Positioning Test 2
Terms
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⬢ The foot contains 26 bones
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o 14 phalanges
o 5 metatarsals
o 7 tarsals
- ⬢ The longitudinal arch as Functions as
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a shock absorber
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The transverse arch
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Assists in supporting the longitudinal arch
- ⬢ The superior surface of the foot is termed the
- dorsum or dorsal surface
- inferior or posterior aspect of the foot is termed the
- Plantar surface
- The base is
- PROXIMAL
- ⬢ The head is
- DISTAL
- ⬢ The CALCANEUS is the largest and strongest tarsal bone AKA
- “os calsis or astragulasâ€
- sesamoid bone
- ⬢ Beneath the head of the first metatarsal are two small bones
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⬢
Prominent on the proximal end of the tibia
- Medial and lateral condyles
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Flatlike superior surfaces of the condyles form smooth facets for articulation with the condyles of the femur.
- Tibial Plateaus
- ⬢ Between the two articular surfaces is a sharp projection,_____, which terminates in two peaklike processes called _______.
- the intercondylar eminence; the medial and lateral intercondyler tubercles
- ⬢ On the anterior surface of the tibia, just below the condyles, is a prominent process called the
- tibia tuberosity
- ⬢ The distal end of the tibia is broad and its medial surface is prolonged into a large process called the
- medial malleolus.
- ⬢ The proximal end of the fibula is expanded into a HEAD, which articulates with the lateral condyle of the tibia. (JOINS THE
- POSTERIOR SURFACE)
- ⬢ enlarged distal end of the fibula
- Lateral Malleolus-
- The distal end of the femur is broadened and has two larger eminences:
- the larger medial condyle and the smaller lateral condyle
- Posteriorly the condyles are separated by a deep depression called the ( This is commonly radiographed)
- intercondylar fossa
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AP Axial Projection (Weight Bearing COMPOSITE METHOD)
Central Ray? -
with the tube in front of the patient and angulation 15 degrees toward heel enterin the base of the 3rd metatarsal for the FIRST exposure.
o Move the tube behind the patient, adjust it for an anterior angulation of 25 degrees towards the toes exiting at the level of the lateral malleolus
To show ant. Profile without superimposition of lower leg
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Weight Bearing Oblique Calcaneous
demonstrates? -
Demonstrates stress fxs. And calcaneal tuberosity
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Weight Bearing Oblique Calcaneous
centering? - Standing affected heel centered to IR; By transversely centering the lateral malleous to IR and toward the lateral aspect longitudinally; leg is perpendicular to the floor
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Weight Bearing Oblique Calcaneous
Central Ray? - Angle tube 45 degrees medially to enter lateral malleolus; ensure calcaneous will be projected to center of cassette
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Weight Bearing Oblique Calcaneous
Evaluation? -
Calcaneal tuberosity in profile
sinus tarsi and cuboid demonstrated
- Demonstrates any loss of joint space that may not be seen on images that pt is recumbent
- AP standing knees
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Intercondyler fossa views
Done to show -
loose bodies called joint mice
- Loose bodies can be
- fragments of bone or pieces of calcified cartilage
- Joint mice can cause
- severe pain, swelling and limited range of motion
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3 Methods to Demonstrate and its eminents in profile
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1. Holmblad
2. Camp Coventry
3. Becelere
- 1) Holmblad....Originally consisted of placing pt.
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In kneeling position in radiographic position.
- No matter which method used for Holmblad, the knee should be flexed
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70 degrees from full extension or 20 degrees away from perp. central ray
o Knee joint is centered to cassette
- Camp Conventry (____PROJECTION)
- PA AXIAL
- Position for Camp Coventry
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o Prone affected knee flexed 40 or 50 degrees and support elevated foot to maintain angle of leg
o Knee joint is centered to upper half of IR
- Central Ray for Camp Coventry
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 Central Ray
o Perp to long axis of tibia and centered to IR
o If leg is flexed 40 degrees then CR is 40 degrees
- Position for Beclere
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o Supine
o Flex affected knee so long axis of femur is at a 60 degree angle with the long axis of fibula
o Place IR below knee and center CR to IR
o Can use sandbags, sponges, curved cassette if available
- Central Ray for Beclere
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 Central Ray
o Perpendicular to long axis of tibia entering the knee joint
- ⬢ Hip consists of ________ to form acetabulum or hip joint
- ilium, pubis, ishium
- Key elements of ilium-
- ala or wing- includes iliac crests and ASIS (landmarks)
- parts of pubis-
- Body, inf. And sup. Pubic rami
- ⬢ Ishium consist of
- body, ishial ramus, and ishial tuberosity
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____,____, and forms obstrator formen
- Ishial ramus and superior pubic ramus and inferior Pubic ramus
- Small depression on femoral head called
- fovea capitis
- - attaches femoral head to pelvis via various other ligaments
- ligamentum teris
- ⬢ Dislocations of hip accompanied by fx. Can tear this ligament
- ligamentum teris
- ⬢ PA axial projection of hip to demonstrate fovea capitus and superior wall of acetabulym
- Teufel
- Positioning of Teufel
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Positions
Place pt anterior oblique position with affected hip down; correctly rotate pt. Arms and legs so MCP forms 30 degrees from tabletop
- Central Ray for Teufel
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 Central Ray
o 12 degrees cephalic entering inferior coccyx and two inches lateral to MSP toward side being examined
o Align IR to CR
- Eval Criteria for Teufel
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 Evaluation Criteria
o Hip joint centered to film
o Femoral head with fovea capitus in profile
- ⬢ Both views in general are for showing fxs. Of acetabulym
- Judet
-  Position and demonstration for Internal Oblique (judet)
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o Demonstrates iliopubic column; anterior and posterior rim of acetabulym- supine oblique 45 degrees with affected side up
-  Position and demonstration for External Oblique (Judet)
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o Ilioishial column-posterior and anterior rim of aceabulym
o Supine; 45 degrees with affected side down
- CR for Judet
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 Central Ray
o Internal- perp. entering 2 inches inferior To ASIS of affected side (side up)
o External- perp. entering at pubic symphysis
- Eval for Judet
- o Acetabulym centered and appropriate anatomy for each position
- Central Ray for Taylor?
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o Males- 20-35 degrees cephalic entering two inches distal to superior border of pubic symphysis
o Females-30-45 degrees cephalic entering two inches distal to superior border of pubic symphysis
- Eval for Taylor
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 Evaluation Criteria
o Pubic and ishial rami centered and in profile
- ⬢ ___ Exposures will be made of each limb; no movement
- 3
- ⬢ projection of long bone with a small as possible OID and long as possible SID
- Teleroentgenoraphy-
- ⬢ central ray directed through joint space;
- Orthoroentgenography-
- Long bone measurement may also be done with CT; the biggest advantage is ____ ; it is 50 to 200 times less
- biggest advantage is reduction of radiation exposure