General Terminology and Positioning Principles

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Flexion or bending the foot downward toward the sole is called ________________.  Plantar flexion

Circular movement of a limb is called ___________.  Circumduction

Turning away from the regular standard or course is called ______________.  Deviation

______________ is the turning or rotating of body or a body part around its axis; rotation of a limb is either medial (toward the midline of the body from the anatomic position) or lateral (away from the midline of the body from the anatomic position.  Rotation

The position that is achieved by having the patient lean backward while in the upright body position so that only the shoulders are in contact with the IR is called the _________________.  Lordotic position

The patient is in the recumbent position with the left lateral side touching the table and the back closest to the IR and the central ray is horizontal and parallel to the floor. Specifically, what position is this?  Left lateral decubitus

The patient is in the recumbent position with the right lateral side touching the table and the back is closest to the IR and the central ray is horizontal and parallel to the floor. Specifically, what position is this?  Right lateral decubitus

__________ refers to parts nearer the point of attachment, point of reference, origin, or beginning; toward the center of the body.  Proximal

__________ refers to parts farthest from the point of attachment, point of reference, origin, or beginning; away from the center of the body.  Distal

_________ refers to parts away from the head of the body.  Caudal (caudad)

_________ refers to parts toward the head of the body.  Cephalic (cephalad)

_________ is the movement of a part away from the central axis of the body or body part.  Abduction

__________ is the movement of a part toward the central axis of the body or body part.  Adduction

__________ refers to the straightening of a joint; when both elements of the joint are in the anatomic position; normal position of a joint.  Extension

________ is the act of bending a joint.  Flexion

__________ is the inward turning of the foot at the ankle.  Inversion

__________ is the outward turning of the foot at the ankle.  Eversion

When joints are involved in the prime interest area, how many projections are required?  Minimum of 3

Requires a minimum of two projections:

1) joints are involved in the prime interest area

2) determination of alignment of fractures

3) anatomic structures are superimposed

4) localization of lesions or foreign bodies

5) long bones  a) 1, 2, 3, 4 and 5

b) 2, 3, 4 and 5

c) 1, 3 and 5

d) 3, 4 and 5

Answer: b) 2, 3, 4 and 5

When a minimum of three projections are required, what projections are required?  AP or PA, lateral, and oblique

_________ bones are small and oval and develop inside and beside tendons.  Sesamoid

__________ bones are bones with peculiar shapes and variety of forms that do not allow them to fit in any other category.  Irregular

_________ bones consist primarily of cancellous (trabecular/spongy bone) containing red marrow and a thin outer layer of compact bone.  Short

The patella is an example of a _________ bone.  Sesamoid

Vertebrae, pelvis, and facial bones are examples of ___________ bones.  Irregular

Carpal bones and tarsal bones fit under what classification of bones?  Short bones

The strong, dense outer layer of all bones that serves to protect and strengthen the bones so they can support the body is called ______________.  Compact bone

The softer, inner layer of bone that contains a speculated network of interconnecting spaces called the trabeculae, which are filled with red and yellow marrow, is called _____________.  Spongy bone

A tough, fibrous connective tissue that covers all bony surfaces except the articular surfaces, which are covered by the articular cartilage, is called the ____________.  Periosteum

The tissue that lines the medullary cavity (cavity within long bones that contains trabeculae filled with yellow marrow) of bones is called the ____________.  Endosteum

________ bones consist largely of two tables of compact bone. The narrow space between the inner and outer tables contains cancellous bone and red marrow (diploe).  Flat

The cranium, sternum, and scapula are examples of ______ bones.  Flat

During development only, the long shaft of the bone is called the ___________.  Diaphysis

Secondary ossification occurs after birth when a separate bone begins to develop at both ends of each long bone. Each end is called the ___________.  Epiphysis

What are the functional classifications of joints?  Synarthroses, Ampiarthroses, and Diarthroses

The functional joint classification characterized by immovable joints is called ____________.  Synarthroses

