# data[].attributes.body
Projection)
A. 
B. 
C. Acromial extremity
D. Acromioclavicular joint
E. Acromion process

Question 3 (AP Elbow)
A. Olecranon process

# data[].attributes.body
v- Technical Factors
           kvp- 65-75
           mAs- 6-12
           SID- 100cm
           Size IR- 10' x 12 ' (crosswise)
           Grid- yes

# data[].attributes.body
Question 1 (PA Wrist)

A. Trapezoid
B. Trapezium
C. Capitate
D. Scaphoid
E. Radius Styloid Process
F. Radius
G. Ulna
H. Ulna styloid process
I. Lunate
J. Triquetrium
K. Pisiform
L. Hamate
M. Metacarpal

Question 2 AP Projection

A. First Rib
B. Scapular Notch
C. Clavicle
D. Acromioclavicular Joint
E. Acromion process of Scapula

Question 3 (AP Projection of Elbow)

A. Olecranon Process
B. Lateral Epicondyle
C. Humeroulna joint
D. Radial Head
E. Neck of Radius
F. Radius
G. Ulna
H. Radial Tubercle
I. Coronoid Tubercle
J. Trochlea
K. Medial Epicondyle
L. Olecranon Fossa
M. Humerus

Question 4
1. PA Elbow
- Greater OID
- Image appear to be magnified
- Low resolution, not sharp, the structure is not detail

2. AP Elbow
- Smaller OID
- No magnification
- High resolution, image appear sharper, the structure is in detail

Question 5
a) i- Patient preparation
- Identify the patient
-  Ask LMP
- Remove all the radiopaque object  at the shoulder region such as necklace
- Help patient to remove her personal belongings if needed
ii- Patient positioning
-Ask the patient to stand erect, back of the patient contact with IR.
- Rotate body slightly towards the left side to make contact with the IR
- Do not attempt to rotate the left arm
-  Apply the lead shielding at the gonad area
iii- Part positioning
-  Position patient to centre scapulohumeral joint to IR
- Place patient's arm as it is (neutral position) , epicondyle generally 45' to plane of IR.
iv- Tube Positioning
- Tube must be perpendicular to IR (Horizontal beam)
v- Technical Factors
kvp- 65-75
mAs- 6-12
SID- 100cm
Size IR- 10' x 12 ' (crosswise)
Grid- yes

b) Transthoracic lateral
c) i- Patient positioning
- Patient in upright position
- Place the left arm in lateral position against the IR
- Apply the lead shileding at the gonad area.
ii- Part positioning
- Place the left arm in neutral position
- Raise the right arm and place the arm over the top of head to prevent superimposition with the left arm
- Centre the surgical neck and centre of IR to CR and projected through the thorax.
- Ensure the thorax in true lateral position.

ii- Tube positioning
- Place the tube perpendicular to IR (horizontal)

v- Technical Factors
kvp- 70-80
mAs- 6-12
SID- 100cm
Size IR- 10' x 12 ' (crosswise)
Grid- yes

# data[].attributes.body
Q1 (PA WRIST)

A: Trapezoid

B: Trapezium

C: Capitate

D: Scaphoid

E: Radial Styloid Process

F: Radius

G: Ulna

H: Ulna Styloid Process

I: Lunate

J: Triquetrum

K: Pisiform

L: Hamulus of Hamate

M: Metacarpals

Q2 ( AC Joint AP Projection)

A: First Rib

B: Coracoid Process

C: Clavicle

D: Acromioclavicular Joint

E: Acromion

Q3 ( AP projection of the elbow)

A: Olecranon Process

B: Lateral Epicondyle

C: Humeroradial joint

D: Head of Radius

E: Neck of Radius

F: Radius

G: Ulna

H: Radial Tubercle

I: Coronoid Tubercle

J: Trochlea

K: Medial Epicondyle

L: Olecranon Fossa

M: Humerus

Q4: Differentiate the radiographic image of the thumb if the radiographer is to undertake the PA projection instead of the AP projection;

PA Elbow | AP Elbow
1. Object to image receptor (IR) distance:
| Increased | Decreased
2. Magnification:
| High Magnification | Low Magnification
3. Resolution:
| Decreased | Increased

Q5:  Dislocation of the scapula humeral joint
a) AP projection

(i)         Patient preparation
-Ask the last menstrual period (LMP) of the patient
-Patient must remove her bra if she can tolerate
-Place gonad shielding on her waist to shield the gonads

(ii)       Patient positioning
-Patient's left arm is not being rotate due to the fracture.
- Patient is in erect position.

