Medical image examination positioning device
By designing a robotic arm with ground-adaptive fixation and gravity self-balancing, combined with augmented reality technology, the problems of insufficient positioning accuracy and insufficient patient interaction in medical imaging examinations have been solved. This has achieved stable fixation and efficient, accurate positioning guidance, thus improving the user experience.
Patent Information
- Application Number
- CN202610004295.2
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2026-01-05
- Publication Date
- 2026-03-03
AI Technical Summary
Existing medical imaging positioning devices lack sufficient positioning accuracy under different examination bed and floor conditions, making it difficult to meet the requirements for precise alignment. Furthermore, they lack intuitive patient interaction guidance, leading to prolonged examination time and increased patient discomfort.
The device employs a ground-adaptive fixing mechanism with a mobile unit, a multi-degree-of-freedom robotic arm, and an optical guidance and sensing module. Combined with gravity self-balancing and damping design, it achieves stable fixing and attitude stabilization on different ground surfaces and provides intuitive positioning guidance through augmented reality technology.
It achieves stable fixation and high-precision positioning on different ground surfaces, improving the efficiency and accuracy of examinations and reducing patients' anxiety and discomfort.
Smart Images

Figure CN121587754A_ABST
Abstract
Description
Technical Field
[0001] This invention relates to the field of imaging examination, and in particular to a positioning device for medical imaging examination. Background Technology
[0002] In medical imaging examinations such as CT, MRI, and X-ray, patients typically lie supine on the examination table for scanning. Accurate positioning before the examination is crucial for image quality and directly affects diagnostic accuracy. However, traditional positioning methods rely heavily on manual operation by technicians, including manual measurement, the use of surface markers, and verbal guidance to patients on adjusting their position. This approach suffers from problems such as positioning accuracy depending on the operator's experience, low efficiency, and susceptibility to human error. This is particularly problematic for examinations requiring precise alignment (such as tumor radiotherapy positioning and specific segmental spinal scans), where traditional methods struggle to meet the positioning requirements.
[0003] While some existing auxiliary positioning devices have improved accuracy to some extent, they have significant shortcomings in applications on examination beds: for example, most fixed positioning devices cannot be flexibly adjusted to adapt to changes in the height and position of different examination beds; mobile devices lack stability when close to the examination bed, and robotic arms or optical devices are prone to deviation due to bed vibration or patient movement. In particular, some positioning devices with cantilever structures are prone to swaying when extended above the examination bed, affecting positioning accuracy.
[0004] Current guidance methods also have limitations for patients on examination beds. When lying flat, patients have a limited field of vision, making it difficult to observe and understand traditional two-dimensional diagrams or verbal instructions. Although some devices use laser positioning or projection guidance, these methods often lack real-time interactive feedback. Patients cannot intuitively understand whether their position is correct, nor can they cooperate to make fine adjustments. This leads to frequent repositioning during the examination, prolonging the examination time and increasing patient discomfort.
[0005] Furthermore, the floor conditions in the inspection room are complex, with different areas possibly having different flooring materials (such as anti-static flooring, tiles, carpets, etc.). Traditional mobile positioning equipment is not stable on these surfaces, especially when precise positioning is required; even slight movements of the equipment can affect the positioning results.
[0006] Therefore, there is an urgent need in the field for an imaging examination positioning device specifically designed for patients on examination beds, which can be stably fixed on different surfaces and has a highly stable positioning mechanism, while providing intuitive patient interaction guidance so that patients lying flat can clearly understand the positioning requirements and actively cooperate to complete the position adjustment, thereby improving the efficiency and accuracy of imaging examinations. Summary of the Invention
[0007] The present invention aims to at least solve one of the technical problems existing in the prior art. Therefore, one object of the present invention is to provide a medical imaging examination positioning device.
