Merrill's Atlas of Radiographic Positions & Radiologic Procedures, Vol 3

609 Pages·2003·73.27 MB·English

by  Philip W. Ballinger PhD RT(R) FAERS FASRT

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Mosby
An AffiliaotfeE lsevSiceire nce
1183W0e stliInned ustDrriiavle
S1L.o uiMsi.s sour6i3 146
MERRILL'AST LASO F RADiOORAPHICPO SITIONSA ND ISBN( Set0)- 323-01604-9
RADIOLOOICP ROCEDURES.E D \0 (VolumTew o)0 -323-01607-3
Copyrighet 20 03,M osby, IAnlclri. g htresesrv ed.
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InternationSaltand ard Book Number( Set)0 -323-01604-9
(VolumeI I0)- 323-01607-3
PublishAenrd:r eAwl len
ExecutiEvdei toJre:a nnWei lke
DevelopmeEdnittaolr Jse:n niGfeenre tMtoo rheadC.a rolKyrnu se
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SenioPrro jecMta nageMre:l isMsraa zL astarria
BookD esigMna nageGra:i Mlo reyH udson
MediclalllustraJteoarn:n Reo bertson
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25
PAULAP ATE·&'CJllODER
OUTLINE
,
ANATOMY -'>::�f
Barin
Fodre scrpiuprtpiotvshecee es n,tn rearl­ Ad eeceplf cta,l tlhleeod n gitsuudli­nal
voussy st(eemN Sis)d ievdii don ttwToh ber aiicsno mpoosfe odau ntp eorr ticousn(n iteermshiphefrsiiscu rsee)p,a rates
par(t)Ist :hb er aiwnh iocchc utphieeo sfg ramya tctaellreth dec ortaenaxd ni n­thcee rebirtnuormg i hat ndlfte hemi­
*,
cranciatavylia, n (d2 t)h sep incaodlr, nepro irotonfw h imtaet tTehrbe.r acionn s­pherewsh,i acrhce l osceolnyn ebcyt ed
whiicssh u spewnidtethdhi vene rtesbirosafttl sh c ee rebtrhuceme ,r ebealnldub ma,n odfns e rfvieb oercr osm,m isTshuer es.
caanl. thber aienms,wt hiicsch o ntiwniutolhura sg ecsotm miesb seutrwtehecene rebral
thsep icnoar(ldiF g2.5 -T1h)be.r ainshteesmmpi heirste hsce o rpcuasl loTshuem .
conss oifst thmeid brianp,o nsa,n dc orpcuasl lioassm uimd els itnruei cnt­ur
*Maniyt aleidwc oirzdasr ed efinaedtt heen d tohfe
chapter. meduolbllao ngata. freiotro ltohneg itsuudlicEnuaascl.h
Thcee rebirsu lmtra hgeep sator ftt hec erehberimpashle croen taaf uilinds- filled
braini srae nfdet roar set dhf eore braicna.v itya l cataelvrelaneltd rA ittc hldeei .­
Itssru faicsec onveodbl yus tulacnid e ncepoharsl eocnop,no rdt oifto hbner ain,
grootvhedasiti v dieit tn ol obaensld o bt­hteh alami tshtuehr dir vroeunntrdi cle.
uelsT.h ese tmleip okrttihocanot n neIcnetfrsit ootr hd eei ncepihtsah lpeio tnu itary
thcee rebtrotu hpmeo nasn cde reelblugml antdh;me a steenrd ocgrlniadn eto hfe
iste rmtehmdei dbiranT.h e ceelrleubbmo,dT yh.pe i tarugyil tarneds iidne st he hy­
ponasn,md e dlaulo blonmgaakutepta h ep ophyfssoesoaaftl h selea lt urcica.
hindbrain. Thcee reelbltuhmle,a rpgaesrtt of the
hnidbriassie np,a rfartotemhcd ee rebrum
bya deetpr vaenrscslee Tfhteh. e mi­
spheorfe sct ehrele lbueamrce o nnected
bya m edicaonn setdr iaccrtaelatl heed
vermTihsse.u f raoceft hcee rlelbcueomn ­
tainnusm ertoruasn ssvueltrcshieaa ­ ct
coufnotr c ailflutiosw aeprp earTahnec e.
tisbseutewste hecenu rvseudla crceia lled
foliTah. e pwohnisfc,roh m tsh uep per
paorftt h heid nbraitishn ce,o mmsiusorre
bridge tbhecete wreebecrneu rmleu,lbm e,
anmde dlulTah.me e dlaul,w hiecxht ends
betwtehepeno nasn sdp icnoarlfd ro,m s
thleo weri oopnfto hrhetid nbrnaA.il tlh e
fibterrab cettsw tehebenr aainnsd p inal
cord pastsh meted hulrlao.u gh
Lateral sulcus
������-- Cerebrum
Corpcuasl losum
(
)
..,.. .....
