Abstract:
Novel devices and apparatus are provided to support the arms of a person when lying in the prone position. In preferred embodiments, an arm supporting apparatus comprises an elongate center panel with a generally planar top surface, a first arm board connected to the center panel at one end, and a second arm board connected to the center panel at a second end. In some further embodiments, the first and second arm boards are adapted to swing or pivot from an extended position whereby the arm boards are generally level with the center panel to a lowered depressed position. In yet further embodiments, the arm boards may curve or slope upwards at their distal ends helping to secure a person&#39;s arms and prevent them from falling off of the boards.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims priority to and the benefit of the filing date of U.S. Provisional Application No. 61/924,414, filed on Jan. 7, 2014, entitled “SURGICAL BED ARM SUPPORT FOR PRONE PATIENTS”, which is hereby incorporated by reference in its entirety. 
     
    
     FIELD OF THE INVENTION 
       [0002]    This patent specification relates to the field of devices for supporting or stabilizing a portion of the human anatomy during procedures and therapies. More specifically, this patent specification relates to rotating arm boards for supporting a patient&#39;s arms in the prone position. 
       BACKGROUND 
       [0003]    During medical procedures and therapies, a patient may be asked to lie in a prone position for extended periods of time on an examination or therapy table. Currently, there are several medical examination tables with arm boards configured to support an arm or another body part of a patient. These medical examination tables are constructed with built in arm boards, but these solutions fail to meet the cost effective needs of the market because the cost of these medical tables are typically very expensive and their unitary construction makes them difficult to repair them should a component fail. 
         [0004]    Other attempts at providing arm supporting structures include separate arm boards that attach to medical examination tables post retail, but, these structures are similarly unable to meet the needs of the market because they must be clamped on to the table which limits the position of use. In addition, the clamping mechanism is often proprietary which further limits the breadth of use on various tables. 
         [0005]    Still other attempts at providing arm supporting structures consist of arm boards that do not clamp or bolt on to the table. These structures are often wedged under portions of the patient with the patient&#39;s own body weight holding them in place. In some instances the patient may inadvertently move their body which may result in the supporting structure becoming unbalanced and falling. These arm supporting structures fail to meet market needs because they lack stability. 
         [0006]    Therefore, a need exists for novel supporting structures and apparatuses that serve as an efficient, cost-effective board for supporting a patient&#39;s arms during medical procedures and the like. There is a further need for novel supporting structures and apparatuses that are not limited in the position of use by being clamped onto medical examination tables. Another need exists for novel supporting structures and apparatuses that do not require a proprietary clamping mechanism which limits the breadth of use on various tables from different manufactures. 
       BRIEF SUMMARY OF THE INVENTION 
       [0007]    Novel devices and apparatus are provided to support the arms of a person when lying in the prone position. In preferred embodiments, an arm supporting apparatus comprises an elongate center panel with a generally planar top surface, a first arm board connected to the center panel at one end, and a second arm board connected to the center panel at a second end. In some further embodiments, the first and second arm boards are adapted to swing or pivot from an extended position whereby the arm boards are generally level with the center panel or in a lowered or raised depressed position. In yet further embodiments, the arm boards may curve or slope upwards at their distal ends helping to secure a person&#39;s arms without the need for restraints and prevent them from falling off of the boards. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0008]    Some embodiments of the present invention are illustrated as an example and are not limited by the figures of the accompanying drawings, in which like references may indicate similar elements and in which: 
           [0009]      FIG. 1  depicts a perspective view of an example of an arm support apparatus for prone patients shown in the extended position according to various embodiments described herein. 
           [0010]      FIG. 2  illustrates a perspective view of an example of an arm support apparatus for prone patients in a downward folded or lowered depressed position according to various embodiments described herein. 
           [0011]      FIG. 3  shows a perspective view of an example of an arm support apparatus for prone patients shown in a partially folded position according to various embodiments described herein. 
           [0012]      FIG. 4  depicts a perspective view of an example of an arm support apparatus for prone patients shown in an upward folded position according to various embodiments described herein. 
           [0013]      FIG. 5  illustrates a plan view of the bottom of an example of an arm support apparatus for prone patients in an extended and locked position according to various embodiments described herein. 
           [0014]      FIG. 6  shows a perspective view of an example of an arm support apparatus for prone patients in an extended and locked position supporting the arms of a patient according to various embodiments described herein. 
           [0015]      FIG. 7  depicts a perspective partial view of an example of an alternative embodiment of an arm support apparatus for prone patients. 
