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MIS Projections > Angles > Flashcards

Angles Flashcards

To memorise the angles in various x-ray image projections.

1
Q

Where is the centre point for a finger projection (PA, Lateral and Oblique)?

A

Proximal-Inter-Phalangeal (PIP) Joint (first joint above knuckles)

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2
Q

What is the film size for a finger projection?

A

18 x 24

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3
Q

What is the centre point for a thumb projection?

A

1st Metacarpophalangeal (MCP) joint (knuckles), AKA thumb knuckle

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4
Q

What is the film size for a thumb projection?

A

18 x 24

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5
Q

What is the collimation for a thumb projection?

A

Distal phalanx (finger) to trapezium (bone directly under thumb)

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6
Q

What is the centre point for a PA or Oblique hand x-ray?

A

Head of the 3rd Metacarpal (3rd knuckle)

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7
Q

What is the centre point for a Lateral hand x-ray?

A

Head of the 2rd Metacarpal (2nd knuckle from the thumb)

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8
Q

What is the collimation for a hand x-ray?

A

Distal Radius & Ulna to distal Phalanges (fingers)

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9
Q

What is the elbow angle for a hand x-ray?

A

90 degrees

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10
Q

What is a Norgaard Series?

A

PA bilateral hands, and “ball catchers” bilateral hands. Film size is 24 x 30

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11
Q

What is the centre point for a wrist x-ray?

A

Lateral: radial styloid process
PA or Oblique: between radial and ulnar styloid processes

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12
Q

What is the elbow angle for a wrist x-ray?

A

90 degrees

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13
Q

What is the collimation for a wrist x-ray?

A

Distal 1/3rd of radius and ulna to mid-MC (middle of palm)

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14
Q

What deviation of the hand is used for a scaphoid image?

A

Ulna deviation, external/ lateral deviation

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15
Q

What angle is used for a scaphoid x-ray?

A

30 degrees towards elbow (cephalad technically)

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16
Q

What is in a scaphoid series?

A

PA wrist, Oblique wrist and angled PA - all with ulnar deviations. And then a lateral wrist

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17
Q

What is the centre point for a lateral and AP forearm

A

Mid forearm

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18
Q

What direction should the hand face for a AP forearm?

A

Hand supinated, palm up

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19
Q

What angle should the elbow be for a lateral forearm?

A

90 degrees, thumb facing upward

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20
Q

What positions are in a elbow series

A

AP, external oblique, and lateral

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21
Q

What is the technique for a radial head projection?

A
  1. 45 degree cephalad tilt (along humerus)
  2. Patient perpendicular to table
  3. elbow flexed at a 90 degree angle
  4. centre point is radial head
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22
Q

What is in a trauma shoulder series?

A

AP, Glenohumeral joint, lateral

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23
Q

What is the technique for a AP shoulder?

A

Positioning: internal or external rotation, just ensure the opposite is done for the GH

Centre point: 2.5cm inferior to coracoid process

Central Ray: perpendicular to patient

Collimation: include clavicle, scapula and soft tissue

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24
Q

What is the technique for a GH shoulder?

A

Positioning: patient rotated 35-45 degrees facing the beam, affected side on plate, opposite hand rotation to AP

Centre point: GH joint

Central Ray: 15-20 degrees caudad

Collimation: tight to GH

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25
Q

What is the technique for a lateral shoulder

A

Positioning: patient facing the buckey, rotate 45-60 degrees to IP, affected side on IP, hand on tummy

Centre point: mid scapula

Central ray: perpendicular

Collimation: to include scapula and acromion

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26
Q

What is in a chronic shoulder series?

A

AP, GH, Neer’s and SI (Axial)

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27
Q

What is a Neer’s projection?

A

A shoulder projection of joint outlet

Positioning: patient facing bucky, body rotated 45-60 degrees, affected side on IP, arm by side or across abdomen

Centre point: humeral head or mid-scapula, depending on request

Central ray: 10-15 degrees caudad

Collimation: tight to outlet or whole scapula, depending on request

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28
Q

What is a SI (axial) projection?

A

Positioning: patient sitting, arm abducted, elbow flexed 90 degrees, head tilted away from affected side as much as possible

Centre point: shoulder joint

Central ray: 5-15 degrees to elbow (caudad)

Collimation: soft tissue and joint

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29
Q

What is the difference between a 1st presentation clavicle and a follow up clavicle?

A

1st presentation: AP shoulder
Follow up: AP clavicle
Both have an Axial clavicle

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30
Q

What is the angle for an axial clavicle?

A

15-30 degrees cephalad

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31
Q

What is in a scapula series?

A

AP shoulder, lateral shoulder

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32
Q

What is an AC joint series?

A

AP bilateral non-weight bearing
AP bilateral weight bearing

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33
Q

What is in a humerus series?

A

AP, lateral

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34
Q

What is the technique for a lateral humerus?

A

Patient is perpendicular to IP, and their elbow is extended posteriorly, with their hand on their abdomen

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35
Q

What are all the types of chest x-rays? (5)

A
  1. PA Chest
  2. Lateral
  3. AP supine chest (patient laying on back)
  4. Lateral decubitus (patient laying on their side)
  5. Lordotic (patient leans back)
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36
Q

What is the angle for a lordotic chest, when a patient cannot lean back?

A

15-20 degrees cephalad

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37
Q

Inhale or Exhale for a standard chest x-ray?

A

Inhale

38
Q

What is the difference between a LPO and RAO?

A

RAO has the patient facing the buckey, LPO the patient faces the beam

39
Q

What is the centre point for an AP lower ribs?

A

Midline between zyphoid and lower rib cage

40
Q

Inspiration or expiration for an AP ribs?