;
Cerebellum
.../ ...
Fi2g5.- 1L atesruarlfa ancdme i dsecotfbi ronan.i
2
SpinCaoldr Menniges
The outsehremacotalshlet,td h deu ra
Thes pincaodlr i s selan deeorln,g atTehdbe r aainnsd p icnoaraldr e en ocsleidn m ate(arL ti"nh,am rodt hefrro"m)ts,h e
struecc otnusriosfat nii nennrgg, r acye,l t­hrceoen tinpurootutisevmc,ee m brasnterso finbgr,oc uosv eorfit nhbger aainnd
lurls uabstwahnichceaha,s n shaopne c allemde nnigeTsh.ei nnsehre actalhle,ds picnoarlTd h.ed uria s eparfarmto ed
H
transsveteciroasnnea,d no uetrw,h iftie­t,h pei maa t(eaLrt i"tne,n mdoetrh) ei,rs "t haerc ahnobiytd hs eu bdusrpaalac en d
brosuusb st(aiFngc2se5. - a2n d2 5-3h)i.g hvalsyc aunlda r closeltoy f raodtmhh evere ernttep berrailo sbtyte huem
Thceo redx tefnrmdo tsh ber awihne,ir tet huen derblryaaiinnncdg o rsdt ructeupried.us rpaalcT eh.es spea dcoen soc to m­
icso encntetdh mete odl uloab lonagta tTah dee alticece ntsrhaeilas t hlc etadhl em untiewc iatthhve e ntrsiycsutTlehamer.
thlee vetlh feroo afm meang nutmot, h ea archdn.oT ihimse mbriassn eep aradtuaer mda tiesrc omopseodf tlwaoy ers
appiramotxlee voeftl h sep abceet wefermno thpei a mbayat c eorm ptairvaetlhyr ouigthcsor uatnp iotariloT nh.eo uter
thfier asntsd e colmnubda vre rteTbhreaw edi.es pacceal letdh seu baacrhnoliady lneierts h cer anbioantlehs su,es r ving
spicnoarled n disna p oinetxeetdmry i tspacweh,i icwshi deinne dc earrteaaaisspn. e riotsott ehueimine rnrs ruafcTeh.e
caltlheceod n muesd ullTahrfieilsut.me rT­heasree aisn ecoarfsw eidd atrhce a lliendnl earyp erro ttehcet sab nrsdapu ipno rts
minail eal c itadefie,b rosutsrt ahneadxt ­ subarachcniositdTe rhwnesi .d aerseitas t he bvleososTdeh llesa .y erh afa uolrs o
tenfdrsot mh tee rmtiinapan lad t tacthhecessi termnaag n(act iesrcnear le­bpeatrittihopanrtsio dvseu ppaonrpdtr otec­
thceo rtdo utphpece orc cysgeegamle nlto.dm eurli)lTs.ah itsr iancgauvilissati ryt t­ifoonr vtahreip oaurostft s hb er aOinne.
