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newSchoolWorks.com › VoTechWorks › Health & Personal Services › Limited X-Ray / Radiologic Technology › Anatomy & Positioning for Radiographic Practice › Lesson 1
HLT-RADI64-03 · Lesson 1 · 20 clock hours · theory

Radiographic Terminology, Planes, and Positioning Fundamentals

Objective. Students will correctly define and apply standard anatomical planes, directional terms, body positions, and projection nomenclature used in radiographic practice.

⚠ Pending professional review

This lesson, its worked examples and its practice questions has not yet been verified by a licensed clinician in the field or by a certification or approval body. It is a study draft and may contain errors. Do not use it to make decisions about any patient or medication. Always follow your instructor, your supervising professional, and current official references and regulations.

VoTechWorks program approval and accreditation are still in progress. Credentials are issued only by the certifying bodies named in each program, after their own exams.

Why Standard Terminology Matters

Radiographic practice depends on precise communication. When a physician orders a "PA chest" or a "lateral lumbar spine," every technologist in the country must understand exactly what that means. Using standard anatomical planes, directional terms, body positions, and projection nomenclature ensures that images are reproducible, reports are accurate, and—most importantly—patients receive the correct examination safely. Misunderstanding a positioning term can lead to a repeated exposure, an incorrect diagnosis, or unnecessary radiation dose. Mastering this vocabulary is your first patient-safety obligation.

Anatomical Position: The Universal Starting Point

All terminology in radiography is defined relative to the anatomical position: the patient is standing erect, facing forward, arms at the sides with palms facing forward, and feet together. It does not matter how the patient is actually lying or standing during the exam—directions always refer back to this standard reference. This prevents confusion when a patient is supine, prone, or rotated.

Body Planes

Planes are imaginary flat surfaces that divide the body into sections.

Knowing which plane bisects a structure helps you align the central ray and the image receptor correctly.

Directional Terms

Directional terms describe relationships between body parts or the path of the x-ray beam.

Body Positions

Body position describes how the patient is placed.

Projection Nomenclature

A projection describes the path of the central ray through the body, named by where it enters and where it exits.

View vs. Projection: Strictly, "view" describes what the image receptor sees; "projection" describes the beam path. Radiographers produce projections. Radiologists interpret views. In clinical practice the terms are often used interchangeably, but on credentialing exams use "projection" for the technologist's action.

Oblique Position Naming Rule

Oblique positions are named by the body surface closest to the image receptor. If the patient's right posterior surface is closest to the table or upright Bucky, the position is RPO. In an RPO the beam enters the left anterior surface—so the projection is sometimes called a left anterior oblique (LAO). This relationship (RPO = LAO; LPO = RAO) is tested on credentialing exams.

Patient Safety and Positioning

Key terms8

Anatomical positionThe standard reference posture: body erect, facing forward, arms at sides with palms facing forward, feet together. All directional terms are defined relative to this position.
ProjectionThe path of the central x-ray beam through the patient, named by the surface the beam enters and exits (e.g., AP, PA, lateral). Describes the technologist's action in producing the image.
Sagittal planeAn imaginary vertical plane that divides the body into right and left portions. The midsagittal plane passes through the exact midline.
Coronal planeAn imaginary vertical plane perpendicular to the sagittal plane that divides the body into anterior and posterior portions.
Axial projectionA projection in which the central ray is angled significantly along the long axis of the body, either cephalad (toward the head) or caudad (toward the feet).
ObliqueA body position or projection in which the patient or central ray is angled between the true frontal (AP/PA) and the true lateral; named by the body surface nearest the image receptor.
SupineBody position in which the patient lies on their back, face upward.
Tangential projectionA projection in which the central ray skims the surface of a curved or superficial structure to profile it without overlying bone or soft tissue.
In class: Read and annotate the positioning terminology chapter from Merrill's Atlas of Radiographic Positions, then create a personal reference card listing all major planes, positions, and projection terms with sketched diagrams. · Complete a 40-item matching exercise pairing positional terms (PA, AP, lateral, oblique, axial, tangential) with written descriptions and anatomical diagrams. · In pairs, one student calls out a positioning term while the partner demonstrates the corresponding body orientation on a positioning table, then roles reverse; instructor observes and corrects.
Materials: Merrill's Atlas of Radiographic Positions & Radiologic Procedures (current edition), anatomical body-plane posters, positioning terminology flashcard set, positioning table
Check: Score ≥ 80% on a 40-item terminology quiz covering planes, directional terms, projections, and body positions; all ten core projection types correctly demonstrated in the partner activity with instructor sign-off.

Practice check8

Answer each question, then check it. Nothing is recorded; this is your own practice.

Radiographic Procedures – Positioning and Projections
1. A physician orders a PA chest radiograph. In this projection, the x-ray beam travels:
Radiographic Procedures – Positioning and Projections
2. A patient is lying on the x-ray table with their right posterior side closest to the table surface and their body rotated approximately 45°. This body position is correctly described as:
Radiation Protection and Anatomy – Anatomical Planes
3. Which anatomical plane divides the body into superior and inferior portions?
Radiographic Procedures – Patient Positioning
4. When positioning a patient who is supine with the head tilted lower than the feet, the correct term for this position is:
Radiographic Procedures – Positioning and Projections
5. The central ray in an axial projection of the calcaneus is angled significantly toward the patient's head. This angulation is correctly described as:
Patient Care and Safety – Scope of Practice
6. A limited-scope radiographer is asked by a nurse to perform a projection outside the technologist's state-authorized scope of practice. The correct action is to:
Radiation Protection and Anatomy – Directional Terms
7. The term 'distal' when applied to the forearm means:
Radiographic Procedures – Positioning and Projections
8. Which projection would best profile the surface of the patella without significant superimposition of the distal femur?
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