Procedures-Positioning
Terms
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- The Norgaard Method is sometime referred to as ____ and assists in detecting _____.
- ball catchers position; rhematoid arthitis
- Along with detecting rhematoid arthritis, Norgaard Method is also used to demonstrate _____.
- fx of the base of he fifth metacarpal
- Evaluation criteria for the Norgaard Method.
- 1. both hands from the carpal area to the tips of the digits
- rhematoid arthritis
- chronic systemic disease which affects small joints of hands and feet; begins with inflammation of synovial membrane and causes erosion of the underlying bony cortex and sometimes bone effustion across the joint; crippling deformities result in the end stage of this disease
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AP Oblique/Pisiform (Medial)
Central Ray?
Evaluation Criteria? -
Midcarpal Area;
Carpals on medial side of wrist;
Triquetrum, hook of hamate, and pisiform free of superimpostion -
PA projection, Ulnar Deviation
CR?
Evaluation? -
perp. to scaphoid
demonstrates the lateral aspects of the carpals -
PA Projection, Radial Deviation
CR?
Evaluation Criteria? -
perp. to scaphoid
demonstrates medial aspects of carpals - flex had _____for radial deviation.
- medial
- flex hand ____for ulnar deviation
- laterally
- CR for PA projection Radial Deviation
- midcarpal area
- CR and angle for Stetcher
- scaphoid and 20 degrees
- CR for clements Nakayama
- angled 45 degrees distally to enter the anatomic snuffbox of the wrist and pass through the trapezium
- Why do u perform Gaynor Hart?
- compression of the median nerve results in pain; Also fx of the hook of hamate, pisiform, and trapezium are seen
- CR for Gaynor Hart?
- CR- Directed to the palm of the hand at a pt. Ap. 1 inch distal to the base of the third metacarpal and at an angle of 25 to 30 degrees to the long axis of the hand
-
Distal Humerus- AP Projection/ ACUTE FLEXION
CR? - perp. to the humerus app. 2 inches superior to the olecranon process
-
Proximal Forearm-PA Projection/ACUTE FLEXION
CR? - perp. to the flexed forearm, entering app. 2 inches distal to the olecranon process
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Radial Head Series
Positions? -
1st exposure with hand supinated
2nd exposure in lateral
3rd is with hand pronated
4th is interally rotated
-
Radial Head Series
Evaluation? - Radial Tuberosity anterior for supination and lateral and the Posterior for the Pronation and Internally Rotated
-
COYLE METHOD)
CR? - 45 degrees toward shoulder to radial head
- Position of LAWERENCE Method?
- abduct the arm of the affected side at right angles to the longs axis of the body; EXTERNAL ROTATION ;have the patient turn the head away from the side being examined so IR can be placed against neck. Put as close to possible to neck.
- CR for the Lawrence Method?
- Horizontally through the axilla to the region of the AC Articulation. 15 to 30 degrees; the greater the abduction the greater the angle
- RAFERT demonstrates what?
- anterior dislocation of the humeral head can result in a wedge-shaped compression fracture of the articular surface of the humeral head called the HILL SACS DEFECT.
- Position of RAFERT
- exaggerated external rotation; externally rotate arm until hand forms a 45 degree oblique. The thumb pointing downward.
- CR of RAFERT-
- horizontal and angled app. 15 degrees medially and entering the axilla and passing through the AC joint
- Evaluation of Rafert
- Scapulohumeral joint, corocoid process pointing anterior, lesser tubercle in profile and anterior, AC joint, proximal humerus
-
GRASHEY METHOD
CR? - Center the IR to the Scapulohumeral joint (2 inches medial and 2 inches inf. To break of shoulder ; rotate the body app. 35 to 45 degrees toward the affected side to put scapula parallel with the plane of the IR.; Abduct the arm slightly in internal rotation, and place palm of the hand on the abdomen
-
NEER METHOD
Position? - place the pt. In a seated or standing position facing the bucky. ; with the pts. Affected shoulder centered and in contact with the IR ; average rotation is 45 to 60 degrees. Place arm at patients side. (scapula perp. to IR)
-
Neer Method "Outlet"
CR- - angled 10 to 15 degrees caudal entering the superior aspect of the humeral head
- STRYKER “NOTCH†METHOD demonstrates
- hill sachs defect
-
STRYKER “NOTCH†METHOD
CR? - CR- Angled 10 degrees cephalad entering the coracoids process
-
STRYKER “NOTCH†METHOD
Position? - Arm slightly beyond 90 degrees and place the palm of the hand on the top of the head with the fingertips on head
-
Stryker Notch
Eval? - overlapping of corocoid process and clavicle ; long axis of humerus aligned with the long axis of the patients body
- Fisk demonstrates what?
- intertubecular groove
-
Fisk
Position? - supine is preferred to reduce OID(can be done seated or standing)
- Fisk CR?
- CR- angled 10 to 15 degrees posterior (downward from horizontal) to the long axis of the humerus for the supine postion
-
AC Joints
Position? - seated or standing ensuring weight is equally distributed; one exposure with weights affixed to wrists and one exposure without weights
- AC Joints Eval?
- AC joints visualized with some soft tissue and without excessive density
- Arthrography is done on the _______
- shoulder, knee, TMJ, elbow, wrist, ankle, hip,
- Pneumoarthrography
- most painful normally because of large amts. of air to fill joint space
- Sometimes with arthrography a ___contrast is used to be readily used
- water soluable ionated
- A combination of positive and negative contrast utilizes ____
- best aspects of each and reduces risks of each
- Exams start with administration of _____and completed with a _______
- local anesthetic and aseptic technique
- Radiologists insert ___, injects ___, and maniputlates ____
- needle, contrast and anatomy
- Hip Arthrography is in children for what?
- to show congenital abnormalities
- Hip arthrography is in older pts. for
- evaluation of hip prothesis
- Shoulder Arthrography is performed for
- rotator cuffs, persistent pain, or frozen shoulder