Capitolo 2 Arti superiori

Transcript

Capitolo 2
Arti superiori
2
t 'BUUPSJUFDOJDJFQSPUF[JPOFEBMMFSBEJB[JPOJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Arti superiori
Dita
R1"EFMMFEJUB3
R1"PCMJRVBEFMMFEJUB3
. . . . . . . . R1"F1"PCMJRVBEFMMFEJUBo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R-BUFSBMFEFMMFEJUB3
. . . . . . . . . . . Pollice
R"1EFMQPMMJDF3
. . . . . . . . . . . . . . R-BUFSBMFEFMMFEJUBF"1
EFMQPMMJDFo"OBMJTJDSJUJDB R1"PCMJRVBEFMQPMMJDF3
. . . . . . . R-BUFSBMFEFMQPMMJDF3
. . . . . . . . . . R1"PCMJRVBFMBUFSBMF
EFMQPMMJDFo"OBMJTJDSJUJDB R"1BTTJBMFEFMQPMMJDF4
. . . . . . . . Mano
R1"EFMMBNBOP3
R"1BTTJBMFEFMQPMMJDF
F1"EFMMBNBOPo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R1"PCMJRVBEFMMBNBOP3
R-BUFSBMFEFMMBNBOPiBWFOUBHMJPw
FJOFTUFOTJPOF3
R1"PCMJRVBEFMMBNBOP
FMBUFSBMFEFMMBNBOP
BiWFOUBHMJPwo"OBMJTJDSJUJDB . . . . R"1CJMBUFSBMFPCMJRVBEFMMBNBOP
4
R"1CJMBUFSBMFPCMJRVB
EFMMBNBOPo"OBMJTJDSJUJDB . . . . . . Polso
R1"EFMQPMTP3
R1"PCMJRVBEFMQPMTP3
. . . . . . . . R1"F1"PCMJRVBEFMQPMTPo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R-BUFSBMFEFMQPMTP3
. . . . . . . . . . . R-BUFSBMFEFMQPMTPo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R1"BTTJBMFEFMQPMTP4
R1"BTTJBMFEFMMPTDBGPJEFo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R1"EFMQPMTP4
R1"EFMQPMTPo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R5BOHFO[JBMFEFMDBOBMFDBSQBMF
4
R5BOHFO[JBMFEFMDBOBMFDBSQBMFo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . Avambraccio
R"1EFMMBWBNCSBDDJP3
R-BUFSBMFEFMMBWBNCSBDDJP3
R"1FMBUFSBMFEFMMBWBNCSBDDJPo
"OBMJTJDSJUJDB . . . . . . . . . . . . . . . . . Gomito
R"1EFMHPNJUP3
R"1EFMHPNJUPDPNQMFUBNFOUF
FTUFTPo"OBMJTJDSJUJDB . . . . . . . . . . R"1EFMHPNJUPQBS[JBMNFOUF
ĘFTTPo"OBMJTJDSJUJDB R.FEJBOBFMBUFSBMFPCMJRVF
EFMHPNJUP3
. . . . . . . . . . . . . . . . . 20
0020-0064_cap02_Bontrager.indd 20
23/04/14 13.45
R-BUFSBMFBTTJBMFEFMHPNJUP
OFMQB[JFOUFUSBVNBUJ[[BUPo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . Paziente pediatrico
R"1EFHMJBSUJTVQFSJPSJ4
. . . . . . . R-BUFSBMFEFHMJBSUJTVQFSJPSJ4
. . . 2
R.FEJBOBFMBUFSBMFPCMJRVF
EFMHPNJUPo"OBMJTJDSJUJDB. . . . . . R-BUFSBMFEFMHPNJUP3
R-BUFSBMFEFMHPNJUPo
"OBMJTJDSJUJDB. . . . . . . . . . . . . . . . . . R-BUFSBMFBTTJBMFEFMHPNJUP
OFMQB[JFOUFUSBVNBUJ[[BUP4
Arti superiori
3
3PVUJOF4
4QFDJBMF
21
23/04/14 13.45
Fattori tecnici
2
Arti superiori
1FSNBTTJNJ[[BSFMBEFĕOJ[JPOFEFMMFJNNBHJOJSFMBUJWFBUVUUFMFQSPDFEVSFDIFSJHVBSEBOPHMJBSUJTVQFSJPSJÒOFDFTTBSJPUFOFSFJODPOTJEFSB[JPOFJTFHVFOUJGBUUPSJUFDOJDJ
t %'1DN0*%NJOJNP
t .BDDIJBGPDBMFQJDDPMB
t 4FO[BHSJHMJBPUBWPMPTDIFSNJTJTUFNJBOBMPHJDJ
QFSEFUUBHMJ
t -FJNNBHJOJEJHJUBMJSJDIJFEPOPVOBQBSUJDPMBSFBUUFO[JPOFBMMBcentratura dell’RC
con la parte anatomica FBuna collimazione precisa.
t 5FNQPEJFTQPTJ[JPOFMJNJUBUP
t *NNPCJMJ[[B[JPOFTFOFDFTTBSJP
t Esposizioni multiple su un singolo IR:ÒQPTTJCJMFVTBSFMBTUFTTB*1
QFSMBSFHJTUSB[JPOFEJQJáJNNBHJOJ"UBMĕOFÒOFDFTTBSJPDPMMJNBSF
DPOBUUFO[JPOFFVUJMJ[[BSFVOBTDIFSNBUVSBQJPNCBUBQFSFWJUBSF
MBQSFFTQPTJ[JPOFPMBOOFCCJBNFOUPEFMMFBMUSFJNNBHJOJ
t Uso della griglia con i sistemi digitaliQFSQBSUJBOBUPNJDIFDPOTQFTTPSJQBSJ
BDNPNFOPJOHFOFSFMFHSJHMJFOPOTJVTBOP5VUUBWJBBMDVOJTJTUFNJEJHJUBMJ
QSFWFEPOPMBQPTTJCJMJUËEJSJNVPWFSFMBHSJHMJBEFMSFDFUUPSF*ORVFTUJDBTJ
ÒOFDFTTBSJPBUUFOFSTJBMMFJOEJDB[JPOJDPOUFOVUFOFMQSPUPDPMMPEFMQSPQSJP
EJQBSUJNFOUPImportante:TFTJVTBMBHSJHMJBÒOFDFTTBSJPDFOUSBSFMBQBSUF
BOBUPNJDBJONPEPEBFWJUBSFJMMJNJUFEFMMBTUFTTB
Protezione dalle radiazioni
Collimazione
6OBDPMMJNB[JPOFQSFDJTBÒMBQSBUJDBQJáFďDBDFQFSFWJUBSFVOFTQPTJ[JPOFOPOOFDFTTBSJBBMQB[JFOUF
Protezione del paziente
Paziente in stazione eretta: JQB[JFOUJTFEVUJBMUBWPMPEFWPOPsempreindossare
una protezione sugli organi radiosensibiliQFSFWJUBSFMFTQPTJ[JPOFBMMFSBEJB[JPOJ
EJČVTFFBMGBTDJPQSJNBSJPEJWFSHFOUF
Paziente in posizione supina: TFJMQB[JFOUFÒCBSFMMBUPPTVQJOPTVMUBWPMP
QFSVOFTBNFBHMJBSUJTVQFSJPSJÒCVPOBQSBUJDBVTBSFTFNQSFVOBQSPUF[JPOF
TQFDJBMNFOUFTVMMBSFHJPOFEFMMFHPOBEJ
22
23/04/14 13.45
PA delle dita
2
R
Routine alternativa: OFMMF QSPJF[JPOJ 1" EFMMF EJUB
QFSTPTQFUUPUSBVNBTFDPOEBSJPBEBMUSFQBSUJEFMMBNBOP
JODMVEFSFMBNBOPJOUFSBTJWFEB1"EFMMBNBOP
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
t .BTDIFSBQJPNCBUBQFSFTQPTJ[JPOJNVMUJQMF
TVMMPTUFTTP*3
Intervallo kV:
DN
Sistemi analogici: 50-55 kV
kV
N"
5FNQP
N"T
Arti superiori
Posizione
t 1B[JFOUFTFEVUPBMDBQPEFMUBWPMPHPNJUP
ĘFTTPB¡QSPUF[JPOFQJPNCBUBTVMHSFNCP
t 1PTJ[JPOBSFMBNBOPQSPOBTFQBSBSFMFEJUB
Fig. 2-1 1"EFMMJOEJDF
t $FOUSBSFFBMMJOFBSFMBTTFQJáMVOHPEFMEJUP
EFMMFEJUBBMMBQPS[JPOFFTQPTUBEFMM*3
Raggio centrale: 3$ DFOUSBUPBMMBHJVOUVSBJOUFSGBMBOHFB
DFP: DN
Collimazione: BJRVBUUSPMBUJEFMMBSFBEJJOUFSFTTF
Sistemi digitali: 55-60 kV
%'1
*OEJDBUPSFEJFTQPTJ[JPOF
1
.
