An Introduction to Radiographic Views & Anatomy

Size: px
Start display at page:

Download "An Introduction to Radiographic Views & Anatomy"

Transcription

1 An Introduction to Radiographic Views & Anatomy Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D An Introduction to Radiographic Views & Anatomy M.S.P.T University of Miami Nova Southeastern University Associate Professor Department of Physical Therapy Fort Lauderdale, Florida Boca Raton Orthopaedic Group Director of Physical Therapy Boca Raton, Florida 1

2 Topics Indications overview The basics of viewing Two dimensions & added distortion Density & Interpreting the grey Radiographic views & anatomy Spine (Cervical and Lumbar) Knee Ankle Foot Introduction Nice to Know or Need to Know? 2

3 Does Your Patient Need a Radiograph? Indications. Risk for more serious pathology e.g. Fracture, Cancer, Infection Condition not immediately amenable to rehab Therapeutically informative vs. uninformative Kolber, MJ. Does Your Patient Need a Radiograph? On-Demand Webinar Does Your Patient Need a Radiograph? Indications.Suspicion of fracture Trauma Reduced weight-bearing (lower extremity) Bone tenderness e.g. Ankle-malleolus; Midfoot-navicular/base 5 th MT e.g. Spine-midline tenderness; Knee-patella/fib. head Acute motion loss e.g. Knee-flexion 90 ; Elbow-incomplete extension e.g. Cervical rotation < 45 bilaterally Other: risk profile, medications, etc. Kolber, MJ. Does Your Patient Need a Radiograph? On-Demand Webinar 3

4 Does Your Patient Need a Radiograph? CPRs Examples Ottawa Ankle CPR Malleolar pain plus either of the 2 below: Tenderness malleolar zone (not anterior) Limited WB Pittsburgh decision rules Blunt trauma/fall MOI plus either of the following: Age younger than 12 years or older than 50 years Inability to walk four weight-bearing steps immediately & in ER Kolber, MJ. Does Your Patient Need a Radiograph? On-Demand Webinar Nomenclature X-ray or Radiograph 4

5 X-ray Computed tomography (CT) Bone densitometry (DEXA) Radiography Fluoroscopy Plain film radiography Digital radiography Digital vs. Plain Film 5

6 Basic Science X-ray tube generates x-rays that exit tube & enter body: some absorbed & others pass through. What passes through is intercepted by a film cassette or image receptor creating visual image (various shades of gray) X-rays produce a radiographic image dependent upon: Radiographic Density *Structural density of the area of interest Image Quality Optical density, distortion, & detail Basic Science Structural density: x-ray absorption determined by a structures density & thickness: Lead 11g/cm 3 Ca 1.54 g/cm 3 Greater density/thickness: x-ray absorption = opacity *Radiopaque: substance impermeable to x-ray. Thicker & more dense (metal, sclerosed bone, contrast) Less density/thickness: x-ray absorption = lucency *Radiolucent: a substance readily permeable to x-rays. Less dense & thin ( i.e. air, adipose, fracture line) 6

7 Increasing Structural Density Radiolucent Image Air (lungs, digestive track) Adipose (around muscle/organs) Water (muscle, vessels) Bone (normal bone) Contrast (barium, gadolinium) Heavy metal (lead, hardware) Radiopaque Image Decreasing Structural Density Air (lungs) Adipose (around muscle) Water (muscle) Bone (cortical is more opaque) Contrast media (Isovue) Heavy metal (fillings) 7

8 Shapes & Images Radiographs are 2-dimensional Shape and image are density dependent 8

9 Distortion Distortion vs. object positioning Radiation beam Radiation beam Objects Solid wooden stick Films Distortion 9

10 Viewing Radiographs R vs. L Minimum Views 2 film projections (views) minimum (90 to each other) are required to examine the body part for all three anatomical dimensions (length, depth, width) 10

11 Minimum 2 Views Radiographic Views AP: X- ray beam enters anterior part of body & exits posterior to contact cassette. Posterior contacts cassette PA: Beam enters posterior and exits anterior. Used for chest films because heart & lungs are more anterior. Also used with hand/wrist films (Why?) Oblique: rotate body 45 from AP or PA position Lateral: at a right angle to the AP or PA position. Left lateral beam enters right & exits left to cassette Axial: superior to inferior or inferior to superior Ex. Knee: skyline/sunrise 11

12 Radiograph Views Standard views (at minimum) AP Lateral PA (chest and hand) Standard views* Oblique (spine) Oblique (knee, ankle (mortise), foot) AP Open-mouth (cervical spine) Radiograph Specialty Views Axial PFJ (sunrise/sunset/skyline) Stress Cervical/Lumbar: instability Spot Lumbar: L5-S1 Cross table lateral Knee: trauma 12

13 Radiographic Views: Cervical Spine AP Cervical Spine Radiographic Views: Cervical Spine AP Cervical Spine C3 body C4 spinous process (SP) Intervertebral space C3-4 C3-4 uncovertebral joints Pedicle and SP C7 T1 SP T1 transverse process First rib 13

14 Radiographic Views: Cervical Spine Lateral Cervical Spine Radiographic Views: Cervical Spine Lateral Cervical Spine C3 Vertebral body* Intervertebral disc space* Pedicle Facet Joint* (SAP & IAP) C4 Lamina C4 Spinous process 14

15 Radiographic Views: Cervical Spine Lateral Cervical Spine Spinous process Post arch atlas Dens Atlanto-dens interval (ADI) Radiographic Views: Cervical Spine Anterior Oblique Cervical Spine (RAO) 15

16 Radiographic Views: Cervical Spine Anterior Oblique Cervical Spine (RAO) Anterior Oblique usually RAO = Right anterior oblique Image gets flipped Image quality? Intervertebral foramen* Radiographic Views: Cervical Spine Open Mouth 16

17 Radiographic Views: Cervical Spine Open Mouth Dens Position Lateral Mass C1 Space between mass C1-2 Joint C1 transverse process AO joint C2 spinous process C2 body Radiographic Views: Cervical Spine Stress Views-Instability 17

