What is done differently for PUC?
- patient seated for all views
- patient is in neutral position (not “after class slump” or rigid posture)
- patient head tilt stays, rotation does not
PUC series in order
palmer lateral AP palmer APOM nasium base posterior/vertex
SID PUC lateral cervical
72”
film size PUC lateral cervical
10x12
CR position PUC lateral cervical
through C1 TVP
collimation PUC lateral cervical
collimate out eyes, but not C7 spinous process
AP PUC cervical
same as routine cervical
ID blocker for PUC APOM
down
bucky placement for APOM
touching back fo the head and shoulder, patient is in neutral position
tube tilt for APOM
5-15 degree cephalic tube tilt
filter for APOM
filter out orbits
why do we need a bucky tilt?
to visualize C1 while maintaining body’s neutrl position
minimize magnification distortion
nasium SID
40”
film size for nasium
8x10
collimation for nasium
8x10
ID blocker location for nasium
down
bucky position for nasium
touching the back of the head and shoulders, patient is in neutral position
tube tilt for nasium
caudal tilt determined by the lateral film and atlas plane line
CR nasium
exiting the inferior tips of the mastoids
filters for nasium
filter eyes
base posterior SID
38-42”
film size base poisterior
8x10
collimation for base posterior
8x10 ID blocker down
bucky placement for base posterior
bucky at 45 degrees
patient positioning for base posterior
vertex to center of bucky
CR base posterior
enters 1” behind chin, goes in front of EAM, exits vertex
filter for base posterior
filter eyes
which positions need a slight bucky tilt?
APOM
nasium
which positions need a 45 degree bucky tilt?
BP/vertex
which positions need a tube tilt? What kind of tube tilt?
AP- 15 cephalic
APOM 5-15 cephalic
nasium- 5-20 caudal
which films do you filter out orbits?
APOM
nasium
BP/vertex
differences in PUC lateral compared to routine lateral
PUC lateral- film size: 10x12 eliminate orbits CR C1 seated Routine lateral- film size: 8x10 orbits are included CR C4 seated/standing
ID blocker placement
Up: lateral, AP
down: APOM, nasium, BP/vertex
PUC APOM vs APOM
PUC- slight bucky tilt seated filterout orbits don't collimate orbits 5-15 cephalic tube tilt don't manipulate patient APOM- no bucky tilt seated/standing no orbit filter collimate eyes no tube tilt manipulate to perfect image
why do we take AP cervical in a PUC series?
opposing view of the lateral
check for pathology