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Positioning Test 3
| Question | Answer |
|---|---|
| Osteology | Study of structure and function of bones. 206 bones. 126 Appendicular and 80 Axial bones. |
| Trabeculae definition | Network of spaces in spongy bone |
| Ossification definition | Bone formation. Primary:starts before birth. Secondary:occurs after birth, epiphyseal plate,usually closed by age 21 |
| Classifications of bones | 1)long-limbs only (femur, phalanges,etc) 2)short-carpals and tarsals 3)flat-sternum, cranium, etc 4)irregular-no other category (vertebra,pelvic bones) 5)sesamoid-patella,foot,base of thumb and great toe |
| Arthrology definition | Study of joints (arthritis: Inflammation of a joint) |
| Rule out F/B protocol | 2 projections 90° from each other. AP/PA and a lateral. May need to mark entrance/exit of F/B on film. Soft tissue technique:decrease mAs 1/3 from what you would normally use. |
| Adjustments in techniques for casts | Dry plaster casts:increase 5-7 kvp from normal range used for that part. Wet plaster casts:increase 8-10 kvp or double mas. Fiberglass cast:increase 3-4 kvp |
| Don't forget the golden rule! | Set your panel before you position the patient!!!! |
| Most frequently fractured carpal bone? | Scaphoid/Navicular located in the "anatomical snuff box" |
| Carpal Sulcus | Bridge made by metacarpals. Comprises roof of carpal tunnel (floor is flexor retinaculum). Houses the median nerve. Compression of nerve is carpal tunnel syndrome. |
| 1)Colles Fracture 2)Boxers Fracture | 1)fracture of distal radius w/ posterior displacement 2)fracture to neck of metacarpal (typically the 5th metacarpal) |
| Definitions: 1)metastases 2)osteopetrosis 3)osteoporosis | 1)spread of cancer from one site to another 2)increased density of bone 3)loss of bone density |
| Routine finger radiography digits 2-5 | 3 views: 1.PA 2.PA Oblique 3.Lateral (Mediolateral 2&3 and lateromedial 4&5). Decrease field of view, increase collimation, 40"SID tabletop,want to see bony trabeculation |
| Why keep digits parallel to film? | 1) Keep joint spaces open 2) Prevent foreshortening |
| PA digits 2-5 pos,proj,cr loc | 1)Projection: PA 2)Position of part: prone 3)CR location: proximal interphalangeal joint space |
| PA digits 2-5 image evaluation | Rotation: 1)equal concavity of phalangeal shafts 2)equal amount soft tissues on both sides 3)fingernail centered over distal phalanx |
| Lateral digits 2-5 pos,proj,cr loc | 1)Position:lateral 2)Projection:Mediolateral (2&3) Lateromedial (4&5) 3)CR location: proximal interphalangeal joint space |
| Lateral digits 2-5 image evaluation | Rotation: 1)Concave anterior bone 2)Open joint spaces 3)No overlap w/other digits 4)Anatomy:head, body, and base |
| Oblique digits 2-5 pos,proj,cr loc | 1)Position:lateral or external rotation (45°) 2)Projection: Posteroanterior Oblique 3)CR location: proximal interphalangeal joint space |
| Thumb Routine | 1) AP 2) PA Oblique 3) Mediolateral |
| AP Thumb (NOT PA!) pos,proj,cr loc | 1)Position:supinated 2)Projection:anteroposterior 3)CR location:metacarpophalangeal joint space |
| AP Thumb evaluation criteria | Rotation: 1)equal concavity of phalangeal shafts 2)equal amount soft tissues on both sides 3)thumbnail centered over distal phalanx //include trapezium\\ |
| PA Oblique Thumb pos,proj,cr loc | 1)Position:hand pronated 2)Projection:PA Oblique 3)CR location:metacarpophalangeal joint |
| Lateral Thumb pos,proj,cr loc | 1)Position:Lateral 2)Projection:Mediolateral 3)CR location:metacarpophalangeal joint |
| Lateral Thumb evaluation | Concave anterior surface |
| Hand radiography routine and optional | 1)PA 2)PA Oblique 3)"Fan" Lateral 4)optional:lateral in extension |
| PA Hand pos,proj,cr loc | 1)Position: prone 2)Projection: PA 3)CR Location: 3rd metacarpophalangeal joint |
| Hand radiograph evaluation & 3 ways to determine | 1)equal concavity 2)equal amounts of soft tissue 3)fingernail centered over distal phalanx & open joint spaces, soft tissue, and 1" of distal forearm |
| PA Oblique hand pos,proj,cr loc | 1)Position:lateral rotation 2)Projection:PA Oblique 3)CR Location:3rd metacarpophalangeal joint |
| PA Oblique hand evaluation | 1)minimum overlap 3-4 & 4-5 metacarpal shafts 2)slight overlap of metacarpal base and heads 3)separation of 2-3 metacarpals |
| Fan Lateral pos,proj,cr loc | 1)pos:fan lateral 2)proj:lateromedial 3)CR loc:2nd metacarpophalangeal joint |
| Fan Lateral evaluation | 1)superimposed metacarpal 2)individual phalanges without superimposition 3)distal forearm superimposed |
| Lateral in extension pos,proj,cr loc | 1)pos:lateral in extension 2)proj:lateromedial 3)CR loc:2nd metacarpophalangeal joint |
| Lateral in extension evaluation | 1)superimposed digits, metacarpals, & distal forearm 2)thumb abducted |