Thsep icnoarildcs o nnectto3e 1dp airusa tietndh e lpoowstefersor sibaoe rt weoeftn h eep atriiotntshf,eal xc ererburin,s
ofs pinnearlv eeasca,hr i in fgr otmw ot hbea soef ctehreeel blaunmtd h deo rstahlr otuhgiehen rthemisfipshseeau rnridc
rooattt hsei detsh seop fic noarlTd h.e s rufaocfet hmee dulolbal ongatpar.o vTiuhdpeep sof rrot th cee rehbermail­
neravretesr anstmhirtotueigdnh vt eetrrhs­ebu arhancosipdai ccseo ntiwniuttohhue ss pheTrheetse .n toirsiau enmt-t shaedp
tebarnasdla cfroaarml ina.n eSrpvivene anlt rsiycsutoleftam hrb e r aainncd o m­flodo fd ura setphaatrt ahcteee rse brum
belowt etrhmeio nfta htseip oicnno areldx ­muincawtiheti stt h rotuhfgeroh ma iano f ancde rleulbmeC.h anigents h neo rmal
tenidne rfitohrrloyu vgehr ttcehabenr aatllh .e fvoeunrttTrhhi vece lnet.r oiftc hlepe oss iotfti hoenssste r uecsot futirenndt iec a
Thenseer vreeessm balh eo rsteaa'insld b raainntd h seu bcahrnaosipadcc oen tapiant hoTlhodegu ayrm .a teexrt ebnedlso w
arree ferretdhc eat uode aqa usiT nhae.c erepbirnofasllu( iCdS CFS)F.i tsh tei st­hsep icnoar(ldt t ohl ee voeftl hs ee cond
pinal cnoerrdvw eoasrtn kod g ettoh seurfe ul iodft hber aainnsd p icnoarlid t;s acrsaelg metnoet n)c ltohsseep inal
tranasnmrdie tc esiesvnoer myo,t oarn,ds urroaunncddu ss htihosent sr uecsot fu nrervwehsi,ca rhpe r oloinnegfreido rly
refmleesxs atgoae nfsdr m o thber na.i thcee ntnrearlvs oyusst em. frmo thceo rtdot heriesrtp ieevcxeiT thse.
lowpeorr toifto hnde ua rm atiecsra l led
thdeu ral Thsaecc a.u edquai niase n­
clsoebdyt hdeu rsaalc .
Pons
�.h'�'--- Meduolbllao ngata
Spicnoarld
Antenreirrovoreo t
Whistueb stance
Fi2g5.- T2r ansvseercstoeifs o pni cnoarld . Fig. S2a5g-i3t tals hsoewcsitpniigo nna l
cord.
3
VentcruilSayrs tem
Eaclha tveernatlcr oincsloiefas c tesn ­Thet hdi vrentriisc sllaei e tc alviikty
Thvee ntrsiycsutleamr b roafi nt htecr opanol­r tcialolend botdhoyeft hcea viwtiyta.s h o mewqhuaatad treisrlhaalIp ites .
sitsso ff uori rraergfl,uu dli-ocntnnaigi Thbeo diyps r ongleoda nterpioosrtlesyri,itt ­euidatn h mejd sagpiltatjnauteils n ef­
cavitthicaetos m miucnawtieto hn e aonr­layni,d ne frioitrnohl oylr einp kotrionrsit ootr h lee voeftl hb eo doifte hsle a teral
other ctohnrnoeuccghthai nn(ngiFe glsst. h agti vteh vee ntrainac plopexrm iatev ent.rT ihcilse ecxatveiantndyts ee r­oinf
254-t o2 5-T6h)te.w uop pcearv iatriee ss hapTeh.ep rolopnogtreidoa nrser iofrrlotymh pei ngelanaldw ,h ipcrho ­
U
ani denptaiaicnrad l s airmecp alllyet dh ek noawsnt haen tieoprr,o stearniidfon e­r, ducaer se cess in wailltt,sot hpeo sterior
rigahntld e lfat tevreanlt rTihcelaeyrs e.r iohro rnsE.a clha tveernatlir scio cnl­oep tcihci awshmi,pc rho duarc eecsie ns s
ituaotneeod ne, a cshi doeft hmei d­necttoet dht ehd iv rentbryi ccahl aen nietls antewralol.i nferior
sagiptltaainlnte h,ie ne frimoerd ipaarlct a lletdh ien tervenftorraimceounrl a rT hei nertvecnultafrroia rmniaeo,n e
oft hceo ersrponhdeimsnpigh eorfte h ef roameonfM onoret,h rowuhgihci htf rmo eaclha tveernatlro ipceinln ett,ho e
cerebrum. commiucnadtiersew citttlhhtye h d iv rena­nterospuopretoriftio hotnerh d iv rentri­
triacnliden e dcitrwlihytt hoep polsaittc­elT eh.ce a viicsto yn tipnousootuieesnr­ f
ervaelni tcrle. riowrilttyhh f euo rtvhe ntbryia pc alse­
sagken owanst hceee rbrlaa quedourc t
aqueduScytl .vo ifu
Thfeou trhv enitcrildse i amsohnadp ed
anidls o caittne hader oefat hheid nbarin.