The functional joint classification characterized by freely movable joints is called _____________.  Diarthroses

The functional joint classification characterized by slightly movable joints is called ___________.  Ampiarthroses

What structurally classified joint has no joint space and is virtually immovable?  Cartilaginous

What cartilaginous joint is characterized by being slightly movable, with a pad of fibrocartilage separating bones?  Symphysis

What cartilaginous joint is characterized by being immovable, and contains a rigid cartilage that unites two bones?  Synchondrosis

The vertebrae and pubic symphysis are examples of what kind of joint?  Symphysis

The epiphyseal plate found between the epiphysis and diaphysis of a growing long bone is an example of what kind of joint?  Synchondrosis

Joints that permit a wide range of motion, and they all are freely movable are called ________ joints.  Synovial

_______ joints have uniaxial movement; permits only flexion and extension; the motion is similar to that of a door.  Hinge

_______ joints have biaxial movement; permits movement in two axes, similar to the ellipsoid joint; articular surface is saddle-shaped.  Saddle (sellar)

________ joints have uniaxial movement; the simplest synovial joint; permit slight movement; flattened or slightly curved surfaces.  Gliding (plane)

________ joints are uniaxial; allow only rotation around a single axis; a rounded or pointed surface of one bone articulates within a ring formed partially by the other bone.  Pivot (trochoid)

_________ joints have multiaxial movement; permits movement on many axes, including flexion and extension, abduction and adduction, circumduction, and rotation.  Ball and socket (spheroid)

__________ joints have biaxial movement, primary; permits movement in two directions at right angles to each other, including flexion and extension, abduction and adduction.  Ellipsoid (condyloid)

The intercarpal and intertarsal joints or the wrist and foot are examples of ________ joints.  Gliding (plane)

The carpometacarpal joint between the trapezium and the first metacarpal is the only ________ joint in the body.  Saddle (sellar)

What is another name for Sellar joints?  Saddle joints

The elbow, knee, and ankle are examples of ________ joints.  Hinge (ginglymus)

The articulation of the atlas and axis of the cervical spine is an example of a(n) ________ joint.  Pivot (trochoid)

The hip and shoulder are examples of __________ joints.  Ball and socket (spheroid)

The radiocarpal joint of the wrist is an example of a(n) ___________ joint.  Ellipsoid (condyloid)

What are the types of synovial joints? (6 types)  Gliding, Hinge, Pivot, Ellipsoid, Saddle, and Ball-and-socket

What is another name for a Condyloid joint?  Ellipsoid joint

____________ refers to the path of the central ray as it exits the x-ray tube and goes through the patient to the IR.  Projection

____________ refers to the overall posture of the patient or the general body position and the specific placement of the body part in relation to the radiographic table or IR during imaging.  Position

*The ___________ plane divides the body into equal anterior and posterior halves.  Midcoronal

The __________ plane is also referred to as horizontal, axial, or cross-sectional plane  Transverse

*The __________ plane is a specific sagittal plane that passes through the midline of the body and divides it into equal right and left halves.  Midsagittal

Plane  real or imaginary flat surface

Median (Midsagittal) Plane  goes from front to back and top to bottom; divides the body into left & right halves

Sagittal Plane  parallel to the midsagittal plane; divides the body into unequal left 7 right portions

Frontal (Coronal) Plane  goes from top to bottom and side to side; divides the body into anterior & posterior halves

Transverse (Horizontal) Plane  goes across the body at right angles to the long axis; divides the body into superior & inferior sections

Longitudinal Plane  any plane that follows the long axes (sagittal or coronal)

Addison’s Planes  nine divisions/areas of the abdomen to help localize anatomy

Anterior (Ventral)  located towards the front of a structure or the front of the body

Posterior (Dorsal)  located towards the back of a structure of the back of a body

