RADIOGRAPHIC POSITIONING(Lecture 2nd Copy) pp 76

by: Frank

BONE MARKINGS AND FEATURES

PROCESSES OR PROJECTIONS

Condyle – rounded process at an articular extremety.Crest – ridgelike processCoracoid or coronoid – beaklike or crownlike

processEpicondyle – projection above a condyleFacet – small, smooth surface for articulation with

another structureHamulus – hook-shaped processHead – expanded end of a long boneHorn – hornlike process on a boneMalleolus club-shaped processProtruberance – projecting part of prominenceSpine – sharp processStyloid – long, pointed processTrochanter – either of two large, rounded, and

elevated processes ( greater or major and lesser or minor) located at junction of neck and shaft of femur

Tubercle – Small, rounded, and elevated process

Tuberosity – Large, rounded, and elevated process

DEPRESSIONS

Fissure – cleft or deep grooveForamen – hole in a bone for transmission of blood

vessels and nervesFossa – pit,fovea, or hallow spaceGroove – shallow linear channelMeatus – tubelike passageway running within a boneNotch – Indentention into the border of a boneSinus – Recess, groove, cavity or hallow space such

as (1) a recess or grove in bone- as used to designate a channel foe venous blood or inner surface of cranium.

Sulcus – furrow, trench, or fissurelike depression

FRACTURE> is break in the bone. Several terms pertain to

fractures:.Closed – fracture that does not break through

the skin.Open - serious fracture in which the broken

bone or bones project through the skin

.Nondisplaced – Fracture in which the bone retains its normal alignment

.Displaced - more serious fracture in which the bones are not in anatomic alignment

COMMON CLASSIFICATIONS OF FRACTURES

CompressionOpen or compoundSimpleGreenstickTransverseSpiral or obliqueComminuted

` `>Impacted

ANATOMIC RELATIONSHIP TERMSPP 77

Anterior ( Ventral ) – refers to forward or front part of the body or forward part of an organ

Posterior ( Dorsal) – refers to the back part of a body or organ ( note, however that the superior surface of the foot is referred to as the dorsal surface)

Caudad – refers to parts away from the head of the body

Cephalad – refers to the part towards the head of the body

Superior – refers to nearer the feet or situated below

Central- refers to mid area or main part of an organPeripheral – refers to part at or near the surface,

edge, or outside of another body part.Medial refers to parts towards the median plane of

the body or toward the middle of another body part.

Lateral – refers to parts away from the median plane of the body or away from the middle of another body part to the right or left

Superficial – refers to parts near the skin or surfaceDeep – refers to parts far from the surfaceDistal – refers to parts farthest from the point of

attachment, point or reference, origin, or beginning, away from the center of the body.

Proximal – refers to parts nearer the point of attachment, point or reference, origin or beginning; toward the center of the body

External – refers to parts outside an organ or on the outside of the body

Internal – refers to parts within or on the inside of an organ

Parietal – refers to the wall or lining of a body cavityVisceral – refers to the covering of an organIpsilateral – refers to a part or parts on the same side

of the bodyContralateral – refers to a part or parts on the

opposite side of the bodyPalmar – refers to the palm of the hand

Plantar – refers to the sole of the footDorsum refers to the top or anterior surface of the

foot of to the back or posterior surface of the hand

FOUR POSITIONING TERMS MOST COMMONLY USED IN RADIOGRAPHY

1. Projection2. Position3. View4. Method

PROJECTION – define as the path of the CR as it exits the x-ray tube and goes trough the patient to the IR. Point of entry and point of exit.

AP PROJECTION – perpendicular CR enters the anterior body surface and exits the posterior body surface. AP projection can also be achieved with upright , seated or lateral decubitus positions.

PA PROJECTION - CR is entering the posterior body surface and exiting the anterior body surface. Can also achieved with seated, prone,

*ventral recumbent) and lateral decubitus positions.

AXIAL PROJECTION - There is longitudinal angulation of the CR with long axis of the body or a specific body part. This angulation is based on the anatomic position and is most often produced by angling the CR cephalad or caudad

The term AXIA L , as used- refers to all projections in which the longitudinal angulation between the

CR and long axis of the body part is 10 degrees or more .

TANGENTIAL PROJECTION- CR is directed toward the outer margin of a curved body surface to profile a body part just under the surface and project it free of superimposition.

LATERAL PROJECTION-a perpendicular CR enters one side of the body or body part, passes transversely along the coronal plane, and exits on the opposite side.

OBLIQUE PROJECTION – The CR enters the body or body part from side angle following an oblique plane. It may enter from either side of the body and from anterior or posterior surface.