G
23
23/04/14 13.45
PA obliqua delle dita
R
2
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
t .BTDIFSBEJQJPNCPQFSFTQPTJ[JPOJ
NVMUJQMFTVMMPTUFTTP*3
Fig. 2-2 1"PCMJRVBEFMMJOEJDFQBSBMMFMPBMM*3
Arti superiori
Posizione
.JOJNBEJBGSBNNBUVSB
t 1B[JFOUFTFEVUPNBOPTVMUBWPMP
HPNJUPĘFTTPB¡
TDIFSNPQJPNCBUPTVMHSFNCP
t "MMJOFBSFMFEJUBMVOHPMBTTFNBHHJPSFEFMMBQPS[JPOFFTQPTUBEFMM*3
t 3VPUBSFMBNBOPEJ¡NFEJBMNFOUFPMBUFSBMNFOUFBTFDPOEBEFMEJUP
FTBNJOBUP
BQQPHHJBOEPMBTVVODVOFPEJTVQQPSUPDPOBOHPMPEJ¡
t 4FQBSBSFMFEJUBBTTJDVSBSTJDIFJMEJUPMFEJUBJOUFSFTTBUFTJBTJBOPQBSBMMFMBFBMM*3
DFP: DN
Collimazione: BJRVBUUSPMBUJEFMEJUPEFMMFEJUBJOUFSFTTBUPFFBMMBTQFUUPEJTUBMF
EFMNFUBDBSQP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
24
23/04/14 13.46
PA delle dita
Criteri di valutazione
Anatomia radiografica
t %BMMBGBMBOHFEJTUBMFBMNFUBDBSQBMFEJTUBMF
FBSUJDPMB[JPOJBTTPDJBUF
Esposizione
t $POUSBTUPFEFOTJUËPUUJNBMJMVNJOPTJUËFDPOUSBTUP
QFSMFJNNBHJOJEJHJUBMJ
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPDIJBSBNFOUF
WJTJCJMJOFTTVONPWJNFOUP
Fig. 2-3 1"EFMMFEJUB
$POUSPMMPEJDPNQFUFO[B
5FDOJDP %BUB
Arti superiori
2
Posizione
t "TTFMVOHPEFMEJUPQBSBMMFMPBMM*3DPOBSUJDPMB[JPOJ
BQFSUF
t /FTTVOBSPUB[JPOFEFMEJUPDPOBTQFUUPTJNNFUSJDP
EFJDPSQJ
PA obliqua delle dita
Posizione
t "SUJDPMB[JPOJJOUFSGBMBOHFFFNFUBDBSQPGBMBOHFF
BQFSUF
t /FTTVOBTPWSBQQPTJ[JPOFEFMMFEJUBBEJBDFOUJ
Esposizione
Fig. 2-4 1"PCMJRVBEFMMFEJUB
5FDOJDP
%BUB
25
23/04/14 13.46
Laterale delle dita
R
2
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
t .BTDIFSBEJQJPNCP
QFSFTQPTJ[JPOJNVMUJQMF
TVMMPTUFTTP*3
Arti superiori
Posizione
t 1B[JFOUFTFEVUPNBOP
Fig. 2-5 -BUFSBMF
Fig. 2-6 -BUFSBMF
EFMMBOVMBSF
EFMMJOEJDFEJUPQBSBMMFMP
TVMUBWPMPTDIFSNP
BMM*3
QJPNCBUPTVMHSFNCP
t .BOPJOQPTJ[JPOFMBUFSBMF
QPMMJDFSJWPMUPWFSTPMBMUP
QFSJM¡¡¡EJUP
QPMMJDFWFSTPJMCBTTPQFSJM¡
t "MMJOFBSFMFEJUBMVOHPMBTTFNBHHJPSFEFMMBQPS[JPOFFTQPTUBEFMM*3
DFP: DN
Collimazione: BJRVBUUSPMBUJEFMEJUPJOUFSFTTBUPFBMMBTQFUUPEJTUBMF
EFMNFUBDBSQP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
26
23/04/14 13.46
AP del pollice
2
R
Posizione
t 1B[JFOUFJOQJFEJPTFEVUPNBOPSVPUBUB
WFSTPMJOUFSOPDPOJMQBMNPBQFSUPJONPEP
EBQPSUBSFMBTVQFSĕDJFQPTUFSJPSFEFMQPMMJDF
BEJSFUUPDPOUBUUPDPOM*3
t "MMJOFBSFJMQPMMJDFMVOHPMBTTFNBHHJPSF
EFMMBQPS[JPOFFTQPTUBEFMM*3
Raggio centrale: 3$ DFOUSBUP
BMMBBBSUJDPMB[JPOFNFUBDBSQPGBMBOHFB
DFP: DN
Collimazione: DPMMJNBSFQSFDJTBNFOUFBMMBSFB
EFMQPMMJDFJODMVEFSFMJOUFSP¡NFUBDBSQP
Intervallo kV:
DN
Fig. 2-7 "1EFMQPMMJDF
3$QFSQFOEJDPMBSF
BMMBBBSUJDPMB[JPOF.$'
kV
N"
5FNQP
N"T
Arti superiori
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
%'1
1
.
