Road to Radiography

Well… The first semester has finally come to a close.  I finished my final exams for my classes on Tuesday, and I don’t return to school until January 7th.  It was a tough semester and I’m definitely ready for this break.  I got A’s in all of my classes, so my 4.0 GPA is intact for now.  I certainly hope that I can maintain that for another semester.  Sometimes I wish I would just get a B in a class so the 4.0 would be gone and I wouldn’t worry so much about it, but having a perfect GPA is certainly a worthwhile goal. 

When I return to class in January, I’ll be taking the second semester (RAD-112) of my positioning class, and we’ll be starting with positioning on the cervical and thoracic spine, followed by the lumbar spine.  I’ll also have my first clinical rotation in an orthopedic office, and should be able to knock out a lot of my comps for the semester.  As of Tuesday, I’m passed off in lab on the lower extremities, so those comp opportunities should come quickly in the ortho office.  My Patient Care & Intro to Rad (RAD-110) class is over, and I’ll be starting my Rad Imaging I (RAD-121) class.  Here’s the book for that class:

…yet another $52.00 paperback book.  I’ll never cease to be amazed at the cost of college textbooks!  I’m looking forward to this class though, because I should start to learn more of the technical side of radiographic imaging.  As a photographer, my interest in this material is quite high. 

I hope everyone has a safe and happy holiday!  I’ll see you back here in January…

Tags: 1st Semester, Clinical, RAD-110, RAD-111 by John Setzler
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This is the first time since I started this blog that I have skipped any school days when it comes to writing entries here.  After the Thanksgiving break, I just decided to take a couple days off of the blogging so I could focus on the tasks I have at hand.  We don’t have any tests this week, but I have two next week and at least two more before our final exams.  That being the case, I’m going to be covered up for the next three weeks or so.  I have clinical tomorrow where I am going to do my best to get at least one more comp completed.  After thinking about it, I am going to talk to the techs and see if I can’t get them to help me get my KUB, Erect Abdomen, and Portable Chest completed as soon as possible.  I really need to get these knocked out because I’m most likely going to be in an orthopedic office on my next rotation in January.  I’m really looking forward to that because I’ll have completed my lower limb lab tests before I go there.  I hope to complete a lot of master comps when I find my way into the ortho office.  This lower limb study is dragging out.  We have completed the actual training on it, but we can’t test off in lab until exam time, because it’s our final exam in lab.  We can’t knock it out early, so we get to simply practice it in lab until mid December.  The pace of the positioning class seems slow sometimes, but in a case like this where we are getting a LOT of practice time, I should be able to easily ace the positioning test.

On a side note…

I was out photographing a high school wrestling match last night, and I was witness to a rather severe injury.  It appeared that one of the wrestlers received a severe dislocation of the scapulohumeral joint.  His shoulder was a complete mess and I thought I could see the lump on his shoulder where the head of the humerus was trying to protrude.  They didn’t move him from the wrestling mat until the EMS people arrived.  I felt bad for the kid receiving that kind of injury, but I would love to see the x-ray.  Even though I’m working in a hospital environment right now, I’m not seeing a lot of trauma, especially more severe examples of it. 

Oh well… such is life… I’ll be back tomorrow to talk about any comp advancements I should make at clinical… ;)

Tags: 1st Semester, RAD-111 by John Setzler
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Tomorrow is our written test on the lower limb anatomy and positioning techniques.  I started studying for this yesterday, but I still feel overwhelmed with the amount of information I need to know in the morning.  I’m going to be grinding on this until the wee hours of the morning in hopes of getting a great score on the test.  I need a good grade on this one since I got an 84 on the last test.  I’m going to keep things short today and keep on studying.  Tomorrow is my last day this week before our Thanksgiving holiday.  I get the rest of the week off, including clinical day…

Tags: 1st Semester, RAD-111 by John Setzler
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We started learning the physical positioning of the lower extremity in lab today.  We covered these procedures:

AP Foot

AP Oblique Foot

Lateral Foot

Calcaneus (Axial)

Calcaneus (Lateral)

AP Ankle

Ankle (AP - Mortise)