| Why use lateral in extension? | 1)locate foreign body 2)show soft tissue 3)show metacarpal fracture displacements |
| Wrist radiography routine 4 views | 1)PA 2)PA Oblique 3)Lateromedial 4)AP Oblique |
| Wrist radiography optionals | 1)ulnar deviation 2)radial deviation 3)Stecher method 4)Gaynor Hart Method |
| PA wrist pos,proj,cr loc | 1)pos:prone 2)proj:PA 3)CR loc:midcarpals |
| Lateral wrist pos,proj,cr loc | 1)pos:lateral 2)proj:lateromedial 3)CR loc:wrist joint |
| Lateral wrist evaluation | 1)prox 1/2 metacarpal to distal forearm 2)superimposed radius, ulna, carpals, and metacarpals 3)trapezium and scaphoid are most anterior carpal bones, thumb abducted |
| PA Oblique wrist pos,proj,cr loc | 1)pos:lateral rotation from prone 2)proj:PA Oblique 3)CR loc:midcarpals |
| PA Oblique wrist evaluation | Demos scaphoid and trapezium; carpals on lateral aspect |
| AP Oblique wrist pos,proj,cr loc | 1)pos:medial rotation from supine 2)proj:AP Oblique 3)CR loc:midcarpals |
| AP Oblique wrist evaluation | Shows pisiform free from superimposition |
| Ulnar Deviation wrist pos,proj,cr loc | 1)pos:prone w/ ulnar deviation 2)proj:PA 3)CR loc:to scaphoid |
| Ulnar Deviation wrist evaluation | Carpals on lateral aspect; shows scaphoid w/o foreshortening & adjacent joints open |
| Radial Deviation wrist pos,proj,cr loc | 1)pos:prone with radial deviation 2)proj:PA 3)CR loc:midcarpal |
| Radial Deviation wrist evaluation | Carpals on medial aspect |
| Stecher Method pos,proj,cr loc | 1)pos:Stecher method 2)proj:PA Axial 3)CR loc:angled 20° toward elbow entering scaphoid |
| 3 ways to do Stecher method (all PA Axial Projections,improved images with ulnar deviation) | 1)wrist and film on 20°sponge, cr perpendicular 2)wrist and film flat, cr angled 20° 3)wrist and film flat, curl fingers, cr perpendicular |
| Stecher method wrist evaluation | Shows scaphoid w/o foreshortening; from proximal 1/2 of metacarpals to distal ulna and radius |
| Gaynor Hart Method pos,proj,cr loc | 1)pos:Gaynor Hart Method,slight rotation to thumb 5-10° 2)proj:tangential 3)CR loc:25-30° to long axis of hand,1" distal to base of 3rd metacarpal |
| Tangential pos,proj,cr loc | Another Gaynor Hart view 1)pos:extreme hyperextension 2)proj:tangential 3)CR loc:angled 25-30°,enters midpoint of wrist |
| 3 Elbow Fat Pads | Anterior and supinator fat pads always seen. Occult fracture will show posterior fat pad. |
| Forearm: Routine | 1)AP-supine 2)Lateromedial //2 projections 90° from eachother,long bones require both joints on IR,humerus and elbow in same plane |
| AP Forearm pos,proj,cr loc | 1)pos:hand supinated 2)proj:AP (humeral epicondyles should be parallel to film) 3)cr loc:mid shaft |
| AP Forearm evaluation | Elbow to proximal carpals shown; elbow joint slightly open if shoulder was in same plane; minimal superimposition of radial head |
| Good Lateral forearm position (3 important points) | 1)elbow flexed 90° 2)hand and wrist in true lateral position 3)humerus resting on tabletop |
| Lateral Forearm pos,proj,cr loc | 1)pos:lateral 2)proj:lateromedial 3)cr loc:midshaft of forearm |
| Lateral Forearm evaluation | Superimposed distal radius and ulna, radial head over coronoid, superimposed humeral epicondyles, superimposed humeral condyles (if not, trochlear notch not seen) |
| Basic elbow routine | 1)AP supine 2)2 AP Obliques:medial rotation and lateral rotation 3)Lateromedial |
| Optional elbow exams | 1)2 APs: partial flexion 2)Coyle method 3)radial head series |
| AP elbow pos,proj,cr loc | 1)pos:supinated (fully extend limb, entire limb same plane, humeral epicondyles parallel,hand supinated) 2)proj:AP 3)cr loc:elbow joint |
| Lateromedial Elbow pos,proj,cr loc | 1)pos:lateral 2)proj:lateromedial 3)cr loc:elbow joint |
| What does lateral elbow best demonstrate? | Superimposed humeral epicondyles open the trochlear notch and demos the Olecranon process |
| AP Oblique Elbow w/ medial rotation pos,proj,cr loc | 1)pos:medial rotation or internal rotation 2)proj:AP Oblique 3)cr loc:elbow joint ((Best demos coronoid process)) |
| AP Oblique Elbow w/ lateral rotation pos,proj,cr loc | 1)pos:lateral Oblique or external Oblique 2)proj:AP Oblique 3)cr loc:elbow joint ((Shows radial head, neck, and tuberosity)) |
| AP Projection - partially flexed elbow pos,proj,cr loc | 1)pos: partial flex distal humerus 2)proj:AP 3)cr loc:elbow joint |
| AP Projection - partially flexed elbow pos,proj,cr loc | 1)pos: partial flex proximal forearm 2)proj:AP 3)cr loc:elbow joint |
| Radial Head Series | Done with hand in 4 positions |
| Coyle Method pos,proj,cr loc | 1)pos:Coyle method 2)proj:axiolateral 3)cr loc:elbow joint;angulation and direction:45° toward shoulder ((Demos radial head, neck, and tuberosity)) |
| The Coyle Method takes the place of what oblique position? | External Oblique |
Created by:
Rsuter
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