G
27
23/04/14 13.46
Laterale delle dita
2
Posizione
t -BUFSBMFQFSGFUUBBSUJDPMB[JPOJBQFSUF
MFTVQFSĕDJBOUFSJPSJEFJDPSQJEFMMFGBMBOHJ
BQQBJPOPDPODBWF
Arti superiori
Esposizione
t $POUSBTUPFEFOTJUËPUUJNBMJMVNJOPTJUË
FDPOUSBTUPQFSMFJNNBHJOJEJHJUBMJ
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTP
DIJBSBNFOUFWJTJCJMJOFTTVONPWJNFOUP
Fig. 2-8 -BUFSBMFEFMMFEJUB
5FDOJDP
%BUB
AP del pollice
t %BMMBGBMBOHFEJTUBMFBUVUUPJMNFUBDBSQP
FUSBQF[JP
R
Posizione
t "TTFMVOHPEFMEJUPQBSBMMFMPBMM*3
DPOBSUJDPMB[JPOJBQFSUF
t /FTTVOBSPUB[JPOFEFMQPMMJDFBTQFUUP
TJNNFUSJDPEFHMJDPSQJ
Esposizione
Fig. 2-9 "1EFMQPMMJDF
5FDOJDP
%BUB
28
23/04/14 13.46
PA obliqua del pollice
2
R
Posizione
t 1B[JFOUFTFEVUPNBOPTVMUBWPMPHPNJUP
ĘFTTPTDIFSNPTVMHSFNCP
t .BOPQSPOBQPMMJDFMFHHFSNFOUFBCEPUUP
2VFTUBQPTJ[JPOFUFOEFBSVPUBSF
Fig. 2-10 1"PCMJRVB
OBUVSBMNFOUFJMQPMMJDFJOQPTJ[JPOFPCMJRVB
EFMQPMMJDF3$QFSQFOEJDPMBSF
B¡
DFP: DN
Collimazione: DPMMJNBSFQSFDJTBNFOUFBMMBSFBEFMQPMMJDFJODMVEFSFMJOUFSPQSJNP
NFUBDBSQPFUSBQF[JP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
t .BTDIFSBEJQJPNCPQFSFTQPTJ[JPOJNVMUJQMF
TVMMPTUFTTP*3
%'1
1
.
G
29
23/04/14 13.46
Laterale del pollice
R
2
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
Arti superiori
Posizione
t $POMBNBOPQSPOBFMFHHFSNFOUFBSDVBUB
SVPUBSFMBNBOPNFEJBMNFOUF
Fig. 2-11 -BUFSBMFEFMQPMMJDF
3$QFSQFOEJDPMBSF
ĕOPBRVBOEPJMQPMMJDFTJUSPWBJOQPTJ[JPOF
MBUFSBMFQFSGFUUB
DFP: DN
Collimazione: DPMMJNBSFQSFDJTBNFOUFBMMBSFBEFMQPMMJDFJODMVEFSFMJOUFSPQSJNP
NFUBDBSQPFUSBQF[JP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
30
23/04/14 13.46
PA obliqua del pollice
2
t %BMMBGBMBOHFEJTUBMFBMNFUBDBSQBMF
EJTUBMFFUSBQF[JP
Posizione
t "TTFMVOHPEFMEJUPQBSBMMFMPBMM*3
DPOBSUJDPMB[JPOJBQFSUF
Fig. 2-12 1"PCMJRVBEFMQPMMJDF
5FDOJDP
%BUB
Arti superiori
Esposizione
DIJBSBNFOUFWJTJCJMJ
R
Laterale del pollice
t %BMMBGBMBOHFEJTUBMFBMNFUBDBSQBMF
EJTUBMFFUSBQF[JP
Posizione
t -BUFSBMFQFSGFUUB
BQFSUF
t 4VQFSĕDJFBOUFSJPSFEFMQSJNPNFUBDBSQBMFFGBMBOHF
QSPTTJNBMFVHVBMNFOUFDPODBWFMFTVQFSĕDJ
QPTUFSJPSJTPOPSFMBUJWBNFOUFESJUUF
Esposizione
Fig. 2-13 -BUFSBMFEFMQPMMJDF
5FDOJDP
%BUB
31
23/04/14 13.46
AP assiale del pollice
(Metodo di Roberts modificato)
R
2
Nota: RVFTUB TQFDJBMF QSPJF[JPOF FTQPOF
BM NFHMJP MB SFHJPOF EFMMB 1a articolazione
carpo-metacarpale.
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
Arti superiori
Fig. 2-14 "1BTTJBMFEFMQPMMJDF
QFSMBBBSUJDPMB[JPOF$.$
3$B¡QSPTTJNBMNFOUF
Posizione
t 1B[JFOUFTFEVUPPJOQJFEJNBOPSVPUBUBJOUFSOBNFOUFMBTVQFSĕDJFQPTUFSJPSF
EFMQPMMJDFQPHHJBEJSFUUBNFOUFTVMM*3
t "MMJOFBSFJMQPMMJDFMVOHPMBTTFNBHHJPSFEFMMBQPS[JPOFFTQPTUBEFMM*3
t &TUFOEFSFMFEJUBFUFOFSFJOQPTJ[JPOFDPOMBMUSBNBOPQFSFWJUBSF
MBTPWSBQQPTJ[JPOFEFMMBCBTFEFMQPMMJDFDPOMBSFHJPOFEFMMBBBSUJDPMB[JPOF
DBSQPNFUBDBSQBMFSFRVJTJUPFTTFO[JBMFQFSVODPSSFUUPQPTJ[JPOBNFOUP
Raggio centrale: 3$JODMJOBUPEJ¡JOEJSF[JPOFQSPTTJNBMFDFOUSBUP
BMMBBBSUJDPMB[JPOFDBSQPNFUBDBSQBMF
DFP: DN
Collimazione: DPMMJNBSFQFSGFUUBNFOUFBMMJOUFSPQPMMJDFJODMVTPJMUSBQF[JP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
32
23/04/14 13.46
PA della mano
2
R
Posizione
t "MMJOFBSFMBTTFMVOHPEFMMBNBOPFJMQPMTP
Fig. 2-15 1"EFMMBNBOP
QBSBMMFMBNFOUFBMNBSHJOFEFMM*3
t .BOPDPNQMFUBNFOUFQSPOBEJUBMFHHFSNFOUF
TFQBSBUF
Raggio centrale: 3$ DFOUSBUPBMMBBBSUJDPMB[JPOF.$'
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFJNBSHJOJFTUFSOJEFMMBNBOPFEFMQPMTP
*ODMVEFSFJMDBSQP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
t ¨DNWFSUJDBMF
P
t ¨DNWFSUJDBMF
QFSNBOPQJáQJDDPMB
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
%'1
1
.
G
33
23/04/14 13.46
AP assiale del pollice
(Metodo di Roberts modificato)
2
t %BMMBGBMBOHFEJTUBMFBMNFUBDBSQBMFFUSBQF[JP
t #BTFEFM¡PTTPNFUBDBSQBMFFUSBQF[JPCFOFFTQPTUJ
Posizione
t "TTFMVOHPEFMEJUPQBSBMMFMPBMM*3DPOBSUJDPMB[JPOJ
BQFSUF
t /FTTVOBSPUB[JPOF
Arti superiori
Esposizione
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPDIJBSBNFOUF Fig. 2-16 "1BTTJBMFEFMQPMMJDF
5FDOJDP
%BUB
PA della mano
t .BOPQPMTPFDNEFMMBWBNCSBDDJP
EJTUBMF
Posizione
t "SUJDPMB[JPOJJOUFSGBMBOHFF
FNFUBDBSQPGBMBOHFFBQFSUF
t /FTTVOBSPUB[JPOFEFMMBNBOP
BTQFUUPTJNNFUSJDPEFJDPSQJEFMMFPTTB
NFUBDBSQBMJFEFMMFGBMBOHJ
t %JUBMFHHFSNFOUFTFQBSBUF
Esposizione
Fig. 2-17 1"EFMMBNBOP
5FDOJDP
%BUB
34
23/04/14 13.46
PA obliqua della mano
2
R
Posizione
t 3VPUBSFMBUFSBMNFOUFMJOUFSBNBOPFJMQPMTP
Fig. 2-18 1"PCMJRVBEFMMBNBOP
EJ¡TPTUFOFSFDPODVOFPPTVQQPSUP
EJUBQBSBMMFMFBMM*3
BHSBEJOJ"MMJOFBSFMBNBOPFJMQPMTPBMM*3
t "TTJDVSBSTJDIFUVUUFMFEJUBTJBOPMFHHFSNFOUF
TFQBSBUFFQBSBMMFMFBMM*3
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMMBNBOPFEFMQPMTP*ODMVEFSFJMDBSQP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
t ¨DNWFSUJDBMF
P
t ¨DNWFSUJDBMF
QFSNBOPQJáQJDDPMB
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
%'1
1
.
