Positioning and anatomy

The four fundamental body planes

Sagittal

Coronal

Horizontal

Oblique

Horizontal plane

Often is referred to as an axial transverse, or cross-sectional plane

Special planes

Interiliac plane

Occlusal plane

Interilliac plane

Transects the pelvis at the top of the iliac crests at the level of the fourth lumbar spinous process

It is used in positioning the lumbar spine, sacrum and coccyx

The two great body cavities

Thoracic and abdominal cavities

C1

Mastoid tip

C2,C3

Gonion (angle of mandible)

C3,C4

Hyoid bone

C5

Thyroid cartilage

C7, T1

Vertebra prominens

T1

Approximately 2 inches above jugular notch

T2,T3

Level of jugular notch

T4,T5

Level of sternal angle

T7

Level of inferior angles of scapula

T9,10

Level of xiphoid process

L2,L3

Inferior costal margin

L4,L5

Level of superior-most aspect of iliac crests

S1,S2

Level of anterior superior iliac spine (ASIS)

Coccyx

Level of pubic symphysis and greater trochanters

206 primary bones

The adult human skeleton is composed of

Synarthroses

Immovable joints

Amphiarthroses

Slightly movable

Diathroses

Freely movable

Adams apple

The thyroid cartilage forms the laryngeal prominence or the

Mediastinum

Is the area of the thorax bounded by the sternum anteriorly, the spine posteriorly, and the lungs laterally

The esophagus

Is the part of the digestive canal that connects the pharynx with the stomach

Atelactasis

Collapse of all or part of the lung

Pleural effusion

Collection of fluid in the pleural cavity

Pneumoconiosis

Lung disease resulting from inhalation of industrial substances

Pneumothorax

Accumulation of air in the pleural cavity resulting in collapse of the lung

AP soft tissue neck

10X12 lengthwise

Patient either supine or upright depending on patient condition

Center MSP to midline of the grid

Extend the patient neck slightly

Chest PA oblique projection

14X17 lengthwise

72 SID

RAO and LAO

Have patient turn approximately 45 degrees

Central ray = t7

Chest AP oblique projection

RPO and LPO

72 SID

45 degree oblique

Patient facing tube

Exposure on full inspiration

Chest AP axial projection (lindblom method)

Lordotic for pulmonary apices

14 X 17 LW

72 SID

Place the patient upright position, facing the xray tube and standing approximately 1 foot in front of the vertical grid device

Top of IR 3 inches above upper border of shoulders

AP axial pulmonary apices (if pt can’t lean back)

14X17 LW

72 SID

Flex patients elbows and place the hands on the hips with the palms out, or pronate the hands beside the hips

Central ray directed at an angle of 15-20 cephalad to the center of IR

Approximately 1 inch of field light should be seen above shadow of shoulders

Adjust collimation to 10X12

AP Abdomen supine (KUB)

14x17 LW

40 SID

Central ray at level of iliac crest

Respiration suspend at the end of expiration

AP abdomen upright

14X17 LW

40 SID

Central ray level of 2 inches above iliac crest to include diaphragms

Respiration suspend at the end of expiration

27 BONES

The hand consists of

Metacarpals

The bones the form the palm of the hand

8 carpal bones

The wrist has

Physiology

Which term refers to the study of the function of the body organs

Sagittarius, coronal, horizontal , oblique

Which are the four fundamental body planes

Midsagittal

Which plane divides the body into equal right and left halves

Thoracic and abdominal

Which are the two great cavities of the torso

Heart

Which body structure is located within the thoracic cavity

Right lower quadrant

In which quadrant of the abdomen is the appendix located

Hypogastrium

Which region of the abdomen is located below the umbilical region

T10

Which vertebra is located at the level of the xiphoid process

Hypersthenic

Which body habitus represents a person of large massive stature in whom the stomach is located high and nearly horizontal within the abdomen

206

Excluding small sesamoid and accessory bones in the skull, how many bones comprise the skeleton?