18 Radiographic Views: Lumbar Spine AP Lumbar Spine Radiographic Views: Lumbar Spine AP Lumbar Spine L4-5 disc space L4 Spinous process L3 Vertebral body L3 TP Lamina Pedicle 18

19 Radiographic Views: Lumbar Spine Lateral Lumbar Spine Radiographic Views: Lumbar Spine Lateral Lumbar Spine 19

20 Radiographic Views: Lumbar Spine Lateral Lumbar Spine (Spot View) Radiographic Views: Lumbar Spine Right Posterior Oblique Lumbar Spine 20

21 Radiographic Views: Lumbar Spine Right Posterior Oblique Lumbar Spine Radiographic Views: Lumbar Spine Right Posterior Oblique Lumbar Spine 21

22 Radiographic Views: Lumbar Spine Stress Views Lumbar Spine Radiographic Views: Knee AP Knee 22

23 Radiographic Views: Knee AP Knee Patella Intercondylar notch/fossa Medial joint line Lateral joint line Tibial spines (intercondylar tubercles) Fibular head Neck of fibula Radiographic Views: Knee Lateral Knee 23

24 Radiographic Views: Knee Lateral Knee Retropatellar compartment Femoral condyles Post. aspect lat. tibial plateau Region of inferior pole Radiographic Views: Knee Lateral Cross-Table (Trauma) Knee 24

25 Radiographic Views: Knee Lateral Cross-Table (Trauma) Knee Radiographic Views: Knee Oblique Knee **Fibular head/neck 25

26 Radiographic Views: Knee Sunrise/Sunset/Skyline Knee Radiographic Views: Knee Sunrise/Sunset/Skyline Knee Considered an axial view Knee flexed Medial facet - patella Lateral facet - patella Trochlear groove Sulcus angle Congruence angle (a) 26

27 Radiographic Views: Ankle AP Ankle Radiographic Views: Ankle AP Ankle *Medial malleolus *Lateral malleolus *Talus 27

28 Radiographic Views: Ankle Lateral Ankle Radiographic Views: Ankle Lateral Ankle *Lateral malleolus *Medial malleolus *Talus *Navicular *Calcaneus 28

29 Radiographic Views: Ankle Oblique Ankle (Mortise-Medial Oblique (20 ) Radiographic Views: Ankle Oblique Ankle (Mortise-Medial Oblique (15-20 ) 29

30 Radiographic Views: Foot AP Foot Radiographic Views: Foot AP Foot 1 st MTP joint Sesamoid bones Cuboid 3 Cuneiforms 3 rd cuneiform & cuboid? Navicular 5th metatarsal 30

31 Radiographic Views: Foot Lateral Foot Radiographic Views: Foot Lateral Foot Navicular Talus Calcaneus Sesamoid 5 th Metatarsal Cuneiform region 31

32 Radiographic Views: Foot Oblique Foot Radiographic Views: Foot Oblique Foot 1 st & 2nd Cuneiform 3 rd Cuneiform* 5th MT Cuboid* Talus Navicular Calcaneus Sesamoid 32

33 Questions? Thank You References Stiell IG et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med Dec 25;349(26): Stiell IG et al. Prospective validation of a decision rule for the use of radiography in acute knee injuries. JAMA Feb 28;275(8): Bachmann LM et al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ Feb 22;326(7386):417. Weber JE et al. Clinical decision rules discriminate between fractures and nonfractures in acute isolated knee trauma. Ann Emerg Med Oct;26(4): Seaberg DC & Jackson R. Clinical decision rule for knee radiographs. J Emerg Med Sep;12(5): Dalinka MK et al. Imaging evaluation of suspected ankle fractures. American College of Radiology. ACR Appropriateness Criteria Radiology Jun;215 Suppl: Pavlov H et al. Acute trauma to the knee. American College of Radiology. ACR Appropriateness Criteria. Radiology Jun;215 Suppl: **Bontrager and Lampignano. Textbook of Radiographic Positioning and Related Anatomy 8th ed. Elsevier-Mosby, St. Louis, Missouri

Topics. Does Your Patient Need a Radiograph? Evidence-Informed Decision Making 6/8/2016

Topics. Does Your Patient Need a Radiograph? Evidence-Informed Decision Making 6/8/2016 Does Your Patient Need a Radiograph? Evidence-Informed Decision Making Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D Does Your Patient Need a Radiograph? Evidence-Informed Decision Making M.S.P.T. 1995-University

More information

radiologymasterclass.co.uk

radiologymasterclass.co.uk http://radiologymasterclass.co.uk Hip X-ray anatomy - Normal AP (anterior-posterior) Shenton's line is formed by the medial edge of the femoral neck and the inferior edge of the superior pubic ramus Loss

More information

INDEPENDENT LEARNING: DISC HERNIATION IN THE NATIONAL FOOTBALL LEAGUE: ANATOMICAL FACTORS TO CONSIDER IN REVIEW

INDEPENDENT LEARNING: DISC HERNIATION IN THE NATIONAL FOOTBALL LEAGUE: ANATOMICAL FACTORS TO CONSIDER IN REVIEW INDEPENDENT LEARNING: DISC HERNIATION IN THE NATIONAL FOOTBALL LEAGUE: ANATOMICAL FACTORS TO CONSIDER IN REVIEW CDC REPORT - CAUSES OF DISABILITY, 2005 REVIEW QUESTIONS ABOUT DISC HERNIATION IN THE NATIONAL

More information

RADIOGRAPHY OF THE ANKLE and LOWER LEG

RADIOGRAPHY OF THE ANKLE and LOWER LEG RADIOGRAPHY OF THE ANKLE and LOWER LEG Patient Position: ANKLE AP Projection Part Position: True Slight to place foot s long axis Center to Central Ray: to IR Midway Note: Ankle joint is to tips of malleoli

More information

Chapter 7: Skeletal System: Gross Anatomy

Chapter 7: Skeletal System: Gross Anatomy Chapter 7: Skeletal System: Gross Anatomy I. General Considerations A. How many bones in an average adult skeleton? B. Anatomic features of bones are based on II. Axial Skeleton A. Skull 1. Functionally

