chapters, Quiz 3 anatomy only TBA FINAL EXAM Note: Instructional slides for each of the anatomy for each body part listed are provided to the student on Blackboard. Students are responsible for this information and will be tested accordingly. In addition, it is the student's responsibility to supplement this information using the appropriate related chapters in the textbook and workbook, as well, as all areas are subject to testing.

6 RAD 1125 Lecture Outline Fall, 2015 WEEK 1: Introduction, Imaging Systems, Overview of Terms and the Patient I. Responsibility of the Radiographer II. Terms 1. Image Receptor A. Types B. Placement C. Collimation 2. Imaging Systems A. Film Screen B. Digital 1) Computed (CR) 2) Direct (DR) 3. Radiograph A. Identification B. Anatomic markers C. Display 1) Anatomic Position 2) Projection 3) View 4. Essentials of a Radiographic Image A. Density B. Contrast C. Detail D. Distortion 5. Department Protocol 6. General Anatomy Terms III. Patient Communication and Care WEEK 2: Positioning of the Chest & Abdomen I. Chest A. PA B. Lateral

7 WEEK 2: Positioning of the Chest & Abdomen (CONTINUED) II. Abdomen - AP (KUB) - Upright WEEK 3: Positioning of the Hand, Wrist, Digit and Thumb I. Hand A. PA B. Oblique C. Lateral II. Wrist A. PA B. Oblique C. Lateral III. Digit A. PA Hand B. Oblique Digit C. Lateral Digit

8 WEEK 3: Positioning of the Hand, Wrist, Digit and Thumb (CONTINUED) IV. Thumb Thumb B. PA Hand (For oblique thumb) C. Lateral Thumb 4. Tube angle WEEK 4: QUIZ #1 WEEK 5: Positioning of the Forearm & Elbow I. Forearm b. Lateral II. Elbow b. Lateral c. Medial Oblique d. Lateral Oblique WEEK 6: Image Evaluation Review I. Chest 1. PA 2. Lateral II. Abdomen 1. AP 2. Upright III. Hand & Wrist, Digit and Thumb 1. PA 2. Oblique 3. Lateral

9 WEEK 6: Image Evaluation Review (CONTINUED) IV. Forearm 1. AP 2. Lateral V. Elbow 1. AP 2. Medial Oblique 3. Lateral Oblique 4. Lateral WEEK 7: MIDTERM EXAMINATION WEEK 8: Positioning of the Humerus and Shoulder I. Humerus b. Lateral c. Transthoracic II. Shoulder Neutral B. AP Internal Oblique C. AP External Oblique D. Scapular Y View WEEK 9: Positioning of the Foot & Ankle I. Foot B. Lateral C. Oblique

10 II. Ankle B. Oblique 1) 45 degree 2) Mortise C. Lateral III. Toes Foot B. Oblique Toes B. Lateral Toe IV. Os Calcis A. Plantodorsal B. Lateral WEEK 10: QUIZ #2 WEEK 11: Positioning of the Lower Leg, Knee and Patella I. Lower Leg B. Lateral

11 WEEK 11: Positioning of the Lower Leg, Knee & Patella (CONTINUED) II. Knee B. Lateral C. Obliques D. PA Axial (Intercondylar Fossa) III. Patella A. Settegast B. Tangential Projection WEEK 12: Positioning of the Femur, Hip & Pelvis I. Femur B. Lateral II. Hip B. Lateral ( Frog Lateral / Cross Table Lateral) C. Axiolateral ( Trauma Lateral)

12 WEEK 12: Positioning of the Femur, Hip & Pelvis (CONTINUED) II. Hip (CONTINUED) III. Pelvis - AP WEEK 13: Positioning of the Ribs I. Ribs High and Low Unilateral B. AP High and Low Bilateral C. RPO/LPO WEEK 14: Quiz 3: Anatomy of the chest, abdomen, upper and lower extremities, shoulder girdle, femur, hips, pelvis and ribs

13 LEARNING OUTCOMES Week 1: Introduction to Positioning Procedures, Overview of Terms and the Patient This lecture will introduce the student to the course sequence and provide the student with an introduction to radiographic positioning, general positioning terms and expectations when dealing with patients. The importance of radiation protection will also be discussed. This lecture will also focus on a discussion of body surfaces and planes, directional terms, and relevance of anatomic position. 1. Identify body planes and surface landmarks. 2. List and describe basic radiographic positions. 3. Identify body surfaces and planes. 4. Explain the relevance of the anatomic position. 5. State the importance of radiation protection and shielding patients. 6. Classify the four types of image receptors. 7. List and briefly explain the four essentials of a radiograph. 8. Differentiate between position, projection and view. 9. Recognize directional terms. 10. State the relevance of patient history taking. 12. List considerations used when preparing to radiograph a patient. Week 2: Positioning of the Chest and Abdomen Week 3: Quiz #1 The focus of this lecture will be on the skill needed to position patients for the chest and abdomen. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation criteria needed to determine proper positioning. The concept of the decubitus view will be discussed. 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the chest and abdomen by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the chest and abdomen. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify & evaluate each projection by assessing evaluation criteria as stated in lecture & text. 7. Identify the proper patient preparation needed prior to performing the examination. 8. Explain the importance of breathing instructions for both chest and abdomen. 9. Differentiate between the decubitus view and other views. 10. Differentiate between erect and supine views of both the chest and abdomen. Week 4: Positioning of the Hand, Wrist, Digits and Thumb The focus of this lecture will be on the skill needed to position patients for the hand, wrist, digits and thumb. In addition, structures demonstrated on each will be discussed, as well as the evaluation criteria needed to determine proper positioning.

