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14. Bontrager chapter 1 (2).ppt - Radiographic Procedures 1...

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Unformatted text preview: Radiographic Procedures 1 Chapter 1 Structural Organization All structures are composed of atoms Atoms are joined to form molecules Molecules are organized to form cells A group of cells: tissues A group of tissues: organ A group organs : organ system 10 organ systems: organism 10 body systems Skeletal system Circulatory system Digestive system Respiratory System Urinary System Reproductive Nervous system Muscular system Endocrine system Integumentary system The diaphragm separates the two ventral body cavities Visera-general name for organs within the ventral cavity Serous membrane- layer lining the walls of cavities and covers surfaces of viscera A Serous membrane in the thoracic cavity is called the pericardium which lies in the mediastinum Visceral pericardiam- covers the surface of the heart Parietal pericardium- covers the opposing surface Another Serous membrane in the thoracic cavity is the pleura Visceral pleura- covers the outer surfaces of the lung Parietal pleura- covers the opposing surface The Serous membrane in the abdominopelvic cavity is the peritoneum Visceral peritoneum- covers the outer surfaces of organs Parietal peritoneum- covers the opposing surface Axial vs. Appendicular Skeleton There are 80 axial bones to include the skull, vertebral column , ribs and sternum There are 126 bones in the appendicular skeleton to include upper limbs, lower limbs, pectoral girdle and pelvic girdle Skeletal System: axial (80) 8 14 1 6 26 1 24 cranial facial hyoid auditory ossicles vertebral sternum ribs Skeletal System: appendicular (126) 2 2 2 2 2 16 10 28 clavicles scapula humerus ulna radius carpals metacarpals phalanges 2 2 2 2 2 14 10 28 hip bones femur 2 tibia fibula patella tarsals metatarsals phalanges Microscopic features of bones Osteocytes- mature bone cells Osteoclasts- giant cells with 50 or more nuclei; dissolves bony matrix Osteoblasts- cells responsible for new bone production Sesamoid Bones Small oval shaped bones found in tendons The patella are the largest sesamoid bones in the body Found at the head 1st metatarsal on the plantar surface Also found on the palmar surface of the hand at the head of the 1st metacarpal 4 bone shapes Long- humerus, femur Short- carpals, tarsals Flat- scapula, skull Irregular – vertebrae, pelvis Long Bone Composition The outer shell is a hard dense tissue known as compact bone (cortex) Inside the compact bone is spongy bone (cancellous); where red blood cells are produced The hollow portion of the body is known as the medullary cavity A dense fibrous membrane, the periosteum, covers the bone except for the articular ends which are covered by articular (hyaline) cartilage Ossification Process in which bones form within the body Begins at the of embryonic 6th week bone replacing membranes is called intramembranous ossification Bone replacing cartilage is called endochondral ossification Wide portion of a long bone near the epiphyseal plate is the metaphysis The primary center of endochondral ossification occurs in the midbody area of long bones; diaphysis The secondary centers appear near the ends of long bones; epiphysis Epiphyseal plates (growth plates), are between the epiphysis and diaphysis until skeletal growth is complete (around 25) Epiphyseal plates Arthrology (study of joints) Classification of joints (structural) Fibrous Cartilaginous Synovial What are you made of? Functional Classifications (mobility) Synarthrosis- immovable joint Amphiarthrosis- joint with limited movement Diarthrosis- freely moveable joint Do you move? Movements of synovial joints A synovial joint contains a capsule (bursae)that contains synovial fluid Movements of synovial joints: 1. plane (gliding)- a sliding or gliding motion between the articulating surfaces ex: intercarpal joints 2. ginglymus (hinge) – flexion and extension movements ex: elbow 3. trochoid (pivot)- rotational movement ex: radioulnar joints 4. ellipsoid (condyloid)- flexion, extension, abduction and adduction ex: wrist joint 5. sellar (saddle)- flexion, extension, abduction, adduction and circumduction ex: 1st carpometacarpal joint 6. Spherodial (ball and socket)- flexion, extension, abduction, adduction, circumduction, medial and lateral rotation ex: hip joint 7. bicondylar movement in a single direction ex. Knee How do you move? Types of movement Flexion-reduces the angle between articulations Extension- increases the angle between articulations Hyperextension- extension past the anatomical position Abduction- movement away from the midline of the body Adduction- movement toward the midline of the body Rotation- turning around the long axis of the body Pronation- moving the hang from facing up to facing down Supination- moving hand from facing down to facing up Inversion- twisting motion toward the inside Eversion- twisting movement toward the outside Dorsiflexion- flexion of the ankle Plantarflexion- extension of the ankle Opposition- movement of the thumb that allow it to grasp an object Anatomical landmarks Quadrants Anatomical Regions General terms Radiography- the