Upper extremity anatomy & positioning

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Anatomia y Posicionamiento de las extremidades superiores. Deseo aclarar que el video no me pertenece de ninguna manera. Se esta compartiendo publicamente con el fin de ayudar a los futuros tecnologos a obtener conocimiento para su revalida.

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Upper extremity anatomy & positioning

  1. 1. Radiographic Anatomy and Positioning of the Upper Extremity Dennis Winders Jeff Ahrendsen
  2. 2. Anatomy
  3. 3. Upper extremity consists of: <ul><li>Phalanges </li></ul><ul><li>Metacarpals </li></ul><ul><li>Carpals </li></ul><ul><li>Radius </li></ul><ul><li>Ulna </li></ul><ul><li>Humerus </li></ul>
  4. 4. Anatomy of the Hand & Wrist
  5. 5. The hand & wrist consists of : <ul><li>27 Bones </li></ul><ul><ul><li>Phalanges - 14 </li></ul></ul><ul><ul><li>Metacarpals - 5 </li></ul></ul><ul><ul><li>Carpals - 8 </li></ul></ul>
  6. 6. Phalanges <ul><li>Fingers & thumb </li></ul><ul><li>3 separate bones Digits 2-5 </li></ul><ul><ul><li>Proximal </li></ul></ul><ul><ul><li>Middle </li></ul></ul><ul><ul><li>Distal </li></ul></ul><ul><ul><ul><li>Tuft </li></ul></ul></ul><ul><li>Thumb </li></ul><ul><ul><li>Proximal </li></ul></ul><ul><ul><li>Distal </li></ul></ul>
  7. 7. Naming of Digits <ul><li>1 </li></ul><ul><li>2 </li></ul><ul><li>3 </li></ul><ul><li>4 </li></ul><ul><li>5 </li></ul><ul><li>Thumb </li></ul><ul><li>Index </li></ul><ul><li>Middle </li></ul><ul><li>Ring </li></ul><ul><li>Little </li></ul>
  8. 8. Joints <ul><li>Interphalangeal </li></ul><ul><li>Metacarpophalangeal </li></ul><ul><li>Distal Interphalangeal </li></ul><ul><li>Proximal Interphalangeal </li></ul>
  9. 9. Metacarpals <ul><li>Palm </li></ul><ul><li>Numbering </li></ul><ul><li>Three parts </li></ul><ul><ul><li>Head </li></ul></ul><ul><ul><li>Shaft </li></ul></ul><ul><ul><li>Base </li></ul></ul><ul><li>Joints </li></ul><ul><ul><li>MP </li></ul></ul><ul><ul><li>Carpometacarpal </li></ul></ul>Head Base Shaft
  10. 10. Carpals (Wrist) <ul><li>8 bones </li></ul><ul><li>Proximal row </li></ul><ul><ul><li>Navicular - Scaphoid </li></ul></ul><ul><ul><li>Lunate - Semilunar </li></ul></ul><ul><ul><li>Triquetral - Cuneiform </li></ul></ul><ul><ul><li>Pisiform </li></ul></ul>a b c d
  11. 11. Carpals (continued) <ul><li>Distal row </li></ul><ul><ul><li>Greater Multangular - Trapezium </li></ul></ul><ul><ul><li>Lesser Multangular - Trapezoid </li></ul></ul><ul><ul><li>Capitate - Os Magnum </li></ul></ul><ul><ul><li>Hamate - Unciform </li></ul></ul>a b c d
  12. 12. Mnemonic <ul><li>Never </li></ul><ul><li>Lower </li></ul><ul><li>Tillies </li></ul><ul><li>Pants </li></ul><ul><li>Grandma </li></ul><ul><li>Might </li></ul><ul><li>Come </li></ul><ul><li>Home </li></ul><ul><li>Some </li></ul><ul><li>Sassy </li></ul><ul><li>Children </li></ul><ul><li>Play </li></ul><ul><li>Through </li></ul><ul><li>Their </li></ul><ul><li>Old </li></ul><ul><li>Underwear </li></ul><ul><li>Some </li></ul><ul><li>Lovers </li></ul><ul><li>Try </li></ul><ul><li>Positions </li></ul><ul><li>That </li></ul><ul><li>They </li></ul><ul><li>Can’t </li></ul><ul><li>Handle </li></ul>Alternative mnemonic
  13. 13. Carpal Joints <ul><li>Radiocarpal </li></ul><ul><li>Intercarpal </li></ul>
  14. 14. Distal Radius & Ulna <ul><li>Radial Styloid Process </li></ul><ul><li>Ulnar Styloid Process </li></ul><ul><li>Distal Radioulnar Jt. </li></ul>
  15. 15. Radiographic Anatomy
  16. 16. A. B. C. D. E. F. G. H.
