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Sudan University of Science and Technology College of $Edical Radiologicjfciences Department of Piagiiosticpechnology Project Ti INIS-SD-136 SD0000061 SD0000061 Sudan University of Science and technology College of $edical Radiologicjfciences Department of Piagiiosticpechnology This Research is presented to the department ofpiagnostic Radiologic ^technology for the Award. of(B.SC inftadiolctgicjechnology) Project title: u (h? Prepared by: Ahmed Mohamed Saeed Mahsin Hago Hamad Elneil Mohamed A.Alla Elawad 4th Diagnostic supervised By Ustaz Elsadig Abdalla A. Tarn Ass- Professor, Head of diagnostie RadiologicTechnology Khartoum , (Jun 2000} We sincerely appreciate the kind assistance and guidance of Mr El Sadig A. A El Tarn our research supervisor 5 we should also extend our thanks and appreciation to the teaching staff members of the college of Medical Radiologic ^cience^ our clinical supervisors in the various clinical department for their an failing evidence and support, the college library staff in giving us the references without hesitation and finally to Miss Azhar without whose professional typing we would not have done thin piece of research project The Researchers ^esearchobj^tiyes] *> In doing this research we thought thatjwill:- 1. Assist student* technologists, in shedding light to the important aspects of upper limb radiography, 2. To show the most appropriate projections with several alternative methods. 3. To draw the attention of radiographers to the most references which would broaden their knowledge in radiographic technique A» Contents - Acknowledgement - Introduction - Research Objectives - Section One :- Anatomy Section Two :- Physiology - Section Three :- Pathology - Section Four :- Basic Technique Optional Views - Conclusion • References Introduction Radiologic technology is an Important medical specially without which no hospital or clinic would be complete. In our research we have considered anatomy, physiology and pathology of upper limbs. The research is divided into four main sections. The first section deals with anatomy of upper limbs and shoulder griddle in details. The second section include the physiology of the bone of the upper limbs. The third section deals with pathology and the diseases which affected the upper limbs JL The fourth section consist of />Basic techniques and additional techniques of the upper limbs. (Qdfo$<vvyhy * At the end of the research there are conclusion and photographs which include pathology symptoms: We hope that our research would be of more benefits and useful for students and researchers in the future. The researchers ANATOMY Coracoid process Acromlon Superior (Medial) angle Lesser tubercle Sternal end Greater tubercle Intertubercular sutcus (Bicipital groove) Medial (Vertebra!) border Surgical neck Deltoid tuberosUy Inferior nnjjle Lateral (.Axillary) border HUMERUS Lateral supracondylar ridge—^-1-f* "Media! siijirnroudylnr Lateral epicondyle Medial rpicondyle Capitulum Tronhlen Head of radius Coronoid process Tuberosity of radius Tuberosity of ulna Anterior oblique line Pronator Teres impression RADIUS ULNA •.-"Pronntor" crest -Hend of ulna Styloid process Stylold process — Carpnl boneR Metncarpnl bones Proximal phalanx—y Distal phalanx- (1st) Proximal — (2nd) Middle — (3rd) Dlstnt } 6-1 BONES OF THE UPPER LIMB, FROM THE FRONT For bones of the hand, see Figures 6-97 nnd 6-114. For muscle attachments, see Figures 6-10, 6-3.5, nnd 6-55. Rough for flnger-pftd for Fl. Digit. Profundus , /Fibrous shcnth Distal end for \F1. Digit. Sitpernc. Head (Trochlea) Head for Fibrous slienth (Trochlea) Head Tubercle Trapezoid Hook of hamate Tubercle (Crest) of trapezium Pisiform (gtr. multangular) Triquetrum Tubercle of senphoid (nnvictitnr) A. PALMAR ASPECT Smooth for I Distal fiiiRci-nnil Phalanges Middle Proximal en<l Hetacarpals Shaft or Mclncnrpnls Trapezoid arpals Trapezium Scaphoid L,lnnte Triquetnim B. DORSAL ASPECT BONES OF THE HAND The bones of the upper limb The upper limb is attached to trunk by the shoulder girdle , which is made up of two bones. The clavicle anteriorly and the scapula posteriorly. The shoulder girdle is attacked to the trank by one joints the sterno clavicular joint, and by muscles the shoulder girdle is able to move in several directions, and its movements are important in the range of movements that are possible with the upper limb . The upper consists of three segments :- 1- the upper arm, which has one bone the humerus 2-the forearm, which has two bones the radius and the ulna 3-the wrist and hand, which is made up of: The (8) carpal bones. - The (5) metacarpal bones and the (14) phalanges. The clavicle : the clavicle or coller bone is a long bone it differs from other long bones in tow ways :- 1 - it has no medullar cavity 2- it is ossified in membrane The shaft of the clavicle is S. shaped : the medal two thirds of the shaft is concave anteriorly, and the lateral third is concave posteriorly the lateral third of the shaft is flatterned