Positioning

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Author:
Brie
ID:
112240
Filename:
Positioning
Updated:
2011-10-26 23:23:00
Tags:
Elbow humerus shoulder scaupula
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Description:
elbow, humerus, shoulder, scapula
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  1. What is the patient and part position for an AP Elbow Projection (fully extended)?
    • Patient seated with elbow fully extended
    • Hand supinated
  2. Where and how is the CR directed for AP elbow (extended, not fully extended, oblique and lateral)?
    • CR perpendicular
    • mid-elbow joint
  3. What is the criteria for an AP elbow projection?
    • entire elbow
    • distal humerus
    • proximal radius and ulna
  4. What is the patient and part position for an AP elbow (not fully extended) and how many views?
    • Patient seated
    • elbow partially flexed
    • 2 images obtained
    • Forearm to IR
    • Humerus to IR
  5. What is the criteria for an AP elbow (npot fully extended)?
    • Humerus-distal humerus
    • Forearm-proximal radius and ulna

    Elbow partially obscured
  6. What is the patient and part position for an AP Oblique Lateral with external rotation?
    • Patient seated with arm fully extended
    • Supinate hand
    • Rotate laterally
    • 45* rotation
  7. What is the criteria for an AP Oblique projection for elbow with external rotation?
    • radial head, neck, tuberosity free of superimposition
    • lateral epicondyle and capitulum in profile
  8. What is the patient and part position for an AP Oblique projection of the elbow with Medial Internal rotation?
    • Patient seated with arm fully extended
    • Hand pronated
    • Rotate medially
    • 45* rotation
  9. What is the criteria for an AP Oblique projection for the elbow with medial internal rotation?
    • coronoid process in profile
    • Superimposition of radius and ulna
  10. What is the patient and part position for a Lateral Projectio for the elbow?
    • Patient seated
    • Elbow flexed at a 90* angle
    • Drop shoulder
    • Thumb up
  11. What is the criteria for a lateral projection of the elbow?
    • Lateral humerus
    • three concentric circles
    • trochlear sulcus
    • double ridges of the capitulum and trochlea
    • and the trochlear notch
  12. What is the patient and part position for the Jones Method (elbow)?