  17. 17. Tuft 2nd DIP Jt. 2nd PIP Jt. 2nd MP Jt. IP Jt. 1st MP Jt. CM Jt. Radiocarpal Jt.
  18. 18. A. B. C. D.
  19. 19. Trapezium Trapezoid Scaphoid Pisiform
  20. 20. A. B. C. D.
  21. 21. Os Magnum Semilunar Unciform Cuneiform
  22. 22. Carpal Canal <ul><li>Trapezium </li></ul><ul><li>Os Magnum </li></ul><ul><li>Unciform </li></ul><ul><li>Pisiform </li></ul>
  23. 23. Motions of the Hand & Wrist <ul><li>Radial Flexion (Ulnar Deviation) </li></ul><ul><li>Ulnar Flexion (Radial Deviation) </li></ul>
  24. 24. Positioning of the Hand & Wrist
  25. 25. Finger <ul><li>Routine projections </li></ul><ul><ul><li>PA </li></ul></ul><ul><ul><li>Medial Oblique </li></ul></ul><ul><ul><li>Lateral Oblique </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><li>Film size </li></ul><ul><li>SID </li></ul><ul><li>CR </li></ul>
  26. 26. PA
  27. 27. Lateral
  28. 28. Medial oblique
  29. 29. Lateral oblique
  30. 30. Parallel vs. Not Parallel
  31. 31. Structures shown
  32. 32. Technique
  33. 33. Prevention of <ul><li>Immobilize </li></ul><ul><ul><li>Sandbags </li></ul></ul><ul><ul><li>Tape </li></ul></ul><ul><li>Short exposure time </li></ul><ul><ul><li>10mAs = 200mA x .05s </li></ul></ul><ul><ul><li>10mAs = 400mA x .025s </li></ul></ul>
  34. 34. Thumb <ul><li>Routine projections </li></ul><ul><ul><li>AP </li></ul></ul><ul><ul><li>PA Oblique </li></ul></ul><ul><ul><li>AP Oblique </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><li>Film size </li></ul><ul><li>SID </li></ul><ul><li>CR </li></ul>
  35. 35. AP
  36. 36. Lateral
  37. 37. PA Oblique
  38. 38. AP Oblique
  39. 39. Structures shown
  40. 40. Technique
  41. 41. Hand <ul><li>Routine projections </li></ul><ul><ul><li>PA </li></ul></ul><ul><ul><li>PA Oblique-Lateral Rotation </li></ul></ul><ul><ul><li>Fan Lateral </li></ul></ul><ul><li>Non-routine projections </li></ul><ul><ul><li>Lateral for Foreign Body </li></ul></ul>
  42. 42. Routine Hand Projections <ul><li>Routine projections </li></ul><ul><ul><li>PA </li></ul></ul><ul><ul><li>PA Oblique-Lateral Rotation </li></ul></ul><ul><ul><li>Fan Lateral </li></ul></ul><ul><li>Film size </li></ul><ul><li>SID </li></ul><ul><li>CR </li></ul>
  43. 43. PA
  44. 44. PA Oblique-Lateral Rotation
  45. 45. Fingers Down vs. Fingers Straight
  46. 46. Fan Lateral
  47. 47. Structures Shown
  48. 48. Technique
  49. 49. Non-routine projections of the Hand
  50. 50. Lateral for Foreign Body
  51. 51. Wrist <ul><li>Routine projections </li></ul><ul><ul><li>PA (Ulnar Flexion) </li></ul></ul><ul><ul><li>PA Oblique-Lateral Rotation </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><li>Non-routine projections </li></ul><ul><ul><li>PA-no flexion </li></ul></ul><ul><ul><li>Stetcher </li></ul></ul><ul><ul><li>Carpal Canal (Gaynor-Hart) </li></ul></ul><ul><ul><li>Lateral for Pisiform </li></ul></ul>
  52. 52. Routine Wrist Projections <ul><li>Routine projections </li></ul><ul><ul><li>PA (Ulnar Flexion) </li></ul></ul><ul><ul><li>PA Oblique-Lateral Rotation </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><li>Film size </li></ul><ul><li>SID </li></ul><ul><li>CR </li></ul>
  53. 53. PA (Ulnar Flexion)
  54. 54. PA Oblique-Lateral Rotation
  55. 55. Lateral
  56. 56. Structures shown
  57. 57. Technique
  58. 58. Non-routine projections of the Wrist
  59. 59. PA-no flexion
  60. 60. Scaphoid views (Stetcher)
  61. 61. Carpal Canal (Gaynor -Hart)
  62. 62. 10° Supination Lateral
  63. 63. Casted Extremities