having superior and inferior surface and anterior and posterior borders, hi the middle third of the shaft the anterior borders become progressively less promnent and the medial third of the shaft is cylindrical. The superior surface of bone is subcutaneous through out its length. The medial two - third of this surface is smooth but the lateral third is roughened where the dettoid and trapezes muscles are attached to it. The inferior surface has a roughened area at its medial end where aligament. The Costo claviculor ligament is attached this ligament binds the medial end of the clavicle to the 1st ribe. At the outer end of the inferior surface, and close to the posterior border there is a projection, the coroniod tubercle, and running laterally and from this turbid is ridge the trapezoid line the cronoid tubercle and the trapezoid line give attachment to the clavicle ligament which binds the lateal prat of the clavicle to the coracoid proess of the scapula. The scapula The scapula, or shoulder blad, is posterior bone of shoulder girdle. It is aflattened triagular bone consisting of tringular body at latral angle of which is an expanded portion the head of the scapula. This bears the glenoid cavity which articulates with the head of humerus at the shoulder joint. A process called the coracoid process. Projects forwards from the anterior part at the head of scapula. The posterior surface of the body is divided in to two parts by the spine of the scapula, which widens out at it's latral end to form the acromion proccess . The body of the scapula :- The body of the scapula is aflat triangle having anterior and postierior surface, and latral, medial and superior borders . The anterior or costal surface is concave and is called the subscapular fossa. Attached to the medial two - thirds of the floor of this fossa is a muscle, the scapular muscle and the floor is therefore, slightly ridged . The posterior surface:- The posterior surface of the body is slightly convex. The spine of the scapula divides the posterior surface into and upper third called the supraspinous fossa and lower two - theerd called infraspinous fossa. The superior border of the body runs slihtly up words from the root of the coracoid process to the superior angle, close to the root of the coracoid process there is anotch in the superior border colled the suprascapular notch. The medial border of the scapula longist to order and it extend from the superior to inferior angles. It is slightly convex, reaching apromince at the root of the spine of the scapula. The latralporder:- Runs from the inferior angle to the head of the scapula. The head of the scapulaisthe thickest part of the bone and forms the latral angle. The medial border of the scapula is longist border and it extend from the superior to inerior angles. It is slihgtly convex. Reaching and promince at the root of the spine of the scapula. The latral sutface to the head bears the glenoid couity which is oval , slightly concave articular surface. Between the head of the scapula and the body, there is slight constriction called the neck of scapula. The coracoidprocess :- The coracoid process arises from the upper part of the anterior side of the head of the scapula and bends sharply to runs for word and laterally, so that it has the appearance of abent finger. The outer part of the coracoid process is slightly flattened and overhangs the glenoid cavity . The spine ofscapula:- The spine of scapula project from the posterior surface of the body dividing in the supera spinous and infraspinous and infraspinous fossae . The spine project in creasingly from the body as it runs laterally. The crest of the spine has aflat subcutaneous surface. The upper and lower borders of which give attachment to muscles . • The humerus ;- The humerus is along bone. It is largest bone of the upper limbs and possesses a shaft and lower and upper ends . The Radius: The radius is the latral bone of the forearm and it is along bone. It has a shaft , as mall circular upper end and wider lower end. The upper end of the radius :- The upper end of the radius is composed of the head, the neck and the radial tuberosity. The head of the radius is disc-shopped and its upper surface is concave particular surface which articulates with the capitutum of the humor as at the elbow joint - the circumference of the head is narrow , smooth articular surface. Which articulates with the radial notch of the ulna at superior radioulner joint. Below the head is constricted portion. The neck of the radius on the medial side of bone, just below the neck, is ablunt projection called the rachial tuberosity . Which gives attachment to the biceps brachii muscle . The lower end of radius :- The lower end of radius a widest portion of the bone, and is quadrilateral in cross - section . The lateral surface projects down ward below the rest of bone as the styloid process of the ulna. The medial surface has anarrow concave articular surface, the ulner notch.
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