[0008] The technical solution of the present invention is as follows: A medical imaging examination positioning device, characterized in that it comprises:
[0009] A mobile unit, comprising a base, wheels, and a ground-adaptive fixing mechanism; the base has several wheels at its bottom and integrates the ground-adaptive fixing mechanism, which is used to securely fix the device to ground of different materials during operation;
[0010] The positioning unit includes a robotic arm, an attitude stabilization platform, and an optical guidance and sensing module. The robotic arm is mounted on the base and is a multi-degree-of-freedom robotic arm. The end of the robotic arm is equipped with a freely swingable attitude stabilization platform, and a gravity self-balancing mechanism is provided between the attitude stabilization platform and the robotic arm to maintain the inertial stability of the attitude stabilization platform's spatial attitude. The attitude stabilization platform also has a damping mechanism to attenuate its own swing. The optical guidance and sensing module is integrated into the attitude stabilization platform and includes a laser projector for projecting positioning guidance graphics onto the patient's body surface and a camera for acquiring real-time video images including the patient and guidance images.
[0011] The patient interaction display unit is connected to the base via an adjustable bracket. The patient interaction display unit is configured to receive real-time video images captured by the camera and superimpose virtual guidance information generated by the laser projector onto the real-time video images to form an augmented reality image and display it to the patient.
[0012] Furthermore, the ground adaptive fixing mechanism includes a support plate, a suction cup fixing mechanism, and a friction fixing mechanism. The support plate is located at the bottom of the base and can be raised and lowered relative to the base. The support plate is provided with a negative pressure adsorption component and a friction fixing component. The negative pressure adsorption component is used to generate negative pressure adsorption with the ground when the support plate descends for fixing. The friction fixing component is used to generate static friction between the support plate and the ground for fixing when the support plate descends.
[0013] Furthermore, the base has a storage groove at its bottom, the support plate is disposed in the storage groove, and the base has a first electric push rod connected to the support plate to drive the support plate to move downward away from the storage groove or move upward to hide in the storage groove.
[0014] Furthermore, the negative pressure adsorption assembly includes a suction cup and an air pump. The suction cup is located at the bottom of the support plate, and the air pump is located on the base. The suction cup is connected to the air pump through an air pipe.
[0015] Furthermore, the friction fixing assembly includes a guide shaft, a spring, and a friction pad. The support plate is provided with a guide hole, the guide shaft is slidably inserted into the guide hole, the bottom of the guide shaft is provided with the friction pad, and the spring is sleeved on the guide shaft and connected between the support plate and the friction plate to provide elastic pressure towards the ground for the friction pad.
[0016] Furthermore, the robotic arm includes a base, a first robotic arm, and a second robotic arm. The base is connected to a pedestal and can rotate horizontally relative to the pedestal. The first robotic arm is connected to the base and can rotate vertically relative to the base. The second robotic arm is rotatably connected to the first robotic arm. The end of the second robotic arm away from the first robotic arm is provided with the attitude stabilization platform.
[0017] Furthermore, the gravity self-balancing machine includes a pivot shaft and a connecting plate. The pivot shaft is fixedly mounted at the end of the robotic arm. The connecting plate is provided with a pivot hole and freely pivots with the pivot shaft through the pivot hole. The attitude stabilization platform is fixedly mounted at the bottom of the connecting plate.
[0018] Furthermore, the damping mechanism includes a magnetic damping component and a particle damper. The magnetic damping component is disposed on the pivot shaft and the pivot hole. The magnetic damping component is used to generate a restoring torque when the attitude stabilization platform swings away from the stable position. The attitude stabilization platform has a cavity inside, which is filled with a particle damper. The particle damper is configured to serve as both a counterweight mass block of the attitude stabilization platform and a vibration damping medium.
[0019] Furthermore, the magnetic damping structure includes a first magnetic attracting element and a second magnetic attracting element that magnetically attract each other. A plurality of first magnetic attracting elements are embedded on the outer wall of the pivot shaft and spaced apart along the circumference of the pivot shaft. A plurality of second magnetic attracting elements are embedded on the inner wall of the pivot hole and spaced apart along the circumference of the pivot hole.
[0020] Furthermore, the adjustable support includes a first support and a second support. The first support is disposed on the base, the second support is connected to the first support, the patient interaction display unit is connected to the second support, and the second support can be horizontally extended and retracted and can move up and down relative to the first support.