Bodoyf
Iitas n tetroti hoceree rbleml aunpdo ste­
latevreanlt ricle
ritootr h peo nasn tdh uep ppeorr toifo n
thmeed ulolbal onTghaet adp.io sitnatle,d
Thivredn tricle enodf t hfeuo rtvhe ntirscio cnltei nuous
Antehroironr
witthhc ee ntcraanolaft l h meed ulolb­a
longCaetrae.b iranolfs ulpid etxhiet s
.-._-,..- Posrtiehoorr n fourvtehn tritinoct lhese u bcahrnaoid
spavciteah m ee diaapne re(t oufrramoefn
Magenadnide l)ta hteearp aelr t(uofrreas­
Cerebral
aqueduct menL ushka).
Interventricular
foramen
Fig. L2a5t-e4ar sapleo cft cerveebnrtarlii nrce lleastt osi uornf oafc aebi rn.
Thivredn tricle
Antehroironr
Bodoyfl ateral
venictler
.----t,...- Infehroironr
Bodoyf
lateral Laterreacle ss
ventricle
_--7- Anterior
horn Posrtieor horn
'--�'!--I--- Inferior
horn
Fi2g5.- A5n tearsipoeroc flt a tecrearle bvreanlt riinc leFsi 2g5.- S6u pearsipoeroc fct e rebvreanlt riclest osi unr froaefcl ea tion
relattosi uornf oafbc rea in. brain.
4
PlianR adiaopghric
Afttehrce r ossl-attarebarldaeil o grRaapdhi ogorfta hspeph issn heo aullawdy s
Examniation
habse ecnh ecaknecddel arbeyad p hysbieo­ btabienfeomdry eeg lroapRhoyu.t ine
Neourriaodloagssiecs smledbn etg iscnhi oatunhf,elo o lwicnegr vsipcipanrljeo e ci­mgaeosft hvee rtceoblruamlhn ep lfaurle
witnho nnviasiimvaegg pirnocedutrieossnh.so ulodb tbaeia nnAe P,bd :it learailan s sensasrrionwdgei kdss pabceec ause
Radiogorfa pcthehsre e abnrvdasi lc erAaPlo bli(qturea tuemcah nmiaqybu ee o fd egeneorfta htdeii ospnko ,s taoitpveer
cranainudm v tehret ceoblruamlma ny bnee cesasnaadrn Ay P) ,dt eom sotnrtahtece hanigtneh sse p ineo,s taenodpo eft rosis
empyleod detmoo tnrsabtoena yn atodmeyn.As v.e rtaecrbhro,ar ll l paiiram ge, thovfee rtecbourlmanBl.e catuhsceeo n­
Int rauemdap taitzienCthsa p(5ts)ee,rt e hc ee rvsipcianlep rmioadvayed dititornaaasglte u nstesid nm yoeglrampahyy ob-
radiogroabpthasti onad eredet b eocnty i nofrmataibootnuh tpe o steproirotric ounsrsoe m aen omanloine-sc,os nptirnaaslt
inrjyus,u bluxoardt ilisoocna,ot fti hoeno ft hcee rvviecratle( bsrCeaheea p8t)e.ir am gecso mpletmhmeeyn etl ogerxa­phic
vertceoblraualmnt ndod etertmheiexn ­eA nu prilgahttec rearlvs ipciarnlaei d ­amniatiaonnodf tperno vaidddei tional
teanntsd t laybio itf btohneijy nu ry. ogrampahya lsboer equetsobt eetdt ienorfr mation.
