Rad Positioning- Upper Extremity
What is the tube tilt for "Y" view of shoulder film?
10 degree caudal tube tilt
What is the cassette size and orientation for AP shoulder with external rotation film?
10x12, crosswise
What is the cassette size and orientation for AP shoulder with internal rotation?
10x12, crosswise
What is the cassette size and orientation for PA hand film?
10x12, crosswise
What is the cassette size and orientation for PA wrist film?
10x12, crosswise
What is the cassette size and orientation for lateral wrist film?
10x12, crosswise
What is the cassette size and orientation for medial oblique hand film?
10x12, crosswise
What is the cassette size and orientation for medial oblique wrist film?
10x12, crosswise
What is the cassette size, placement, and orientation for the clavicle series?
10x12, crosswise
What is the cassette size and orientation for AP elbow film?
10x12, lengthwise
What is the cassette size and orientation for PA wrist with ulnar deviation?
10x12, lengthwise
What is the cassette size and orientation for medial oblique elbow?
10x12, lengthwise
What is the cassette size and orientation for lateral elbow film?
10x12, long axis of the film is parallel to the forearm
What is the cassette size and orientation for "Y" view of shoulder film?
10x12, vertical *"lengthwise"*
What is the FFD for ALL extremity views?
40"
What is the CR placement for "Y" view of shoulder film?
a point 1/2 " inferior to intersection of medial border of scapula + scapular spine
T/F: Fingers do not have to be curled for PA wrist with ulnar deviation
False, ALWAYS CURL FINGERS WITH ANY WRIST FILM
T/F: The distal row of metacarpals should be visualized wit a PA wrist view
False, proximal row of metacarpals should be visualized
T/F: Patients are supine for elbow, wrist, or hand views?
False, seated
T/F, Supertech: You must double the mAs for the AC series after calculation
False: half the mAs
T/F: The clavicles can only be shot on an AP view
False: you can shoot x-rays either AP or PA for clavicles
What should the hand placement be for all wrist views?
Fingers curled loosely in a fist
Accessory views for the shoulder?
Grashey's and Y projection
What are the 5 accessory views of the upper extremity?
Grashey's projection "Y" projection PA wrist with ulnar deviation Lateral thumb AP thumb
What anatomy is visualized for medial oblique elbow?
coronoid process, elbow joint, distal humerus, and proximal radius/ulna
What is the patient placement for PA hand film?
hand *pronated*, fingers slightly spread
What is the cassette size and orientation for AC joint unweighted/weighted film?
8x10, crosswise
What is the cassette size and orientation for lateral hand film?
8x10, lengthwise
What is the CR placement for AC joint unweighted/weighted film?
@ AC joint
Where do you measure for the clavicle series?
AP through the mid-portion of the clavicle
Where do you measure for AC series?
AP through the shoulder
ID blocker for AP with IR or ER goes where?
Towards the spine
Where does the ID blocker go for the accessory shoulder views?
Towards the spine
T/F: All cassettes are oriented crosswise in all films of the standard wrist series
True
T/F: The only difference between AP elbow and medial oblique elbow is that the hand is pronated in the medial oblique view
True
T/F: You measure through the central ray for all films in the wrist series
True
What is the orientation of the scapula compared to the film for "Y" view of shoulder film?
scapula in lateral position *perpendicular* to the bucky
What does the Mitchell marker signify in extremity films?
side being x-rayed
When is it okay to take a PA wrist with ulnar deviation film?
if a wrist series has already been performed
What is the patient placement for lateral hand film?
place hand in lateral position, ulnar side touching film
What is the patient placement for lateral elbow film?
*flex elbow 90º* with forearm in a true lateral position (thumb up)
What is the patient placement for PA wrist film?
*palm down* with a *relaxed fist*
What is the CR placement for AP shoulder views?
1" inferior to coracoid process
What is the CR placement for AP shoulder with external rotation film?
1" inferior to coracoid process
Tube tilt for PA axial clavicle:
15 degrees caudal
What is the tube tilt for AP axial clavicle?
15º cephalic
What is the CR placement for AP elbow film?
Antecubital fossa
What is the central ray placement for medial oblique elbow?
Antecubital fossa
What is the shielding for all extremities?
Half apron
What is the purpose of having the fingers curled in a loose fist?
It flattens out the carpals against the film
What is the collimation for lateral hand film?