           [0016]      FIG. 8  illustrates a sectional, through line  8 - 8  shown in  FIG. 2 , elevation view of an example of an arm board with cushion pad according to various embodiments described herein. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0017]    The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well as the singular forms, unless the context clearly indicates otherwise. It will be further understood the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. 
         [0018]    Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one having ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and the present disclosure and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein. 
         [0019]    In describing the invention, it will be understood that a number of techniques and steps are disclosed. Each of these has individual benefit and each can also be used in conjunction with one or more, or in some cases all, of the other disclosed techniques. Accordingly, for the sake of clarity, this description will refrain from repeating every possible combination of the individual steps in an unnecessary fashion. Nevertheless, the specification and claims should be read with the understanding that such combinations are entirely within the scope of the invention and the claims. 
         [0020]    New patient support devices and apparatuses are discussed herein. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the present invention. It will be evident, however, to one skilled in the art that the present invention may be practiced without these specific details. 
         [0021]    The present disclosure is to be considered as an exemplification of the invention, and is not intended to limit the invention to the specific embodiments illustrated by the figures or description below. 
         [0022]    The present invention will now be described by example and through referencing the appended figures representing preferred and alternative embodiments.  FIG. 1  illustrates an example of an arm support apparatus for prone patients (“the apparatus”)  100  according to various embodiments. In this example, the apparatus  100  comprises a center panel  11  rotatably coupled to two arm boards  21 . The arm boards  21  may each be configured to rotate or swing about a hinged coupling  16  and to temporarily lock in an extended position ( FIGS. 1 ,  5 , and  6 ) with the arm boards  21  in the same general plane as or co-planar with the center panel  11 . The apparatus  100  may be positioned beneath a patient and/or under a bed or cushion that may be supporting the patient with the center panel  11  positioned below the patient&#39;s back, shoulders or chest, and the arm boards  21  may be positioned in the extended position and one or both of the patient&#39;s arms may be placed on and supported by an arm board  21  ( FIG. 6 ). When not in use, the arm boards  21  may be rotated about the hinged coupling and out of the extended position and into another position such as a raised position ( FIG. 4 ) or a lower depressed position ( FIG. 2 ). In one example of the principled disclosed herein, the apparatus may be removably affixed to the examination table through standard devices, such as bolts or clamps. In other examples, the apparatus may be held in position by the weight of the patient alone. 
         [0023]    Referencing now to  FIG. 1  and  FIG. 5 , a center panel  11 , a first arm board  21 , and a second arm board  21  may each comprise a generally planar rectangular shape with a height dimension that is substantially less than the length dimension and the width dimension. It should be understood to one of ordinary skill in the art that in other embodiments, a center panel  11 , a first arm board  21 , and/or a second arm board  21  may be configured in a plurality of sizes and shapes including “T” shaped, “X” shaped, square shaped, rectangular shaped, cylinder shaped, cuboid shaped, hexagonal prism shaped, triangular prism shaped, or any other geometric or non-geometric shape, including combinations of shapes. In further embodiments, a center panel  11 , a first arm board  21 , and/or a second arm board  21  may be configured in curved or uncurved shapes such as a Saddle surface with normal planes in directions of principal curvatures, Gaussian curvature, hyperboloids, and the like. It is not intended herein to mention all the possible alternatives, equivalent forms or ramifications of the invention. It is understood that the terms and proposed shapes used herein are merely descriptive, rather than limiting, and that various changes may be made without departing from the spirit or scope of the invention. 
         [0024]    In preferred embodiments and as best shown in  FIG. 1  and  FIG. 5 , a center panel  11  may comprise a generally planar center panel top surface  12  and an opposing generally planar center panel bottom surface  13 . Preferably, the center panel top surface  12  may be positioned below the patient&#39;s back, shoulders or chest, while the center panel bottom surface  13  may contact an examination table or the like. In some embodiments, the center panel top surface  12  and the center panel bottom surface  13  may be textured with a pattern such as grooves, waves, circles, lines, or any suitable pattern to increase the friction between those surfaces and the table or pad and help prevent slippage and movement. In yet further embodiments, the center panel top surface  12  and the center panel bottom surface  13  may be coupled to or coated with a non-slip material such as rubber or foam matting. A first center panel end edge  14  ( FIGS. 2 ,  4 ,  7 ) and a second center panel end edge  14  ( FIGS. 2 ,  4 ,  7 ) may be located generally parallel and opposite to each other, along the width dimensions of the center panel top surface  12  and the center panel bottom surface  13 . A first center panel longitudinal side edge  15  and a second center panel longitudinal side edge  15  may be located generally parallel and opposite to each other and generally perpendicular to the first center panel end edge  14  and the second center panel end edge  14 , along the length dimensions of the center panel top surface  12  and the center panel bottom surface  13 . In some embodiments, all or portions of the first center panel end edge  14 , the second center panel end edge  14 , the first center panel longitudinal side edge  15 , and/or the second center panel longitudinal side edge  15  may be rounded, beveled, angled, curved, or the like to facilitate the positioning of the center panel  11  under a patient or under the pad of an examination table. 
