Forearm, Elbow, and Humerus
How many AP projections are necessary to best demonstrate the elbow without distortion when an injury prevents full extension of the elbow? (BC)
2 projections
What is the collimation for a AP forearm? Where do you center? (JL)
2" distal and proximal of the forearm and 1" side to side. Center at the mid forearm.
For the AP distal humerus projection, what part of the upper limb should be parallel and in contact with the IR? (MW)
Distal Humerus
For the AP projection of the forearm, how should the elbow be positioned? (MW)
Fully extended
AP Humerus (te)
Greater tubercle is in profile.
For the lateral projection of the forearm, how should the elbow be positioned? vs
flexed 90 degrees
What projection or radiographic position best demostrate the anatomy of a Olecranon process? (JL)
Lateral Elbow
For the axiolateral projection of the ulnar coronoid process the elbow is flexed at what angle? (SL)
80 degrees
For the axiolateral projection of the radial head to be best demonstrated when the elbow is flexed at what angle? (SL)
90 degrees
Which projection of the thumb requires the patient to rotate the hand into extreme internal rotation? (KAYLE)
AP projection
routine for an forearm (SM)
AP& Lateral
For the AP proximal forearm projection, what part of the upper limb should be parallel and in contact with the IR? (MW)
Radius and Ulna
The forearm contains two bones?
Radius and ulna
How would pronation of the hand affect an AP elbow? (JL)
Radius crosses over Ulna.
Axiolateral elbow for radial head requires what angle on the CR and what direction? (SL)
Central ray angled 45 degrees toward shoulder
Which two things can be done to improve image quality for a Transthoracic Lateral for Proximal Humerus? BB
Suspend Breathing & Breathing Technique
Condyle (MG)
rounded process at an articular extremity
Tubercle (CC)
small, rounded, elevated process
How should the humeral epicondyles appear in the image of the lateral projections of the elbow? vs
superimposed
How should the humeral epicondyles appear in the image of the lateral projection of the forearm? (Kayle)
superimposed over each other
Name two reasons Griswold gave for flexing the elbow at a 90 degree angle. (Mikew)
(1)the olecranon process can be seen in profile. (2) the elbow fat pads are less compressed.
Projections for Radial Head (SM)
-AP oblique projection with lateral rotation -Coyle method,axiolateral projection, part at 90 degrees, cr 45 degrees medial angulation.
AP Partial Flexion Elbow (Trauma) (SM)
-When patient is unable to straighten eblow, it is necessary to do an AP partial flexion -AP for distal humerus- CR perpendicular to the humerus at joint -AP for proximal forearm- CR perpendicular to the foream at joint.
in which A.P. projection with partial flexion does the prox. radius S.I. over the ulna(JR)
...
when doing a lateral projection of the elbow, what two positioning techniques will ensure a true lateral image.(JR)
1) adjust the hand in a lateral position -w- thumb to the top side 2) check to ensure epicondyles are perpindicular to the I.R.
How many fat pads are associated with the elbow that are only seen on lateral projections? (JB)
3 Fat pads
How much medial rotation of the elbow is needed to position it for AP oblique projections? (MP)
45 degrees
Intertubercular groove (CC)
A depression or groove between the greater & lesser tubercle
Styloid process (CC)
A long pointed process at the distal end of the radius and ulna
What projection or radiographic position best demostrate the anatomy of a Greater Tubercle? (JL)
AP Humerus
Greater Tubercle is in profile view lateraly in a... (MA)
AP Humerus Radiograph
The Capitulum should be visual in a... (MA)
AP Lateral Oblique Elbow
Which fat pad resembles a tear drop? BB
Anterior Fat Pad
How do you know if you have used the right technique for imaging the forearm. (NC)
BTST
What is the most common mistake made when doing a Lateral Humerus? BB
Clipping the shoulder.
AP Medial Oblique of the elbow best shows? (MA)
Coronoid process and the trochlear
Axiolateral elbow for radial head is also known as what method? (SL)
Coyle Method
Lateral Elbow (MW)
Epicondyles superimposed. CR perpendicular to elbow joint. 3 inches proximal and distal, 1 inch on sides. Epicondyles parallel to IR. AOI-elbow joint. Radial head superimposed over coronoid process
Coyle Method (Coronoid process) (MG)
Hand pronated, arm is angled 80 degrees, CR 45 degrees away from body/shoulder
What structure of the proximal radius are seen slightly superimposed over the proximal ulna in the AP projection of the elbow?(Mikew)
Head,neck, and radial tuberosity
The distal end of the Humerus is called?(HR)
Humeral Condyle
Lateral elbow (te)
Humeral epicondyles are superimposed.
If you are doing a lateral projection with the patient in the lateral recumbent position and an IR is placed between the arm and the thorax, which portion of the humerus is missing from the image? (BC)
Humeral head
This joint is between the capitulum of the distal humerus and the radial head? (SL)
Humeroradial joint
Epicondyles and Condyles should be superimposed in a... (MA)
Lateral Forearm Radiograph
Lesser Tubrecle is in profile view medally in a... (MA)
Lateral Humeral Radiograph
How should the forearm and elbow be rotated to best demonstrate the radial head free of superimposition from the ulna? (Kayle)
Laterally (externally)
What is the method name for the transthoracic lateral projection? (TS)
Lawrence Method
State the method name for the transthoracic lateral projection used in this class and give the anatomy demonstrated. (JB)
Lawrence Method - Lateral humerus - proximal side of the humerus
Which AP oblique projection positioning movement requires the hand to be pronated? (MW)
Medial Rotation
Which AP oblique projection positioning movement requires the hand to be pronated? (MP)
Medial rotation
In what projection are fat pads visible? (TS)
Only seen on lateral projections
Why would you use an AP Partial Flexion projection? (TS)
Only used when patient is unable to straighten elbow.