Foart raumaptaitziweeidntp tho ssidbelmeo antsaetl rignomfte hnvete rtebrRaoeu tsiknueil mglae ssh oubleod b ­
CNSi nvolvaec mreonstsl-,at taceberlraea­l n tdo a sstehsneso rmlaolr dcoutrivcta a­iwnheedtn hp eos silibtoiyfa s kluflr ­ac
vicsaplir naed iosghroauplhod b taitnueordfet hsep ine. tureexs it.s tIrna upmaat iae cnrtoss s­
be
t rtuol ef rtoauucortrem isganlmieonft Tomogrampahyby e u setdos uppltea­blltaee ralu proirlg tahetr kalu ll
fir
thcee rvsipciAanplepo .rx imattweol tyh miernidtms a goefts hs ep ifnoierin tsicarle erna­diomgursabtpeoh b tationde edm on­
ofs iginciapfnatt hocloongdiicat ffieocnitsn­p gu rpo(sseCeshe a p3t2e)Hr.o wevesrt,ra ai-trfleu liedv ientl hsse p hensoii­d
intgh sep icnaen d eteocntt ehidin si ttioamlo grhaapsh ylb aeregnre elpylb ayc endu Isnm.a niysn tantcheeassri e-u fillde v­
be
iamgCea.r meu stt akteodn e moantsetc romputed t(oCmTio)mng a rnaiypn hsyte ilm­sa yb et hien iitnidailc oafat ion
be
theen etc ierrvsipciaandlee quiantcelltuyud,t­ (isoCenhesa p3t3eT)rom. o grampahyyb asislukalfrlr t aucrIena. d ditsuikloln,
intghC e7 -IT tairculImatat yi onnec.e bse­e mlpoyteod demolnosnctgor,na ttiienam ­geasrh ee lpifnu gldn ioasriecnatgi ve
be
sartyoe mpltohyTe wi ni(nSgw iemrmsu)o uasr eoafts h sep iDnsiea.d vanotfa bgoenfsero matiaonngd e nearelartla tiino ns
meth(eo edC hap8t)te odr e motnrsattheit so mogrianupcdhley l tahocefks o tfsitu et hsek ursleull gt ifrnvoamr oiafep t ayt ho­
anatroemigiorcna dipohgircaally.d etaanitdlh dei fficiunpl otsyi tai olnoigncigoc n diitinocnlgsu P,da itgne'dsi s­
trauemdpa attifizoelrnta ter al tomeoagsrfeai,pb hrdioycus sp ,lh aesmiaangiomas,
radiographs. ancdh anigtneh ssel ea lt urcica.
5
Myeloapghry Mosmty eglroaamrspe e rfoomnla end C ONTRASMTE DIA
Myeloagprh(yG remeyke,l "omasr,r oowu;t patient barseicso,v eAwr initonhng w -apstaoetlriiueobnndltaiest,e e sdt (eoir­
thsep icnoadr"l)i st hgee netrearalmp ­foarp pirmoaxt4e tlo8y h ouartfset rh ep hend[yaPlnattoep] aw)qa uisen otdruced
piletdo r adioelxoagmiicn oaftt hieop nr oucereb defobreeir negl etaors eetdu irn1n4 92. Beicta ucnsooebut ela dbs orbed
CNSs truecsst uiuatrtweidt thhivene rtheo­me.m anIpyna rotfts h ceo uyn,ht orw­byt hbeo dtyh,i lpsii da-sbecdo ntt ra
brcaaln Tahlie.sx aminiapste irofnor emveemdra ,g nerteisco niamnacge(i MnRgI m)ed iurmeu qierd repmoopsvrtao lc edure.
byi tnrdoucaic nogn tmreaidsutimt n ot he( eseC hap3t6eh)ra a sgr elylr eplmaycee­Fdr equseonmtcelo ynt rreamsatii nnteh de
subcahrnaosipda bcyes pipnuanlc tluorger,aM pyhegylr.oa pchoyn titon utbehesec anaanlcd a bnes eeonnn on-cornat­rast
moscto mmonlLy2 a-otLrL 3 3t 4-hi eLn ­prefeerxraemdi nmaettihfooondr asdsieoasgpsrh­sp aotfi wehnoht astd h mey ­
tersopraa ttc hece it sernmaa gbneat weienng ddieisassikepn ta iesnw tictohn atirndeiol­grapprhoyc ebdeufroterh ieetn roc­du
C aIn tdh oec cibpointea.l catitooMn Rsl s ucahsp acemaokre trisoo fnt hnee werd imulemo.p haetned yl
meatlcpl oistsepriifnouarsl ri oodns . wauss eidnm yeglroapfhoyr many years
Myeglroapihsey m plotyode edm onb­uitsn ol oncgoemrm ceiraalvlayi lable.