Longitudinally and horizontally to film size
What is the collimation for lateral wrist film?
Longitudinally to film size, horizontally to include soft tissues
What is the collimation for AP elbow film?
Longitudinally to film size, laterally to include soft tissues
What is the collimation for PA hand film?
Longitudinally to film size, laterally to include soft tissues
What is the collimation for PA wrist film?
Longitudinally to film size, laterally to include soft tissues
What is the collimation for medial oblique elbow?
Longitudinally to film size, laterally to include soft tissues
What is the collimation for medial oblique hand film?
Longitudinally to film size, laterally to include soft tissues
What is the collimation for medial oblique wrist film?
Longitudinally to film size, laterally to include soft tissues
What is the CR placement for PA wrist film?
Lunate
What is the CR placement for PA wrist with ulnar deviation film?
Lunate
What is the CR placement for medial oblique wrist film?
Lunate
What is the CR placement for lateral wrist film?
Proximal carpal row
What is the CR placement for lateral elbow film?
Radial head
What is the purpose of PA wrist with ulnar deviation?
Stresses the scaphoid, so it is able to demonstrate fractures of the scaphoid
Is the hand supinated or pronated for AP elbow?
Supinated
What is the tube tilt for AC joint unweighted/weighted film?
There is none :)
Where do you measure for AP elbow?
Through the central ray
T/F: There is no tube tilt for Frontal clavicle
True, only tube tilt for axial clavicle
What film is performed to confirm dislocation of the humerus?
Y projection
What is the only shoulder view that the cassette is lengthwise?
Y projection
What is the patient placement for AC joint unweighted/weighted film?
arms at patient's sides in neutral anatomic position
What is the breathing instructions for all extremity views?
don't breathe don't move
What is the patient placement for medial oblique wrist film?
from PA position supinate wrist 45 degrees
What is the CR placement for lateral hand film?
head of the 2nd metacarpal
What is the CR placement for PA hand film?
head of the 3rd metacarpal
What is the CR placement for medial oblique hand film?
head of the 3rd metacarpal
What anatomy does the AP shoulder with internal rotation help visualize?
lesser tuberosity
What is the CR placement for the clavicle series?
mid clavicle
What is the general rule for extremity imaging with regards to using table top or bucky?
parts under 11 cm = table top •upper extremities hand thru elbow are table top
What is the patient placement for "Y" view of shoulder film?
patient in anterior oblique position with affected shoulder against bucky
What is the patient placement for AP elbow film?
seated; shoulder, elbow, and wrist parallel with table top
What is the patient placement for medial oblique hand film?
supinate hand *45º* from PA; make O.K. sign
Bucky or table top for lateral elbow film?
table top
Do you use the bucky or table top for the elbow series?
table top
What is the collimation for "Y" view of shoulder film?
to film size
What is the collimation for AC joint unweighted/weighted film?
to film size
What is the collimation for AP axial clavicle?
to film size
What is the collimation for AP shoulder with internal rotation film?
to film size
What is the collimation for Frontal clavicle film?
to film size
What is the collimation for lateral elbow film?
to film size
What is the collimation for AP shoulder with external rotation film?
to film size •10x12
What anatomy does the AP with external rotation help visualize?
•greater tuberosity
What is the patient placement for lateral wrist film?
wrist in true lateral position with the *ulna touching* film; wrist is straight and thumb tucked behind index MCP
What 2 films make up the AC joint series?
•unweighted •weighted
What films of the upper extremity are *NOT* crosswise?
•"Y" projection •AP elbow •Medial oblique elbow •Lateral elbow* •PA wrist with ulnar deviation •Lateral hand
What 3 films of the upper extremity have tube tilts, and what are those tube tilts?
•"Y" view, 10º caudal •AP axial clavicle, 15º cephalic •PA axial clavicle 15º caudal
What films make up the standard elbow series?
•AP elbow •lateral elbow •Medial (internal) oblique
What are the standard shoulder series?
•AP with *internal* rotation •AP with *external* rotation
What 2 films make up the clavicle series?
•Frontal clavicle (AP) •Axial clavicle (AP)
What 3 films make up the hand series?
•PA hand •Medial oblique hand •lateral hand
What 3 films make up the standard wrist series?
•PA wrist •Medial oblique wrist •lateral wrist