AP Oblique Ankle

Lateral Ankle

AP Tibia-Fibula

Lateral Tibia-Fibula

I think I’m going to create an Excel Spreadsheet on positioning technique for my own use in studying, and I’ll probably share it via this website as well.  I’m planning to use the following columns:

PART/VIEW - FILM SIZE - TT/BUCKY - CR & DIRECTION - POSITIONING TIPS

I’m not sure what the best way to break this down will be… maybe I need to add some columns… your suggestions would be appreciated :)  If I come up with something I like, I’ll go back and add all my previous positioning to it, and continue it throughout my program…

Tags: 1st Semester, RAD-111 by John Setzler
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We continued our study of lower limb positioning today in the RAD-111 class.  We have covered from the toes to the distal and mid femur in the book so far.  We’ll start the physical positioning process on those tomorrow in lab.  I don’t think we are actually going to practice toe positioning in lab though.  We will need to know those for the written test though.  There are a lot of positions to deal with in the lower extremity, and I’m not exactly sure how I’m going to memorize all this yet.  We’ll be tested on Tuesday of next week and I’ll have to have ‘mental’ knowledge of all of it by then.  Our last written test in the positioning class was my worst grade so far this semester.  I got an 84 on that test, and I’m confident that it was because of the number of positions and detail we had to cover.  This unit has even more positions, so I guess I need to start working on my strategy for learning all of it with a high level of confidence.  I think I’ll make another chart of all the lower extremity positions and work from that.  I’ll probably try to post that list here over the weekend…

Tags: 1st Semester, RAD-111 by John Setzler
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We had an interesting turn of events in our positioning lab today.  We were scheduled to learn the clavicle, AC joints, and scapula positions, which we did.  We decided to ask our instructor to go ahead and test us on these positions because we weren’t scheduled to take that test for two more weeks, and we wanted to get them out of the way before we dive into the lower extremities tomorrow in class.  So, we tested and now have a few more pre-comps we can start working on in clinical this week.  Just like last time, this was a hat draw method of testing, so we didn’t have to demonstrate each position.  We had to know them all because we didn’t know what we would draw, and I got the most difficult one of the bunch I think.  The superoinferior axial shoulder view is what I came up with from the hat.  I knocked it out though… perfect score on the positioning test.  This is the only shoulder view that uses an angled tube, and it’s a table-top exam rather than at the wall bucky.  So tomorrow, we start lectures on the lower limb anatomy and positioning.  There are a lot of positions to learn here, so getting a head start will be nice…

Tags: 1st Semester, RAD-111 by John Setzler
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My written test in my positioning class today was a disaster.  I spent a lot of time studying for it, but apparently it wasn’t enough.  I made an 84, which is my lowest grade of the semester in any of my classes.  After taking the test, I realized that my study approach was simply not the right one, so this mistake won’t happen again.  I’ll be much better prepared for my next test.  I’m simply not good at memorizing long lists of information, which is what I really needed to do for this test.  All of the shoulder girdle positions, including the alternate and obscure, were included on this test, and I needed to know everything from patient position and central ray angulation to what the resulting radiographs look like.  I’ll do better next time…

In the RAD-110 class, we started discussing “MedicoLegal” talk.  We covered things like assault and battery and slander and libel.  Healthcare facilities and the people who work in the industry are too often targets of lawsuits, so being aware of proper procedure is very important.  If you aren’t familiar with “Res Ipsa Loquitur” you might want to look it up…  This is where innocent until proven guilty doesn’t necessarily apply…

Tags: 1st Semester, RAD-110, RAD-111 by John Setzler
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My RAD-110 test today seemed way too easy.  It could possibly be the first test where I get a perfect score this semester.  I knew all the answers, so unless I made a stupid mistake or mislabeled the scantron test sheet, I think I did really well on this one.  My weekend is going to be spent studying for the next positioning written test.  The anatomy won’t be too difficult, but the long list of positions of the proximal humerus and shoulder girdle is going to take a lot of work to learn.  In the actual positioning lab, I only have to be able to demonstrate these positions:

