Positioning 2 Test 4 PDF

Distal humerus AP projection Acute Flexion Position of patient: ​ Seat the patient at the end of the radiograph table with the elbow fully flexed Position of part: ​ Center the IR proximal to the epicondylar area of the humerus. ​ The long axis of the arm and forearm should be parallel wit...

Distal humerus AP projection Acute Flexion Position of patient: ​ Seat the patient at the end of the radiograph table with the elbow fully flexed Position of part: ​ Center the IR proximal to the epicondylar area of the humerus. ​ The long axis of the arm and forearm should be parallel with the long axis of the IR Central Ray: ​ Perpendicular to the humerus approximately 2 inches superior to the olecranon process Collimation: ​ Adjust radiation field to include the proximal half of the forearm and 1 inch beyond olecranon process and sides on the elbow Structures Shown: ​ This position superimposes the proximal forearm and distal humerus ​ the olecranon process should be clearly shown Proximal Forearm PA projection Acute Flexion Position of part: ​ Center the flexed elbow joint to the corner of the IR ​ The long axis of the superimposed forearm and arm should be parallel with the long axis of the IR Central Ray:  ​ Angled perpendicular to the flexed forearm entering approximately 2 inches distal to the olecranon process Structures Shown: ​ This position superimposes the proximal forearm and distal humerus ​ The elbow joint should be more open than for the projection of the distal humerus Distal Humerus AP projection Partial Flexion: Position of Patient: ​ Seat the patient low enough to place the entire humerus on the same plane ​ Support elevated forearm Position of Part: ​ If possible, supinate the hand. ​ Place the IR under the elbow, elevated to the condyloid area of the humerus Central Ray: ​ Perpendicular to the humerus, traversing the elbow joint. ​ Depending on the degree of Flexion, angle the CR distally with the joint Collimation: ​ Adjust the radiation field 3 inches proximal and distal to the elbow joint and 1 inch on the sides​ Structures shown: ​ The distal humerus when the elbow cannot be fully flexed Proximal Forearm AP Projection Partial Flexion: Position of Patient: ​ Seat the patient at the end of the radiographic table, with hand supinated Position of Part: ​ Seat the patient 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 ​ Adjust the IR so that it passes at midpoint Structures Shown: ​ The proximal forearm when the elbow cannot be fully flexed Radial Head Lateral Projection: Position of Part: ​ Flex the elbow 90º center the joint to the IR and place the joint in the lateral position ​ 1st exposure -hand supinated ​ 2nd exposure - hand lateral ​ 3rd position - hand pronated ​ 4th position - hand in extreme internal rotation Central Ray: ​ Perpendicular to elbow joint Collimation: ​ Adjust radiation field to 3 inches proximal and distal to the elbow joint Structures Shown: ​ The radial head is projected in varying degrees of rotation Radial Head and Coronoid Process Axiolaterla Projection: Position of Patient: ​ Place the humerus, elbow, and wrist joints in the same plane ​ Pronate the hand and flex the elbow 90º (radial head) or 80º (Coronoid process) ​ Center the IR to the elbow joint Supine Patient: ​ Elevate distal humerus on radiolucent sponge ​ Place IR vertically centered to elbow joint ​ Epicondyles should be perpendicular ​ Slowly flex the elbow 90º (radial head) or 80º (Coronoid process) ​ Turn the hand so that the palmar aspect is facing medially Central Ray: RADIAL HEAD: ​ Directed toward shoulder ar 45º to radial head (SEATED) ​ Horizontal CR directed cephalad at 45º to radial head (SUPINE) CORONOID PROCESS: ​ Direct away from shoulder at 45º to Coronoid process (SEATED) ​ Horizontal CR directed caudad at 45º to Coronoid process (SUPINE) Structures Shown: ​ Resulting projection show an open elbow joint between the radial head and capitulum ​ Resulting projection show an open elbow joint between the Coronoid process and trochlea