More information

bio4165 lab quiz 1 Posterior View Anterior View Lateral View Anterior View bio fall.quarter lab.quiz.1...page.1 of 6

bio4165 lab quiz 1 Posterior View Anterior View Lateral View Anterior View bio fall.quarter lab.quiz.1...page.1 of 6 B A Posterior View D C E Lateral View bio.4165...fall.quarter.2005...lab.quiz.1...page.1 of 6 F I G 35 Posterior View H bio.4165...fall.quarter.2005...lab.quiz.1...page.2 of 6 J Posterior View L K Inferior

More information

RADIOGRAPHY OF THE KNEE, PATELLA, and FEMUR

RADIOGRAPHY OF THE KNEE, PATELLA, and FEMUR RADIOGRAPHY OF THE KNEE, PATELLA, and FEMUR KNEE AP Projection Patient Position: Part Position: Leg in Center Femoral condyles Central Ray: - Asthenic patient - if ASIS to tabletop is < 19 cm Sthenic patient

More information

Riverside Community College Anatomy & Physiology 2B SPRING 2012 EXAM #1-ABC (Nervous System)

Riverside Community College Anatomy & Physiology 2B SPRING 2012 EXAM #1-ABC (Nervous System) Riverside Community College Anatomy & Physiology 2B SPRING 2012 EXAM #1-ABC (Nervous System) Name: 1) This vertebra is an example of a(n). 1) A) thoracic B) axis C) atlas D) lumbar E) sacral 1 2) W hich

More information

Biology 218 Human Anatomy. Adapted from Martini Human Anatomy 7th ed. Chapter 7 The Skeletal System Appendicular Division

Biology 218 Human Anatomy. Adapted from Martini Human Anatomy 7th ed. Chapter 7 The Skeletal System Appendicular Division Adapted from Martini Human Anatomy 7th ed. Chapter 7 The Skeletal System Appendicular Division Introduction The appendicular skeleton includes: Pectoral girdle Shoulder bones Upper limbs Pelvic girdle

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 11/24/2012 Radiology Quiz of the Week # 100 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

Bone Flashcards for 10a

Bone Flashcards for 10a Bone Flashcards for 0a CLAVICLE (collar bone). Sternal extremity (end) flat end. Acromial extremity (end) rounded end. SCAPULA (shoulder blade). Right or left scapula?. Superior border (superior margin).

More information

Introduction. The primary function of the ankle and foot is to absorb shock and impart thrust to the body during walking.

Introduction. The primary function of the ankle and foot is to absorb shock and impart thrust to the body during walking. The ankle 1 Introduction The primary function of the ankle and foot is to absorb shock and impart thrust to the body during walking. OSTEOLOGRY The term ankle refers primarily to the talocrural joint,

More information

17.2 A-P Lower Leg Measure: A-P at mid-lower leg Protection: Apron draped over pelvis SID: 40 Table top No Tube Angle Film: 7 x17 I.D. down or diagonal 14 x 17 www.fisiokinesiterapia.biz A-P Lower Leg

More information

Figure 7: Bones of the lower limb

Figure 7: Bones of the lower limb BONES OF THE APPENDICULAR SKELETON The appendicular skeleton is composed of the 126 bones of the appendages and the pectoral and pelvic girdles, which attach the limbs to the axial skeleton. Although the

More information

PRE-LAB EXERCISES. Before we get started, look up the definitions of these common bone marking terms: Canal: Condyle: Facet: Fissure:

PRE-LAB EXERCISES. Before we get started, look up the definitions of these common bone marking terms: Canal: Condyle: Facet: Fissure: 1 PRE-LAB EXERCISES When studying the skeletal system, the bones are often sorted into two broad categories: the axial skeleton and the appendicular skeleton. This lab focuses on the appendicular skeleton,

More information

Clarification of Terms

Clarification of Terms Clarification of Terms The plantar aspect of the foot refers to the role or its bottom The dorsal aspect refers to the top or its superior portion The ankle and foot perform three main functions: 1. shock

More information

SCALING Radiographic Technique

SCALING Radiographic Technique SCALING Radiographic Technique SCALING FOR DIGITAL X-RAYS As images become filmless. Current planning practices with acetate sheets become difficult or obsolete. When images are printed to film sometimes

More information

Radiology Positioning Practical Test #2 Table (By Jung Park):

Radiology Positioning Practical Test #2 Table (By Jung Park): Radiology Positioning Practical Test #2 Table (By Jung Park): (Lower Extremity): patient is fully gowned / no artifacts / properly shielded (exposure for femur and below : hold still, don t move ) (exposure

More information

Human Anatomy - Problem Drill 06: The Skeletal System Axial Skeleton & Articualtions

Human Anatomy - Problem Drill 06: The Skeletal System Axial Skeleton & Articualtions Human Anatomy - Problem Drill 06: The Skeletal System Axial Skeleton & Articualtions Question No. 1 of 10 Instructions: (1) Read the problem and answer choices carefully, (2) Work the problems on paper

More information

LESSON ASSIGNMENT. Positioning for Exams of the Spine. After completing this lesson, you should be able to identify:

LESSON ASSIGNMENT. Positioning for Exams of the Spine. After completing this lesson, you should be able to identify: LESSON ASSIGNMENT LESSON 4 Positioning for Exams of the Spine. LESSON ASSIGNMENT Paragraphs 4-1 through 4-15. LESSON OBJECTIVES After completing this lesson, you should be able to identify: 4-1. Identify

More information

Outline. Ankle/Foot Anatomy Ankle Sprains Ottawa Ankle Rules DDx: The Sprain That Wasn t

Outline. Ankle/Foot Anatomy Ankle Sprains Ottawa Ankle Rules DDx: The Sprain That Wasn t Ankle Injuries Outline Ankle/Foot Anatomy Ankle Sprains Ottawa Ankle Rules DDx: The Sprain That Wasn t Anatomy: Ankle Mortise Bony Anatomy Lateral Ligament Complex Medial Ligament Complex Ankle Sprains