streaxtterc i snpsiicnoarlcd o mpresTshiefo inrw satts eorl-unbolnei,o inoidci,­
causbeyd h aen riteadd iks,b onfer agn­atceodn targaesntt , mewtars­i zianmide,
men,to r t umoarsws e,la lss picnoarldt roduicnte hdle a te I 970s. Thereafter,
swelinlrgse ulgtf riontmr aumijanutyir.cw atoelru-csbolnett ram eqduiiac kly
be­
Theseen ocarhcmenatpsp eraard icoa­mteha eg eonfct hso iNcoen.i ownatei­rc,
grhaipcaasld leaoyf r miitnth yse u rbaachs­olucbolnetm readspitra o vgiodovedi su­
nosipda ocre o abns trouftc htpeia osns aagilez atoifno enr rvoeo (tiFsg 2.5 -a7n)d
oft hceo luomfcn o natsmrte idmu withgiono edn hancfeomfrelo onlwt- uCpTo f
thseu rbaahcnosipda Mcey.eo lgraipsht yh sep inea.d diIttnih eoasnge,e natrse
alussoe ifniud le ntifwyiinongfgt h nera edrairalobys orbbye bdto hdeOy n.ed s iad­
subcahrnaosipdabc yee valutahdteyi ­nvga ntoafmg eet rizwaamisit tdsee n dency
namfliocpw attoeftr hnCesS F. tobe a bsovrebredy lqyTu.hi ecrkerfao­re
doigrawpehrsre eu qiedr btepo r oduced
promapntadlc yc urately.
Fi2g5.- M7y elogursaimwn agt -esrolcuobnl­e
tramsetd i(umme trizNaemrivrdeoeo )st.es e n
ata rorws,
6
Further rteots heietan rrdcouhc tliPeoRdnEA PRATIOONF E XAMIINNG Thes pinpauln cet aunrdc onatsrt
ofi pmrovneodn iwoantiseclor bu lceo ­nROOM mediuimn jeacrtpeie ornf oirtnmh ere­da
traasgte nstusca hsi oheixoopldarni,o lO,n eof t hrea diogrraeopsnhpseiirt'biside liso ldoegptyam renUtn.d efrlu oroscopic
anido veirnts homeli d18 90sI.mp roviest­o p reept ahreex ajmngir noobme foorbes aetrivpolcnae,m eonftt h 2e0 -to2 2-
menitnnso nicoonnitcr ashta vraeeg ­tehnpeta sit enatr'arsli Tv.h er adiogrgaapuhsgipeci nneaeldi lnte hs eu barachnoid
sueldit fnwe esri edfeefc tCso.ne que,n etqluyipsmheonubtle cd h eckBeedc.a usspea icse vearnitdfh cieoe nadts,mrt e dium
thehya vbee cotmhepe r efecrornetdrt ahspetr oceidnuvroeal sveeptste icch niiqsiuj nee,c tTehdes .t etrriaalnyetd h e non­
medifao bro tcho nvenatnidCo Tn atlht ea balnoedv erheeqaudi pmmuesbntet s teirtielrmees q ufiortreh idin sii aptlr o­ce
myoeglra(piFhg2y.5 -8). cleaTnhefedo .o tbsohalorbudde a ttacdhueerd s ohulbde r eadfyoc ro nnvieent
tot htea balnetd,h p ea ddheodu lsdueprp­ lacement.
porstohsu lbdep alceadn rde afdoyar d ­
jsutmetnott hp ea tiheenitgT'hhstei . m­
agien tensshiofubielle dor c skoet dh iatt
cannaoctcn itdaeclolmyie nc o ntwaictth
thsep inneaelad nldes/ tolerfier e ild.
Fi2g5.- L8a teral porflo ujmebcsatprii onne
myelogursaimwn agt erl-usbcoloen trast
mediu(mi ohexol).
7
EXAMINTAIOPNR OCDEURE Scoiumta giensuc,dl ianc gr otsasb lues etdod emotnrsatceo ntmuhesed ullaris.