[0021] Compared with the prior art, the beneficial effects of the present invention are as follows:
[0022] 1. Intelligent adaptive fixing and stable positioning of the mobile positioning device is realized: Through the ground adaptive fixing mechanism, it can be stably fixed on different ground materials; through the gravity self-balancing mechanism and dual damping design, the high stability of the optical guidance module is ensured, and accurate positioning guidance is achieved.
[0023] 2. It has augmented reality interactive guidance function: it integrates laser guidance with real-time video images to form an augmented reality picture, providing patients with intuitive positioning guidance, improving examination cooperation and positioning accuracy.
[0024] 3. Flexible operation and good user experience: The multi-degree-of-freedom robotic arm and adjustable display stand enable the device to adapt to different examination needs and patient positions, enhancing real-world interaction and reducing patient anxiety.
[0025] Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Attached Figure Description
[0026] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention, and the drawings are only examples and not strictly drawn to scale. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort:
[0027] Figure 1 This is a schematic diagram of the usage state of the present invention;
[0028] Figure 2 yes Figure 1 The main view;
[0029] Figure 3 This is an overall schematic diagram of the present invention;
[0030] Figure 4 yes Figure 3 Bottom diagram;
[0031] Figure 5 This is a cross-sectional view of the base portion of the present invention;
[0032] Figure 6 This is a schematic diagram of the support plate portion of the present invention;
[0033] Figure 7 This is a schematic diagram of the positioning unit of the present invention;
[0034] Figure 8 This is a schematic diagram of the attitude stabilization platform portion of the present invention;
[0035] Figure 9 This is an internal schematic diagram of the attitude stabilization platform part of the present invention.
[0036] Figure label:
[0037] 1. Moving unit; 11. Base; 12. Wheels; 13. Support plate; 14. Storage slot; 15. First electric push rod; 16. Suction cup; 17. Air pump; 18. Guide shaft; 19. Spring; 110. Friction pad;
[0038] 2. Positioning unit; 21. Base; 22. First arm; 23. Second arm; 24. Pivot shaft; 25. Connecting plate; 26. Pivot hole; 27. First magnetic chuck; 28. Second magnetic chuck; 29. Attitude stabilization platform; 210. Particle damping material; 211. Laser projector; 212. Camera;
[0039] 3. Patient interaction display unit; 31. First stent; 32. Second stent. Detailed Implementation
[0040] To make the objectives, technical solutions, and advantages of the embodiments of the present invention clearer, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.
[0041] The embodiments of the present invention are described in detail below. Examples of the embodiments are shown in the accompanying drawings, wherein the same or similar reference numerals denote the same or similar elements or elements having the same or similar functions throughout. In the description of the present invention, it should be understood that the terms "upper," "lower," "front," "rear," "left," "right," "inner," "outer," "vertical," "circumferential," etc., indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings, and are only for the convenience of describing the present invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation, and therefore should not be construed as a limitation of the present invention.
[0042] In this invention, unless otherwise explicitly specified and limited, the terms "installation," "connection," "linking," and "fixing," etc., should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium; and they can refer to the internal connection of two components. Those skilled in the art can understand the specific meaning of the above terms in this invention according to the specific circumstances.
[0043] In the description of this invention, "first feature" and "second feature" may include one or more of the indicated features. Furthermore, the terms "first" and "second" are used for descriptive purposes only and should not be construed as indicating or implying relative importance or implicitly specifying the number of indicated technical features. Thus, a feature defined with "first" and "second" may explicitly or implicitly include one or more of the indicated features.
[0044] like Figures 1-9 The medical imaging examination positioning device shown includes three main parts: a moving unit 1, a positioning unit 2, and a patient interaction display unit 3.
[0045] like Figure 3 and Figure 4 As shown, the mobile unit 1 provides the movement and fixation functions for the entire device. The mobile unit 1 includes a base 11, wheels 12, and a ground adaptive fixing mechanism. The base 11 has several wheels 12 at its bottom, which facilitates the flexible movement of the device in the inspection room. The ground adaptive fixing mechanism is integrated into the bottom of the base 11 and is used to securely fix the device to different materials of the ground during operation, such as tiled floors, wooden floors, or carpeted floors.
