Material de Apoio À

Técnicas Radiológicas II

Membros Superiores

Professora Simara Souza.

 Introdução

Este material foi elaborado com o objetivo de aplicar uma metodologia para instigar os
alunos à pesquisa, proporcionando ao discente o papel de protagonista na construção de
seus conhecimentos.
Para completar o material o aluno deverá fazer pesquisas em bibliografias da área
sugeridas pelo professor e autores de sua preferência, assistir vídeo referente aos exames
estudados.

Fonte das Imagens deste material:

1. BONTRAGER, Kenneth. Posicionamento Radiográfico e Anatomia Associada. 7 ed. Rio

de Janeiro: Elsevier, 2010.
2. Fotos das aulas práticas.

Metodologia:
A cada aula ocorrerá demonstração expositiva e dialogada pelo professor de cada
técnica de posicionamento radiológico dos exames do esqueleto apendicular;
Discussão, retificação, esclarecimento das dificuldades e dúvidas encontradas pelo
aluno na execução dos exames radiológicos estudados.
 Bibliografias Recomendadas

1. BONTRAGER, Kenneth. Posicionamento Radiográfico e Anatomia Associada. 7 ed. Rio

de Janeiro: Elsevier, 2010.

2. BONTRAGER, Kenneth. Posicionamento Radiográfico e Anatomia Associada. 6 ed. Rio

de Janeiro: Elsevier, 2006.

3. NETTER, Frank H. Atlas de Anatomia Humana. 2 ed. Porto Alegre: Artimed, 2000.

4. SOUZA, Raimundo e Henrique M. Lederman. Técnicas Radiológicas. Rio de Janeiro:

Guanabara Koogan, 2006

5. WESTBOOK, Katarine. Ressonâncias Magnética para Práticas. 2 ed. Rio de Janeiro:

Guanabara Koogan, 2000

6. MÖLLER, Tosten B. Atlas de Anatomia Radiológica. 2. ed. Porto Alegre: Artmed, 2001.

7. SOARES, José Luiz Möller Flores Et.L. Métodos Dignóstico Consulta Rápida. 1 ed. Porto
Alegre: Artmed, 2002

8. COTRAN, Ramzi S.; ROBBINS, Stanley L. et al. Patologia Estrutural e Funcional. 5. ed.
Rio de Janeiro: Guanabara Koogan, 1996.

9. STIMAC, Gary K. Introdução ao Diagnóstico por Imagem. Ed. Rio de Janeiro:

Guanabara koogan, 1994.

10. SQUIRE, Fundamentos da Radiologia

11. ROBERTA A. Noveline. 5 ed. Porto Alegre: Artmed, 1999

12. FREITAS, Leo de Oliveira. Radiologia Prática, 2003

13. SEBASTIAN. Atlas de Radiologia Torácica

14. NOBREGA, Almir Inácio da. Tecnologia Radiológica e Diagnóstico por Imagem. 2ª ed.
São Caetano do sul, SP: Difusão, 2007.

15. http://200.134.10.33/hipermidia/
 Revisão anatomia dos ossos:

1) Quirodáctilos (Dedos) e mão.

3
2 4

Visão posterior (dorsal) mão direita

 Análise de imagem:

___________________________________________________________________________
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 TÉCNICA DE QUIRODÁCTILOS:
 POLEGAR (1º dedo)
Exames de rotina: AP e Oblíqua
 Incidência AP
 Cassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
 Oblíqua
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
______________________________________________________________________________
 02
 Perfil
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Exame Complementar

 Incidência PA
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente: ______________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 03
 2º, 3º, 4º E 5º DEDOS
Exames de rotina: PA e Perfil
 Incidência PA
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Perfil
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 04
Exame Complementar

 Oblíqua (rotação medial ou rotação lateral)

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________

Oblíqua 2º quirodáctilo (rotação medial)

Oblíqua 2º quirodáctilo rotação lateral - opcional

Obliqua 4º dedo:
 05

TÉCNICA DE MÃO:
Exames de rotina: PA e Obliqua
 Incidência PA
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
OBS!!! Etiqueta p/ lado direito do paciente.
 Oblíqua
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 06
Exame Complementar
 Incidência Lateromedial – Perfil em extensão
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Exame Especial
 Incidência AP Oblíqua Bilateral – Método de Norgaard ou Posição do Pegador de Bola
 Chassi: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 07

Revisão anatomia dos ossos:

2) Punho.