    How many images?
    • Patient seated
    • Acutely flexed arm
    • No rotation
    • Epicondyles are equidistant
    • Two images obtained
  13. Where is the CR directed for The Jones Method (elbow)?
    • Distal humerus
    • -perp. to humerus
    • -midway between epicondyles
    • Proximal forearm
    • -perp tp forearm
    • -2" superior of olecranon process
  14. What is the criteria for the Jones Method for the distal humerus projection?
    • humerus and forearm superimposed
    • olecranon process
  15. What is the criteria for the Jones Method for the proximal forearm projection?
    ulna and radius
  16. What is the patient and part position for an AP humerus?
    • Patient erect or supine
    • Shoulder/elbow equidistant from ends of IR
    • Rotate body to bring shoulder and humerus in contact w/IR
    • Abduct arm
    • supinate hand
  17. Where is the CR directed for AP and Rotational Lateral projections of humerus?
    midpoint of humerus
  18. What is the collimation of AP and Lateral Rotational projections of humerus?
    • side borders of skin margins
    • include shoulder
    • include elbow and forearm
  19. What is the criteria for an AP projection humerus?
    • entire humerus
    • shoulder/elbow joints included
    • greater tubercle in lateral profile
    • Med/Lat epicondyles in profile (parallel)
  20. What is the patient and part position for Rotational Lateral: Humerus (lateromedial/medialateral)?
    • Lateromedial
    • -back to IR
    • -rotate body to bring shoulder and humerus in contact w/IR
    • -internal rotation
    • Medialateral
    • -facing IR
    • -oblique body to allow contact of humerus to IR
    • -elbow flexed 90*
  21. What is the criteria for a Rotational Lateral: Humerus?
    • entire humerus
    • true lateral
    • shoulder/elbow joints included
    • lesser tubercle in medial profile
    • MEd/Lat epicondyles superimposed (perpendicular)
  22. What is the patient and part position for Trauma Horizontal Beam Lat?
    • Patient recumbent
    • Elbow flexed
    • Cassette btw arm and thorax
    • top of IR at axilla
    • Place support under arm
  23. Where is the CR directed for Trauma projection of humerus?
    midpoint of distal 2/3 humerus
  24. What is the collimation for a Trauma humerus projection?
    • side borders to skin margins
    • include elbow and forearm
  25. What is the criteria for a trauma humerus?
    • mid and distal humerus
    • lateral projection
    • elbow joint included
    • elbow flexed 90*
    • Med/Lat epicondyles superimposed
  26. What is the patient and part position for a humerus when there is trauma?
    • Transthoracic with patient lateral to IR.
    • Affected side closest to IR.
    • Place affected arm at patients side in neutral rotation
    • Drop shoulder, if possible
    • Raise opposite arm and place hand on head
    • Elevate shoulder to prevent superimposition
  27. Where is the CR directed for a Transthoracic Lateral of Humerus?
    Center mid-diaphysis of affected humerus and center IR to CR as projected through thorax.
  28. What is the breathing technique for a Transthoracic Lateral Projection of the humerus?
    Patient should be asked to gently breath short, shallow breaths without moving affected arm or shoulder (this will allow best visualization by blurring out ribs)
  29. If patient is in too much pain to drop injured shoulder for Transthoracic lateral of humerus what should you do?
    Angle CR 10* to 15* cephalad
  30. What is the criteria for a Transthoracic Lateral Prjection of the humerus?
    • Lateral view of the entire humerus and glenohumerul joint should be visualized through the thorax without superimposition of the opposite humerus.
    • The relationship of the humeral head and glenoid cavity should be demonstrated
  31. What is the patient and part position for an AP/External Rotation of the shoulder?
    • Patient erect or supine
    • Rotate shoulder in contact with IR
    • anatomical position
    • Externally rotate arm
    • supinate hand
    • film 1-2" above shoulder
  32. Where should the CR be directed for AP projections of the shoulder?
    1" inferior to corocoid process
  33. What is the criteria for an AP/External projection of the shoulder?
    • True AP humerus
    • Epicondyles to IR
    • lesser tubercle anterior
    • Greater tubercle in profile laterally
  34. What is the patient and part position for AP-Lateral/Internal Rotation of the shoulder?
    • Patient erect or supine
    • Rotate shoulder in contact with IR
    • Internally rotate arm
    • Pronate hand
    • Film 1-2" above shoulder
  35. Where is the central ray directed for AP's of shoulder (external and internal rotation)?
    1" inferior to corocoid process
  36. What is the criteria for an AP Lat/Internal Rotation projection?
    • True lateral humerus
    • Epicondyles perpendicular to IR
    • Greater tubercle anterior
    • Lesser tubercle in profile medially
  37. What is the patient and part position for an Inferosuperior Axial Prjection of the shoulder (Lawrence Method)?
    • Patient supine
    • Shoulder raised 2" from table top
    • Abduct hand 90*
    • External rotation of the hand
    • head away
  38. Where is the CR directed for the Lawrence Method?
    Medial 25-30* to axilla and humeral head
  39. What is the breathing method for shoulder projections?