POSITIONS –used in two ways in radiology:1) identifies the overall posture of the patient of

the general body position: EX: upright, seated or supine

2) The other refers to the specific placement of the body part in relation to the radiographic table of IR during imaging.Itmay be: right lateral, left anterior oblique LAO, RAO

PRIMARY X-RAY PROJECTIONS: BODY POSITIONS

General Body Position

AP UprightPA SeatedLateral SupineAP oblique PronePA Oblique RecumbentAxial Fowler’sAP Axial TrendelenburgPA AxialAP Oblique RadiographicBody

PA Axial Oblique PositionsAP Axial Oblique LateralAxiolateral RightAxiolateral oblique LeftTranstthoracic Oblique

Craniocaudad RPOTangential LPOInferosuperior RAOSuperoinferior LAOPlantodorsal DecubitusDorsoplantar Right lateralLateromedial Left lateralMediolateral /VentralSubmentoverical DorsalAcanthioparietal LordoticParietocanthialOrbitoparietalParieto-orbital

Give laboratory exercises on different positions:Page 78 – 87 and practical exercises

PROJECTIONS1. AP2. PA3. AXIAL 4. Tangential5. Lateral6. Lateromedial

POSITIONS1. Supine position2. Prone3. Recumbent

4. Trendelenburg5. Fowler’s6. Sim’s7. Lithotomy8. Left lateral9. Right lateral10. RAO11. LAO LPO12. RPO 13. Medail Rotation14. Right lateral decubitus15. Left lateral decubitus16. Left ventral decubitus17. Left Dorsal decibitus18. LOrdotic position

BODY MOVEMENT TERMINOLOGY( Assignement)

1. Abduct or adduction – movement of a part away from the central axis of the body

2. Adduct or adduction – movement of a part toward the central axis of the body or body part/

3. Extension – straightening of a joint4. Flexion – act of bending a joint 5. Hyperextension6. evert-eversion7. invert- inversion8. pronate/pronation

9. supinate/supination10. rotate/rotation11. circu,mduction12. tilt13. deviation

BODY MOVEMENT TERMINOLOGY

Abduct or Abduction- movement of a part away from the central axis of the body or

body part.Adduct or Adduction – movement of a part toward

the central axis of the body or body part.Extension- Straightening of a joint: when both

elements of the joint are in the anatomic position; the normal position of the

joint.Flexion – Act of bending of a joint: the opposite of

extension.Hyperextension – forced or excessive extension of a

limb or a joint.Hyperflexion – forced overflexion of a limb or jointEvert/Eversion – Outward turning of the foot at the

anklePronate./Pronation – rotation of the forearm so that

the palm is down

Supinate/supination – rotation of the forearm so that the palm is up ( in the anatomic

position)Rotate/rotation- Turning or rotating of the body part

around its axis. Rotation of a limb will be either medial (toward the midline of the

body from the anatomic position. Or lateral ( away from the midline of the body from the anatomic position.Circumduction – circular movement of a limbTilt – tipping or slanting a body part slightly. The tilt

is in relation to the long axis of the body.Deviation – a turning away from the regular standard

or course.

ANATOMY OF THE UPPER LIMBpage 93 -100

CARPAL TERMINOLOGYCONVERSION

Preferred SynonymsProximal row:Scaphoid NavicularLunate SemilunarTriquetrium Triquetral, cuneiform or

triangularPisiform (none)

Distal rowTrapezium Greater multangularTrapezoid Lesser multangularCapitate Os MagnumHamate Unciform

SUMMARY OF ANATOMY

HAND ARMPhalanges ( bones of digits) humerusDigits

Head HUMERUSBody humeral condyleBase trochlea

Metacarpals capitulumCarpals medial epicondyle

Lateral epicondyleMETACARPALS coronoid fossaFirst to fifth metacarpals radial fossa

Head olecranon fossaNeck bodyBody surgical neckBase lesser tubercle

Sesamoids greater tubercleIntertubercular groove

WRIST anatomic neck

Scaphoid headLunteTriquetrium ARTICULATIONSPisiform interphalangelTrapezium metacarpophalangealTrapezoid carpometacarpalCapitate intercarpalHamate radioulnarHook of hamate humeroulnarAnatomic snuffbox humeroradial

CARPAL SULCUS FAT PADSCarpal tunnel anterior fat padsFlexor retinaculum posterior fat padsMedian nerve supinator fat padsFlexor tendons

( Give Quiz) Labeling - carpals bones- metacarpals- whole hand

FOREARMUlnaRadius

ULNA from here proceed to Olecranon process positioning of the hand

Torchlear notch 2nd USBCoronoid processRadial notch page 102 – 123 handBodyHeadUlnar styloid process

RADIUS HeadNeckRadial tuberosityBodyRadial styloid process

( Give quiz – labeling ulna and radius)

ARM - Labeling exam- humerus- elbow joint AP and lateral