Final Flashcards
Centering for ap bilateral from mod cleaves for the pelvis
Perpendicular to a point 3 inches below the level of Asis ( 1 in superior to pubic symphysis
Centering for ap pelvis
Perpendicular entering midway between level of Asis and pubic symphysis about 2 in inferior to Asis
How much do you abduct femora in bilateral cleaves ?
40-45 from vertical (ensure both are abducted same amount )
Less abduction of ___ in mod cleaves will have what affect on femora
20-30 provides least amount of foreshortening of femoral necks, however provides foreshortening of entire femora
centering for Ap axial outlet Taylor method
Cephalad 20-35 for males and 30-45 for females @ midline point 1-2 inches inferior to superior border of pubic symphysis or greater trochanters
Centering for ap axial inlet projection
40 caudad near perpendicular to plane of inlet at midline point of level of asis
Centering for posterior oblique (judet method)
Downside: centered 2 inches distal and 2 in medial to ASIs
Upside: perpendicular to 2 in distal to upside of ASIs
How much do you oblique pt for judet method
45 degrees
What column is seen on upside of judet method ? Downside?
Downside: ilioischial column
Upside: iliopubic column
Centering for posterior axial oblique acetabulum (teufel)
1 inch superior to level of greater trochanter and approximately 2 in lateral to msp
Patient position for teufel method
Patient semiprone forming 35-40 degree angle from tabletop
Ap unilateral hip centering
Directed 1-2 inches distal to mid femoral necks
2 ways to find femoral necks
1-2 in medial, 3-4 inch distal ASIS
Midpoint of ASIs and Pubic symphysis , head of femur is at right angles from the midpoint and 1.5 distal neck is 2.5 in distal
What is a colcher-Sussman ruler
Used to measure the inlet and outlet of mothers pelvis and the baby’s head
Outlet is measured by ?
Measured by a line between two ischial tuberosity’s in the tip of the coccyx
What is it inlet measured by
The brim of the pelvis
Where are ischial tuberositys located
1 1/2 -2 inch below pubic symphysis
What does the pelvis mean
Basin
Pelvis consists of what
To hipbones sacrum and coccyx
What is the other name for the hip bones
Ossa coxae & innominate bones
Three divisions of hip bones what how much do they make up ?
Ischium: posterior 2/5
Ilium: upper 2/5
Pubis: 1/5 of acetabulum anteriorly
Curve located inferior to ischial spine? Superior ?
Inferior : lesser sciatic notch
Superior: greater sciatic notch
3 parts of the pubis
The body, superior ramis &inferior Ramis
What is cephalopelvimetry? What replaced it?
Measure the inlet and outlet to see if baby head would fit in birth canal replaced by ultrasound
How much do the femur and legs have to be rotated to place the femoral neck parallel with the IR
15-20
To common sites of fractures in elderly
Femoral neck and intertrochanteric crest
What is the a key in determining correct leg and foot position on radiographic image
Lesser trochanter is visible or not
Typical sign for fracture of femoral neck
External rotation of foot
Appearance of proximal femur for ap or external rotation is ?
Lesser trochanter visible
What is ddh
Development dysphasia of hip joint; congenital deformation misalignment of hip joint
Trauma lateral axiolateral inferosuperior danelius miller method centering
Ir is placed in crease above iliac crest adjusted so that it is parallel to femoral neck
-perpendicular to the central ray and femoral neck
What do you need to do with leg unless contraindicated in danelius miller method
Rotate internally 15-20
What is the lauenstein hickey method
Patient is rotated onto affected side until the femur is in contact in parallel to the IR
Lauenstein hickey method better demonstrates what?
Head and acetabulum
Modified axiolateral Clements nakayama method central Ray
Angled medially as needed so that it is perpendicular and centered to femoral neck… It should be angled 15 to 20 From horizontal
How should IR be placed in Clements nakayama
Ir tilted 15 from vertical and face ir perpendicular to cr
How much should leg be abducted for modified cleaves of the hip
45
What is the optimum abduction of the legs in modifed cleaves for the hip and proximal femur ?
20-30 to prevent foreshortening and better demonstration of femoral necks
Central Ray for ap femur
Perpendicular to mid femur top of Ir at level of ASIs and bottom of ir 2 in below knee joint
For ap of femur with knee included rotate leg
5
For ap femur with hip included rotate leg
15-20
Lateral of femur centering and leg flexed?