(iii)      Part positioning
-The affected side of patient is being rotated slightly toward the image receptor to bring shoulder and proximal humerus in contact with image receptor
-The scapulohumeral joint is centred to the center of image receptor
-If possible, patient's arm has to be in neutral rotation

(iv)     Tube Positioning
-The x-ray tube must be perpendicular to image receptor directed 1 inch inferior to coracoid process

(v)       Technical factors used (kV, mAs, FFD, size of IR and orientation, grid or without grid)
-kVp: 65 -75 kVp
-mAs: 6-12 mAs
-SID: 100 cm
-Size of image receptor: 24 cm x 30 cm in crosswise with grid

b)  Projection to demonstrate dislocation of the scapula-humeral joint:
- Transthoracic lateral projection

c) Describe that projection ;

(i)      Patient positioning
- Place patient in an erect position
-Place patient in lateral position with left side closest to image receptor

(ii)     Part positioning
-Place left (affected) arm at patient's side in neutral rotation and drop the shoulder
- Raise opposite arm over the top of head and elevate the shoulder to prevent superimposition of affected shoulder
-Center mid-diaphysis of the left (affected) humerus and center of image receptor to central ray as projected through thorax
- Ensure that thorax is in a true lateral position

(iii)    Tube Positioning
- Central ray perpendicular to image receptor directed through thorax to mid-diaphysis
-Horizontal beam

(iv)     Technical factors used (kV, mAs, FFD, size of IR and orientation, grid or without grid)
kVp: 70-80  kVp
mAs: 25-35 mAs
Size of image receptor: 14 x 17 inches
Orientation: Lengthwise
Grid: Using grid

Q6:  Differentiate the position of the radius and ulna as well as the proximal radio-ulnar joint (if indicated), if radiography of the elbow is undertaken.

# data[].attributes.body
Question 1 (PA WRIST)
A. trapezium
B. trapezoid
C. capitate
D. scaphoid
E. radial styloid process
F. radius
G. ulna
H. ulna styloid process
I. lunate
J. triquetrum
K. pisiform
L. hamate
M. metacarpals

Question 2 (AP AC JOINT)
A.
B.
C. acromion extremity(end)
D. acromioclavicular joint
E. acromion of scapula

Question 3 (AP ELBOW)
A. olecranon process
B. lateral epicondyle
C. humeroradial joint
D. head of radius
E. neck of radius
F. radius
G. ulna
H. radial tubercle
I. coronoid tubercle
J. trochlea
K. medial epicondyle
L. olecranon fossa
M. humerus

Question 4.
Differentiate AP and PA thumb

a) Object Image Distance (OID)
AP: shorter
PA: longer

b) Magnification
AP: Lesser
PA: Higher

c) Resolution
AP: Higher
PA: Lower

5. AP shoulder (Neutral Rotation)
a) i) - Ask LMP to the patient
-Ask the patient to remove all radiopaque materials at the region of interest
-ask the patient to change to the hospital gown
-ask the patient to wear gonad shield

ii)Patient positioning
- patient in erect position
-patient did not have to rotate her arms (neutral position)

iii) Part positioning
- position patient to center scapulohumeral joint to center of cassette
-place patient's arm at side in "as neutral rotation"
- ask the patient to suspend respiration during exposure

iv) tube positioning
- tube must be perpendicular to IR and centered to 1" inferior to coracoid process