When doing a humerus projection and positioning what three projections and positions can you do if the patient is not able to stand? (Mikew)
Patient lying down; AP projection;lateral projection, humerus in lateromedial recumbent position; lateral projection, humerus in a lateromedial recumbent or lateral recumbent position.
AP Elbow (CC)
Patient seated at the end of the table. 10 X 12" transverse. Supinate hand, entire upper extremity on the same plane, CR perpendicular to elbow joint, 40" SID. Collimate 3" proximal and distal to the elbow joint & 1" on the sides. Epicondyles should be parallel with the image receptor. Shield patient.
AP Forearm (CC)
Patient seated at the end of the table. 14 x 17" LW. CR perpendicular to mid-forearm. 40" SID, Supinate hand, include both joints. Collimate 2" proximal to elbow joint and 2" distal to wrist joint, & 1" on the sides. Entire limb should be on the same plane. Shield patient.
Lateral forearm (CC)
Patient seated at the end of the table. 14 x 17" LW. Flex elbow 90 degrees, CR perpendicular to mid-forearm. 40" SID, thumb up, include both joints. Entire limb should be on the same plane. Collimate 2" proximal and distal & 1" on the sides. Shield patient.
Describe how to best position the IR for the lateral projection of the humerus if the AP projection radiograph clearly shows a fracture 2 inches (5cm) superior to the elbow. Mikew
Place the IR between the humerus and thorax
Which fat pad covers the largest area and lies within the Olecranon Fossa of Posterior Humerus? BB
Posterior Fat Pad
When doing a AP Oblique (medial rotation) what position is the hand in? (TS)
Pronate
What position should the hand be in for the axiolateral projection (Coyle Method) of the elbow? (BC)
Pronated
How would pronation of the hand affect a lateral elbow?(JL)
Pronation of the hand on a lateral causes the radius to rotate medially would prevent true lateral alighnment of the radius and ulna.
How would pronation of the hand affect a lateral elbow? (JB)
Pronation would not give a true lateral.
The joint space between the Radial Head and the Coronoid Process is?( HR)
Proximal Radioulnar Joint
Which structure articulates with the trochlea (NC)
Proximal Ulna
AP Partial Flexion - Distal Humerus (te)
Proximal radius superimposed over the ulna, greatly foreshortened proximal forearm
What specific anatomy is best demonstrated on axiolateral projection (Coyle Method) of the elbow when the CR is directed 45 degrees toward the shoulder? (BC)
Radial head
AP Elbow (te)
Radial head and tuberosity are slightly superimposed over the proximal ulna.
AP oblique lateral rotation (te)
Radial head is projected free of ulna.
Coyle Method (Radial head) (MG)
Seated- pronate hand & flex elbow 90 degrees, CR 45 degrees toward body/shoulder
A long pointed process at the distal end of the radius & ulna? (MP)
Styloid process
What structure on the distal end of the ulna should be seen in the image of the AP projection of forearm? (Kayle)
Styloid process
How should the humeral epicondyles appear in the image of the lateral projection of the elbow? (MP)
Superimposed
How should the hand be placed for the AP projection of the humerus? (BC)
Supinated
How should the hand be placed for the AP projection of the humerus? (KAYLE)
Supinated
The humerus can be examined with the patient in either ______ or ______ position. vs
Supine / upright
There are areas of Fat Pads? ( HR)
The posterior fat pat that covers the largest areas and lies on the olecranon fossa posterior humerus, the anterior fat pad that lies on the cornoid and radial foasse of the anterior humerus and the supinator fat pad which positioned anterior to and parallel with the anterior aspect of the proximal radius
What may be the only evidence of injury on a Lateral Elbow? BB
The visualization of the fat pads because an elbow injury causes effusion and displaces the fat pads or alters their shape.
Why should the shoulder, humerus, and elbow be on a level plane for projections of the forearm and elbow? (JB)
To open up the joint space (also to prevent foreshortening)
Small, rounded elevated process? (MP)
Tubercle
How many AP projections are necessary to best demonstrate the elbow without distortion when an injury prevents full extension of the elbow? (Mikew)
Two
What is the purpose of doing a transthoracic lateral projection? (TS)
When trauma has occurred and pt. can't rotate or abduct arm. When proximal humerus is fixed and a true lateral is needed.
Coronoid Process (MG)
anterior surface of ulna, projects anterior and slightly superior, beaklike
In which radiographic position is the radial tuberosity facing anteriorly.(JR)
lateral elbow.
Where is the capitulum located. (NC)
lateral side of the distal humerus
Epicondyle (MG)
projection above condyle
In the Ap proximal forearm projection which part of the upper limb will appear greatly forshortened? vs
proximal radius and ulna
the proximal end of the radius is small and presents a flat disklike area that is called what? (JR)
radial head
What is slightly superimposed on an AP elbow? (JB)
radial head, neck and tuberosity
just below the radial head is a somewhat constricted area that is called what? (JR)
radial neck
When imaging a lateral forearm what bones are supposed to be completely superimposed. (NC)
radius and ulna
How should the hand be placed for the AP projection of the humerus. (NC)
supinated
How should the hand be placed for the AP projection of the humerus? vs
supinated