[0046] In some implementations, such as Figure 4 and Figure 5 As shown, the ground adaptive fixing mechanism includes a support plate 13, a suction cup 16 fixing mechanism, and a friction fixing mechanism. The support plate 13 is located at the bottom of the base 11 and can be raised and lowered relative to the base 11. The bottom of the base 11 is provided with a storage groove 14, and the support plate 13 is located in the storage groove 14. The base 11 is provided with a first electric push rod 15, which is connected to the support plate 13 to drive the support plate 13 to move downward away from the storage groove 14 or move upward and hide in the storage groove 14.
[0047] like Figure 5 and Figure 6 As shown, the support plate 13 is equipped with a negative pressure adsorption assembly and a friction fixing assembly. The negative pressure adsorption assembly includes a suction cup 16 and an air pump 17. The suction cup 16 is located at the bottom of the support plate 13, and the air pump 17 is located on the base 11. The suction cup 16 is connected to the air pump 17 through an air pipe. When the support plate 13 descends, the suction cup 16 contacts the ground, and the air pump 17 operates to generate negative pressure. Fixation is achieved through negative pressure adsorption. This fixing method is particularly suitable for smooth and flat surfaces, providing extremely strong fixing force.
[0048] like Figure 5 and Figure 6As shown, the friction fixing assembly includes a guide shaft 18, a spring 19, and a friction pad 110. A guide hole is provided on the support plate 13, and the guide shaft 18 is slidably inserted into the guide hole. The friction pad 110 is located at the bottom of the guide shaft 18. The spring 19 is sleeved on the guide shaft 18 and connected between the support plate 13 and the friction plate, providing elastic pressure to the friction pad 110 towards the ground. When the support plate 13 descends, the friction pad 110 presses firmly against the ground under the action of the spring 19, achieving fixation through static friction. This fixing method is suitable for rough or uneven surfaces. In this case, the suction cup 16 does not play a role in adsorption and fixation.
[0049] like Figures 1-3 As shown, positioning unit 2 is responsible for precise positioning and guidance. Positioning unit 2 includes a robotic arm, an attitude stabilization platform 29, and an optical guidance and sensing module. Figure 3 As shown, the robotic arm is mounted on the base 11 and is a multi-degree-of-freedom robotic arm. In some embodiments, the robotic arm includes a base 21, a first arm 22, and a second arm 23. The base 21 is connected to the base 11 and can rotate horizontally relative to the base 11. The first arm 22 is connected to the base 21 and can rotate vertically relative to the base 21. The second arm 23 is rotatably connected to the first arm 22. This multi-degree-of-freedom design allows the robotic arm to flexibly adjust its working position and angle.
[0050] The end of the robotic arm is equipped with a posture stabilization platform 29, which can swing freely. A gravity self-balancing mechanism is provided between the end of the robotic arm and the posture stabilization platform 29. A damping mechanism is provided on the posture stabilization platform 29 to attenuate its own swing.
[0051] In some implementations, such as Figure 7 and Figure 8 As shown, the gravity self-balancing mechanism includes a pivot shaft 24 and a connecting plate 25. The pivot shaft 24 is fixedly mounted at the end of the robotic arm, and the connecting plate 25 has a pivot hole 26, which allows it to pivot freely with the pivot shaft 24. The attitude stabilization platform 29 is fixedly mounted at the bottom of the connecting plate 25. This gravity self-balancing mechanism automatically maintains the spatial attitude stability of the attitude stabilization platform 29 through the action of gravity, preventing significant swaying due to the movement of the robotic arm.
[0052] The damping mechanism includes a magnetic damping assembly and particulate dampers 210. The magnetic damping assembly is located on the pivot shaft 24 and the pivot hole 26, and includes first magnetic attracting elements 27 and second magnetic attracting elements 28 that are magnetically attracted to each other. Multiple first magnetic attracting elements 27 are embedded in the outer wall of the pivot shaft 24 at intervals along its circumference, and multiple second magnetic attracting elements 28 are embedded in the inner wall of the pivot hole 26 at intervals along its circumference. When the attitude stabilization platform 29 deviates from its stable position and swings, a restoring torque is generated between the magnetic attracting elements, causing the platform to return to its balanced state.