Permedicoaftt hpieao tnfi oemrny toe glral­atlemurbaalsr p ipnreo neo,f tareren­eF otrh tihspe a tiipsel ncatei dnt hAeP p o­
phiyrs a lryne ecesTshapera yt.si oheunltqd u tee Sdo.m pehy sincspi raetfoeh ra ves itwiiottnhhc e e nrtarcyae len rtetdTo1 -2
bew ehlyld rahtoewde,bv eecr,aa un soen ­thpea tpialecneotdn ttahbeil tneh p er onLeI A. 2X4 3 0c m( Olx 1i2n ccha)s sette
ionwiact,e lrbu-lsceoo tnramsetd iiusmp osiftoitroh nse p ipnuanlc tMuanrye,.i su seCdr.so st-abllaet erraadli ographs
useTdor. e duapcpeer neshainopdnr evehnotw e,vh earvtehp ea tiajeduntste dt hiena re obwtiatgirhn-fi erddoc nats soerat tes
alaartum n peecxtmeadn veeudrus rtihnegl atpeorasliw tiittohhns e p iflneex teod s tatriygo rnitadh;em yu sbtec lsolecyo lli­
procedtuhrreea ,d iogsrhaopeuhxlepdrl awiindt ehnie tn esrpinsopuascf eoesra simeart (eiFdg 2s5.-t 9o2 51-)3.
thdeea tiolfms y eglroapthoty h pea tiienrnottd ucotfti hnoeen e dle. Thpe osiotfti hopena tiheenamtdu' sst
beftohreeex aminbaetg.iiT onhnpe a tieTnhtep hysiucsilualawnyti hdrCaSwFsb eg uradeadst hceo ntcroalsutnm ena rs
houbleid no rfmtehda ta ntghuelo aft fioolrbna o raatnoarlyay nsdi ss ilnojweltcyht cese rvaircetaaopl r evtehnmeted ium
theex amitnaibnwlgie rl elp delaatyne da popxrima9t teol1 y2m lo fc otnrafsrto pma ssiinnttghoc e e revbernatlr icles.
acultcyeh anTghepe.a i tesnhto aullsdo mbedei uAmft.e cro mpltehtieijn negc tiAocneu,e t xtenosfti hohene acdo mpresses
towlhdty h hee amdut maintiaani ntehde phryesmioctviheasesnp innealeled .t hcesi temrangaan natd h purse vfeunrt­s
be
fluleyx tenpdoesdiw thieotnnh t ea bleT raiovsef tl hc eo ntmreadsitcu oml uimsnt hears coefntt hm eed iuBme.c atuhsee
tiedlt tot hTeer ndeulrepgno bsiTthieoo nb.s eravncedod n trflooulrloesidcc loa.ypl csitemrangain ssai tteupdao sitoernrliey­,
radiogmruaspptrh ioedvrae s surtahnacAten guloaftt hiteoa nba llleo ws gtroat vhifertorwy a nrodlr a tfleerxailot hnhe e oafd
thpea tiweinltla fweh etnh tea bilsed ierct ctohnett rota hsaetr eoafi tnerecsotm.p rtehscesie esrstn al cavity.
be
acutaenlgayln etddh eavte rnygpt ohsisiSbploietam geasrt ea ktehnr outghhpeor uot­ Aftecro mploeftt ihpoern o cetdhuer e
wibledl o nteoa vociadu suinenncge sscaerdyuT rheer. a daipohgoerbrt aiiamngse sp atimeunsbttem ontoirienad na ppropri­
dic omfort. att hlee voefal n byl ogceok rad sitortaitroeen c oavreerMayo. sp thy sicrieacnosm ­
in otuhitenl oef t hceo ntcroalsutm mne.nt dh tahtpe a tiheenaatdn's dsh oulders
Convenrtaidoinoaglsr taupdhwiiiects bh,e e veal3t0e dt doe g4r5e es during recov­
thcee ntrradayiel rc tveetdri coarhl olryie ­rBye.rd e st fohro usiresrsve ec­roaml
zontmaalybl eyp ,e rfoarsrm eeqd uesmteendda endfld uidasr een caoguerTdh.e
byt hreai doloTghiceso tnpu.ros j cetiiosnp unces tiutreb eem xuasetmd ib neftohree
patiiresen lte farmso tehdre e coavreeray.
Fi2g5.- L9u mbmayre log: ArPap mrojec­Fi2g5.1- 0C ervimcyaell ogArPap mr:o jection
tiwoint nho n-w-aostleurbiloed incaotne­d showisnygm menterrirvcoe o (tasr roawnsda) x il­
tramsetd iusmh.o wianxgi lploaurcyh es laproyu ch(eaos)n b oth saiswd eelaslss. p inal
andc orrespnoenrdrvioeno g(t asrw r).o cord.
8