G
35
23/04/14 13.46
Laterale della mano “a ventaglio” e in estensione
R
2
t
t
t
t
¨DNWFSUJDBMF
4FO[BHSJHMJB
"DDFTTPSJPTVQQPSUPBHSBEJOJB¡
.BTDIFSBEJQJPNCPQFSFTQPTJ[JPOJ
Fig. 2-19 -BUFSBMF
Fig. 2-20 -BUFSBMF
Arti superiori
EFMMBNBOP
EFMMBNBOPiBWFOUBHMJPw
Posizione
JOFTUFOTJPOF
EJUBOPOTPWSBQQPTUF
t 1B[JFOUFTFEVUPNBOP
QFSTPTQFUUPDPSQP
TVMUBWPMPHPNJUPĘFTTP
FTUSBOFPFEBOOP
TDIFSNPTVMHSFNCP
BMNFUBDBSQP
t .BOPJOQPTJ[JPOFMBUFSBMF
MBUPEFMQPMMJDFWFSTPMBMUP
EJUBTFQBSBUFBQFSUFiBWFOUBHMJPw
FQPTUFTVTVQQPSUPBHSBEJOJSBEJPUSBTQBSFOUFPEJTQPTJUJWPTJNJMF
BTTJDVSBSFMBUFSBMFQFSGFUUBEFMMFPTTBNFUBDBSQBMJ
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMMBNBOPFEFMQPMTP*ODMVEFSFJMDBSQP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
36
23/04/14 13.46
PA obliqua della mano
t .BOPQPMTPFDNEFMMBWBNCSBDDJPEJTUBMF
Fig. 2-21 1"PCMJRVBEFMMBNBOP
5FDOJDP
%BUB
Arti superiori
Esposizione
DIJBSBNFOUFWJTJCJMJ
2
Posizione
t "TTFMVOHPEFMMFEJUBFEFMMFPTTBNFUBDBSQBMJ
QBSBMMFMPBMM*3BSUJDPMB[JPOJBQFSUF
t /FTTVOBTPWSBQQPTJ[JPOFEFMMBQPS[JPOFNFEJBOB
EFJDPSQJEFMMFPTTBNFUBDBSQBMJEBM¡BM¡
Laterale della mano “a ventaglio”
t .BOPQPMTPFDNEFMMBWBNCSBDDJPEJTUBMF
BQFSUF
Posizione
t %JUBJOMBUFSBMFQFSGFUUB
t 'BMBOHJFTVQFSĕDJEFMMFPTTBNFUBDBSQBMJ
TJNNFUSJDJ
t 1PS[JPOJEJTUBMFEJSBEJPVMOBFNFUBDBSQP
TPWSBQQPTUF
Esposizione
DIJBSBNFOUFWJTJCJMJ
Fig. 2-22 -BUFSBMFEFMMBNBOP
iBWFOUBHMJPw
5FDOJDP
%BUB
37
23/04/14 13.46
AP bilaterale obliqua della mano
(Metodo di Norgaard e variante del ricevitore)
Variante del
ricevitore
2
R
t ¨DNUSBTWFSTBMF
P¨DNUSBTWFSTBMF
t 4FO[BHSJHMJB
t "DDFTTPSJoEVFTQVHOF
EJHPNNBQJVNBEB¡
QFSTVQQPSUP
45
45
Fig. 2-23 "1CJMBUFSBMFPCMJRVBB¡
EFMMBNBOP
Arti superiori
Posizione
DPOWBSJBOUFEFMSJDFWJUPSF
t 1B[JFOUFTFEVUPBMDBQP
EFMUBWPMPFOUSBNCFMFCSBDDJBFMFNBOJFTUFTFDPOJQBMNJSJWPMUJWFSTPMBMUP
FNBOJPCMJRVFB¡BTQFUUJNFEJBMJJODPOUBUUP
t %JUBDPNQMFUBNFOUFFTUFTFTPTUFOVUFEBTVQQPSUJB¡
Variante del ricevitore
t -FEJUBTPOPQBS[JBMNFOUFĘFTTFQFSNFUUFVOBCVPOBWJTVBMJ[[B[JPOFEFMMFPTTB
NFUBDBSQBMJFEFMMFBSUJDPMB[JPOJNFUBDBSQPGBMBOHFFNBEJTUPSDFMFBSUJDPMB[JPOJ
JOUFSGBMBOHFF
Raggio centrale: 3$ DFOUSBUPBNFUËEFMMBBBSUJDPMB[JPOF.$'
DFP: DN
Collimazione: DPMMJNBSFBJNBSHJOJFTUFSOJEFMMFNBOJFEFJQPMTJ
*ODMVEFSFMFĕMFQSPTTJNBMFFEJTUBMFEFMMFPTTBDBSQBMJ
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
38
23/04/14 13.46
AP bilaterale obliqua della mano
(Metodo di Norgaard)
2
t &OUSBNCFMFNBOJEBMMFPTTB
DBSQBMJBMMFGBMBOHJEJTUBMJ
t &OUSBNCFMBNBOJPCMJRVF
B¡
Esposizione
t $POUSBTUPFEFOTJUËPUUJNBMJ
Fig. 2-24 "1CJMBUFSBMFPCMJRVBEFMMBNBOP
MVNJOPTJUËFDPOUSBTUP
5FDOJDP
%BUB
t 5FTTVUJNPMMJFUFTTVUPPTTFP
TQVHOPTPDPOBSUJDPMB[JPOJ.$'
DIJBSBNFOUFWJTJCJMJĕOPBMMFGBMBOHJEJTUBMJ
Arti superiori
Posizione
t 1PS[JPOFNFEJBOBEFMMFPTTB
NFUBDBSQBMJEBM¡BM¡
OPOTPWSBQQPTUJ
t "SUJDPMB[JPOJ.$'BQFSUF
39
23/04/14 13.46
PA del polso
R
2
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
Arti superiori
Posizione
t 1B[JFOUFTFEVUPNBOPTVMUBWPMP
TDIFSNPTVMHSFNCP
t "MMJOFBSFMBNBOPFJMQPMTPQBSBMMFMJ
BMNBSHJOFEFMM*3
t "CCBTTBSFMBTQBMMBBQQPHHJBSFJMCSBDDJP
Fig. 2-25 1"EFMQPMTP
TVMUBWPMPQFSHBSBOUJSFMBTTFO[BEJSPUB[JPOF
EFMQPMTP
t .BOPQSPOBEJUBSJMBTTBUFFNBOPMFHHFSNFOUF
BSDVBUBQFSQPTJ[JPOBSFJMQPMTP
BEJSFUUPDPOUBUUPDPOMBTVQFSĕDJFEFMM*3
Raggio centrale: 3$ DFOUSBUPBMMFDBSQBMJNFEJBOF
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMQPMTPJODMVEFSFMBQPS[JPOFEJTUBMF
EFMSBEJPFEFMMVMOBFMBSFBNFEJBOBEFMNFUBDBSQP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
40
23/04/14 13.46
PA obliqua del polso
2
R
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
Posizione
BMNBSHJOFEFMM*3
t 3VPUBSFMBNBOPFJMQPMTPMBUFSBMNFOUF
Fig. 2-26 1"PCMJRVBB¡
JOQPTJ[JPOFPCMJRVBB¡
EFMQPMTP
t 'MFUUFSFMFEJUBQFSTPTUFOFSFMBNBOP
JORVFTUBQPTJ[JPOFPVUJMJ[[BSFVOTVQQPSUP
B¡(inserito).