Lateral [direction]  furthest from the midline

Medial  closest to the midline

Superior  upper portion or the part nearest the head

Inferior  lower portion or the part closest to the feet

Internal  within a structure or the body

External  outside of a structure of the body

Proximal  closes to the point of origin

Distal  farthest from the point of origin

Visceral  relating to an organ

Parietal  relating to the wall of a structure

Intrinsic  originating within an organ or structure

Extrinsic  originating outside of the organ or structure

Cephalad  towards the head

Caudad  towards the feet

Palmar  refers to the front or the palm of hand

Plantar  refers to the sole or the bottom of the foot

Volar  refers to either the sole of the foot or the palm of the hand

Supine  laying on their back; face up, palms up

Prone  laying on their anterior surface; face down, palms down

Adduct  move a part closer to the midline

Abduct  move a part away from the midline

Flex  to bend or decrease the angle or a joint

Extend  to straighten or increase the angle of a joint

Invert  turn inwards or towards the midline

Evert  turn out or away from the midline

Rotate  turn around one axis

Circumduct  turn along multiple axes

*only ball-and-socket joints (hip & shoulder)

Cranial Cavity  encased by the bones of the skull, and it’s main purpose is to protect the brain

Thoracic Cavity  encased by the ribs, sternum and thoracic vertebrae; houses the heart, lungs and mediastinum

Abdominal Cavity  encased by muscles and skin, includes the digestive organs, secondary digestive organs and reproductive organs

Lateral [position]  can be upright or recumbent; the side that is mentioned is closest to the image receptor

Recumbent  lying down

Decubitus  lying down on the body surface mentioned between a horizontal beam and a vertical image receptor

*use dorsal/ventral rather than posterior/anterior

Upright  patient can be either seated or standing but the part of the body being referred to is vertical

Trendelenburg Position  laying with feet elevated above the head;

traditional: supine, at 45º angle

clinical: prone or supine, any angle

Fowler’s Position  semi-sitting at any angle larger than 90º; used if patient has trouble breathing or after certain surgeries

Position  referring to how the patient is situated in relation to the image receptor; always mention the surface that is closest to the image receptor

Projection  referring to the direction of the central beam/ray and “how the x-ray sees the patient”; always mention the 1st & last surface of the body that the beam sees

View  referring to the structures shown on the image and “how the imaging plate sees the patient”; surfaces always opposite of Projection surfaces

Obliques  angles between left/right lateral, anterior, and posterior

How many individual bones are in the adult human adult skeleton?  206

The bones of the body are divided into ___ main groups; What are they?  2; Axial skeleton & Appendicular Skeleton

The skull, neck, thorax, and vertebral column comprise which group of bones?  Axial skeleton

The shoulder girdle, upper limbs, lower limbs, and pelvic girdle make up the _____________ skeleton.  Appendicular

How many bones are in the Appendicular skeleton?  126

How many bones are in the Axial skeleton?  80

Common variations in the shape of the human body are termed the _______ __________.  body habitus

Which organs locations are directly affected by body habitus? (There are 6)  Heart

Lungs

Diaphragm

Stomach

Colon

Gallbladder

The __________ body habitus makes up 10% of the population.  Asthenic

The ___________ body habitus makes up 35% of the population.  Hyposthenic

The ___________ body habitus makes up 5% of the population.  Hypersthenic

The __________ body habitus makes up 50% of the population.  Sthenic

The characteristics of the hypersthenic body habitus include:

1) massive build

2) long abdomen

3) short, broad, deep thorax

4) wide pelvis

5) narrow pelvis  a) 1 and 2

b) 1, 2, and 3

c) 1, 2, 3, and 4

d) 1, 2, 3, and 5

Answer: d) 1, 2, 3, and 5

The characteristics of the sthenic body habitus include:

1) short abdomen

2) moderately heavy build

3) moderately short, broad, and deep thorax

4) relatively small pelvis

5) moderately long abdomen  a) 1, 2, and 4

b) 2, 3, and 4

c) 2, 3, 4, and 5

d) 1, 2, 3, and 4

Answer: c) 2, 3, 4, and 5

The characteristics of the asthenic body habitus include:

