Tutorial 3 by Soo Foon Moey https://padlet.com/moeysf1/jmo16fj57gqx Upper EXtemity en-us 2018-03-29 06:21:29 UTC 2018-03-29 07:44:28 UTC hello@padlet.com Group 2 haidirzamri https://padlet.com/moeysf1/jmo16fj57gqx/wish/247148750 Question1
Anterior Aspect
A. Scapulohumeral joint
B. Acromion
C. Coracoid process
D. Scapula notch
E. Superior border
F. Superior Angle
G. Medial border
H. Inferior angle
I. Lateral border
J. Costal surface

Posterior Aspect
A. Superior angle
B. Crest of spine
C. Body
D. Inferior angle
E. Infraspinous fossa
F. Supraspinous fossa
G. Superior border
H. Scapular notch
I. Coracoid process
J. Acromion
K. Spine of scapula
L. Lateral angle
M. Lateral border

Question 2
Correct part positioning:
-extend elbow, supinate hand and align arm and forearm with long axis of IR
-ask patient to lean laterally as necessary for true AP projecion
-centre the elbow joint to the centre of the IR
-palpate humeral epicondyles so that it is parallel to IR
-support hand if needed

Question 3
-do 2 AP projections with elbow partialy flexed
i) humerus parallel to IR
ii) forearm parallel to IR
-as the patient cannot extend the elbow, there will be distortion thus we need to perform 2 projections for each forearm and humerus

Question 4
A. 1 pathologic indication from above projection
-horizontal fracture of scapula

B. i) patient positioning
-the patient must be in erect position
-face the patient towards the IR in right anterior oblique
- angle the patient at 45 -60 degree degree depending to the patient size

Part positioning
-abduct the right arm of the patient slightly
-rotate the thorax of the patient until the imaginary line of lateral and medial border of the scapula is superimposed
-align patient to midveterbral border to CR

ii) centering point
-centre the patient to the midvertebral of scapula

iii) technical factors
-kVp: 75-85 kVp
-mAs: 16-18 mAs
-SID: 100cm
-IR size: 10 X 12 inches
-use grid

iv)describe
-use left posterior oblique 
-face the patient towards the IR in left posterior oblique







]]> 2018-03-29 06:25:42 UTC https://padlet.com/moeysf1/jmo16fj57gqx/wish/247148750 Group Four https://padlet.com/moeysf1/jmo16fj57gqx/wish/247148824 Question Number 1
Anterior Aspect.
A. Scapulohumeral joint
B. Acromion
C. Coracoid Process
D. Scapular Notch
E. Superior Border
F. Superior Angle
G. Medial Border
H. Inferior Angle
I. Lateral Border
J. Costal Surface

Posterior Aspect.
A. Superior Angle
B. Crest of Spine
C. Body
D. Inferior Angle
E.Infraspinous Fossa
F. Supraspinous Fossa
G. Superior Border
H. scapular Notch
I. Coracoid Process
J. Acromion
K. Spine of Scapula
L. Glenoid cavity
M. Lateral Border

Question 2.
Correct part positioning :
-  Patient has to extend the elbow, supinate hand and align arm and forearm with long axis of IR.
- The center of elbow joint must be centered to the center of IR
- Ask patient to lean laterally as necessary for true AP projection ( Palpate medial and lateral epicondyles to ensure that they are equidistant from IR )
- Use positioning aid to support the patient's hand to prevent it from moving
- Comfort the patient

Question 3.
- The position of the elbow is partially flexed
- Under the forearm, the radiographer will put the support to prevent patient from moving and to give comfort to patient.

Question 4.
A. Fracture or dislocation of proximal humerus and scapula of right shoulder

B. i. Patient positioning
- The patient in erect position
- Face patient toward  IR in RAO position. 
- Right shoulder should make a contact with IR.
- Rotated the patient in average 30 to 45 from the lateral position based on patient size, which results in a 45 to 60 anterior oblique position.
- Align patient to center midverterbral border to CR and to IR.
- Let arm hang down at patient's side to avoid patient become more pain. Abduct arm slightly to prevent superimposed.
- Palpate borders of scapula and rotate patient until the scapula is in true lateral position. 

ii. Centering Point : directed to scapulohumeral joint 
iii. Technical factors :
-70-75 kVp
- 16-18 mAs
- SID 100cm
- Use grid
- Size of IR : 10x12 Inches
- Use lengthwise 

iv.- Do the AP erect position
- Left side of the shoulder must be in contact with the IR (LPO), Right side is the side of interest.
- Turn the patient until medial and lateral border of scapular  superimpose with each other 
- Oblique the patient 45' to 60' according to the patient's size. 