production of radiographs Image receptor (IR)- captures image, refers to film/screen and digital Central ray (CR)- center of the beam, portion of the beam with the least divergence Anatomic Position Upright position with arms abducted, palms forward with head and feet directed forward Planes, sections and lines Sagittal (median plane)- divides the body into right and left; equal division is the MSP Coronal- divides the body into anterior and posterior; equal division is the midcoronal plane Planes and Sections Oblique- longitudinal or transverse plane that is at an angle or slant and is not parallel to sagittal, coronal or horizontal Horizontal (axial)- divides the body into superior and inferior Body surfaces and parts Posterior or dorsal refers to the back half of the patient Anterior or ventral refers to the front half of the patient Plantar refers to the sole or posterior surface of the foot Dorsal refers to the top or anterior surface of the foot; refers to back or posterior surface of hand Palmar refers to the anterior or ventral surface of the hand Radiographic projections Projection is a positioning term that describes the path of the central ray as it passes through the patient PA (posteroranterior) projection- the beam passes from posterior to anterior AP (anteroposterior) projection- the beam passes from the anterior to posterior AP oblique projection- AP projection, but the foot is in an oblique position; must use a qualifying term as in AP medial oblique Mediolaterial and lateromedial projections- a lateral projection described by the path of the CR General Body Positions Supine- lying on back Prone- lying on abdomen, face down Erect- an upright position Recumbent- lying down in any position ex. Dorsal recumbent- lying on back ventral recumbent- lying face down lateral recumbent- lying on side Trendelenburg- recumbent with the whole body tilted so the feet are higher than the head Fowlers- recumbent with the whole body tilted so the head is higher than the feet Sims- pt lying on left anterior side with right knee and thigh flexed Lithotomy- recumbent with knees and hip flexed, thighs abducted and rotated laterally, ankles in stirups Specific body positions Lateral – described by the part closest to the IR or where the CR exits Oblique position- angled position so neither the sagittal or coronal plane is perpendicular to the IR; described by the part closest to the IR or where the CR exits RPO, LPO, RAO, LAO Can be done upright or recumbent Decubitus- means to “lie down”; described by the surface on which the body is resting ex. dorsal decub ventral decub left lateral decub right dorsal decub Term always used with a horizontal beam RT or LT indicates the part against IR or side “down” Special projection terms Axial- describes any angle of the CR more than 10° Inferosuperior or superoinferior- CR enters inferior and exits superior or vice versa Tangential- the CR touches an surface or curve at one point; the CR “skims” the body part Lordotic position, axial projection- using exaggerated lumbar curvature to remove the clavicles from the top of the lungs Relationship terms Medial vs. lateral- closest or furthest from the median plane Proximal vs. distal- closest or furthest from the trunk Cephalad vs. caudad- toward the head or toward the feet Superficial vs. deep- nearer the skin or further from the skin Directional terms Medial rotation vs. lateral rotation Abduction vs. adduction Pronation vs. supination Rotation vs. tilt Radial deviation verses ulnar deviation Projection vs. Position Projection“ the path of the central ray” Position“the patients physical position” markers Every image must have: Patient identification and date Anatomic side markers (with tech initials) Films must have anatomic makers to be used in court* Protocol vs. Routine Routine can be used worldwide Protocol is different for every department and/or Radiologist Basic vs. Special projections Basic projections (routine) are taken on all pts who can cooperate Special projections are used to demonstrate certain pathologies or parts not seen during routines or on a pt who is unable to cooperate Cassette Sizes 10 x 12 14 x 17 14 x 36 Scoliosis cassette Cassettes can be placed “portrait” or “landscape” Positioning rules A minimum of two projections (90° from each other) 1. superimposition of structures 2. location of foreign bodies 3. Fracture alignment * exceptions include supine chest, KUB and pelvis Imaging Joints Imaging of joints requires a minimum of 3 projections Typically AP or PA, oblique or lateral Palpation Process of applying light pressure with the fingertips to locate positioning landmarks Touch gently Let patients know before you palpate in specific areas As a student do NOT palpate the pubic symphysis or ischial tuberosity Body Habitus Hyperstenic “stocky” massive build massive build body type Thoracic cavity is wide and deep from front to back with a short vertical dimension with a high diaphragm Stenic Nearer average but heavy set , muscular Hypostenic Nearer average but slender , taller Astenic Extreme slender body type Thoracic cavity is narrow and shallow with a long vertical dimension with a low diaphragm ...
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