         [0025]    Also in preferred embodiments and as best shown in  FIG. 1  and  FIG. 5 , an arm board  21  may comprise a generally planar arm board top surface  22  and an opposing generally planar arm board bottom surface  23 . Preferably, the arm board top surface  22  may be positioned below the patient&#39;s arms, while the arm board bottom surface  23  may be orientated towards the floor, an examination table, or the like. An arm board proximate end  24  ( FIGS. 2-4 ) and an arm board distal end  25  may be located generally parallel and opposite to each other, along the width dimensions of the arm board top surface  22  and the arm board bottom surface  23 . A first arm board longitudinal side edge  26  and a second arm board longitudinal side edge  26  may be located generally parallel and opposite to each other and generally perpendicular to the arm board proximate end  24  and the arm board distal end  25 , along the length dimensions of the board top surface  12  and the board bottom surface  13 . In some embodiments, the arm board  21  may comprise a first arm board longitudinal side edge  26  and a second arm board longitudinal side edge  26  positioned opposite to each other with the arm board longitudinal side edges  26  being substantially linear proximate to the center panel  11  and non-linear proximate to the arm board distal end  25 . In some embodiments, all or portions of the arm board proximate end  24 , the arm board distal end  25 , the first arm board longitudinal side edge  26 , and/or the second arm board longitudinal side edge  26  may be rounded, bent, beveled, angled, curved, or the like to facilitate the positioning of the arm board  21  under a patient or under the pad of an examination table. 
         [0026]    As shown in  FIGS. 1 ,  5 , and  6 , the apparatus  100  may assume an extended position when the first arm board top surface  22  and the second arm board top surface  22  is substantially co-planar or level with the center panel top surface  12 . In some embodiments, the arm board  21  may be substantially co-planar, level, or considered generally in the same plane as a center panel  11  when portions of the arm board  21  such as the arm board top surface  22  are within plus or minus ten degrees to portions of the center panel  11  such as the center panel top surface  12  about the y-axis of rotation (see  FIG. 2 ) provided by the hinged coupling  16 . 
         [0027]      FIG. 2  illustrates a perspective view of an example of an arm support apparatus for prone patients  100  in a lower depressed position according to various embodiments described herein. In this embodiment, both arm boards  21  of the apparatus  100  have been rotated so the arm board distal end  25  of each arm board  21  is generally positioned the farthest distance from the center panel top surface  12 , having been rotated about the y-axis provided by the axis of the hinged coupling  16 . While the apparatus  100  is preferably removably positioned under portions of a patient&#39;s upper torso on an examination table, the arm boards  21  may be rotated at the hinged coupling  16  allowing the apparatus to assume a lower depressed position. The arm boards  21  may be maintained in a lower depressed position through the action of gravity, or the hinged coupling  16  may be configured to arrest the rotation ability by a mechanical or electrical locking method. Further, the arm boards  21  may be rotated completely underneath the center panel  11 , on top of the center panel  11  (as illustrated in  FIG. 4 ) or at intermediate positions (as illustrated, for example, in  FIGS. 2 and 3 ). The mechanical or electrical locking mechanism or method may be configured or programmed to arrest the arm boards  21  at any desired location with respect to the y-axis of rotation—e.g., anywhere from 180 degrees (rotated completely on top of the center panel) to −180 degrees (rotated completely underneath the center panel  11 ). During procedures, the arm boards  21  will typically be rotated to about 0 degrees—i.e., extending substantially parallel or co-planar with the top or bottom surface of the center panel  11 —though a slight downward rotation—e.g., about 10 or 20 degrees—may provide increased comfort for the patient. 