[0053] like Figure 9 As shown, the attitude stabilization platform 29 has an internal cavity filled with particulate damping material 210. These particulate damping materials 210 serve both as counterweights for the attitude stabilization platform 29, increasing its stability, and as vibration damping media, consuming vibration energy through friction and collision between particles, further attenuating the oscillation.
[0054] The optical guidance and sensing module is integrated into the attitude stabilization platform 29, including a laser projector 211 for projecting positioning guidance graphics onto the patient's body surface and a camera 212 for acquiring real-time video images including images of the patient and the guidance. The laser projector 211 can project guidance graphics such as crosshairs and positioning frames onto the patient's body surface to accurately indicate the examination location and range. The camera 212 acquires a complete view of the patient and the guidance in real time, providing a video source for subsequent augmented reality display.
[0055] The patient interaction display unit 3 is connected to the base 11 via an adjustable bracket for interaction and display with the patient. The adjustable bracket includes a first bracket 31 and a second bracket 32. The first bracket 31 is mounted on the base 21, and the second bracket 32 is connected to the first bracket 31. The patient interaction display unit 3 is also connected to the second bracket 32. The second bracket 32 can extend and retract horizontally and move vertically relative to the first bracket 31, allowing the position of the patient interaction display unit 3 to be adjusted according to the patient's needs.
[0056] The patient interaction display unit 3 is configured to receive real-time video images captured by the camera 212 and overlay virtual guidance information generated by the laser projector 211 onto the real-time video images to form an augmented reality image, which is then displayed to the patient. For example, virtual information such as laser guidance graphics, examination area markings, and operation instructions can be overlaid onto the patient's real-time video image to help the patient better understand and cooperate with the examination process.
[0057] The procedure for using this device is as follows:
[0058] like Figure 1 and Figure 2 As shown, the device is first placed next to the examination bed, and the ground adaptive fixation mechanism is activated for secure fixation. Then, the positions of the robotic arm and the patient interaction display unit 3 are adjusted. During positioning, the laser projector 211 projects positioning guidance graphics onto the patient's body surface, the camera 212 acquires images in real time, and the patient interaction display unit 3 displays augmented reality images to guide the patient in adjusting their position. Throughout the entire process, the posture stabilization platform 29 remains stable, ensuring the precise operation of the optical guidance and sensing module.
[0059] In summary, the medical imaging examination positioning device of the present invention has the following outstanding features:
[0060] 1. Intelligent adaptive fixing and stable positioning of the mobile positioning device is realized: Through the ground adaptive fixing mechanism, it can be stably fixed on different ground materials; through the gravity self-balancing mechanism and dual damping design, the high stability of the optical guidance module is ensured, and accurate positioning guidance is achieved.
[0061] 2. It has augmented reality interactive guidance function: it integrates laser guidance with real-time video images to form an augmented reality picture, providing patients with intuitive positioning guidance, improving examination cooperation and positioning accuracy.
[0062] 3. Flexible operation and good user experience: The multi-degree-of-freedom robotic arm and adjustable display stand enable the device to adapt to different examination needs and patient positions, enhancing real-world interaction and reducing patient anxiety.
[0063] Although some embodiments of the present invention have been shown and described, those skilled in the art will understand that various changes, modifications, substitutions and variations of these embodiments without departing from the principles and spirit of the present invention are within the scope of protection of the claims of the present invention.