More information

Cervical Spine Anatomy and Biomechanics. Typical Cervical Vertebra C3 6. Typical Cervical Vertebra Anterior 10/5/2017

Cervical Spine Anatomy and Biomechanics. Typical Cervical Vertebra C3 6. Typical Cervical Vertebra Anterior 10/5/2017 Cervical Spine Anatomy and Biomechanics Typical Cervical Vertebra C3 6 Small, relatively broad body Bifid SpinousProcess Long and narrow laminae Spinal Canal: large, triangular; remarkably consistent dimensions

More information

Bone List Anatomy

Bone List Anatomy 1 Frontal Bone Skull 2 Parietal Bone Skull 3 Occipital Bone Skull 4 Temporal Bone Skull 5 Coronal Suture Skull 6 Sagittal Suture Skull 7 Squamous suture Skull 8 Lambdoid Suture Skull 9 Surpaorbital Ridge

More information

The radiologist and the raiders of the lost image

The radiologist and the raiders of the lost image The radiologist and the raiders of the lost image Poster No.: P-0072 Congress: ESSR 2014 Type: Educational Poster Authors: M. J. Ereño Ealo, E. Montejo Rodrigo, B. Sancho, E. Pastor; Galdakao/ES Keywords:

More information

ORTHOSCAN MOBILE DI POSITIONING GUIDE

ORTHOSCAN MOBILE DI POSITIONING GUIDE ORTHOSCAN MOBILE DI POSITIONING GUIDE Table of Contents SHOULDER A/P of Shoulder... 4 Tangential (Y-View) of Shoulder... 5 Lateral of Proximal Humerus... 6 ELBOW A/P of Elbow... 7 Extended Elbow... 8 Lateral

More information

National Boards Part 4 Technique. Exam Format 5 stations (1 doctor and 1 patient). 2 setups per station (5 minutes) cervical

National Boards Part 4 Technique. Exam Format 5 stations (1 doctor and 1 patient). 2 setups per station (5 minutes) cervical 1 National Boards Part 4 Technique Exam Format 5 stations (1 doctor and 1 patient). 2 setups per station (5 minutes) cervical thoracic lumbar pelvic extremity Expect examiner interaction Graded on a Scantron

More information

Radiographic Positioning Summary (Basic Projections RAD 222)

Radiographic Positioning Summary (Basic Projections RAD 222) Lower Extremity Radiographic Positioning Summary (Basic Projections RAD 222) AP Pelvis AP Hip (Unilateral) (L or R) AP Femur Mid and distal AP Knee Lateral Knee Pt lies supine on table Align MSP to Center

More information

Country Health SA Medical Imaging

Country Health SA Medical Imaging Country Health SA Medical Imaging REMOTE OPERATORS POSITIONING GUIDE Contents Image Evaluation Page 4 Positioning Guides Section 1 - THORAX 1.1 Chest Page 5 1.2 Bedside Chest Page 7 1.3 Ribs Page 8 Section

More information

Chest Radiology: A Systematic Approach. Objectives. Basic Principles 10/2/2014

Chest Radiology: A Systematic Approach. Objectives. Basic Principles 10/2/2014 Chest Radiology: A Systematic Approach Brian Wetzel ACNP Senior Instructor OHSU School of Medicine Department of Emergency Medicine Objectives A systematic approach to evaluating CXRs Identifying common

More information

Biology 2401 The Skeletal System

Biology 2401 The Skeletal System Biology 2401 The Skeletal System Purpose: The lab will describe the microscopic and gross anatomy of bone, identify bones of the body, and identify important bone markings. I. Overview of the Skeleton

More information

Radiography Protocols

Radiography Protocols Radiography Protocols Upper Limb Second through Fifth Digits (Standard 3 views) First Digit (Thumb) (Standard 3 views) Hand (Standard 3 views) Wrist (Standard 4 views) Forearm (Standard 2 views) Elbow

More information

Spring Written By: J. E. Sutton. Contents: I. Overview of the Skeleton: II. Appendicular Skeleton III. Axial Skeleton IV.

Spring Written By: J. E. Sutton. Contents: I. Overview of the Skeleton: II. Appendicular Skeleton III. Axial Skeleton IV. Spring 2012 Written By: J. E. Sutton Contents: I. Overview of the Skeleton: II. Appendicular Skeleton III. Axial Skeleton IV. Articulations Overview of the Skeleton: I. Orientation to Human Skeleton: a.

More information

The Dance Hall by Vincent van Gogh,1888

The Dance Hall by Vincent van Gogh,1888 The Dance Hall by Vincent van Gogh,1888 Articulations of the pelvic girdle Lumbosacral joints, sacroiliac joints & pubic symphysis The remaining joints of the lower limb Hip joint Knee joint Tibiofibular

More information

Overview of the Skeleton: Bone Markings

Overview of the Skeleton: Bone Markings Name Overview of the Skeleton: Bone Markings Match the terms in column B with the appropriate description in column A. Column A 1. sharp, slender process* 2. small rounded projection* 3. narrow ridge of

More information

Imaging acute knee trauma: Are referral criteria and clinical guidelines used in Belgium?

Imaging acute knee trauma: Are referral criteria and clinical guidelines used in Belgium? Imaging acute knee trauma: Are referral criteria and clinical guidelines used in Belgium? Poster No.: C-2209 Congress: ECR 2010 Type: Scientific Exhibit Topic: Musculoskeletal Authors: M. A. T. Vergauwen,

More information

Journal reading. Introduction. Introduction. Ottawa Ankle Rules. Method

Journal reading. Introduction. Introduction. Ottawa Ankle Rules. Method Journal reading Presenter: PGY 林聖傑 Supervisor: Dr. 林俊龍 102.12.23 The accuracy of ultrasound evaluation in foot and ankle trauma Salih Ekinci, MD American Journal of Emergency Medicine 31 (2013) 1551 1555

More information

Routine Guide EXAMINATION PROJECTION CASSETTE SIZE NOTES PRINT ORIENTATION. 14x17 CW* 14x17LW 14x17LW. 14x17LW 14x17LW 14x17LW

Routine Guide EXAMINATION PROJECTION CASSETTE SIZE NOTES PRINT ORIENTATION. 14x17 CW* 14x17LW 14x17LW. 14x17LW 14x17LW 14x17LW EXAMINATION PROJECTION CASSETTE SIZE NOTES PRINT ORIENTATION A-C Joints without weights with weights 14x17 CW* One 14x17 divided; both shoulders on one exposure. *If part does not fit, do 10x12s CW. Both

More information

Disclosures. Syndesmosis Injury. Syndesmosis Ligaments. Objectives. Mark M. Casillas, M.D.