1) long, shallow thorax

2) frail build

3) moderately short, broad, and deep thorax

4) wide pelvis

5) short abdomen  a) 1, 2, and 4

b) 1, 2, 4, and 5

c) 2, 3, 4, and 5

d) 2, 3, and 4

Answer: b) 1, 2, 4, and 5

Which body habitus is most difficult to classify because it’s organs and characteristics are intermediate between sthenic and asthenic body habitus types?  Hyposthenic

Which plane divides the entire body or a body part into right and left segments and passes vertically through the body from front to back?  Sagittal

Which plane divides the entire body or a body part into anterior and posterior segments and passes through the body vertically from one side to the other?  Coronal

Which plane passes crosswise through the body or a body part at right angles to the longitudinal axis and divides the body into superior and inferior portions?  Transverse

True or False. The midcoronal plane is a specific plane that passes through the midline of the body and divides it into equal right and left halves.  False. The midsagittal plane.

What position refers to the patient standing erect with the face and eyes directed forward, arms extended by the sides with the palms of the hands facing forward, heels together, and tows pointing anteriorly?  Anatomic position

What position refers to the patient being supine with the head elevated higher than the feet?  Fowler’s position

What position refers to the patient being supine with knees and hip flexed and thighs abducted and rotated externally, supported by ankle or knee supports?  Lithotomy position

What position refers to the patient being recumbent and lying on the left anterior side (semi-prone) with the left leg extended and right knee and thigh partially flexed?  Sims position

What position refers to the patient being supine with the head tilted downward so that the feet are higher than the head?  Trendelenburg position

The position with the right side of the posterior body surface closest to the IR is the ______.  RPO (right posterior oblique)

The position with the left side of the anterior body surface closest to the IR is the ______.  LAO (left anterior oblique)

The position with the left side of the posterior body surface closest to the IR is the ______.  LPO (left posterior oblique)

The position with the right side of the anterior body surface closest to the IR is the _____.  RAO (right anterior oblique)

Rotation of the forearm so that the palm is down is called ________.  Pronation

___________ refers to a part or parts on the opposite side of the body.  Contralateral

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    MR said:
    September 13, 2013 at 11:06 pm

    Houda Rafle says she has no room in her life right now for the anger she felt last month when she learned a radiologist at Trillium Health had misread her CT scan and failed to see a tumour sitting above her heart.

    Not only was she devastated at the time to discover she had cancer, but she also learned it had spread to her lungs in the five months since she had the diagnostic scan.

    Facing the fight of her life, the 28-year-old Toronto TV producer is trying to channel all her energies into being positive and battling the advanced disease.

    “I was angry at first, but there was just something in me that made me realize there is no point in being angry over it any more. I have got to deal with it,” she says.

    “I am just trying to beat this and focus on getting better right now,” she adds.

    In the past week, Trillium has sent letters to 3,500 patients, alerting them that their CT scans and mammograms are being reviewed because of concerns that radiologist Dr. Ivo “Ivan” Slezic had been making mistakes.

    Photos View galleryHouda Rafle, 28, is battling advanced cancer months after a Trillium radiologist missed seeing a tumour near her heart on a CT scan. The cancer has since spread to her lungs.zoom

    A team of more than 20 radiologists, led by an outside expert, is taking a second look at scans done between April 1 last year and March 31 this year, to determine if diagnosis errors were made.

    Slezic, who had worked at Trillium hospitals for 33 years, had his privileges restricted on April 1 and subsequently stopped working.

    The Star has learned that in late 2011, he was diagnosed with bowel cancer, for which he was treated with surgery and chemotherapy.

    The controversy has resulted in calls for province-wide radiology standards to root out such errors.

    Rafle says she went to Trillium’s Mississauga Hospital ER on March 5 because she was feeling fatigued, short of breath and feverish.