         [0028]    As shown in  FIG. 2 , an apparatus  100  may assume a lower depressed position when the first arm board top surface  22  and the second arm board top surface  22  is substantially perpendicular to the center panel top surface  12 . In some embodiments, an arm board  21  may be substantially perpendicular to a center panel  11  when portions of an arm board  21  such as the arm board top surface  22  are rotated to within about 80 to 100 degrees from being parallel to the center panel  11 —i.e., pointing substantially downward toward a floor surface. 
         [0029]      FIG. 3  shows a perspective view of an example of an arm support apparatus for prone patients  100  transitioning along the y-axis between a raised position and an extended position according to various embodiments described herein. In this embodiment, both arm boards  21  of the apparatus  100  have been rotated along the y-axis provided by the hinged couplings  16  so the each arm board  21  is generally not positioned in the same plane or not co-planar as the center panel  11 . One skilled in the art will immediately recognize that the arm boards  21  may be rotated independently from each other around the y-axis provided by the hinged couplings  16  allowing the arm boards  21  to be oriented in a plurality of positions from each other and from the center panel  11 . 
         [0030]      FIG. 4  depicts a perspective view of an example of an arm support apparatus for prone patients  100  in a raised position according to various embodiments described herein. In some embodiments and in the present example, one or both arm boards  21  may be rotated about the y-axis at the hinged coupling  16  so that an arm board top surface  22  of an arm board  21  may be brought in close proximity or in contact with a center panel top surface  12  of a center panel  11  allowing the apparatus  100  to assume a raised position. The raised position may facilitate the storage of the apparatus  100  by allowing the apparatus  100  to occupy a smaller storage footprint than the extended position ( FIGS. 1 ,  5 , and  6 ). 
         [0031]    In preferred embodiments, the hinged coupling  16  may comprise a piano hinge which may be formed with one or more portions of an arm board proximate end  24  of which are configured to interlock with one or more portions of a center panel end edge  14 , thereby forming a rotatable coupling or bearing which connects an arm board  21  to a center panel  11  and that is configured to allow an angle of rotation around the y-axis between the arm board  21  to a center panel  11 . In other embodiments, the hinged coupling  16  may comprise a butt hinge, barrel hinge, butt/Mortise hinge, case hinge, flag hinge, strap hinge, H hinge, HL hinge, piano hinge, butterfly hinge, flush hinge, barrel hinge, concealed hinge, continuous hinge, T-hinge, strap hinge, double-acting hinge, Soss hinge, counterflap hinge, flush hinge, coach hinge, rising butt hinge, double action spring hinge, tee hinge, friction hinge, security hinge, cranked hinge or storm proof hinge, lift-off hinge, self closing or self positioning hinge, flexible material hinge, or any other type or style of hinge suitable for pivotally joining an arm board  21  to a center panel  11 . 
         [0032]      FIG. 5  illustrates a plan view of the bottom of an example of an arm support apparatus for prone patients  100  in an extended position with the center panel bottom surface  13  and the board bottom surfaces  23  of the two arm boards  21  visible according to various embodiments described herein. In various embodiments and as shown in  FIGS. 2-5 , the apparatus  100  may comprise one or more locking mechanisms such as a lock tab  30 A and a lock tab guide rail mechanism  30 B which may be configured to temporarily arrest the pivoting ability of the arm board  21  relative to the center panel  11 , thereby securing the arm board  21  into an extended position. A locking mechanism such as the lock tab  30 A may be configured to slidably engage between two lock tab guide rails  30 B. The lock tab  30 A may be slidably coupled to the arm board  21  and may be configured to slide within a channel optionally formed by the two lock tab guide rails  30 B. The lock tab guide rails  30 B may be permanently coupled to or integrally formed within an arm board bottom surface  23  with a lock tab  30 A configured to slide within a channel formed by two lock tab guide rails  30 B. By sliding the lock tab  30 A into and across the axis of rotation provided by the hinged coupling  16  and into contact with portions of a center panel bottom surface  13  as shown in  FIG. 5 , the rotational ability of the hinged coupling  16  and the arm board  21  may be mechanically arrested. By sliding the lock tab  30 A out of the axis of rotation provided by the hinged coupling  16  and withdrawing the lock tab  30 A from contact with portions of a center panel bottom surface  13 , the rotational ability of the hinged coupling  16  and the arm board  21  may be restored. 
         [0033]    In some embodiments, the lock tab  30 A may be slidably coupled to the arm board bottom surface  23  and the lock tab guide rails  30 B may be permanently coupled to or integrally formed within a bottom surface of a center panel bottom surface  13 . In other embodiments, a lock tab  30 A may be slidably coupled to the center panel bottom surface  13  and the lock tab guide rails  30 B may be permanently coupled to or integrally formed within an arm board bottom surface  23 . 