Disclosures. Syndesmosis Injury. Syndesmosis Ligaments. Objectives. Mark M. Casillas, M.D. Disclosures Syndesmosis Injury No relevant disclosures Mark M. Casillas, M.D. 1 Objectives Syndesmosis Ligaments Understand the syndesmosis anatomy and function Classify syndesmosis injuries Describe treatment

More information

VERTEBRAL COLUMN VERTEBRAL COLUMN

VERTEBRAL COLUMN VERTEBRAL COLUMN VERTEBRAL COLUMN FUNCTIONS: 1) Support weight - transmits weight to pelvis and lower limbs 2) Houses and protects spinal cord - spinal nerves leave cord between vertebrae 3) Permits movements - *clinical

More information

Imaging Decision Making: Recommended Radiographic Projections

Imaging Decision Making: Recommended Radiographic Projections WSCC Clinics Protocol Adopted: 3/05 Imaging Decision Making: Recommended Radiographic Projections This document lists the routine, supplemental and alternative projections performed in the Diagnostic Imaging

More information

EASILY MISSED FOOT AND ANKLE FRACTURES NORDIC TRAUMA COURSE 2016, AARHUS

EASILY MISSED FOOT AND ANKLE FRACTURES NORDIC TRAUMA COURSE 2016, AARHUS EASILY MISSED FOOT AND ANKLE FRACTURES NORDIC TRAUMA COURSE 2016, AARHUS Ken F. Linnau, MD, MS Emergency Radiology Harborview Medical Center University of Washington Seattle, WA Thanks to Claire K Sandstrom

More information

The value of weight-bearing functional CT scans

The value of weight-bearing functional CT scans The value of weight-bearing functional scans In musculoskeletal medicine, advanced imaging like computed axial tomography () scanning, has become invaluable to the evaluation and management of patients

More information

Imaging Modalities: Clinical Reasoning and Key Instructional Elements: Radiography

Imaging Modalities: Clinical Reasoning and Key Instructional Elements: Radiography Imaging Modalities: Clinical Reasoning and Key Instructional Elements: Radiography Michael D. Ross, PT, DHSc, OCS mross@daemen.edu Disclosure No relevant financial relationship exists Objectives Determine

More information

Contents of the Posterior Fascial Compartment of the Thigh

Contents of the Posterior Fascial Compartment of the Thigh Contents of the Posterior Fascial Compartment of the Thigh 1-Muscles: B i c e p s f e m o r i s S e m i t e n d i n o s u s S e m i m e m b r a n o s u s a small part of the adductor magnus (h a m s t

More information

Radiographic Procedures 1

Radiographic Procedures 1 Western Technical College 10526149 Radiographic Procedures 1 Course Outcome Summary Course Information Textbooks Description Career Cluster Instructional Level Total Credits 5 Prepares radiography students

More information

It is formed by fusion of 3 bones: I. Ilium (superior bone). II. Pubis (antero-inferior bone). III. Ischium (postero-inferior bone).

It is formed by fusion of 3 bones: I. Ilium (superior bone). II. Pubis (antero-inferior bone). III. Ischium (postero-inferior bone). It is formed by fusion of 3 bones: I. Ilium (superior bone). II. Pubis (antero-inferior bone). III. Ischium (postero-inferior bone). Pubis Acetabulum Ana (242 ) The three constituent of bones of the hip

More information

HANDS ON: Knee Evaluation J. Scott Delaney MD, FRCPC, FACEP, CSPQ

HANDS ON: Knee Evaluation J. Scott Delaney MD, FRCPC, FACEP, CSPQ HANDS ON: Knee Evaluation J. Scott Delaney MD, FRCPC, FACEP, CSPQ FACULTY DISCLOSURE Dr. Delaney has no affiliation with the manufacturer of any commercial product or provider of any commercial service

More information

Lab Activity 9. Appendicular Skeleton Martini Chapter 8. Portland Community College BI 231

Lab Activity 9. Appendicular Skeleton Martini Chapter 8. Portland Community College BI 231 Lab Activity 9 Appendicular Skeleton Martini Chapter 8 Portland Community College BI 231 Appendicular Skeleton Upper & Lower extremities Shoulder Girdle Pelvic Girdle 2 Humerus 3 Humerus: Proximal End

More information

Disclosure. Clinical Chest Radiography Interpretation Part I

Disclosure. Clinical Chest Radiography Interpretation Part I Clinical Chest Radiography Interpretation Part I Anthony M. Angelow, PhD(c), MSN, ACNPC, AGACNP-BC, CEN Associate Lecturer, Fitzgerald Health Education Associates Clinical practice Division of Trauma Surgery

More information

Exercise Science Section 2: The Skeletal System

Exercise Science Section 2: The Skeletal System Exercise Science Section 2: The Skeletal System An Introduction to Health and Physical Education Ted Temertzoglou Paul Challen ISBN 1-55077-132-9 Role of the Skeleton Protection Framework Attachments for

More information

Structure and Function of the Vertebral Column

Structure and Function of the Vertebral Column Structure and Function of the Vertebral Column Posture Vertebral Alignment Does it really matter? Yes it does! Postural Curves The vertebral column has a series of counterbalancing curves posterior anterior