Humerus: AP

Humerus: Lateral

Humerus: Transthoracic Lateral

Shoulder: AP Internal Rotation

Shoulder: AP External Rotation

Shoulder: Superoinferior Axial

Shoulder: Scapular Y-Lateral

For the written test, I have to know these special views in addition to the others:

Shoulder: Lawrence Method (Inferosuperior Axial)

Shoulder: Neer Method (Supraspinatus/Outlet View)

Shoulder: West Point Method (Inferosuperior Axial)

Shoulder: Grashey Method (Posterior oblique / AP projection)

Shoulder: Garth Method (Posterior oblique / AP Axial projection)

Shoulder: Stryker Notch (AP Axial)

I have a lot of studying to do.  On the written test, it’s hard to guess at what the questions will be like.  They are usually multiple choice where a situation is described where we need to look at something specific, and we are asked to choose which method.

Tomorrow, I’m back to clinical.  I hope I’ll get a few more pre-comps completed, and if I’m lucky, I’ll comp something, but I’m not expecting it tomorrow.  The closest I am to another comp is on the hand.  I need two more pre-comps before I can comp that one.  Maybe I’ll get some more pre-comps on things I don’t have yet…

Tags: 1st Semester, RAD-111 by John Setzler
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We started digging in to the humerus and shoulder positioning techniques in lab today.  The positions we studied are:

AP Humerus

Lateral Humerus

Transthoracic Lateral Humerus

AP Internal Shoulder

AP External Shoulder

Superoinferior Axial Shoulder

Scapular Y Lateral Shoulder

All of these views are 40″ SID with the CR perpendicular to the image receptor, except for the suproinferior axial shoulder, which uses a 40″ SID with a 5 to 15-degree angle on the tube towards the elbow.  The AP and Lateral Humerus views use a 14×17 image receptor in most cases, while the rest can use 10×12 (or possibly 8×10 depending on the patient.)

These positions aren’t too difficult.  The transthoracic lateral humerus requires an interesting breathing technique, because it’s a rather long exposure at 4-5 seconds.  The technique is rapid and shallow breathing to blur out some of the anatomy in the picture.  The patient positioning for the AP and Lateral Humerus is practically identical to the positioning for the AP Internal and External shoulder.  The only difference is where you are centering your beam and what you are actually looking at.  We spent about two hours in lab practicing these positions.  Each student took a turn at positioning another student for these routines. 

I really wish we were actually able to make some radiographs.  Our instructor is watching what we do and telling us where our problems may be, but executing a positioning routine and then not having a radiograph to see afterwards still feels strange to me.  We don’t really know how good our positioning technique is without being able to see a resulting image.  I do realize that we can’t radiate each other all semester :) 

I’m having a test in the morning on imaging concepts.  This test is covering a lot of general topics such as the inverse square law, density maintenance formula, mAs calculations, photographic and geometric properties of images, contrast, density, film (what it’s made of and how it works), intensifying screens, grids, grid ratios, grid frequencies, et cetera.  I don’t think it’s going to be too difficult, but I’m going to spend an hour or two studying anyway.

Tags: 1st Semester, RAD-111 by John Setzler
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In today’s positioning class, we started looking at the humerus and shoulder girdle.  The humerus is quite simple with just two primary views.  The AP and Lateral views of the humerus seem simple enough.  The shoulder, however, is going to be quite a bit more complex.  My book is showing 17 views in the shoulder girdle area.  I know some of these are special views, but there is going to be a lot of work here.  We looked at a lot of these in class today via a powerpoint presentation, but we’ll start on them in lab tomorrow.  I think this will be the first really detailed section of the body we have studied so far.  There is a lot of anatomy and bone detail in this area. 

After the three tests I had last week, I thought I was gonna be test free this week, but we’re having a test in the Intro to Rad and Patient Care class on Wednesday.  This test is on basic concepts of imaging, and I don’t think it’s gonna be too difficult.  I’ll have a written test in the positioning class on Monday on the shoulder girdle anatomy and positioning concepts, so this weekend will be spent studying quite a bit. 

Tags: 1st Semester, RAD-111 by John Setzler
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