v) Technical factors
-kVp: 65-75
-mAs : 6-12
-size of IR: 24cm x 30cm
-SID: 100cm
-orientation: crosswise
-use grid

b) Transthoracic lateral (TRAUMA)

c) i) Patient positioning
-patient in erect position
-place patient in lateral position with side of interest against the IR

ii) Part positioning
-place affected arm at the patient's side in neutral rotation; drop shoulder as possible
-raise opposite arm and place hand over top of head; elevate shoulder as much as possible to prevent superimposition of affected shoulder
-center surgical neck and center of IR as projected through thorax
-ensure that thorax is in true lateral position or has slight anterior rotation of unaffected shoulder to minimize superimposition of humerus by thoracic vertebrae

iii) Tube positioning
-

# data[].attributes.body
Question 1  (PA WRIST)
A. Trapezoid
B. Trapezium
C. Capitate
D. Scaphoid
E. Radial styloid process
F. Radius
G. Ulna
H. Styloid process of ulna
I. Lunate
J. Triquetrum
K. Pisiform
L. Hamate
M. Metacarpal

Question 2 ( Ac Joint AP Projection)

A. 1st rib
B. Scapular notch
C. Acromial extremity
D. Acromioclavicular joint
E. Acromion process

Question 3 (AP Elbow)
A. Olecranon process
B. Lateral epicondyle
C. Humeroradial joint
D. Head of radius
E. Neck of radius
F. Body of radius
G. Body of ulna
H. Radial tuberosity
I. Coronoid tubercle
J. Trochlea
K. Medial epicondyle
L. Coronoid fossa
M. Body (shaft) of humerus

Question 4.
AP vs PA thumb

a) Object to Image Receptor Distance (OID)
AP: Smaller
PA: Larger

b) Magnification
AP: Lower
PA: Higher

c) Resolution
AP: High resolution
PA: Low resolution

Question 5.
AP Shoulder (Neutral Rotation)

a)
i) Patient preparation
- Ask LMP for female patient
- Ask the patient to remove necklace, bra and other radiopaque material from region of interest.
- Ask patient to change to hospital gown.
- Shield radiosensitive tissue outside region of interest.

ii) Patient position
- Patient in erect position
- Rotate patient's body slightly towards the left side of shoulder to bring shoulder and proximal humerus close to IR.

iii) Part positioning.
- Position patient to center scapulohumeral joint to center of IR.
- Place patient's arm in neutral position. (Epicondyle 45 degree to plane of IR).

iv) Tube positioning.
- CR perpendicular to IR, directed to scapulohumeral joint.
- Collimation:
-Superior: Soft tissue margin & upper scapula.
-Inferior: Proximal 1/3 humerus.
-Lateral: Soft tissue margin and lateral 2/3 of clavicle.

v) Technical factors:
- Kv: 70-80
- mAs: 6-12
- SID: 100cm
- Size of IR: 10x12 in
- Orientation: Crosswise
- Grid: Use grid

b) Transthoracic Lateral Projection.

c)
i) Patient positioning
- Patient in upright position.
- Place patient in lateral position with left side against IR.

ii) Part positioning
- Place left arm at patient's side in neutral rotation. Drop shoulder if possible.
- Raise right arm and place hand over top of head; elevate shoulder as much as possible to prevent superimposition of left shoulder.
- Center surgical neck and center of IR to CR as projected through thorax.
- Ensure that thorax is in a true lateral position or has slight anterior rotation of right shoulder to minimize superimposition of humerus by thoracic vertebrae.

iii) Tube positioning
- CR is perpendicular to IR, directed through thorax to surgical neck.
- Collimation:
Superior: Clavicle
Inferior: Proximal humerus
Lateral: Soft tissue of humerus and ribs.

iv) Technical factors
- kV : 80-90
- mAs : 6-12
- FFD : 100cm
- size of IR : 24x30 cm (10x12 in)
- Orientation : Lenghtwise
- Grid : with grid

Question 6.
Position radius and ulna (elbow)