DFP: DN
%'1
1
.
G
41
23/04/14 13.46
PA del polso
2
t 0TTBNFEJBOFEFMNFUBDBSQPPTTBDBSQBMJ
QPS[JPOJEJTUBMFEJSBEJPVMOBFBSUJDPMB[JPOJ
BTTPDJBUF
Posizione
t -B1"QFSGFUUBÒHBSBOUJUBEBMMBTJNNFUSJB
EFMMFQPS[JPOJQSPTTJNBMJEFMMFPTTBNFUBDBSQBMJ
t -FQPS[JPOJEJTUBMJEJSBEJPFVMOBTPOPTFQBSBUF
Arti superiori
Esposizione
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPEFMMFPTTB
DBSQBMJDIJBSBNFOUFWJTJCJMJOFTTVONPWJNFOUP
R
Fig. 2-27 1"EFMQPMTP
5FDOJDP
%BUB
PA obliqua del polso
BTTPDJBUF
Posizione
t "TTFMVOHPEFMMBNBOPĕOPBMMBWBNCSBDDJP
BMMJOFBUPBMM*3
t 1PMTPPCMJRVPB¡
Esposizione
EFMMFPTTBDBSQBMJDIJBSBNFOUFWJTJCJMJ
OFTTVONPWJNFOUP
Fig. 2-28 1"PCMJRVBEFMQPMTP
5FDOJDP
%BUB
42
23/04/14 13.46
Laterale del polso
2
L
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
Posizione
t 1B[JFOUFTFEVUPCSBDDJPTVMUBWPMPHPNJUP
ĘFTTPTQBMMBBCCBTTBUBJONPEPDIFPNFSP
BWBNCSBDDJPFQPMTPTJBOPTVMMPTUFTTPQJBOP
PSJ[[POUBMF
BMNBSHJOFEFMM*3
Fig. 2-29 -BUFSBMFEFMQPMTP
t 1PTJ[JPOBSFMBNBOPFJMQPMTPJOQPTJ[JPOF
MBUFSBMFQFSGFUUBTFOFDFTTBSJPVTBSF
VOTVQQPSUPQFSNBOUFOFSFMBQPTJ[JPOF
DFP: DN
%'1
1
.
G
43
23/04/14 13.46
Laterale del polso
2
BTTPDJBUF
L
Posizione
t -BUFSBMFQFSGFUUBEFMQPMTP
t 5FTUBEFMMVMOBTPWSBQQPTUBBMMBQPS[JPOFEJTUBMF
EFMSBEJP
Arti superiori
Esposizione
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPEFMMFPTTB
DBSQBMJDIJBSBNFOUFWJTJCJMJOFTTVONPWJNFOUP
t 4USJTDFFDPSQJWJTJCJMJ
Fig. 2-30 -BUFSBMFEFMQPMTP
5FDOJDP %BUB
44
23/04/14 13.46
PA assiale del polso
(Deviazione ulnare a 15° e metodo di Stecher modificato)
2
R
Fig. 2-31 %FWJB[JPOFVMOBSF
3$B¡WFSTPJMHPNJUP
3$QFSQFOEJDPMBSF
BMMPTDBGPJEF
Arti superiori
Attenzione: MB QSPJF[JPOF JO EFWJB[JPOF VMOBSF EFWF FTTFSF
QSPWBUB TPMP JO DBTP EJ TPTQFUUP USBVNB EPQP BWFS FTDMVTP
MBQSFTFO[BEJGSBUUVSFNBDSPTDPQJDIFBMQPMTPPBMMBQPS[JPOF
EJTUBMF EFMMBWBNCSBDDJP DPO VOB TFSJF EJ QSPJF[JPOJ SPVUJOF
-B QSPJF[JPOJ 1" BTTJBMF Ò SBDDPNBOEBUB OFM DBTP TJ TPTQFUUJ
VOB GSBUUVSB OBTDPTUB 4F JM QB[JFOUF OPO SJFTDF B EFWJBSF
JM QPMTP JO EJSF[JPOF VMOBSF TPQSBFMFWBSF MB NBOP TV VOB
TQVHOBBOHPMBSFB¡
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
t .BTDIFSBEJQJPNCPQFSFTQPTJ[JPOJNVMUJQMFTVMMPTUFTTP
*3
Fig. 2-32 4PMMFWBSFMBNBOP
Posizione
TVTVQQPSUPB¡o.FUPEP
EJ4UFDIFSNPEJĕDBUP
t %BMMBQPTJ[JPOF1"SVPUBSFHFOUJMNFOUFJMQPMTP
3$QFSQFOEJDPMBSFBMM*3
WFSTPJMMBUPVMOBSFĕOP
BDIFJMQB[JFOUFMPUPMMFSB
Raggio centrale: BOHPMPEFM3$B¡JOEJSF[JPOFQSPTTJNBMF
WFSTPJMHPNJUPDFOUSBUPTVMMPTDBGPJEFMBUPEFMQPMMJDFEFMMBSFBDBSQBMF
4FMBNBOPÒTVMTVQQPSUPB¡3$ BMM*3
Nota: QPUSFCCFFTTFSFOFDFTTBSJBVOBTFSJFEBRVBUUSPQSPJF[JPOJDPO3$B¡¡
¡F¡
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMMBSFHJPOFDBSQBMF
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
45
23/04/14 13.46
PA assiale dello scafoide
(Deviazione ulnare a 15° e metodo di Stecher modificato)
2
t 4DBGPJEFDIJBSBNFOUFWJTJCJMFOFTTVO
BDDPSDJBNFOUPPTPWSBQQPTJ[JPOF
EFMMPTDBGPJEFDIJBSBNFOUFWJTJCJMJ
OFTTVONPWJNFOUP
Arti superiori
Posizione
t %FWJB[JPOFVMOBSFFWJEFOUF
t -BSFBQPUSFCCFFTTFSFWJTVBMJ[[BUBNFHMJP
DPOBOHPMBUVSFNVMUJQMFEFM3$
t /FTTVOBSPUB[JPOFEFMQPMTP
Esposizione
EFMMPTDBGPJEFDIJBSBNFOUFWJTJCJMJ
OFTTVONPWJNFOUP
Fig. 2-33 %FWJB[JPOFVMOBSF
3$B¡
5FDOJDP
%BUB
Fig. 2-34 .FUPEPEJ4UFDIFS
NPEJĕDBUP
5FDOJDP
%BUB
46
23/04/14 13.46
PA del polso
(Deviazione radiale)
Attenzione: RVFTUB QPTJ[JPOF EFWF FTTFSF QSPWBUB JO
DBTPEJTPTQFUUPUSBVNBTPMPEPQPBWFSFTDMVTPVOBGSBUUVSF NBDSPTDPQJDB BM QPMTP P BMMB QPS[JPOF EJTUBMF
EFMMBWBNCSBDDJPDPOVOBTFSJFEJQSPJF[JPOJEJSPVUJOF
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
Posizione
t %BMMBQPTJ[JPOF1"SVPUBSFEFMJDBUBNFOUF
JMQPMTPWFSTPJMMBUPSBEJBMF
Fig. 2-35 %FWJB[JPOFSBEJBMF
ĕOPBDIFJMQB[JFOUFMPUPMMFSB
3$QFSQFOEJDPMBSFBMMFPTTBDBSQBMJ
QSPUF[JPOFTVMHSFNCP
NFEJBOFJOFWJEFO[BJMMBUPVMOBSF
Raggio centrale: 3$ BMMFPTTBDBSQBMJ
EFMMFPTTBDBSQBMJ
NFEJBOF
DFP: DN
Collimazione: DPMMJNBSFQFSGFUUBNFOUFBJRVBUUSPMBUJEFMMBSFHJPOFDBSQBMF
ȵDN2
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
2
R
%'1
1
.