Skull

Which structure belongs to the axial skeleton

Tibia

Which bone has a medullary cavity

Shape

Bones are classified according to their

Irregular

Which bone classifications are vertebrae

Short

Which bone classification is the trapezium

Arthrology

Which term specifically refers to the stud of the joints

Styloid

Which term refers to a long pointed process

Projection

Which term refers to the path of the central X-ray

L4

Which vertebra is located at the level of the iliac crest

To expand the lungs better

Why should chest images be performed after the patient has suspended respiration after the second inspiration

Rotate the shoulders forward

For the PA projection of the chest, which positioning maneuver should be performed for the best removal of the scapulae from lung fields

To demonstrate pneumothorax

Why would the chest most likely be demonstrated using two PA projections (in which the patient is seen in suspended inspiration and suspend expiration)

Air or fluid levels

Using a lateral decubitus position for patients who are unable to stand upright best demonstrates which of the following pathologic conditions of the chest

Fluid levels in the left side or free air in the right side of the chest

Which pathologic condition of the lungs is best demonstrated with the AP chest, left lateral decubitus position?

Olecranon process and Coronoid process

Which two bony processes are located on the proximal end of the ulna

Bennett

Fracture at base of first metacarpal

Boxer

Fracture of metacarpal neck

Colles fracture

Fracture of distal radius with posterior dorsal displacement

Smith fracture

Fracture of distal radius with anterior palmar displacement

AP wrist

The carpal interspaces are better shown in this projection

PA ulnar deviation wrist

Central ray is perpendicular to the scaphoid

PA radial deviation wrist

Central ray perpendicular to mid carpal area

Wrist carpal bridge tangential projection

10x12 LW

Central ray directed to A point approximately 1 1/2 inches proximal to the wrist joint at a caudal angle of 45 degrees

Carpal canal tangential wrist Gaynor- Hart method

Central ray directed to the palm of the hand at a point approximately 1 inch distal to the base of the third metacarpal and at an angle of 25-30 degrees to the long axis of the hand

Shoulder girdle

Formed by two bones- the clavicle and scapula

Shoulder external rotation

This projection shows the greater tubercle of the humerus and the site of insertion of the supraspinatus tendon are visualized

Shoulder neutral rotation

This projection shows the posterior part of the supraspinatus insertion, which sometimes profiles small calcific deposits not otherwise visualized

Shoulder internal rotation

This projection shows the proximal humerus in a true lateral position. The lesser tubercle is in profile

Shoulder joint inferosuperior Lawrence method

10x12 CW

40 SID

As much as possible, abduct the arm of the affected side at right angles to the long axis of the body. A minimum of 20 degrees is required to prevent superimposition of the arm on the shoulder

Central ray 15-30 degrees medially

Shoulder joint inferosuperior westpoint method

Abduct the arm of the affected side 90 degrees and rotate so that the forearm rests over the edge of the table or a bucky tray

Place a vertically supported IR against the superior aspect of the shoulder with the edge of the IR in contact with the neck

Support the IR with sandbags or a vertical IR holder

Suspend respiration

Central ray directed at a dual angle of 25 degrees anteriorly from the horizontal and 25 degrees medially the CR enters approx 5 inches inferior and 1 1/12 inches medial to acromial edge and exits the glenoid cavity

Clavicle AP axial

10x12 crosswise

Either the patient is lordotic or you angle the central ray

For lordotic have patient step 1 foot forward then lean back on IR and angle 0-15 degrees cephalic

For standing or supine position angle 15-30 cephalic

9

How many interphalangeal joints are found in one upper extremity

Metacarpal bone

Each proximal phalanx articulates with a

Metacarpals

Which bones comprise the palm of the hand

The proximal interphalangeal joint of the fourth digit

Which joint is formed by the articulation of the proximal end of the middle phalanx with the distal end of the proximal phalanx of the ring finger

The distal interphalangeal joint of the second digit

Which joint is formed by the articulation of the distal end of the middle phalanx with the proximal end of the distal phalanx of the index finger

5

How many metacarpal bones are found in one upper extremity

Carpals

Which of the following articulates with the bases of metacarpal bones

Metacarpophalangeal

Which joint of the hand is formed by the articulation of the head of a metacarpal with a digit

Carpometacarpal

Which joints of the hand are formed by the articulation of the bases of the metacarpals with the bones of the wrist

Scaphoid, lunate, pisiform, and triquetrum

Which bones are located in the proximal row of the wrist

Hamate, capitate, trapezium, trapezoid

Which bones are located in the distal row of the wrist

Lateral side of the proximal row

Where in the wrist is the scaphoid located

Medial side of the distal row

Where in the wrist is the hamate located

Unciform

What other name refers to the carpal bone known as the hamate?

Os magnum

What other name refers to the carpal bone known as the capitate

Greater multangular

What other name refers to the carpal bone known as the trapezium

Lesser multangular

What other name refers to the carpal bone known as the trapezoid

Pisiform

Which carpal bone has only one name

Carpals

Which bones are classified as short bones