    Unable to ascertain what was wrong with her, doctors admitted her for a week and ran a battery of tests, including a CT scan. After she was told it had come back clean, she was discharged from hospital, feeling a little better.

    But at the end of July, the symptoms returned with a vengeance. In fact, they never totally went away, she recounts.

    “I’m very active and I work out a lot, and I noticed I couldn’t do some of the things I used to do,” she says.

    Feeling extremely tired and short of breath again, she went to a walk-in clinic and asked for a chest x-ray. It came back showing some irregularities. She arranged to have it sent to her family doctor, who in turn sent it to a cardiologist at Trillium who had been treating her.

    The cardiologist called her on Aug. 2 and told her to “go to the ER ASAP,” she says. Another CT scan was done the following day and she was told the heartbreaking news.

    “They compared the two scans and they could see the tumour was visible back in March,” Rafle recounts, adding that a doctor informed her it was Slezic who did the first scan.

    “I was very upset and disappointed because the radiologist had missed that and that was (five) months of my life when I could have done something about the cancer. But I wasn’t notified until it spread, and now it is stage four,” she adds.

    In an interview earlier this week, Trillium president Michelle DiEmanuele and chief of staff Dr. Dante Morra said it wasn’t complaints over bungled scans that triggered the review of the 3,500 tests.

    Rather, it was their own vigilance in creating a new radiology quality assurance program through which some of Slezic’s work was reviewed by a new chief of radiology. The radiology chief detected some problems.

    Morra says that through a subsequent internal investigation, “interpretive errors” were found on CT scans of three patients, one of whom has run into a “clinically significant problem.”

    It’s unclear if he is referring to Rafle.

    Premier Kathleen Wynn told reporters Friday she has no reason to believe right now that problems with diagnostic imaging extend beyond Trillium.

    “As far as I know, this is an individual situation, but there is a review going on to make sure that there aren’t systemic issues,” she said.

    Wynne stressed that “quality control is done at the hospital level.”

    Still, she said quality control questions have to be asked.

    “This situation does raise questions, there is no doubt about that,” she said.

    NDP Leader Andrea Horwath accused the premier of “running for cover” by saying quality control was a hospital responsibility and that the problem appears to be isolated to Trillium.

    Horwath noted that other provinces such as British Columbia and Alberta have run into similar problems with diagnostic imaging, resulting in patients being misdiagnosed. They have since started to introduce quality assurance programs that require a portion of a radiologist’s work to be reviewed by another radiologist, and Ontario should do the same, she said.

    “The implementation of that kind of quality assurance would happen through the hospital, but the mandate should come from the province,” Horwath said.

    The Canadian Cancer Survivor Network has also weighed in on the controversy and is calling for more training and oversight of radiologists across the country.

    Health Minister Deb Matthews said she is receptive to looking at suggestions on how to improve radiology.

    “Are there ways to make (quality assurance) stronger? I will always look to improve quality, and if there are steps that need to be taken, I have an open mind,” she said.

    Matthews said the situation at Trillium actually shows Ontario hospitals are diligent: “We do have strong quality assurance in our hospitals, and getting stronger. That is how this case was caught. It was caught internally.”

    Meantime, Rafle says she learned last week that problems at Trillium extend beyond her, when she got a call letting her know about the 3,500-scan review.

    “My heart goes out to anyone else who has been affected by this,” she says.

    Rafle says she was taken aback to read in the Star this week that William “Bill” Gavel, 66, of Mississauga had a CT scan done on the same day as hers last March, and that it had also been misread by Slezic. A cancerous tumour in his lung was missed, but was subsequently picked up through other testing by another doctor before it spread.

    “It is very heartbreaking,” she says of Gavel’s struggle.

    As for her own, Rafle is trying to maintain a good attitude.

    “I am just dealing with it day by day. Having a great frame of mind and being positive does wonders,” she says.

    With files by Robert Benzie.

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