Center mid femur and knee is flexed 45 degrees on affected leg
Centering for sternum
Directed at center of sternum (1 in left of midline and midway between jugular notch and xiphoid process)
Position for sternum
Patient obliques 15-20 RAO thinner pt is 20, larger patient less rotation
Where should the top of the ir be for the sternum
1.5 inch above jugular notch
Breathing instructions for sternum exam?
Orthostatic for a min of 2 seconds otherwise on suspended expiration
How can you determine the amount of rotation for a sternum
Placing one hand on the spinous process in one on the sternum to determine when they are superimposed
Sternum may be performed ___ if patient condition doesn’t permit ____
May be performed lpo if RAO can’t be performed
How long is the sternum
6 to 7 inches
For a lateral sternum what is the Sid
60 to 72 inches is recommended to reduce magnification caused by an increased OID is 40 inches is used a bigger IR may be needed
Centering for a lateral Sternum
Perpendicular to IR entering at center of sternum
What is the alternative position for a lateral sternum
Patient supine with use of horizontal beam
Central ray for sternoclavicular joints
Perpendicular center t2-t3 (3 in distal to vertebral prominens)
Breathing instructions for sternoclavicular joints
Expose on expiration
Sternoclavicular joints bilaterally exam head placement
Rest patient had so midsagittal plane is vertical
Patient head position for unilateral exam
Turn patient head towards affected side
Sternoclavicular oblique central ray
T2-t3 (1-2 inches lateral?)
How much do you rotate the patient for sternoclavicular oblique projection
15-20 in the anterior oblique position toward affected side
RAO of sc joint will best demonstrate:
LAO of sc joint will best demonstrate:
RAO: right side
Lao: left side
What do you do if patient cannot do pa oblique for sc joint
Do them ap
How else can obliques be obtained for SC joints
Angling the center Ray 15° across the patient to project sternoclavicular joint lateral to vertebrae
Posterior ribs central Ray: AD? BD?
AD: 3-4 inches below jugular notch (T7) top of ir should be 1.5 in above shoulders
BD: centered to xiphoid process( bottom of ir at iliac crest)
Anterior ribs central Ray
Perpendicular to t7
Axiallary ribs central Ray
Midway between lateral margins of ribs and spine
AD: 3-4 below jugular notch
BD: level of xiphoid process
To demonstrate axillary portion of ribs rotate patient ?
Right: RPO & LAO
Left: LPO & RAO
What is the first and only requirement in the initial radiographic exam of a patient who has sustained severe trauma to rib cage
Take ap and lateral chest
Sternum consist of what three parts
Manubrium body and xiphoid process
What does the bony thorax consist of
The sternum thoracic vertebra and 12 pairs of ribs
What are the secondary names for the jugular notch
Suprasternal notch and manubrial notch
What is the only bony connection between each shoulder girdle in the bony thorax
Sternoclavicular joints
Where is the sternal angle located
T4-t5
Where does the body of the sternum meet the manubrium
Sternal angle
Xiphoid process also means what
Swordlike
Xiphoid tip is located at what level
T9-t10
Into your ribs do not unite directly with the sternum but with a short piece of cartilage called what
Costocartilage
What are the true ribs
First seven pair
What are the false ribs
Eight through 12
What are the floating ribs
11 and 12
What is intercostal spaces
The space between the ribs
The ribs are situated in an oblique plane slanting anteriorly and inferior anterior ends lie how many inches below the level of their vertebral ends
3 to 5 inches
What are the two ends of each rib
Sternal and and vertebral and
Three parts of a typical rib
The head neck and tubercles
What is the Costal groove
Located along the inferior and Internal border of each rib
If the first three ribs are fractured he could injure what
The vessels
Where is the bony thorax the widest
At the lateral margins of the eighth or ninth rib
What is the articulation between tubercle of rib and the transverse process of the thoracic vertebra
Costotransverse joint
What is the articulation between the head of the rib in the body of the thoracic Vertebra
Costovertebral joint
why do we perform a RAO of the sternum
Shifts the sternum to left of t-spine and into homogenous shadow of the heart
what sid produces quality images of the sternum it also results in an increase in the radiation exposure to the patient and is not recommended
30 inch
Patient’s skin should be at least how many centimeters below the surface of the collimator
15 in (38 cm)
What is flail chest
Fracture of adjacent ribs into or more places cause by blunt trauma and associated with pulmonary injury can lead to instability of chest wall
What is pectus carinatum ?
Congenital defect caused by anterior protrusion of lower sternum and xiphoid usually a by nine condition but could lead to cardio pulmonary complications
What is pectus excavatum
Funnel chest: congenital condition characterized by depressed sternum often corrected surgically for cosmetic reasons