More information

The Appendicular Skeleton

The Appendicular Skeleton 8 The Appendicular Skeleton PowerPoint Lecture Presentations prepared by Jason LaPres Lone Star College North Harris 8-1 The Pectoral Girdle The Pectoral Girdle Also called shoulder girdle Connects the

More information

Radiology of Cervical Spine Trauma. Cervical Spine Trauma. Imaging Standards. Canadian C. Spine Rule 11/28/2016

Radiology of Cervical Spine Trauma. Cervical Spine Trauma. Imaging Standards. Canadian C. Spine Rule 11/28/2016 Radiology of Cervical Spine Trauma Dr. Steven J. Gould, D.C. Board Certified Chiropractic Radiologist Cleveland Chiropractic College, KC. MO. Radiology Residency at CCC, KC Cervical Spine Trauma Vertebral

More information

11/25/2012. Chapter 7 Part 2: Bones! Skeletal Organization. The Skull. Skull Bones to Know Cranium

11/25/2012. Chapter 7 Part 2: Bones! Skeletal Organization. The Skull. Skull Bones to Know Cranium Chapter 7 Part 2: Bones! 5) Distinguish between the axial and appendicular skeletons and name the major parts of each 6) Locate and identify the bones and the major features of the bones that compose the

More information

Vertebral Column. Backbone consists of 26 vertebrae. Five vertebral regions. Cervical

Vertebral Column. Backbone consists of 26 vertebrae. Five vertebral regions. Cervical Vertebral Column Backbone consists of 26 vertebrae. Five vertebral regions Cervical vertebrae (7) in the neck. Thoracic vertebrae (12) in the thorax. Lumbar vertebrae (5) in the lower back. Sacrum (5,

More information

Bones of Lower Limb. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology

Bones of Lower Limb. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Bones of Lower Limb Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Bones of the lower limb Hip Bone Made up of 3 bones: 1) Ilium (flat), superior in position 2) Ischium (L), postero-inferior

More information

Acute Trauma,c Disloca,on Am J Sports Med July 2000 vol. 28 no

Acute Trauma,c Disloca,on Am J Sports Med July 2000 vol. 28 no Patellar subluxa,on Acute Trauma,c Disloca,on Am J Sports Med July 2000 vol. 28 no. 4 472-479 History taking is important: a. Trivial or significant injury b. Requires Hospital or self reducion c. Bilateral,

More information

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES MSAK201-I Session 3 1) REVIEW a) THIGH, LEG, ANKLE & FOOT i) Tibia Medial Malleolus

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 12/29/2012 Radiology Quiz of the Week # 105 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

TEST YOURSELF- Chapter 7

TEST YOURSELF- Chapter 7 TEST YOURSELF- Chapter 7 Cranial Bones 1. Give the name of the bone for each of the following markings. Some of the markings are found on more than one bone. List all that apply. Cranium a. Frontal squama:

More information

Digital Motion X-ray Cervical Spine

Digital Motion X-ray Cervical Spine NAME OF PATIENT: CASE STUDY 4 DATE OF REPORT: DATE OF EXAMINATION: REFERRING PHYSICIAN: TESTING FACILITY: Digital Motion X-ray Cervical Spine 1. In the neutral lateral projection: Shows reversal of the

More information

Basic Principles of Fractures & Easily Missed Fractures. Mr Irfan Merchant Trauma & Orthopaedic Registrar Bedford Hospital, East of England

Basic Principles of Fractures & Easily Missed Fractures. Mr Irfan Merchant Trauma & Orthopaedic Registrar Bedford Hospital, East of England Basic Principles of Fractures & Easily Missed Fractures Mr Irfan Merchant Trauma & Orthopaedic Registrar Bedford Hospital, East of England Objectives Types Fracture Patterns Fracture Healing Assessing

More information

Perpendicular Plate Zygomatic Bone. Mental Foramen Mandible

Perpendicular Plate Zygomatic Bone. Mental Foramen Mandible Glabella Frontal Middle Nasal Concha Nasal Lacrimal Perpendicular Plate Zygomatic Inferior Nasal Concha Maxilla Mental Mandible Skull (anterior view) Squamosal Suture Coronal Suture Frontal Parietal Nasal

More information

Section 4: Tarsal Coalitions

Section 4: Tarsal Coalitions Case H (Figure 2): PedCat CBCT transverse plane reconstruction of right Lisfranc midfoot dislocation compared to normal left foot. Clinical Relevance of the PedCat Study: The weight bearing CBCT study

More information

The Leg. Prof. Oluwadiya KS

The Leg. Prof. Oluwadiya KS The Leg Prof. Oluwadiya KS www.oluwadiya.sitesled.com Compartments of the leg 4 Four Compartments: 1. Anterior compartment Deep fibular nerve Dorsiflexes the foot and toes 2. Lateral Compartment Superficial

More information

Copyright 2010 Pearson Education, Inc.

Copyright 2010 Pearson Education, Inc. E. VERTEBRAL COLUMN 1. The vertebral column extends from the skull to the pelvis and forms the vertical axis of the skeleton. 2. The vertebral column is composed of vertebrae that are separated by intervertebral

More information

Balanced Body Movement Principles

Balanced Body Movement Principles Balanced Body Movement Principles How the Body Works and How to Train it. Module 3: Lower Body Strength and Power Developing Strength, Endurance and Power The lower body is our primary source of strength,

More information

THE VERTEBRAL COLUMN. Average adult length: In male: about 70 cms. In female: about 65 cms.