A

Inspiration

41
Q

Where should the bottom of the image plate be for an AP ribs?

A

Top of iliac crests

42
Q

When do you do an LPO?

A

oblique ribs of one affected side

43
Q

When do you do a RAO

A

RAO sternum, and RAO SCJ

For bilateral SCJ, an LAO is also required.

44
Q

How much should the patient be rotated for a RAO

A

15 - 20 degrees

45
Q

For a sternum RAO, which shoulder should always be on the image plate?

A

right shoulder because it decreases the likelihood of other structures superimposing the sternum

46
Q

What is the centre point for a RAO sternum?

A

2.5cm left of the spine, mid sternum level

47
Q

If you use the Moore method to take a RAO sternum, what degree should the x-ray tube be turned?

A

15-25 degrees

48
Q

Where should the arms be for a lateral sternum?

A

Hands should be clasped behind the back, and shoulders pulled back to bring sternum out

49
Q

What is the centre point for a PA SCJ?

A

T3, through midline

50
Q

What is in a toe series?

A

Dorsal-Plantar (DP), oblique, lateral

51
Q

What angle is used for a DP toe?

A

10 degrees cephalad

52
Q

What is the centre point for a DP toe?

A

Metatarsal-phalangeal joint, first toe knuckle

53
Q

What is the collimation for a DP and oblique toe?

A

Tight to toe, but include 1/2 the metatarsal

54
Q

What direction should you rotate the knee for a DP toe?

A

internally rotate knee

55
Q

What directions should you rotate the foot for a lateral toe?

A

Internal rotation: big toe (hallucis), 2nd and 3rd digits

External rotation: 3rd, 4th and 5th (digiti minimi) digits

56
Q

What is the difference between an acute/ trauma foot x-ray series and a chronic one?

A

All chronic projections are done weight bearing (i.e. standing to bear own body weight)

57
Q

What angle is used for a DP foot?

A

10 degrees cephalad

58
Q

What is the centre point for an oblique and DP foot?

A

Base of 3rd metatarsal

59
Q

Is the knee bent for a DP foot?

A

yes

60
Q

Internal or external rotation of the knee for an oblique foot?

A

internal

61
Q

Where is the other leg positioned for a lateral foot?

A

behind the leg in question to prevent rotation of foot in question

62
Q

Is the foot dorsiflexed or plantarflexed for a lateral foot x-ray

A

dorsiflexed at 90 degrees

63
Q

What is a sesamoid series for the foot?

A

DP, oblique, lateral foot + axial

64
Q

physically show the position for a Axial (prone) foot and a axial (supine) foot

A

prone: foot upside down, toes on image plate, arch overdone to prevent the heel from accidentally being imaged

supine: foot right way up, heel on image plate, band used to pull toes out the way

65
Q

What is the difference between a acute/ trauma ankle series and a chronic series?

A

The chronic series are all weight bearing (i.e. patient is standing so their own body weight acts as a weight)

66
Q

What is in a ankle series

A

AP, oblique/ mortise, lateral

67
Q

What is a mortise ankle?

A

x-ray to image ankle at a 45 degree angle.

It is done by putting the leg straight out, and then medially rotating the knee by 30 degrees

68
Q

How much of the lower leg should you include in an ankle x-ray?

A

distal 1/3rd of the tibia and fibula

69
Q

What is a calcaneus series?

A

Heel series, includes a lateral and axial

70
Q

What is the centre point for a lateral calcaneum?

A

Mid-calcaneus, 2.5cm inferior to medial malleolus

71
Q

How is the foot positioned for an axial calcaneus

A

Foot supine, heel on plate, dorsiflexion as much as possible

72
Q

What angle is used for an axial calcaneus?

A

40 degrees down through the heel

73
Q

What is in a Tib/Fib series?

A

AP and lateral

74
Q

What is in an acute/ trauma knee series?

A

AP and horizontal ray lateral

75
Q

What angle is the beam for an AP knee?

A

+- 5 degrees

76
Q

What is the centre point for an AP knee

A

2.5cm distal to patella

77
Q

What is the centre point for a lateral knee?

A

Midpoint of knee joint

78
Q

What is in a chronic knee series?

A

AP Bilateral weight-bearing
Skyline bilateral
Intercondylar
Lateral

79
Q

What is the midpoint for bilateral AP knees?

A

Performed standing, 1.5cm inferior/ below to patella

80
Q

What angle should the knee be bent for bilateral skyline (axial) knee?

A

45 degree bend

81
Q

What angle is the beam for a bilateral Skyline?

A

10-15 degrees uptilt (ceph)

82
Q

what is the centre point for a skyline knee?

A

midway between patellae

83
Q

Where does the image plate go for a skyline knee?

A

Patient hold it upright on their abdomen

84
Q

What angle is the knee flexed at for a intercondylar knee

A

40-45 degrees

85
Q

What angle should the beam be for an intercondylar knee?

A

40 - 45 degrees cephalad

86
Q

Where does the image plate go for an intercondylar knee?

A

below the knees, preferably not in the table buckey

87
Q

What is the centre point for an intercondylar knee?

A

1.5 cm inferior to patella apex

88
Q

How much should the knee be flexed for a lateral knee?

A

20 - 30 degrees

89
Q

What can you do to make the knee more lateral if the patient is too rotated?

A

rotate the opposite hip to affected knee anteriorly or posteriorly, depending on what is required

90
Q

What is the central ray angle for a lateral knee?

A

5 degrees cephalad

91
Q

Is the medial or lateral side facing up for a lateral knee?

A

medial side

92
Q

What is the centre point for a lateral knee?

A

2.5cm distal to medial epicondyle

MIS Projections (1 decks)

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