Forearm, Elbow, and Humerus Flashcards
What two bones does the forearm consist of?
-ulna
-radius
located on the medial side
Ulna
located on the lateral side
Radius
What is located on the ulna?
-olecranon process (proximal and posterior)
-coronoid process (proximal and anterior) be like process
-trochlear notch
-radial notch
-body (shaft)
-head (distal end)
-ulnar styloid process (distal end)
What is located on the radius?
-radial head (proximal)
-neck (proximal)
-radial tuberosity( proximal)
-body
-radial styloid process
Considered a long bone in the upper arm
Humerus
What does the head of the humerus articulate with?
Articulates with scapula to form shoulder joint
What does the distal end of the humerus form?
Part of the elbow joint
Proximal humerus consist of:
-head
-anatomical neck (superior)
-surgical neck (most fractures)
-greater tubercle (lateral aspect of humerus)
-lesser tubercle
-intertubercular groove (bicipital groove)
What does the distal humerus consist of:
-medial epicondyle (ulna)
-lateral epicondyle (radius)
-trochlea
-capitulum (articulate with radial head)
-coronoid fossa
-olecranon fossa (posterior)
-radial fossa (received radial head)
portion of the humerus that articulates with the radial head?
capitulum
Essential Projections: Forearm
-AP
-Lateral
what is the collimation for the forearm?
2 inches distal to the wrist and proximal to the elbow and 1 inch on the sides
What is the position for AP Forearm?
-elbow fully extended with hand supinated
-long axis of forearm aligned parallel
-Upper limb in the same plane
-Slight superimposition of the radial head, neck, and tuberosity over the proximal ulna
What is the central ray for the AP forearm?
-perpendicular to IR
-Enters patient at midpoint of forearm
When the hand is supinated in an AP forearm
The radius and ulna do not crossover
When the hand is prone in an AP forearm?
The radius and ulna crossover each other
What is the position for a lateral forearm?
-elbow flexed at 90 degrees
-include wrist and elbow joint (distal humerus)
-ulnar and radial styloid process superimposed
-rotate hand into a lateral position (thumb down)
-Keep everything in the same plane
What is the central ray for the lateral forearm?
-perpendicular to the IR
-enters patient at midpoint of forearm
-epicondyles will be perpendicular
-radial tuberosity facing anteriorly
Essential Projections: Elbow
-AP
-Lateral
-AP Oblique (medial rotation) (lateral rotation)
-AP partial flexion
(for distal humerus) and (proximal forearm)
-Axiolateral (Coyle method)
What makes up the elbow joint?
-humerus
-radius
-ulna
Elbow joints consist of:
-proximal radioulnar joint (radial head articulates with radial notch on ulna)
-humeroulnar joint (humerus articulates with trochlea notch)
-humeroradial joint (humerus with head)
In the lateral elbow, you will be able to see
anterior fat pad (teardrop)
if it doesn’t look like a teardrop the anterior fat pad
the radial head has a fracture
When you bend your arm, what happens?
The elbow joint is closed
What is the position for AP elbow?
-upper limb in the same plane with posterior surface in contact with IR
-elbow extended and hand supinated
-elbow centered to middle portion of IR
-epicondyles are parallel with the IR
Where do you center for AP elbow?
perpendicular to elbow joint
What is the collimation for AP elbow?
3 inches proximal and distal to the elbow joint and 1 inch on the sides
What is the criteria for AP elbow?
Radial head, neck, and tuberosity is slightly superimposed over the proximal ulna
What is the part position for the lateral elbow?
limbs all in the same plane
-elbow flexed 90 degrees
-turn hand up in a lateral position
-don’t worry about thumb
-forearm resting on ulnar surface
-wrist in a true lateral
-epicondyles perpendicular to IR
What is criteria for the lateral elbow?
-elbow joint open
-superimposed epicondyles
-radial tuberosity facing anteriorly
-radial head partially superimposing the coronoid process
-olecranon process in profile (only in lateral)
If elbow is not flexed at 90 degrees for the lateral elbow
the posterior elbow fat pad will be seen and stimulates joint pathology
What is the part position for AP Oblique Elbow (medial rotation)
-limb in the same plane
-elbow center IR
-pronate hand (internally)
-epicondlyes will now be at a 45 degrees
Where do we center for the AP Oblique Elbow (medial rotation)
perpendicular to elbow joint
What is the criteria for the AP Oblique Elbow (medial rotation)?
