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Code 1. Questions Write a brief essay on the factors affecting the radiographic image. Add a note on the exposure factors 2. Write a short note on Chest PA view. Add a note on Chest Lateral view. 3. What are the clinical indications for X-ray hand? Add a note on Hand PA view? 4. Write a short essay on the anatomy of the humerus. Add a note on humerus AP view. 5. Write a short note on anatomy of shoulder girdle. 2D15 – BD0041 Answers * Density * Contrast * Magnification * Distortion * Sharpness- types * Exposure factors – mAs, KVp, FFD, Intensifying screens, secondary radiation grids, cones, diaphragms * Patient preparation * Centering * Horizontal beam * Parts demonstrated * Exposure factors * Indications – RTA * Joint diseases * Age estimation * Osteomyelitis * Bone tumors * Hand PA view - Patient preparation * Centering * Horizontal beam * Parts demonstrated * Exposure factors Anatomy The arm has one bone, humerus, which consist of shaft, two articular extremities. Lower part is broad and has medial and lateral condyles and medial and lateral epicondyles. On its inferior surface are two smooth elevations, trochlea for articulation with ulna and capitulum for articulation with head of radius. On the anterior surface just above the trochlea is a shallow depression called the coronoid fossa for reception of coronoid process of ulna, when elbow is flexed. On the posterior surface behind the coronoid fossa is olecranon fossa for reception of olecranon process when elbow is extended. The proximal end of humerus consists of head, anatomic neck and greater, lesser tuberosities and surgical neck. Head is smooth, large, rounded and lies in an oblique plane on the upper medial side of the humerus. It articulates with the glenoid fossa. Just below the head is anatomical neck. Lesser tuberosity is situated below the anatomical neck on the anterior surface. Greater tuberosity is situated below the neck on the lateral surface. Depression between the two tuberosities is known as bicipital groove. Humerus AP a. Patient lies supine on the table. Forearm is supinated elbow extended and arm slightly abducted. Unaffected shoulder raised on sand bags to bring the posterior aspect and arm of the side being examined in contact with the cassette. b. Immobilise limb with sand bags over palm and distal forearm. Expose during arrested respiration. c. Right or left marker and patient identification are placed. d. Centering point midway between the shoulder and elbow joints. e. Centering ray is vertical at 90° to film. f. Humerus is demonstrated. g. Nongrid, screen film FFD: 100 cm Anatomy Shoulder girdle is formed by clavicle & scapula , which require to connect the upper extremities to the trunk. Although alignment of these two bones is considered girdle, it is incomplete both in front & behind. The girdle is completed in front by the sternum which articulates with the medial end of the clavicle. Scapulae are widely separated in the back. Clavicle:- Clavicle lies in an obliquely transverse plane just above the first rib. It has 3 parts: Shaft, medial & lateral ends. Its lateral end articulates with acromion process of scapula & medial end with the manibrium sterni. Scapula:- Scapula is a flat bone. It is triangular in shape & lies on the upper posterior thorax between the 2nd & 7th ribs. It has 2 surfaces & 3 borders & Page 1 of 2 6. Write a short note on anatomy of femur. Add a note on Femur AP. 3 angles. Costal surface is slightly concave. Posterior surface is divided into two portions by a prominent spinous process. Spine arises at the upper third of vertebral border & runs obliquely upward to end in a flattened triangular projection called the acromion. Area above the spine is supraspinatous fossa & below is the infraspinatous fossa. Superior border extends from the medial angle to the coracoid process & presents a depression called scapular notch at its lateral end. Vertebral border extends from the medial to inferior angles. The axillary border from the glenoid fossa to the inferior angle. The lateral angle is the thickest part of the scapula, ends in a shallow, oval depression called the “glenoid fossa”. Glenoid fossa articulates with the head of the humerus. Constricted region around the glenoid fossa is called the neck of the scapula. The coracoid process arises from a thick base that extends from the scapular notch to the upper part of the neck of the scapula. It projects first anteriorly & medially & then curves on itself to project laterally. It is palpated just below & medial to the acromio clavicular articulation. Anatomy Thigh has one bone called femur. The femur consists of shaft and two articular extremities. The lower end is broadened & presents large medial & smaller lateral condyle. A slight prominence above each condyle is medial & lateral epicondyles. Anteriorly the condyles are separated by shallow depression, patellar surface for articulation with patella. Posteriorly the condyles are separated by a deep depression called intercondylar notch. Upper end has a rounded head, which with the acetabulum forms hip joint. Just below the head is neck. Greater and lesser trochanter along the lateral & medial aspect between neck & upper most shaft. Anatomy of Femur Femur AP a. Patient lies supine, leg extended, Rotate the limb to centralise patella over femur. Film positioned against posterior aspect of thigh to include both hip and knee joint. b. Immobilise the patient in same position with sandbags. c. Right or left marker and patient identification are placed. d. Centered to the middle of the film. e. Central Ray at right angles to the mid femur & the center of the cassette. Parts seen are femoral shaft. f. Non grid, screen film, FFD: 100 cm. 2D15 – BD0041 Page 2 of 2