THE VERTEBRAL COLUMN. Average adult length: In male: about 70 cms. In female: about 65 cms. THE VERTEBRAL COLUMN Average adult length: In male: about 70 cms. In female: about 65 cms. 1 Vertebral Column (Regions and Curvatures) Curvatures of the vertebral column: A. Primary curvature: C-shaped;

More information

Anatomy and Physiology II. Spine

Anatomy and Physiology II. Spine Anatomy and Physiology II Spine Bones and Other Structures Vertibrae Contains Cervical, Thoracic, Lumbar, Sacral and Coccygeal regions We use Capital letters to refer to these (C, T, L, S, and Co) and

More information

Topic 7: Hip and pelvis. Parts of the hip. Parts of the femur

Topic 7: Hip and pelvis. Parts of the hip. Parts of the femur Topic 7: Hip and pelvis Parts of the hip Parts of the femur Classifying the hip joint Ball and socket Synovial Multiaxial Movements of the hip: Abduction/adduction Flexion/extension Medial/lateral rotation

More information

SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT

SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT 1 Anatomy 3 columns- Anterior, middle and Posterior Anterior- ALL, Anterior 2/3 rd body & disc. Middle- Posterior 1/3 rd of body & disc, PLL Posterior-

More information

Human Anatomy and Physiology - Problem Drill 07: The Skeletal System Axial Skeleton

Human Anatomy and Physiology - Problem Drill 07: The Skeletal System Axial Skeleton Human Anatomy and Physiology - Problem Drill 07: The Skeletal System Axial Skeleton Question No. 1 of 10 Which of the following statements about the axial skeleton is correct? Question #01 A. The axial

More information

Chest cavity, vertebral column and back muscles. Respiratory muscles. Sándor Katz M.D., Ph.D.

Chest cavity, vertebral column and back muscles. Respiratory muscles. Sándor Katz M.D., Ph.D. Chest cavity, vertebral column and back muscles. Respiratory muscles. Sándor Katz M.D., Ph.D. Chest cavity - bony structures Chest cavity- bony structures Sternum Ribs True ribs: first seven pairs connect

More information

Bontrager, Kenneth: Radiographic Positioning and Related Anatomy 8 th edition, C.V. Mosby, 2010, ISBN# #882 Scan-trons and pencils

Bontrager, Kenneth: Radiographic Positioning and Related Anatomy 8 th edition, C.V. Mosby, 2010, ISBN# #882 Scan-trons and pencils Basic Radiographic Procedures (RADR 1411) Credit: 3 semester credit hours (3 hours lecture, 2 hours lab) Pre-requisite: RADR 1309 Introduction to Radiography and Patient Care Course Description An introduction

More information

2. The vertebral arch is composed of pedicles (projecting from the body) and laminae (uniting arch posteriorly).

2. The vertebral arch is composed of pedicles (projecting from the body) and laminae (uniting arch posteriorly). VERTEBRAL COLUMN 2018zillmusom I. VERTEBRAL COLUMN - functions to support weight of body and protect spinal cord while permitting movements of trunk and providing for muscle attachments. A. Typical vertebra

More information

Bones of the Lower Limb Bone Structure Description Notes. border of the superior ramus. inferolaterally from the pubic symphysis

Bones of the Lower Limb Bone Structure Description Notes. border of the superior ramus. inferolaterally from the pubic symphysis Bones of the Lower Limb Bone Structure Description Notes pubis an angulated bone the forms the anterior part of the pelvis one of three bones that form the os coxae: ilium, ischium, pubis; its forms 1/5

More information

10/12/2010. Upper Extremity. Pectoral (Shoulder) Girdle. Clavicle (collarbone) Skeletal System: Appendicular Skeleton

10/12/2010. Upper Extremity. Pectoral (Shoulder) Girdle. Clavicle (collarbone) Skeletal System: Appendicular Skeleton Skeletal System: Appendicular Skeleton Pectoral girdle Pelvic girdle Upper limbs Lower limbs 8-1 Pectoral (Shoulder) Girdle Consists of scapula and clavicle Clavicle articulates with sternum (Sternoclavicular

More information

Dr.Israa H. Mohsen. Lecture 5. The vertebral column

Dr.Israa H. Mohsen. Lecture 5. The vertebral column Anatomy Lecture 5 Dr.Israa H. Mohsen The vertebral column The vertebral column a flexible structure consisting of 33 vertebrae holds the head and torso upright, serves as an attachment point for the legs,

More information

Biology 152 Appendicular Skeleton Anatomy Objectives

Biology 152 Appendicular Skeleton Anatomy Objectives Biology 152 Appendicular Skeleton Anatomy Objectives We will learn proper bone names, left/right/medial, and the parts of bones in this exercise. Start by learning the names of the bones. As you gain comfort

More information

Pectoral (Shoulder) Girdle

Pectoral (Shoulder) Girdle Chapter 8 Skeletal System: Appendicular Skeleton Pectoral girdle Pelvic girdle Upper limbs Lower limbs 8-1 Pectoral (Shoulder) Girdle Consists of scapula and clavicle Clavicle articulates with sternum

More information

Clarification of Terms

Clarification of Terms Clarification of Terms The Spine, Spinal Column, and Vertebral Column are synonymous terms referring to the bony components housing the spinal cord Spinal Cord = made of nervous tissue Facet = a small,

More information

Foot Injuries. Dr R B Kalia

Foot Injuries. Dr R B Kalia Foot Injuries Dr R B Kalia Overview Dramatic impact on the overall health, activity, and emotional status More attention and aggressive management Difficult appendage to study and diagnose. Aim- a stable

More information

Chapter 8 The Skeletal System: The Appendicular Skeleton. Copyright 2009 John Wiley & Sons, Inc.

Chapter 8 The Skeletal System: The Appendicular Skeleton. Copyright 2009 John Wiley & Sons, Inc. Chapter 8 The Skeletal System: The Appendicular Skeleton Appendicular Skeleton It includes bones of the upper and lower limbs Girdles attach the limbs to the axial skeleton The pectoral girdle consists

More information

Feet First. Michael K. Cooper, DO FACOFP Family Practice/OMM St John Clinic - Claremore OOA 2018 Annual Convention

Feet First. Michael K. Cooper, DO FACOFP Family Practice/OMM St John Clinic - Claremore OOA 2018 Annual Convention Feet First Michael K. Cooper, DO FACOFP Family Practice/OMM St John Clinic - Claremore OOA 2018 Annual Convention Disclaimer I have no conflict of interest. I am not on any pharmaceutical company payroll

More information

Case. Case 8/29/ yo man with fever, cough. Vitals: Temp 102, HR 130, RR 20, bp 120/80. Ill appearing, crackles R side chest. Now what?

