Radiographic Techniques: Distal Humerus & Proximal Forearm

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Questions and Answers

What is the difference in positioning of the IR between the Distal Humerus AP projection Acute Flexion and the Distal Humerus AP projection Partial Flexion?

The IR is positioned perpendicular to the humerus in the Acute Flexion projection and parallel in the Partial Flexion projection.

The IR is positioned proximal to the epicondylar area of the humerus in the Acute Flexion projection, and under the elbow in the Partial Flexion projection. (correct)

The IR is centered to the corner of the IR in the Acute Flexion projection and under the elbow in the Partial Flexion projection.

The IR is placed to the long axis of the forearm and arm in the Acute Flexion projection and to long axis of the arm in the Partial Flexion projection.

In which projection does the long axis of the arm and forearm need to be parallel with the long axis of the IR?

Distal Humerus AP projection Acute Flexion

Distal Humerus AP projection Partial Flexion

Both A and B (correct)

Proximal Forearm PA projection Acute Flexion

For the Distal Humerus AP projection Acute Flexion, where should the central ray be directed?

Angled perpendicular to the flexed forearm, entering 2 inches distal to the olecranon process.

Perpendicular to the humerus, traversing the elbow joint.

Perpendicular to the humerus, entering 2 inches distal to the olecranon process.

Perpendicular to the humerus, approximately 2 inches superior to the olecranon process. (correct)

What is the purpose of supinating the hand when performing a Distal Humerus AP projection Partial Flexion?

This is not specifically mentioned in the text, but it is likely to help align the humorous for the central ray. (C) Signup and view all the answers

What is a key difference between the Distal Humerus AP projection Acute Flexion and the Proximal Forearm PA projection Acute Flexion?

All of the above. (D) Signup and view all the answers

Which of the following positions should the patient be in for a Proximal Forearm AP Projection Partial Flexion?

Seated with hand supinated (D) Signup and view all the answers

What is the primary purpose of making multiple exposures during a Radial Head Lateral Projection?

To clearly visualize the radial head in various degrees of rotation (A) Signup and view all the answers

When performing a Radial Head and Coronoid Process Axiolateral Projection, how is the patient's hand positioned?

Palmar aspect facing medially (B) Signup and view all the answers

What is the angle of the central ray directed toward the shoulder when performing a Radial Head Axiolateral Projection in a seated patient?

45 degrees (B) Signup and view all the answers

In a Supine patient, what should be perpendicular for a Radial Head and Coronoid Process Axiolateral Projection?

The epicondyles and the table (C) Signup and view all the answers

What is the primary structure visualized in a Coronoid Process Axiolateral Projection?

The coronoid process (B) Signup and view all the answers

What is the recommended collimation for a Radial Head Lateral Projection?

3 inches proximal and distal to the elbow joint (D) Signup and view all the answers

Which of the following is a recommended positioning technique for a Proximal Forearm AP Projection Partial Flexion if the elbow cannot be fully extended?

Angle the CR distally with the joint (C) Signup and view all the answers

Study Notes

Distal Humerus AP Projection (Acute Flexion)

Patient positioned at the end of the radiographic table with the elbow fully flexed.
The image receptor (IR) is centered proximal to the humerus' epicondylar area.
The long axes of the arm and forearm should be parallel to the long axis of the IR.
Central ray is perpendicular to the humerus, approximately 2 inches superior to the olecranon process.
Collimation should include the proximal half of the forearm and 1 inch beyond the olecranon process and sides of the elbow.
The projection superimposes the proximal forearm and distal humerus.
The olecranon process should be clearly visible.

Proximal Forearm PA Projection (Acute Flexion)

Center the flexed elbow joint at the corner of the IR.
The long axes of the superimposed forearm and arm should be parallel to the long axis of the IR.
Central ray is angled perpendicular to the forearm entering approximately 2 inches distal to the olecranon process.
This position superimposes the proximal forearm and distal humerus.
The elbow joint should be more open than in a distal humerus projection.

Distal Humerus AP Projection (Partial Flexion)

Patient seated low enough to place the entire humerus on the same plane.
Support the elevated forearm.
If possible, supinate the hand.
The IR is placed under the elbow, positioned over the condyloid area of the humerus.
Central ray is perpendicular to the humerus, traversing the elbow joint. Angling the central ray distally may be necessary based on the degree of flexion.
The radiation field is adjusted to 3 inches proximal and distal to the elbow joint, and 1 inch on the sides.
The distal humerus is shown in cases where the elbow cannot be fully flexed.

Proximal Forearm AP Projection (Partial Flexion)

Patient positioning is similar to the previous projection.
The elbow joint is centered on the IR.
The long axis of the superimposed forearm and arm should be parallel to the long axis of the IR.
Central ray angled perpendicular to the flexed forearm, entering approximately 2 inches distal to the olecranon process.
Superimposing the proximal forearm and distal humerus.

Radial Head Lateral Projection

Position the patient at the radiographic table, with the hand supinated.
Ensure the patient is positioned high enough to permit the dorsal surface of the forearm to rest on the table.
Central ray perpendicular to the elbow joint and long axis of the forearm; passing through the midpoint of the elbow.
Flex the elbow 90 degrees, centering the joint on the IR and placing it laterally.
Four different positions—1st exposure (hand supinated), 2nd (hand lateral), 3rd (hand pronated), and 4th (hand in extreme internal rotation) —are recommended for different views.
The exposed area covers 3 inches proximal and distal to the elbow joint.

Radial Head and Coronoid Process Axiolateral Projection

Patient positioned with the humerus, elbow, and wrist joints in the same plane.
Pronate the hand and flex the elbow either 90° (radial head) or 80° (coronoid process).
Center the IR on the elbow joint.
Position with the patient supine: elevate the distal humerus on radiolucent sponge, with the IR vertically centered on the elbow joint.
Ensure epicondyles are perpendicular.
Gradually flex the elbow to 90° (radial head) or 80° (coronoid process).
Turn the hand to position the palmar side medially.
Central ray, angled to the shoulder: 45° towards the radial head (seated) or horizontally cephalad at 45° to the radial head (supine)
Central ray, angled away from the shoulder: 45° to the coronoid process (seated), or horizontally caudad at 45° to the coronoid process (supine).
Projected view shows an open elbow joint between the radial head and capitulum, and between the coronoid process and trochlea.

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Description

Test your knowledge on the specific radiographic projections for acute flexion of the distal humerus and proximal forearm. This quiz covers positioning, central ray alignment, and imaging techniques vital for accurate radiographic results. Perfect for radiography students and professionals alike!