G
47
23/04/14 13.46
PA del polso
(Deviazione radiale)
2
t .JHMJPSFWJTVBMJ[[B[JPOFEFMMFPTTB
DBSQBMJTVMMBUPVMOBSF
Posizione
t %FWJB[JPOFSBEJBMFFWJEFOUF
t /FTTVOBSPUB[JPOFEFMQPMTP
Arti superiori
Esposizione
TQVHOPTPEFMMBTQFUUPVMOBSF
EFMMBSFHJPOFDBSQBMFDIJBSBNFOUF
Fig. 2-36 %FWJB[JPOFSBEJBMF
5FDOJDP
%BUB
48
23/04/14 13.46
Tangenziale del canale carpale
(Metodo di Gaynor-Hart)
2
R
Fig. 2-37 1SPJF[JPOFUBOHFO[JBMF
EFMDBOBMFDBSQBMFUVOOFM
3$B¡
SJTQFUUPBMMBTTFEFMMBNBOP
Posizione
t 1B[JFOUFTFEVUPNBOPTVMUBWPMPTDIFSNPTVMHSFNCP
t 1PMTPJQFSFTUFTPFTUFOTJPOFEFMQPMTP
ĕOPBDIFJMQB[JFOUFMPUPMMFSB
VTBSFMBMUSBNBOPQFSNBOUFOFSFMFEJUBJOEJFUSP
t 3VPUBSFMFHHFSNFOUFWFSTPMJOUFSOPMBNBOPFJMQPMTPWFSTPJMSBEJPȵ¡
t -BWPSBSFWFMPDFNFOUFMBQPTJ[JPOFQPUSFCCFFTTFSFEPMPSPTBQFSJMQB[JFOUF
Raggio centrale: 3$B¡SJTQFUUPBMMBTTFEFMMBTVQFSĕDJFQBMNBSFEFMMBNBOP
DFOUSBUPBDNEJTUBMNFOUFSJTQFUUPBMMBCBTFEFM¡NFUBDBSQBMF
DFP: DN
Collimazione: DPMMJNBSFBMMBSFHJPOFDBSQBMFȵDN2
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
Attenzione: RVFTUB QPTJ[JPOF Ò UBMWPMUB EFUUB
iQSPJF[JPOFEFMDBOBMFDBSQBMFw%FWFFTTFSFUFO
UBUB TF TJ TPTQFUUB VO USBVNB TPMP EPQP BWFS F
TDMVTPVOBGSBUUVSBNBDSPTDPQJDBBMQPMTPPBMMB
QPS[JPOF EJTUBMF EFMMBWBNCSBDDJP DPO VOB TFSJF
EJQSPJF[JPOJEJSPVUJOF
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
%'1
1
.
G
49
23/04/14 13.46
Tangenziale del canale carpale
(Metodo di Gaynor-Hart)
2
t 0TTBDBSQBMJWJTJCJMJ
JOEJTQPTJ[JPOFBSDVBUB
Posizione
t 1JTJGPSNFFVODJOBUPTFQBSBUJ
t 4DBGPJEFUSBQF[JPEJQSPĕMP
Arti superiori
Esposizione
TQVHOPTPEFMDBOBMFDBSQBMF
DIJBSBNFOUFWJTJCJMJ
R
Fig. 2-38 1SPJF[JPOFUBOHFO[JBMFEFMDBOBMF
DBSQBMF
5FDOJDP
%BUB
50
23/04/14 13.46
AP dell’avambraccio
2
R
t ¨DNWFSUJDBMFP¨DN
QFSQB[JFOUJQJáQJDDPMJ
t 4FO[BHSJHMJB
Fig. 2-39 "1EFMMBWBNCSBDDJP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
Posizione
t 1B[JFOUFTFEVUPBMDBQPEFMUBWPMP
DPOCSBDDJPFTUFTPFNBOPJOTVQJOB[JPOFQSPUF[JPOFTVMHSFNCP
t "TTJDVSBSTJDIFQPMTPFHPNJUPTJBOPFOUSBNCJJODMVTJVUJMJ[[BSFVO*3
EJEJNFOTJPOJTVďDJFOUJQFSJODMVEFSFFOUSBNCFMFBSUJDPMB[JPOJEFMQPMTP
FEFMHPNJUP
t $IJFEFSFBMQB[JFOUFEJQJFHBSTJMBUFSBMNFOUFQFSPUUFOFSFVOB"1QFSGFUUB
EFMMBWBNCSBDDJP
Raggio centrale: 3$ DFOUSBUPBMQVOUPDFOUSBMFEFMMBWBNCSBDDJP
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJJODMVEFSFVONJOJNPEJDNPMUSF
MFBSUJDPMB[JPOJEFMQPMTPFEFMHPNJUP
%'1
1
.
G
51
23/04/14 13.46
Laterale dell’avambraccio
2
R
Arti superiori
t ¨DNWFSUJDBMFP¨DN
QFSQB[JFOUJQJáQJDDPMJ
t 4FO[BHSJHMJB
Fig. 2-40 -BUFSBMFEFMMBWBNCSBDDJP
Posizione
t 1B[JFOUFTFEVUPBMDBQPEFMUBWPMPTDIFSNPTVMHSFNCP
t *MHPNJUPEFWFFTTFSFĘFTTPB¡
t .BOPFQPMTPEFWPOPFTTFSFJOQPTJ[JPOFMBUFSBMFQFSGFUUBMFQPS[JPOJEJTUBMJ
EJSBEJPFVMOBEFWPOPSJTVMUBSFQFSGFUUBNFOUFTPWSBQQPTUF
t "TTJDVSBSTJDIFFOUSBNCFMFBSUJDPMB[JPOJEFMQPMTPFEFMHPNJUPTJBOPJODMVTF
BNFOPDIFRVFTUPTJBDPOUSPJOEJDBUP
Raggio centrale: 3$ DFOUSBUPBMQVOUPDFOUSBMFEFMMBWBNCSBDDJP
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJJODMVEFSFVONJOJNPEJDNPMUSF
MFBSUJDPMB[JPOJEFMQPMTPFEFMHPNJUP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
%'1
1
.