Claims
1. A medical imaging examination positioning device, characterized in that, include: A mobile unit, comprising a base, wheels, and a ground-adaptive fixing mechanism; the base has several wheels at its bottom and integrates the ground-adaptive fixing mechanism, which is used to securely fix the device to ground of different materials during operation; The positioning unit includes a robotic arm, an attitude stabilization platform, and an optical guidance and sensing module. The robotic arm is mounted on the base and is a multi-degree-of-freedom robotic arm. The end of the robotic arm is equipped with a freely swingable attitude stabilization platform, and a gravity self-balancing mechanism is provided between the attitude stabilization platform and the robotic arm to maintain the inertial stability of the attitude stabilization platform's spatial attitude. The attitude stabilization platform also has a damping mechanism to attenuate its own swing. The optical guidance and sensing module is integrated into the attitude stabilization platform and includes a laser projector for projecting positioning guidance graphics onto the patient's body surface and a camera for acquiring real-time video images including the patient and guidance images. The patient interaction display unit is connected to the base via an adjustable bracket. The patient interaction display unit is configured to receive real-time video images captured by the camera and superimpose virtual guidance information generated by the laser projector onto the real-time video images to form an augmented reality image and display it to the patient.
2. The medical imaging examination positioning device according to claim 1, characterized in that, The ground adaptive fixing mechanism includes a support plate, a suction cup fixing mechanism, and a friction fixing mechanism. The support plate is located at the bottom of the base and can be raised and lowered relative to the base. The support plate is provided with a negative pressure adsorption component and a friction fixing component. The negative pressure adsorption component is used to generate negative pressure adsorption with the ground when the support plate descends for fixing. The friction fixing component is used to generate static friction between the support plate and the ground for fixing when the support plate descends.
3. The medical imaging examination positioning device according to claim 2, characterized in that, The base has a storage groove at its bottom, and the support plate is located in the storage groove. The base is provided with a first electric push rod, which is connected to the support plate to drive the support plate to move downward away from the storage groove or move upward to hide in the storage groove.
4. The medical imaging examination positioning device according to claim 2, characterized in that, The negative pressure adsorption assembly includes a suction cup and an air pump. The suction cup is located at the bottom of the support plate, and the air pump is located on the base. The suction cup is connected to the air pump through an air pipe.
5. The medical imaging examination positioning device according to claim 2, characterized in that, The friction fixing assembly includes a guide shaft, a spring, and a friction pad. The support plate has a guide hole, and the guide shaft is slidably inserted into the guide hole. The friction pad is located at the bottom of the guide shaft. The spring is sleeved on the guide shaft and connected between the support plate and the friction plate to provide elastic pressure to the friction pad towards the ground.
6. The medical imaging examination positioning device according to claim 1, characterized in that, The robotic arm includes a base, a first robotic arm, and a second robotic arm. The base is connected to a pedestal and can rotate horizontally relative to the pedestal. The first robotic arm is connected to the base and can rotate vertically relative to the base. The second robotic arm is rotatably connected to the first robotic arm. The end of the second robotic arm away from the first robotic arm is provided with the attitude stabilization platform.
7. The medical imaging examination positioning device according to claim 1, characterized in that, The gravity self-balancing machine includes a pivot shaft and a connecting plate. The pivot shaft is fixedly mounted at the end of the robotic arm. The connecting plate is provided with a pivot hole and freely pivots with the pivot shaft through the pivot hole. The attitude stabilization platform is fixedly mounted at the bottom of the connecting plate.
8. The medical imaging examination positioning device according to claim 7, characterized in that, The damping mechanism includes a magnetic damping component and a particle damper. The magnetic damping component is disposed on the pivot shaft and the pivot hole. The magnetic damping component is used to generate a restoring torque when the attitude stabilization platform swings away from the stable position. The attitude stabilization platform has a cavity inside, which is filled with a particle damper. The particle damper is configured to serve as both a counterweight mass block of the attitude stabilization platform and a vibration damping medium.
9. The medical imaging examination positioning device according to claim 8, characterized in that, The magnetic damping structure includes a first magnetic attractor and a second magnetic attractor that attract each other. A plurality of first magnetic attractors are embedded on the outer wall of the pivot shaft and spaced apart along the circumference of the pivot shaft. A plurality of second magnetic attractors are embedded on the inner wall of the pivot hole and spaced apart along the circumference of the pivot hole.
10. The medical imaging examination positioning device according to claim 1, characterized in that, The adjustable support includes a first support and a second support. The first support is disposed on the base, and the second support is connected to the first support. The patient interaction display unit is connected to the second support. The second support can extend and retract horizontally and can move up and down relative to the first support.