         [0034]    In some embodiments, when slid into and across the axis of rotation provided by the hinged coupling  16  and into contact with portions of the center panel bottom surface  13 , the lock tab  30 A may be configured to support the arm board  21  in an extended position with the arm board  21  in generally the same plane as the center panel  11  (i.e., co-planar) as shown in  FIGS. 1 ,  5 , and  6 . In other embodiments, when slid into and across the axis of rotation provided by the hinged coupling  16  and into contact with portions of the center panel bottom surface  13 , the lock tab  30 A may be configured to support the arm board  21  in an extended position with the arm board  21  in generally above or below the plane of the center panel  11 . 
         [0035]    As perhaps best shown in  FIGS. 1-4  and in the embodiments described herein, the arm board distal end  25  of the arm board  21  may be curved towards the arm board top surface  22  of the arm board  21 . In other embodiments, the arm board distal end  25  of the arm board  21  may be curved towards the board bottom surface  22  of the arm board  21 . In alternative embodiments, the arm board distal end  25  of the arm board  21  may be angled towards the arm board top surface  22  of the arm board  21 . In other alternative embodiments, the arm board distal end  25  of the arm board  21  may be angled towards the board bottom surface  22  of the arm board  21 . 
         [0036]    In one example, a substantial portion of the arm board top surface  22  may be generally planar so that when the apparatus  100  is in the extended position ( FIGS. 1 ,  5 , and  6 ), a substantial portion of the arm board top surface  22  of the arm boards  21  and the center panel top surface  12  of the center panel  11  are in generally the same plane, while portions of the arm board top surface  22  including the arm board distal end  25  may be raised slightly above the substantial portion of the first and second arm board top surface  22  that are planar. In some embodiments, a substantial portion of the arm board top surface  22  may comprise between 51% to 100% of the arm board top surface  22  as generally planar so that when the apparatus  100  is in the extended position, the majority of the arm board top surface  22  of the arm boards  21  and the center panel top surface  12  of the center panel  11  may be in generally the same plane. In other embodiments, 1.0% to 51% of the arm board top surface  22  may be generally planar so that when the apparatus  100  is in the extended position, 1.0% to 51% of the arm board top surface  22  of the arm boards  21  and the center panel top surface  12  of the center panel  11  may be in generally the same plane. 
         [0037]      FIG. 6  shows a perspective view of an example of an arm support apparatus for prone patients  100  in an extended position supporting the arms of a patient  200  according to various embodiments described herein. As perhaps best illustrated by  FIG. 6 , portions of a center panel  11  may be positioned under the upper torso of a patient  200  and preferably removably positioned on top of a table such as an examination table  300  and under a covering such as an examination table pad as shown by  FIG. 6 , disposable sanitary covering, or the like. When positioned in an extended position, with the first arm board top surface  22  (FIGS.  1 , 2 , 3 , 8 ) and second arm board top surface  22  substantially co-planar with the center panel top surface  11 , the patient&#39;s chest or back may rest on or above the center panel top surface  11  while the patient&#39;s first and/or second arm may be supported by the first arm board top surface  22  and/or second arm board top surface  22 , respectively. In some embodiments, the weight of the patient&#39;s torso and/or weight of the person&#39;s arms may facilitate the stable engagement of the apparatus  100  to a patient support structure such as a medical examination table. 
         [0038]      FIG. 7  depicts a perspective partial view of an example of an arm support apparatus for prone patients  100  comprising a hinged coupling  16  which is rotatably coupling an arm board  21  to a center panel  11  according to various embodiments described herein. In this alternative embodiment, the hinged coupling  16  may be configured to rotatably couple the arm board  21  to the center panel  11  and also to temporarily arrest the rotational ability of the arm board  21  relative to the center panel  11 . The hinged coupling  16  may comprise a locking mechanism such as an offset tab  30 C which may be temporarily inserted into a tab slot  30 D. The portions of the hinged coupling  16  may be configured to be rotatably coupled and slidably coupled within a coupling channel  31  which may be joined to a center panel longitudinal side edge  15  and/or a center panel end edge  14 . By sliding the arm board  21  towards the center panel  11 , portions of the hinged coupling may slide within the coupling channel  31  and the offset tab  30 C may be inserted into the tab slot  30 D which may inhibit the rotational ability of the hinged coupling  16 . By sliding the arm board  21  away from the center panel  11 , portions of the hinged coupling may slide within the coupling channel  31  and the offset tab  30 C may be freed from the tab slot  30 D, thereby restoring the rotational ability of the hinged coupling  16 . 