G
52
23/04/14 13.46
AP dell’avambraccio
t 3BEJPFVMOBDPNQMFUJ
t (PNJUPFDBSQBMJQSPTTJNBMJ
Esposizione
R
Fig. 2-41 "1EFMMBWBNCSBDDJP
WJTJCJMJ
5FDOJDP
%BUB
Arti superiori
2
Posizione
t -FHHFSBTPWSBQQPTJ[JPOFEFMMFQPS[JPOJEJTUBMJ
EJSBEJPVMOB
t &QJDPOEJMJEFMMPNFSPEJQSPĕMP
Laterale dell’avambraccio
t 3BEJPFVMOBDPNQMFUJ
t (PNJUPFDBSQBMJQSPTTJNBMJ
Posizione
t -BUFSBMFQFSGFUUB
t &QJDPOEJMJEFMMPNFSPTPWSBQQPTUJ
t -BUFTUBEFMMVMOBFMBQPS[JPOFEJTUBMF
EFMSBEJPTPOPTPWSBQQPTUJ
Esposizione
EFMDBOBMFDBSQBMFDIJBSBNFOUFWJTJCJMJ
Fig. 2-42 -BUFSBMFEFMMBWBNCSBDDJP
5FDOJDP
%BUB
53
23/04/14 13.46
AP del gomito
2
R
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
Fig. 2-43 "1EFMHPNJUPDPNQMFUBNFOUF
FTUFTP
Arti superiori
Posizione
t (PNJUPFTUFTPFNBOPTVQJOBQSPUF[JPOFTVMHSFNCP
t $IJFEFSFBMQB[JFOUFEJQJFHBSTJMBUFSBMNFOUF
QFSPUUFOFSFVOB"1QFSGFUUBQBMQBSFHMJFQJDPOEJMJ
t 4FJMHPNJUPOPOQVÛFTTFSFDPNQMFUBNFOUFFTUFTP
BDRVJTJSFEVFQSPJF[JPOJ"1DPNFNPTUSBUP
'JHHF
DPO3$ BMMBQPS[JPOFEJTUBMF
EFMMPNFSPJOVOBF BMMBQP[JPOFQSPTTJNBMF
EFMMBWBNCSBDDJPOFMMBMUSB
Raggio centrale: 3$ DFOUSBUPBMQVOUPNFEJBOP
EFMMBSUJDPMB[JPOFEFMHPNJUP
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMMBSFB
EJJOUFSFTTF
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Fig. 2-44 3$QFSQFOEJDPMBSF
BMMPNFSP
Fig. 2-45 3$QFSQFOEJDPMBSF
BMMBWBNCSBDDJP
%'1
1
.
G
54
23/04/14 13.46
AP del gomito completamente esteso
t 1PS[JPOFEJTUBMFEFMMPNFSP
t 1PS[JPOJQSPTTJNBMJEJSBEJPFVMOB
R
2
Posizione
t -FHHFSBTPWSBQQPTJ[JPOFEFMMFQPS[JPOJEJTUBMJ
EJSBEJPVMOB
Arti superiori
Esposizione
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPEFMHPNJUP
Fig. 2-46 "1EFMHPNJUP
DPNQMFUBNFOUFFTUFTP
5FDOJDP
%BUB
55
23/04/14 13.46
AP del gomito parzialmente flesso
2
Arti superiori
R
R
Fig. 2-47 0NFSPQBSBMMFMPBMM*3
5FDOJDP
%BUB
Fig. 2-48 "WBNCSBDDJPQBSBMMFMP
BMM*3
5FDOJDP
%BUB
t EFMMBQPS[JPOFEJTUBMFEFMMPNFSP
t EFMMBQPS[JPOFQSPTTJNBMFEFMMBWBNCSBDDJP
Posizione
t -FHHFSBTPWSBQQPTJ[JPOFEFMMFQPS[JPOJEJTUBMJEJSBEJPVMOB
Esposizione
t $POUSBTUPFEFOTJUËPUUJNBMJMVNJOPTJUËFDPOUSBTUPQFSMFJNNBHJOJEJHJUBMJ
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPDIJBSBNFOUFWJTJCJMJOFTTVONPWJNFOUP
56
23/04/14 13.46
Mediana e laterale oblique del gomito
2
R
Fig. 2-49 .FEJBOBPCMJRVBB¡
EFMHPNJUP
Posizione
Mediana obliqua:
t (PNJUPFTUFTPNBOPQSPOB
t 1BMQBSFHMJFQJDPOEJMJQFSDPOUSPMMBSF
MBSPUB[JPOFJOUFSOBB¡
Fig. 2-50 -BUFSBMFPCMJRVBB¡
Laterale obliqua: QPTJ[JPOFTJNJMF
EFMHPNJUP
NBDPONBOPJOTVQJOB[JPOFFHPNJUPSVPUBUP
EJ¡WFSTPMFTUFSOP1JáEJďDJMFQFSJMQB[JFOUF
QJFHBSFMBQBSUFTVQFSJPSFEFMDPSQPMBUFSBMNFOUF
Raggio centrale: 3$ DFOUSBUPBMQVOUPNFEJBOPEFMMBSUJDPMB[JPOFEFMHPNJUP
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMMBSFBEJJOUFSFTTF
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
-B QSPJF[JPOJ mediana obliqua (interna) WJTVBMJ[[B BM NFHMJP JM QSPDFTTP DPSPOPJEFP -B QSPJF[JPOF laterale obliqua (esterna) WJTVBMJ[[BNFHMJP
MBUFTUBFJMDPMMPEFMSBEJPQSPJF[JPOFPCMJRVBQJá
DPNVOF
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
%'1
1
.
G
57
23/04/14 13.46
Mediana obliqua del gomito
t &QJDPOEJMPNFEJBOBFUSPDMFB
2
Posizione
t 1SPDFTTPDPSPOPJEFPEJQSPĕMP
t 5FTUBDPMMPSBEJBMJTPWSBQQPTUJBMMVMOB
Arti superiori
Esposizione
DIJBSBNFOUFWJTJCJMJ
R
Fig. 2-51 .FEJBOBPCMJRVB
EFMHPNJUP
5FDOJDP
%BUB
Laterale obliqua del gomito
t &QJDPOEJMPMBUFSBMFFDBQJUFMMP
Posizione
t 5FTUBDPMMPFUVCFSPTJUËEFMSBEJPMJCFSJ
EBTPWSBQQPTJ[JPOJ
t &QJDPOEJMJEFMMPNFSPFDBQJUFMMPEJQSPĕMP
Esposizione
R
Fig. 2-52 -BUFSBMFPCMJRVB
EFMHPNJUP
5FDOJDP
%BUB
58
23/04/14 13.46
Laterale del gomito
2
R
Posizione
t (PNJUPĘFTTPB¡TQBMMBBCCBTTBUBRVBOUP
OFDFTTBSJPQFSQPHHJBSFBWBNCSBDDJPFPNFSP
EJQJBUUPTVMUBWPMPFTVMM*3
TDIFSNPTVMHSFNCP
Fig. 2-53 -BUFSBMFEFMHPNJUP
t $FOUSBSFJMHPNJUPBMDFOUSPEFMM*3
ĘFTTPB¡
PBMMBQPS[JPOFFTQPTUBEFMM*3BWBNCSBDDJP
QBSBMMFMPBMCPSEPEFMMBDBTTFUUB
t 1PTJ[JPOBSFNBOPFQPMTPJOQPTJ[JPOFMBUFSBMF
QFSGFUUB
Raggio centrale: 3$ DFOUSBUPBMQVOUPNFEJBOPEFMMBSUJDPMB[JPOFEFMHPNJUP
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJJODMVEFSFVONJOJNPEJDJSDBDN
EFMMBWBNCSBDDJPFEFMMPNFSP
Intervallo kV:
DN
kV
N"
5FNQP
N"T
Arti superiori
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
TVMMPTUFTTP*3
%'1
1
.