5º 4º 3º 2º 1º

VISTA DORSAL (POSTERIOR)

FONTE: NETTER
 08
TÉCNICA DE PUNHO:
Exames de rotina: PA e Perfil
 Incidência PA
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
 Incidência Perfil
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________

___________________________________________________________________________
___________________________________________________________________________
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 09

Exame Complementar
 Incidência Oblíqua
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Observações!!
___________________________________________________________________________
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 Exames Especiais
 Incidência PA para Escafóide – Flexão Ulnar
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
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 10
 Incidência PA para Escafóide – Mão Elevada com Flexão Ulnar – Método de Stecher Modificado

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
______________________________________________________________________________
Alternativa:
 Incidência PA – Flexão Radial
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 11
 Incidência Túnel (ou Canal) do Carpo – Incidência Tangencial
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

 Incidência Ponte do Carpo – Incidência Tangencial

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente: ______________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 12

Revisão anatomia dos ossos:

3) Antebraço.

Figura 1. Figura 2.

Rádio e Ulna Direitos em supinação Rádio e Ulna Direitos em pronação

Mão em AP Mão em PA

FONTE: NETTER
 13
TÉCNICA DE ANTEBRAÇO:
Exames de rotina: AP e Perfil
 Incidência AP
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
 Perfil
 Chasete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________

___________________________________________________________________________
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 14
Revisão anatomia dos ossos:

4) Cotovelo.

VISTA ANTERIOR E POSTERIOR

FONTE: NETTER
 15
TÉCNICA DE COTOVELO:
Exames de rotina: AP e Perfil
 Incidência AP
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________

Suporte P/ posicionamento!!!!

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
 Perfil
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Observação!!! Diferença da posição da parte imagem 1 e 3 !! Posição do cassete!

___________________________________________________________________________
___________________________________________________________________________
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 16
Exames Complementares
 Oblíqua Rotação Lateral (=Externa)
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

 Oblíqua Rotação Medial (=Interna)

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente: ______________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 17

Exames Especiais

 Flexão Aguda – Método de Jones

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Porção distal do úmero

RC  ao úmero

Porção proximal do antebraço

RC  ao antebraço
 AP cotovelo: quando paciente não consegue estender totalmente o braço

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 18

Revisão anatomia dos ossos:

5) Úmero

VISTA ANTERIOR
FONTE: NETTER
 19
TÉCNICA DE ÚMERO:
Exames de rotina
 Incidência AP
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Perfil
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 20
Revisão anatomia dos ossos

6) Cintura Escapular.

Vista Anterior

6
5

9 10
 21

Vista Posterior

7 5

10

11

12
13

22
 TÉCNICA DE OMBRO: SÉRIE DOR

 Incidência AP do ombro Rotação interna

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/ Rotação Interna: _______________________________________________
_______________________________________________________________________________
______________________________________________________________________________
AP Verdadeiro: RC reto
AP corrigido RI : RC 15º caudal
 Incidência AP do ombro Rotação Externa
 Chassete: ______________________________________
 Dfofi: __________________________________________
 Posição paciente/ Rotação externa: _______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Raio Central: __________________________________________________________________
_______________________________________________________________________________
_____________________________________________________________________________
Respiração: _________________________________________________________________
AP Corrigido RE AP verdadeiro
 23

 Incidência Transaxilar Superoinferior em PA do ombro = hobbs Modoficado

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________
 Incidências Série Trauma

 AP do ombro Rotação Neutra

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________
 24

 Lateral Transtorácica – Método de Lawrence

 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________
 Escapular em Y - Lateral
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________
 25
 Incidência Tangencial – Método de Neer ( Túnel Supraespinal)
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
 Incidência AP Apical Oblíqua Axial – Método de Garth
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
 26

TÉCNICA DE CLAVÍCULA:

 Incidência AP
 Chassete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: ________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________
 Incidência AP Axial
 Chasete: ______________________________________
 Dfofi: ________________________________________
 Posição paciente: ______________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________
 27
TÉCNICA DE ESCÁPULA:
 Incidência AP
 Chassi: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________

Mão em supinação
 Perfil
 Chassi: ______________________________________
 Dfofi: ________________________________________
 Posição paciente: ______________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________

Corpo da Escápula Acrômio ou Processo Coracóide

 TÉCNICA DE ARTICULAÇÕES CROMIOCLAVICULARES:
 Incidência AP bilateral sem peso
 Chassi: ______________________________________
 Dfofi: ________________________________________
 Posição paciente/parte: _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________

 Incidência AP bilateral com peso

 Chassi: ______________________________________
 Dfofi: ________________________________________
 Posição paciente: ______________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
 Raio Central: __________________________________________________________________
_______________________________________________________________________________
 Respiração: __________________________________________________________________
_______________________________________________________________________________