Image Analysis Final (central rays) Flashcards
CR: Digits 2-5
perpendicular to PIP joint of affected digit
CR thumb/first digit:
perpendicular to MCP joint
CR for PA and oblique hand:
perpendicular to the 3rd MCP joint
CR for lateral hand:
perpendicular to the 2nd MCP joint
CR for wrist
perpendicular to midcarpal area
what is best demonstrated on a PA oblique wrist:
trapezium and distal half of scaphoid
what is best demonstrated on AP oblique wrist?
pisiform
CR for AP and Lateral forearm:
perpendicular to the midpoint of the forearm
why is AP forearm is done over PA?
pronation of hand crosses radius over ulna at the proximal third and rotates the humerus medially creating an oblique – AP keeps them separated
CR for AP elbow?
perpendicular to elbow joint
What is best demonstrated on the lateral elbow?
olecranon process
CR for AP medial oblique elbow:
perpendicular to elbow joint
what is best demonstrated on AP Medial oblique elbow?
coronoid process
CR for AP Lateral Oblique elbow:
perpendicular to elbow joint
what is best demonstrated on AP Lateral Oblique Elbow?
radial head and neck
CR AP and Lateral humerus:
perpendicular to the mid-portion of the humerus and the center of the IR
CR for AP External SHoulder:
perpendicular 1 inch inferior to coracoid process
Hand placement for AP External shoulder?
supinate the hand
what is best demonstrated on the AP external shoulder?
greater tubercle
CR for AP internal shoulder:
perpendicular 1 inch inferior to coracoid process
hand placement for AP internal shoulder
back of hand on hip
what’s best demonstrated on an AP internal shoulder?
lesser tubercle
CR for Transthoracic Lateral Shoulder
perpendicular to the IR entering the MCP at the level of the surgical neck
Placement of affected arm in a Transthoracic Lateral Shoulder
By side
Placement of unaffected arm in a Transthoracic Lateral Shoulder
Raise it and rest forearm on head and elevate shoulders as much as possible
CR for Axillary Shoulder (Inferosuperior)
horizontally through the axilla to the region of AC articulation – medial angulation of CR depends on degree of abduction of arm (15-30)
What is the lesser tubercle placement in Axillary Shoulder(inferosuperior)
in profile and directed anteriorly
CR for bilateral AP AC joints:
perpendicular to the midline of the body at the level of the AC joints for a single projection
CR for AP Axial AC joints:
Directed to the coracoid process at a cephalic angle of 15 degrees
CR for AP Clavicle:
perpendicular to midshaft of the clavicle
CR for AP Axial Clavicle:
15 degrees cephalic enter the midshaft of the clavicle
What is the purpose of angulation for AP Axial Clavicle?
To project the clavicle off the scapula and ribs
CR for AP scapula
perpendicular to mid-scapular area at a point approximately 2 inches inferior to the coracoid process
Where is the affected arm placed for a AP scapula?
Abduct the arm to a right angle with body, flex the elbow, and support the hand in a comfortable position
CR for lateral scapula:
perpendicular to the mid-medial border of the protruding scapula
What makes up the “Y” in the lateral scapula?
Acromion, coracoid process, and body of scapula
CR for AP Axial Toes
15 degrees posteriorly through 3rd MTP joint
CR for AP oblique Toes:
Perpendicular and entering the third MTP joint
CR for Lateral Toes:
entering IP joint for great toe or proximal IP joint for lesser toes
CR for AP or AP Axial Foot
10 degrees toward the heel entering the base of 3rd metatarsal
or
entering base of third metatarsal
CR for lateral foot
perpendicular to the base of third metatarsal
CR for AP medial Oblique Foot
base of third metatarsal
Degree of obliquity for AP Medial Oblique Foot
30 degrees
AP Medial Oblique Foot critique for correct rotation
if more than 30 degrees the lateral cuneiform tends to be thrown over other cuneiforms – cuboid in profile
CR for Axial Calcaneus
cephalic angle of 40 degrees to the long axis of the foot entering the base of the third metatarsal
CR for lateral calcaneus
1 inch distal to medial malleolus – subtalar joint
CR AP ankle
perpendicular through the ankle joint at a point midway between the malleoli
CR Lateral Ankle:
perpendicular to the ankle joint entering the medial malleolus
CR for AP medial oblique ankle:
perpendicular to the ankle joint entering midway between malleoli
AP medial oblique ankle critique to check rotation
distal ends of the tibia and fibula shown and tibiofibular articulation should be shown
CR AP and Lateral Lower Leg
perpendicular to the center of the leg
CR AP knee
5 degrees cephalic 1/2 inch inferior to the patellar apex
CR Lateral Knee
5-7 cephalic 1 inch distal to medial epicondyle
CR AP medial oblique knee
1/2 inch inferior to the patellar apex
Patient position for intercondylar fossa (camp Coventry)
prone – patient knee to a 40-50 degree angle
CR of intercondylar fossa (camp Coventry)
perpendicular to the long axis of the lower leg and centered to the knee joint – angle 40 degrees when knee is 40 degrees
CR for tangential patella (settegast method)
perpendicular to the joint space between the patella and the removal condyles when the joint is perpendicular – angle 15-20 degrees
CR for AP Femur
perpendicular to the mid-femur
what is the purpose of rotating limb internally 15-20 degrees on a AP Femur?
places femoral neck in profile
CR for lateral femur
perpendicular to the mid-femur
CR for AP Pelvis:
2 inches inferior to ASIS and 2 inches superior to pubic symphysis
how to check for proper lower limb rotation in AP pelvis?
if femoral necks parallel with plane of image receptor
CR for AP Hip:
perpendicular to femoral neck
AP Hip, hip localization technique:
left thumb on ASIS, second finger is on superior margin of pubic symphysis. CR is positioned 1.5 inches distal to center of line drawn between ASIS and pubic symphysis
CR for lateral frog hip
perpendicular through the hip joint (midway between ASIS and pubic symphysis)
Greater tubercle position in lateral frog hip
greater trochanter overlaps femoral neck
CR Axiolateral Hip
perpendicular to long axis of the femoral neck
Relationship of femoral neck and IR in Axiolateral Hip
parallel
CR AP open mouth
perpendicular to center of IR and entering the midpoint of open mouth
Position of mouth for AP Open Mouth
open mouth as wide as possible, adjust head so that a line from the low edge of the upper incisors to the tip of the mastoid process is perpendicular to IR
AP Open Mouth SID and why:
30 inch to increase the field of view of the odontoid area
AP Axial Cervical CR
15-20 degrees cephalic through C4
which vertebra must be see on AP Axial Cervical
C3-T2
what is demonstrated on the AP Axial Cervical
the lower 5 cervical bodies, upper 2 or 3 thoracic bodies, the interpediculate spaces, the superimposed transverse and articular processes and the intervertebral disk spaces
CR lateral cervical
horizontal and perpendicular to C4
SID for lateral cervical and why
60-72” increased object to IR distance to show C7
what is best demonstrated on lateral cervical
spinous processes and cervical bodies and interspaces, open zygapophyseal joints