G
59
23/04/14 13.46
Laterale del gomito
2
t 1PS[JPOFQSPTTJNBMFEJSBEJP
VMOBFQPS[JPOFEJTUBMF
EFMMPNFSP
t 3FHJPOFEFJDPSQJBEJQPTJ
EFMMBSUJDPMB[JPOF
Arti superiori
Posizione
t 1SPDFTTPPMFDSBOJDPJODJTVSB
USPDMFBSFEJQSPĕMP
t &QJDPOEJMJEFMMPNFSP
TPWSBQQPTUJ
t (PNJUPĘFTTPB¡
R
Fig. 2-54 -BUFSBMFEFMHPNJUP
5FDOJDP
Esposizione
MVNJOPTJUËFDPOUSBTUPQFSMFJNNBHJOJEJHJUBMJ
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPDIJBSBNFOUFWJTJCJMJ
%BUB
60
23/04/14 13.46
Laterale assiale del gomito nel paziente traumatizzato
(Metodo di Coyle)
2
R
Fig. 2-55 -BUFSBMF
Posizione e raggio centrale
BTTJBMFEFMHPNJUP
Testa e collo del radio
QFSUFTUBFDPMMP
t (PNJUPĘFTTPB90¡TFQPTTJCJMF
EFMSBEJP
NBOPQSPOB
t 3$JODMJOBUPEJ¡WFSTP
JMUPSBDFDFOUSBUPTVMMBUFTUBFDPMMPEFMSBEJP
JM3$FOUSBBMQVOUPNFEJBOPEFMMBSUJDPMB[JPOFEFMHPNJUP
Fig. 2-56 -BUFSBMF
BTTJBMFEFMHPNJUP
QFSQSPDFTTP
DPSPOPJEFP
Arti superiori
1SPJF[JPOJTQFDJBMJQFS MBWJTVBMJ[[B[JPOF
EFMMB testa radiale F EFM processo coronoideo.
t ¨DNWFSUJDBMF
t 4FO[BHSJHMJB
Processo coronoideo
t (PNJUPĘFTTPBsoli80¡NBOPQSPOB
t 3$JODMJOBUPEJ¡EBMUPSBDFDFOUSBUPTVMQSPDFTTPDPSPOPJEFP
JM3$FOUSBBMQVOUPNFEJBOPEFMMBSUJDPMB[JPOFEFMHPNJUP
DFP: DN
Collimazione: DPMMJNBSFBJRVBUUSPMBUJEFMMBSFBEJJOUFSFTTF
Intervallo kV:
DN
Sistemi analogici: 65-70 kV*
kV
N"
5FNQP
N"T
%'1
1
.
G
"VNFOUBSFJGBUUPSJEJFTQPTJ[JPOFEJL7QFSMBMBUFSBMFEFMHPNJUPFQFSMJODMJOB[JPOFEFM3$
61
23/04/14 13.46
Laterale assiale del gomito nel paziente traumatizzato
(Metodo di Coyle)
2
Arti superiori
Fig. 2-57 -BUFSBMFBTTJBMF
EFMHPNJUPQFSUFTUBDPMMP
FDBQJUFMMPEFMSBEJP
5FDOJDP
Fig. 2-58 -BUFSBMFBTTJBMF
EFMHPNJUPQFSQSPDFTTP
DPSPOPJEFPFUSPDMFB
5FDOJDP
%BUB
%BUB
Anatomia radiografica e posizione – RC a 45° verso la spalla
t 5FTUBDPMMPFDBQJUFMMPEFMSBEJPHPNJUPĘFTTPB90¡
Anatomia radiografica e posizione – RC a 45° dalla spalla
t 1SPDFTTPDPSPOPJEFPFUSPDMFB
t 1SPDFTTPDPSPOPJEFPEJQSPĕMPHPNJUPĘFTTPB80¡VOBĘFTTJPOFNBHHJPSF
EJ¡DPQSFJMQSPDFTTPDPSPOPJEFP
Esposizione
t $POUSBTUPFEFOTJUËPUUJNBMJMVNJOPTJUËFDPOUSBTUPQFSMFJNNBHJOJEJHJUBMJ
t 5FTTVUJNPMMJFUFTTVUPPTTFPTQVHOPTPDIJBSBNFOUFWJTJCJMJOFTTVONPWJNFOUP
62
23/04/14 13.46
AP degli arti superiori nel paziente pediatrico
2
R
4F TJ TPTQFUUB VO USBVNB TQPTUBSF MBSUP NPMUP
EFMJDBUBNFOUF DPO NPWJNFOUJ NJOJNJ 3BEJPHSBGBSF VOB WPMUB QFS FTDMVEFSF GSBUUVSF NBDSPTDPQJDIFQSJNBEJFTFHVJSFVMUFSJPSJJOEBHJOJ
t -BEJNFOTJPOFEFMM*3TJEFUFSNJOBJOCBTF
BMMFUËFBMMFEJNFOTJPOJEFMQB[JFOUF
t 4VMUBWPMP*3PSFDFUUPSFEJNNBHJOF
Posizione
t 1PTJ[JPOFTVQJOBCSBDDJPBCEPUUPEBMDPSQPQSPUF[JPOFQJPNCBUBTVMMBSFBQFMWJDB
t *ODMVEFSFMBSUPDPNQMFUPBNBOPDIFOPOTJBOPJOEJDBUJVOBSUJDPMB[JPOFPVOPTTP
TQFDJĕDP
t *NNPCJMJ[[BSFDPOGBTDJBFMBTUJDBSBEJPUSBTQBSFOUFTBDDIFUUJEJTBCCJBPOBTUSP
t 4FOFDFTTBSJPDIJFEFSFMBTTJTUFO[BEFMHFOJUPSFGPSOJSFHVBOUJFHSFNCJVMF
QJPNCBUJ
Raggio centrale: 3$ DFOUSBUPBMQVOUPNFEJBOPEFMMBSUP
DFP: DN
Intervallo kV:
DN
Arti superiori
Fig. 2-59 "1EFHMJBSUJTVQFSJPSJ
OFMQB[JFOUFQFEJBUSJDP
Sistemi analogici e digitali: 50-65 kV
kV
N"
5FNQP
N"T
%'1
1
.
G
63
23/04/14 13.46
Laterale degli arti superiori nel paziente pediatrico
R
2
t -BEJNFOTJPOFEFMM*3TJEFUFSNJOBJOCBTF
BMMFUËFBMMFEJNFOTJPOJEFMQB[JFOUF
t 4VMUBWPMPTDIFSNJEJEFUUBHMJP
PSFDFUUPSF
EJJNNBHJOF%3
Fig. 2-60 -BUFSBMFEFHMJBSUJTVQFSJPSJ
Arti superiori
Posizione
OFMQB[JFOUFQFEJBUSJDP
t 1PTJ[JPOFTVQJOBDPOCSBDDJPBCEPUUP
EBMDPSQPQSPUF[JPOFQJPNCBUBTVMMBSFB
QFMWJDB
t *ODMVEFSFMBSUPDPNQMFUPBNFOPDIFOPOTJBJOEJDBUBVOBSUJDPMB[JPOFPVOPTTP
TQFDJĕDP
t *NNPCJMJ[[BSFDPOGBTDJBFMBTUJDBSBEJPUSBTQBSFOUFTBDDIFUUJEJTBCCJBPOBTUSP
t 'MFUUFSFJMHPNJUPFSVPUBSFMJOUFSPCSBDDJPJOQPTJ[JPOFMBUFSBMF
t 4FOFDFTTBSJPDIJFEFSFMBTTJTUFO[BEFMHFOJUPSFGPSOJSFHVBOUJFHSFNCJVMF
QJPNCBUJ
Raggio centrale: 3$ DFOUSBUPBMQVOUPNFEJBOPEFMMBSUP
DFP: DN
Intervallo kV:
DN
Sistemi analogici e digitali: 50-65 kV
kV
N"
5FNQP
N"T
%'1
1
.
G
64
23/04/14 13.46

Capitolo 2 Arti superiori

Transcript

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