Case. Case 8/29/ yo man with fever, cough. Vitals: Temp 102, HR 130, RR 20, bp 120/80. Ill appearing, crackles R side chest. Now what? Kate Aberger, MD August 28, 2016 Help from : Raphael Brancato DO, and Jordan Jeong DO Case 56 yo man with fever, cough Vitals: Temp 102, HR 130, RR 20, bp 120/80 Ill appearing, crackles R side chest Now

More information

Proteus XR/f Patient positioning guide

Proteus XR/f Patient positioning guide Proteus XR/f Patient positioning guide PROTEUS XR/F Now a single digital x-ray room accommodates nearly all your radiographic studies. With extended tube coverage and wireless detectors, Proteus XR/f gives

More information

Where to Draw the Line:

Where to Draw the Line: Where to Draw the Line: Anatomical Measurements Used to Evaluate Patellofemoral Instability Murray Grissom, MD 1 Bao Do, MD 2 Kathryn Stevens, MD 2 1 Santa Clara Valley Medical Center, San Jose, CA 2 Stanford

More information

MEDICAL IMAGING OF THE VERTEBRAE

MEDICAL IMAGING OF THE VERTEBRAE MEDICAL IMAGING OF THE VERTEBRAE Vertebrae are your friends Matthew Harper MS-IV LECTURE OBJECTIVES INTRODUCE THE MOST COMMON MODALITIES OF MEDICAL IMAGING AND BASIC TECHNIQUES FOR READING THESE IMAGES

More information

Commonly missed fractures in the Emergency Department

Commonly missed fractures in the Emergency Department Commonly missed fractures in the Emergency Department Poster No.: C-2327 Congress: ECR 2015 Type: Educational Exhibit Authors: A. A. Tegzes; Cluj-Napoca/RO Keywords: Education, Digital radiography, Conventional

More information

Axial Skeleton: Vertebrae and Thorax

Axial Skeleton: Vertebrae and Thorax Axial Skeleton: Vertebrae and Thorax Function of the vertebral column (spine or backbone): 1) 2) 3) Composition of Vertebral column The vertebral column is formed by 33 individual vertebrae (some of which

More information

BIOLOGY 113 LABORATORY Skeletal System

BIOLOGY 113 LABORATORY Skeletal System BIOLOGY 113 LABORATORY Skeletal System Objectives Distinguish between the axial and appendicular skeleton. Distinguish between the cranium and facial skeleton. Locate and name the bones of the skull and

More information

Copyright 2004, Yoshiyuki Shiratori. All right reserved.

Copyright 2004, Yoshiyuki Shiratori. All right reserved. Ankle and Leg Evaluation 1. History Chief Complaint: A. What happened? B. Is it a sharp or dull pain? C. How long have you had the pain? D. Can you pinpoint the pain? E. Do you have any numbness or tingling?

More information

4/28/2010. Fractures. Normal Bone and Normal Ossification Bone Terms. Epiphysis Epiphyseal Plate (physis) Metaphysis

4/28/2010. Fractures. Normal Bone and Normal Ossification Bone Terms. Epiphysis Epiphyseal Plate (physis) Metaphysis Fractures Normal Bone and Normal Ossification Bone Terms Epiphysis Epiphyseal Plate (physis) Metaphysis Diaphysis 1 Fracture Classifications A. Longitudinal B. Transverse C. Oblique D. Spiral E. Incomplete

More information

Orthopedic X-Rays most commonly missed

Orthopedic X-Rays most commonly missed Orthopedic X-Rays most commonly missed Vukiet Tran, MD, MHSc, MBA University Health Network Toronto, Canada 1 COI Disclosure I am the current Medical Director for Best Doctors Canada. Presenter: Dr. Vu

More information

My Technique for Adjusting the Excessively Pronated Foot

My Technique for Adjusting the Excessively Pronated Foot My Technique for Adjusting the Excessively Pronated Foot by Mark N. Charrette, DC One can think of Chiropractic in terms of science, art, and philosophy. The art or application of Chiropractic technique

More information

Clarification of Terms

Clarification of Terms Clarification of Terms The Spine, Spinal Column, and Vertebral Column are synonymous terms referring to the bony components housing the spinal cord Spinal Cord = made of nervous tissue Facet = a small,

More information

EXTREMITY injury is a common cause for visits

EXTREMITY injury is a common cause for visits ACADEMIC EMERGENCY MEDICINE October 1999, Volume 6, Number 10 1005 Validation of the Ankle Rules in Children with Ankle Injuries AMY C. PLINT, MD, BLAKE BULLOCH, MD, MARTIN H. OSMOND, MD, IAN STIELL, MD,

More information

Clarification of Terms

Clarification of Terms Clarification of Terms The Spine, Spinal Column, and Vertebral Column are synonymous terms referring to the bony components housing the spinal cord Spinal Cord = made of nervous tissue Facet = a small,

More information

Injuries to the lower extremity II Aree Tanavalee MD Associate Professor Department of Orthopaedics Faculty of Medicine Chulalongkorn University

Injuries to the lower extremity II Aree Tanavalee MD Associate Professor Department of Orthopaedics Faculty of Medicine Chulalongkorn University Injuries to the lower extremity II Aree Tanavalee MD Associate Professor Department of Orthopaedics Faculty of Medicine Chulalongkorn University Topics Fracture of the shaft of the femur Fractures around

More information

ANKLE JOINT ANATOMY 3. TALRSALS = (FOOT BONES) Fibula. Frances Daly MSc 1 CALCANEUS 2. TALUS 3. NAVICULAR 4. CUBOID 5.

ANKLE JOINT ANATOMY 3. TALRSALS = (FOOT BONES) Fibula. Frances Daly MSc 1 CALCANEUS 2. TALUS 3. NAVICULAR 4. CUBOID 5. ANKLE JOINT ANATOMY The ankle joint is a synovial joint of the hinge type. The joint is formed by the distal end of the tibia and medial malleolus, the fibula and lateral malleolus and talus bone. It is

More information