-best demonstrates the coronoid process in profile
-elongates medial epicondyle
-ulna superimposed by the radial head and neck
-trochlea is being demonstrates
-olecranon process within the olecranon fossa
What is the part position for AP Oblique Elbow (lateral rotation)
-limb in the same plane
-elbow extended
-elbow centered to IR
-Supinate hand and laterally (externally) away from the body
-Epicondyles will be at a 45 degrees
-First and second digit will touch table that’s when you will know if you rotated elbow enough
Where do you center for the AP Oblique Elbow (lateral position)
perpendicular to elbow joint
What is the criteria for AP Oblique Elbow (lateral position)?
-elbow joint space open
-radial head off the ulna
-radial neck off the ulna
-radial tuberosity off the ulna
-capitulum is being demonstrated
-lateral epicondyle elongated
What is the part position for AP Elbow Distal Humerus (Partial Flexion)
-humerus resting on IR
-forearm elevated supoorted
-supinate hand, if possible, center IR to condyles of humerus
Where do we center for the AP Elbow Distal Humerus (Partial Flexion)
Perpendicular to humerus, passing through elbow joint
AP Elbow Distal Humerus (Partial Flexion) show?
-humerus in contact demonstrates distal humerus without rotation or distortion
-proximal radius superimposed over the ulna
-joint space is closed
-foreshortened proximal forearm
What is the position for AP Ebow Proximal Forearm (Partial Flexion)?
- leave elbow flexed, place dorsal surface of forearm on IR
-supinate hand if possible - proximal radius and ulna without rotation or distortion
-partially open eblow joint
-foreshortened distal humerus
-radial head, neck, and tuberosity slight superimposed over proximal ulna
Where do we center for AP Elbow Proximal Forearm (Partial Flexion)?
perpendicular to elbow joint and long axis of forearm
Why do we do the Axiolateral (Coyle Method)?
To demonstrate trauma of radial head and coronoid process if you are unable to do the obliques of the elbow
For the radial head for Coyle Method you need to?
-Elbow at 90 degrees
-Angle 45 degrees toward shoulder
What does the Coyle method show for the radial head?
-open joint space between radial head and capitulum
-epicondyles are distorted as a result of central ray angulation
-radial tuberosity facing posteriorly
-radial head, neck, tuberosity in profile and free from superimposition
-radial head elongated
-radial head off ulna
For the Coyle Method what do you do for the coronoid process?
-elbow flexed at 80 degrees
-Angled 45 degrees away from the shoulder (angle down)
Essential projections: Humerus
-AP
-lateral
lateral for known or suspected fracture
What is the collimation for the humerus?
2 inches distal to the elbow joint and superior to the shoulder, and 1 inch on the sides
What does the Coyle Method of the coronoid process show?
-open joint space between the coranoid process and trochlea
-coranoid process in profile
What is the part position for AP Humerus?
-place top border of IR approximately 1 1/2 inches (3.8 cm) above humeral head
-slight abduct humerus from body and supinate hand
-coronal plane passes through epicondyles and they will be placed parallel to IR
Where do we center for the AP Humerus?
perpendicular to mid portion of humerus and centered to IR
What do you see in an AP Humerus?
-see elbow and shoulder joints
-epicondyles are without rotation parallel
-humeral head and greater tubercle in profile to the lateral
-outline of the lesser tubercle, located between the humeral head and the greater tubercle
-beam divergence resulting in distortion of the elbow joint
What is the part position for Lateral Humerus?
-place top border of IR approximately 1 1/2 inches (3.8 cm) above humeral head
-if posssible internally roate humerus, flex elbow 90 degrees
-rest palm of hand on hip
-epicondyles are perpendicular to the IR
Where do we center for the Lateral Humerus?
Mid humerus
Where do we center for the Lateral Humerus?
Mid humerus
What do you see in a lateral Humerus?
-elbow and shoulder joint
-superimposed epicondyles (perpendicular to IR)
-lesser tubercle in profile on medial aspect (best demonstrated)
-greater tubercle superimposed over the humeral head
What’s the breathing technique for the humerus?
Suspended breathing