]]> 2018-03-29 06:26:09 UTC https://padlet.com/moeysf1/jmo16fj57gqx/wish/247148824 GROUP 1 https://padlet.com/moeysf1/jmo16fj57gqx/wish/247148837 1. Anterior aspect
A) Scapulohumeral joint
B) Acromion
C) Coracoid process
D) Scapular notch
E) Superior border
F) Superior angle
G) Medial border
H) Inferior angle
I) Lateral border 
J) Costal surface subscapular fossa

Posterior aspect
A) Superior angle
B) Crest of spine
C) Body
D) Inferior angle
E) Infraspinous fossa
F) Supraspinous fossa
G) Superior border
H) Scapula notch
I) Coracoid process
J) Acromion
K) Spine of scapula
L) Lateral angle
M) Lateral border

2. Patient has to lean laterally with extend elbow, supinate hand and align arm and forearm with long axis of IR. Palpate humeral epicondyles to ensure that they are parallel to IR. 

3. Seat patient at the end of the table with elbow partially flexed:
Obtain two AP projections- one with forearm parallel to IR, another one with humerus parallel to IR. Or angle the tube 10-15 degree. 

4.
A) Fractures or dislocations of proximal humerus and scapula. 

B) 
I. 
-Patient in PA position whether in erect or recumbent position. 
-Rotate the patient 45-60 degree facing the IR with the right shoulder against the IR. 
-Palpate the superior angle of the scapula and AC joint articulation. 
-Rotate the patient until an imaginary line between those two points perpendicular to IR.
- Center the scapulohumeral joint to CR and to center of IR. 
- Abduct arm slightly if possible so no superimposition of proximal humerus over ribs occur.  

II. -CR perpendicular to IR, directed to scapulohumeral joint. ( 2 or 2.5 inch below top of the shoulder)

III.
-SID: 100cm
-IR: 10-12 inch
-kVp: 75-85 kVp (digital)
-mAs: 16-18 mAs
-Use grid

IV.  
Do the AP oblique with the patient in erect or recumbent position by rotating the patient 45-60 degree  with the left shoulder against the IR and the right shoulder is raised a bit. Rotate the patient until the medial and lateral border of scapula is symmetry.


]]> 2018-03-29 06:26:12 UTC https://padlet.com/moeysf1/jmo16fj57gqx/wish/247148837 GROUP 3 https://padlet.com/moeysf1/jmo16fj57gqx/wish/247149072 1. 
-Anterior aspect
a) Scapulohumeral joint 
b) Acromion
c) Coracoid process
d) Scapular notch
e) Superior border
f) Superior angle
g) Medial (vertebral) border
h) Inferior angle
i) Lateral (axillary) border 
j) Costal surface subscapular fossa

-Posterior aspect
a) Superior angle
b) Crest of spine
c)  Medial (vertebral) border
d) Inferior angle
e) Infraspinous fossa
f) Supraspinous fossa
g) Superior border
h) Scapular notch
i) Coracoid process
j) Acromion
k) Spine of scapula
l) Lateral angle
m) Lateral border

2. Correct part postioning true AP elbow
-The patient need to lean laterally 
- Palpate both humeral epicondyles to ensure that the humeral epicondyles parallel to IR. 

3. Patient should do AP projection with the elbow partially flexed. It can be done by obtaining two AP projection which is one with forearm parallel to IR and one with  humerus parallel to IR.

4. A) Fracture or dislocation of right proximal humerus and scapula.

4. B)i) Patient positioning:
- Patient is in erect position.
- Face patient toward IR in an right anterior oblique position.
Part positioning:
- Angle the patient 45 to 60 degree until lateral and medial border of scapula superimpose.
- abduct arm slightly if possible so that the proximal humerus did not superimpose with ribs.

ii) Perpendicular to IR directed to mid-vertebral border of scapula.

iii) -kVp: 70-75
-mAs: 16-18
- IR size with orientation: 24 x 30 cm.(lengthwise)
-SID: 100 cm
-use grid

iv)-Patient position: patient in erect or recumbent position by rotating 45-60 degree with the left shoulder against the IR and the right shoulder is raised a bit.
Rotate the patient until the medial and lateral border of scapula is symmetry

]]> 2018-03-29 06:28:02 UTC https://padlet.com/moeysf1/jmo16fj57gqx/wish/247149072