         [0039]      FIG. 8  illustrates a sectional, through line  8 - 8  shown in  FIG. 2 , elevation view of an example of an arm board  21  according to various embodiments described herein. In some preferred embodiments, an arm board top surface  22  of a first arm board  21 , an arm board top surface  22  of a second arm board  21 , and/or a center panel top surface  12  ( FIGS. 1-5 , and  7 ) may comprise a cushion pad  17  or other suitable cushion layer. A cushion pad  17  may cover all or portions of an arm board top surface  22  or a center panel top surface  12  and may be configured to absorb impacts or provide a resilient cushioning layer between a patient and an arm board  21  or center panel  11 . In some embodiments, a cushion pad  17  may comprise a cushion layer  18  such as neoprene foam. In other embodiments, a cushion pad  17  may comprise a cushion layer  18  such as silicone rubber, silicone foams, rubber foams, plastic foams, latex foam rubber, polyurethane foam rubber, or elastomer materials such as elastic plastics, elastic silicone, elastic rubbers, silicone rubbers, or any other suitable elastomer or resilient material. 
         [0040]    In some embodiments, an arm board top surface  22  of a first arm board  21 , an arm board top surface  22  of a second arm board  21 , and/or a center panel top surface  12  of a center panel  11  ( FIGS. 1-5 , and  7 ) may comprise a removably coupled cushion pad  17  or other suitable cushion layer. A cushion pad  17  may be removably coupled to an arm board top surface  22  or a center panel top surface  12  by being press fit or snap fit together, by one or more hook and loop type fasteners such as Velcro type fasteners, sealable tongue and groove fasteners, clip type fasteners, clasp type fasteners, ratchet type fasteners, threaded type fasteners such as screws and bolts, buckle type fasteners and the like, or any other suitable joining method capable of temporarily coupling or securing portions of a cushion pad  17  to an arm board top surface  22  or a center panel top surface  12 . 
         [0041]    In other embodiments, an arm board top surface  22  of a first arm board  21 , an arm board top surface  22  of a second arm board  21 , and/or a center panel top surface  12  of a center panel  11  ( FIGS. 1-5 , and  7 ) may comprise a substantially permanently coupled cushion pad  17  or other suitable cushion layer. A cushion pad  17  may be substantially permanently coupled to an arm board top surface  22  or a center panel top surface  12  with heat bonding, chemical bonding, adhesives, clasp type fasteners, clip type fasteners, rivet type fasteners, threaded type fasteners, other types of fasteners, by being integrally molded or formed together, or any other suitable joining method capable of substantially permanently securing portions of a cushion pad  17  to an arm board top surface  22  or a center panel top surface  12 . 
         [0042]    The elements that comprise the apparatus  100  such as a center panel  11  ( FIGS. 1-5 , and  7 ), arm boards  21  ( FIGS. 1-8 ), hinged coupling  16  ( FIGS. 1-5 , and  7 ), and locking mechanisms such as a lock tab  30 A ( FIGS. 1-5 ), lock tab guide rail  30 B ( FIGS. 2-5 ), offset tab  30 C ( FIG. 8 ), tab slot  30 D ( FIG. 8 ), and/or coupling channel  31  ( FIG. 8 ) may be made from durable materials such as hard plastics, radiologically translucent plastics, metal alloys, wood, hard rubbers, carbon fiber, or any other suitable materials including combinations of materials. Additionally, one or more elements may be made from durable and slightly flexible materials such as soft plastics, silicone, soft rubbers, or any other suitable materials including combinations of materials. As used herein the term “substantially” shall mean a majority of a something, such as at least 60% of something, but preferably at least 70% of something, and more preferably at least 80% of something. In this regard, a surface that is substantially planar shall, in some embodiments, mean the surface is at least 60% planar, or preferably at least 70% planar, or optionally at least 80% planar. 
         [0043]    Although the present invention has been illustrated and described herein with reference to preferred embodiments and specific examples thereof, it will be readily apparent to those of ordinary skill in the art that other embodiments and examples may perform similar functions and/or achieve like results. All such equivalent embodiments and examples are within the spirit and scope of the present invention, are contemplated thereby, and are intended to be covered by the following claims.