14 Week 4: Positioning of the Hand, Wrist, Digits and Thumb (CONTINUED) 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the hand, wrist, digits, and thumb by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the hand, wrist, digits and thumb. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify and evaluate each projection by assessing evaluation criteria as stated in lecture and the text. 7. Identify the proper patient preparation needed prior to performing the examination. 8. State the relevance of the oblique view for the hand, wrist, digits and thumb. Week 5: Week 6: Positioning of the Forearm and Elbow The focus of this lecture will be on the skill needed to position patients for the forearm and elbow. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation criteria needed to determine proper positioning. An introduction to trauma views vs. general projections will also take place. 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the forearm, elbow and by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the forearm and elbow. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify and evaluate each projection by assessing evaluation criteria as stated in lecture and text. 7. Identify the proper patient preparation needed prior to performing the examination. 8. State the importance of taking two views, 90 degrees from each other, for radiographic examinations of long bones. 9. Differentiate between the trauma and non-trauma patient 10. State the trauma protocols for both the elbow and why used and how they differ from the non-trauma protocol. Image Evaluation Review The focus of this lecture will be on the skill needed to properly evaluate positioning and technical factors for routine images of the chest, abdomen, hand, wrist, digit, thumb, forearm and elbow. 1. Recognize proper positioning, marking and technical factors for all routine images 2. Be able to correct positioning and technical errors for all routine images Week 7: ***** MIDTERM EXAMINATION*****

15 Week 8: Positioning of the Humerus and Shoulder The focus will be on the skill needed to position patients for the shoulder and humerus for both trauma and non trauma views. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation criteria needed to determine proper positioning. Week 8: Positioning of the Humerus and Shoulder (CONTINUED) 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the shoulder by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the shoulder and humerus. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify & evaluate each projection by assessing evaluation criteria as stated in lecture & text. 7. Identify the proper patient preparation needed prior to performing the examination. 9. Differentiate between the trauma and non-trauma patient 10. Differentiate between the trauma & non-trauma protocols for examinations of the humerus and shoulder. Week 9: Positioning of the, Foot and Ankle, Toes and Os Calcis The focus of this lecture will be on the skill needed to position patients for the foot, ankle toes and os calcis. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation criteria needed to determine proper positioning. 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the foot, ankle, toes and os calcis by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the foot, ankle, toes and os calcis. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify and evaluate each projection by assessing evaluation criteria as stated in lecture and text. 7. Identify the proper patient preparation needed prior to performing the examination. 8. Differentiate between the two obliques for the examination of the ankle. 9. Discuss the use of positioning aids used for the plantodorsal view of the calcaneus and the oblique and lateral views of the toes. Week 10: Quiz #2 Week 11: Positioning of the Lower Leg, Knee and Patella The focus will be on the skill needed to position patients for the lower leg, knee and patella. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation

16 criteria needed to determine proper positioning. Also, diagonal film placement will also be discussed. Week 11: Week 12: Week 13: 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the lower leg, knee and patella by stating the patient position, central ray placement, SID, and tube angle needed. Positioning of the Lower Leg, Knee and Patella (CONTINUED) 3. On a diagram AND radiograph, identify the pertinent anatomy of the lower leg, knee and patella. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify & evaluate each projection by assessing evaluation criteria as stated in lecture & text. 7. Identify the proper patient preparation needed prior to performing the examination. 8. Explain the purpose of diagonal film placement for lower leg. 9. State the measurement criteria used to interpret the tube angle for the examination of the AP knee. 10. Describe a tangential view and be able to identify which of the patella fall into this category. 11. Distinguish a transverse fracture and state why it would restrict the use of a Settegast view of the patella. 12. Recognize that the Settegast view is one tangential view that can be performed using several methods. Positioning of the Femur, Hip and Pelvis The focus of this lecture will be on the skill needed to position patients for the femur, hip and pelvis. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation criteria needed to determine proper positioning. Differences between a male and female pelvis will also be addressed. The concept of foreshortening will be explained as well as the method to avoid its occurrence during positioning of the AP pelvis and AP hip. This lecture will also include a discussion concerning the performance of the trauma view of the hip and the criteria for its necessity. 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the femur, hip and pelvis by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the femur, hip and pelvis 4. List the structures best demonstrated on each projection/view. 5. State the proper size & placement of the IR, and marker placement for each projection/view. 6. Identify & evaluate each projection by assessing evaluation criteria as stated in lecture & text. 7. Identify the proper patient preparation needed prior to performing the examination. 8. Explain why four views are needed to obtain an AP and lateral view of the femur. 9. State and recognize the differences between the male and female pelvis. 10. State the method & recognize when to perform the cross table lateral trauma view of the hip. Positioning of the Ribs The focus of this lecture will be on the skill needed to position patients for the ribs. In addition, the structures demonstrated on each view will be discussed, as well as the evaluation criteria needed to determine proper positioning.

17 Week 13: Positioning of the Ribs (CONTINUED) 1. Discuss the location of each structure for a patient in anatomic position. 2. Recognize and discuss the positions needed for radiographic images of the ribs by stating the patient position, central ray placement, SID, and tube angle needed. 3. On a diagram AND radiograph, identify the pertinent anatomy of the ribs. 4. List the structures best demonstrated on each projection/view. 5. State the proper IR size and placement, as well as marker placement for each projection/view. 6. Identify & evaluate each projection by assessing evaluation criteria as stated in lecture & text. 7. Identify the proper patient preparation needed prior to performing the examination. Week 14: Quiz 3: Anatomy of the chest, abdomen, upper and lower extremities, shoulder girdle, femur, hips, pelvis and ribs TBA: Final Examination Students will take a comprehensive examination which will evaluate their knowledge of the total course content from weeks 1 through 14.