  64. 64. Changes in technique <ul><li>No cast </li></ul><ul><ul><li>Extremity film </li></ul></ul><ul><ul><li>10mAs @ 60kV </li></ul></ul><ul><li>Casted </li></ul><ul><ul><li>Regular film </li></ul></ul><ul><ul><li>Lower mAs 10 times </li></ul></ul><ul><li>Wet cast </li></ul><ul><ul><li>Add 15 to the kV </li></ul></ul><ul><li>Dry cast </li></ul><ul><ul><li>Add 10 to the kV </li></ul></ul><ul><li>Fiberglass </li></ul><ul><ul><li>Add 5 to the kV </li></ul></ul>
  65. 65. Anatomy of the Forearm & Elbow
  66. 66. Radius <ul><li>Distal </li></ul><ul><ul><li>Styloid Process </li></ul></ul><ul><ul><li>Ulnar Notch </li></ul></ul><ul><li>Proximal </li></ul><ul><ul><li>Head </li></ul></ul><ul><ul><li>Neck </li></ul></ul><ul><ul><li>Tuberosity </li></ul></ul><ul><li>Shaft </li></ul>
  67. 67. Ulna <ul><li>Distal </li></ul><ul><ul><li>Head </li></ul></ul><ul><ul><li>Styloid Process </li></ul></ul><ul><li>Proximal </li></ul><ul><ul><li>Olecranon process </li></ul></ul><ul><ul><li>Coronoid process </li></ul></ul><ul><ul><li>Trochlear notch </li></ul></ul><ul><ul><li>Radial notch </li></ul></ul><ul><li>Shaft </li></ul>
  68. 68. Effects of pronation on the forearm
  69. 69. Distal Humerus <ul><li>Humeral Condyle </li></ul><ul><ul><li>Trochlea (Medial condyle) </li></ul></ul><ul><ul><li>Capitulum (Lateral condyle) </li></ul></ul><ul><li>Lateral epicondyle </li></ul><ul><li>Medial epicondyle </li></ul><ul><li>Depressions </li></ul><ul><ul><li>Coronoid fossa </li></ul></ul><ul><ul><li>Radial fossa </li></ul></ul><ul><ul><li>Olecranon fossa </li></ul></ul>posterior anterior
  70. 70. Classification of Joints <ul><li>Radioulnar </li></ul><ul><ul><li>Proximal </li></ul></ul><ul><ul><li>Distal </li></ul></ul><ul><li>Elbow </li></ul>
  71. 71. Radiographic Anatomy
  72. 72. A. B. C. D. E. F. G. H. I. J. (Jt.) K.
  73. 73. Medial Epicondyle Coronoid Process Shaft (Ulna) Ulnar Head Ulnar Styloid Process Lateral Epicondyle Radial Head Radial Tuberosity Shaft (Radius) Distal Radioulnar Jt. Radial Styloid Process
  74. 74. A. B. C. (Jt.) D. E. F. G. Post. H. I. J.
  75. 75. Lateral epicondyle Capitulum Proximal radioulnar jt. Radial head Radial neck Radial tuberosity Olecranon fossa Medial epicondyle Trochlea Coronoid process
  76. 76. C. B. A. D. E. (not the jt.) F. G. (depression)
  77. 77. Coronoid Process Radial head Radial neck Condyles Trochlear notch Olecranon process Radial notch
  78. 78. Positioning of the Forearm & Elbow
  79. 79. Forearm <ul><li>Routine projections </li></ul><ul><ul><li>AP </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><li>Film size </li></ul><ul><li>SID </li></ul><ul><li>CR </li></ul>
  80. 80. AP
  81. 81. Lateral
  82. 82. Structures shown
  83. 83. Technique
  84. 84. Elbow <ul><li>Routine projections </li></ul><ul><ul><li>AP </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><ul><li>Coyle </li></ul></ul><ul><li>Non-routine </li></ul><ul><ul><li>Obliques </li></ul></ul><ul><ul><li>Reverse Coyle </li></ul></ul><ul><ul><li>Partial Flexion </li></ul></ul><ul><ul><li>Rotational views of the radial head </li></ul></ul>
  85. 85. Routine Elbow <ul><li>Routine projections </li></ul><ul><ul><li>AP </li></ul></ul><ul><ul><li>Lateral </li></ul></ul><ul><ul><li>Coyle </li></ul></ul><ul><li>Film size </li></ul><ul><li>SID </li></ul><ul><li>CR </li></ul>
  86. 86. AP
  87. 87. Lateral
  88. 88. Coyle
  89. 89. Structures shown
  90. 90. Technique
  91. 91. Non-routine projections of the Elbow
  92. 92. Obliques
  93. 93. Reverse Coyle
  94. 94. Partial Flexion
  95. 95. Humerus parallel
  96. 96. Forearm parallel
  97. 97. Rotational views of the Radial Head
  98. 98. Hand supinated
  99. 99. Hand AP oblique
  100. 100. Hand lateral
  101. 101. Hand pronated
  102. 102. Lateral positioning

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