    suspend respiration
  40. What is the criteria for the Lawrence method?
    • lateral humerus
    • Profile of lesser tublercle and coracoid
  41. What is the patient position for the Grashey Method?
    • Patient supine
    • Rotate body 45*
    • Arm abducted
    • Neutral rotation
    • Film 2" above top and lateral borders
  42. What is the criteria for the Grashey Method?
    • Glenoid cavity in profile
    • No humeral head in superimposition
  43. What is the patient position for shoulder trauma oblique with neutral rotation?
    • Patient erect/supine
    • Rotate shoulder in contact with IR
    • No arm rotation
    • palms at sides
    • Film 1-2" above shoulder
  44. Where is the CR directed for a trauma shoulder oblique?
    Midscapulohumeral joint
  45. What is the criteria for an Oblique shoulder-trauma?
    • 45* obliqued humerus
    • Epicondyles 45* < to IR
    • Greater/Lesser tubercles anterior
  46. What is the patient position for a Transthoracic Lateral (Lawrence Method) trauma?
    • Erect/Supine
    • Lateral position
    • Affected arm at side in neutral rotation
    • Opposite arm over head
    • Drop injured shoulder
    • Elevate opposite shulder
  47. What is the breathing technique and exposure time for the Lawrence MEthod (trauma)?
    • Short shallow breaths
    • 2-4 sec exposure (longer than normal)
  48. What is the criteria for the Lawrence Method (trauma)?
    • Lateral proximal humerus
    • humeral cavity/glenoid cavity
    • neutral rotation
    • blurred out lungs
  49. What is the patient and part position for a scapular Y Lateral?
    • Erect/recumbent
    • Rotate into anterior oblique
    • 45-60*
    • Abduct arms
  50. Where is the CR directed for the Lawrence Method of the shoulder (trauma)?
    • through thorax at axilla
    • exits at surgical neck
  51. Where is the CR directed for the scapular Y lateral of shoulder?
    scapulohumeral joint
  52. What is the criteria for a scapular Y projection of the shoulder?
    • Lateral scapula
    • w/out rib superimposition
    • acromion and coracoid symmetrical
    • humeral head and scapula superimposed
  53. What is the patient and part position for an AP and Axial Projection of the clavicle?
    • Erect or supine
    • Arms at sides, chin raised, looking forward
    • Posterior shoulder in contact with IR w/o rotation
  54. Where and how is the CR directed for AP and Axial Projections of the clavicle?
    • AP: perpendicular to midclavicle
    • Axial: 15*-30* cephelad to midclavicle
  55. What is the preferred breathing method for AP and Axial Projections of the clavicle?
    • Suspend respiration at end of inhalation
    • -Helps to elevate clavicle
  56. What is the criteria for an AP projection of the clavicle?
    Entire clavicle including both AC and sternoclavicular joints
  57. What is the criteria for an axial projection of the clavicle?
    • Most of clavicle above scapula and ribs
    • Only medial portion of clavicles superimposed by 1st and 2nd ribs
  58. What should be done differently for an asthenic patient when taking an axial projection of the clavicle?
    Angle CR 10* to 15* more cephalad
  59. What is the patient and part position for a Lateral Projection (RAO or LAO) of the scapula?
    • Erect or recumbent
    • Face patient towards IR in an anterior oblique position
    • Patient rotated 30*-45* from lateral position
    • Arm reached across from of chest to grasp opposite shoulder or drop affected arm, flex elbow and place arm behind lower back partially abducted or let hang at side
  60. Where is the CR directed for a lateral projction of the scapula?
    to mid vertebral border of scapula
  61. What is the preferred breathing method for a lateral scapula?
    suspend breathing
  62. What is the criteria for a lateral projection of the scapula?
    • entire scapula in lateral position evidenced by direct superimposition of vertebral and lateral borders
    • body of scapula in profile
    • minimal superimposition of humerus on area of interest
  63. During a lateral prjection of the scapula what does reaching across chest do and what does dropping the arm demonstrate?
    • Requires less rotation
    • Demonstrates acromion and coracoid process
  64. What is the patient and part position for an AP projection of the AC joints?

    W/or w/out weights
    • Erect
    • Posterior shoulders against cassette with equal weight on both feet
    • Arms at side, no rotation of shoulders
  65. Where is the CR directed on an AP projection for the AC joints?
    perpendicular to midpoint between AC joints, 1" above jugular notch
  66. What is the criteria for an AP projection of the AC joints?
    • Both AC joints
    • Clavicles
    • SC joints
    • AC joints on same horizontal plane
  67. What is the patient position for AP scapula?
    • Erect or supine
    • Posterior shoulder in contact with IR
    • No rotation of thorax
    • Abduct arm 90* and supinate hand to move scapula laterally
  68. What is the preferred breathing method AP scapula?
    breathing technique
  69. What is the criteria for an AP projection of the scapula?
    • Lateral portion of scapula free of superimposition
    • Medial scapula seen through thoracic structures
    • Lateral border of scapula free of superimposition due to 90* abduction of arm

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