Unit 1: upper extremity (Fingers, Hand, wrist, forearm, elbow, humerus)

Collimation for PA and PA oblique finger

1 inch on all sides

Central Ray for PA and PA oblique finger

Perpendicular to PIP joint

Evaluation criteria for PA finger

-Equal concavity on both sides

-Open IP and MCP joint spaces

-Entire digit from fingertip to distal portion of adjoining metacarpal

Collimation for lateral finger

1 inch on all sides

Central Ray for lateral finger

Perpendicular to PIP joint

Evaluation criteria for lateral finger

-no rotation

-no superimposition of the proximal phalanx or MCP joint

-open IP joint spaces

Evaluation criteria for PA oblique finger

-digit rotated at 45 degrees seen by concavity of the elevated side

-no superimposition of the proximal phalanx or MCP joint

-open IP and MCP joint spaces

Collimation for AP/oblique/lateral thumb

1 inch on all sides

Central ray for AP/oblique/lateral thumb

Perpendicular to MCP joint spaces

Evaluation criteria for AP thumb

-Entire thumb demonstrated (including first CMC joint)

-CR at first MCP joint

-No rotation

-concavity of phalangeal and metacarpal bodies

-Open IP and MCP joints

Evaluation criteria for lateral thumb

-entire finger and entire metacarpal from distal thumb to trapezium

-Open IP and MCP joint spaces

-all concavity on anterior side of phalange

Evaluation criteria for oblique thumb

-entire finger and entire metacarpal from distal thumb to trapezium

-Open IP and MCP joint spaces

-concave surface of elevated side of proximal phalanx and metacarpal

collimation for PA hand, PA oblique

1 inch on all sides of the hand, including 1 inch proximal to the ulnar styloid

Central ray for PA hand and PA oblique

3rd MCP joint

Evaluation criteria for PA hand

-entire hand and wrist are visible

-MCP and IP joint should be open

-slightly separate digits

-equal concavity of metacarpal and phalangeal bodies

Evaluation criteria for PA oblique hand

-Entire hand, carpals, and 1" of radius/ulna shown

-open MCP and IP joints

-45 degrees of rotation

-partial superimposition of the third fourth and fifth metacarpal bases and heads

Collimation for lateral hand

1 inch in all sides of the shadow of the hand and thumb including 1 inch proximal to ulnar styloid

Central Ray for lateral hand

2nd MCP joint

Evaluation criteria for lateral hand

-extended digits

-Hand in a true lateral position

-superimposed phalanges

-superimposed metacarpals

-superimposed distal radius and ulna

-thumb free of motion and superimposition

Collimation for ALL wrist

2.5 inches proximal and distal to the wrist joint and 1 inch on the sides

Central ray for PA wrist

midcarpal area

Central ray for PA oblique wrist

Perpendicular to midcarpal area, just distal to radius

Central ray for lateral wrist

Perpendicular to the wrist joint

Evaluation criteria for PA wrist

-Distal radius, ulna, and carpals demonstrated

-Center of field at midcarpals

-No rotation

-open radioulnar joint space

-no excessive flexión of digits to overlap

Evaluation criteria for lateral wrist

- distal radius and ulna, carpals, and proximal half of metacarpals

- superimposed distal radius and ulna

- superimposed metacarpals

Evaluation criteria for PA oblique wrist

-Distal radius, ulna, and carpals demonstrated

-45 degrees rotation, slight overlap of distal radius and ulna

-Trapezium seen in its entirety and distal half of scaphoid without imposition

-carpals on lateral side of wrist

Central Ray for ulnar deviation

Perpendicular to scaphoid

-CR angulation of 10-15 degrees proximally or distally sometimes required

Central ray for PA axial projection (stetcher)

Perpendicular to the table and directed to enter the scaphoid

Evaluation criteria for PA wrist ulnar deviation

Scaphoid w adjacent articulations open

-No rotation of wrist

-maximum ulnar deviation

-distal radius and ulna carpals and proximal half of metacarpals

Evaluation criteria for PA axial wrist

-distal radius and ulna and carpals and proximal half of metacarpals

-scaphoid w adjacent articulations open

-no rotation of wrist

-20 degree angulation

Collimation for for tangential projection (gaynor-hart)

1 inch on all three sides of shadow of wrist

Central ray for tangential projection (gaynor-hart)

-Palm of the hand at 1 inch distal to the base of the third metacarpal at an angle of 25-30 degrees

Evaluation criteria for tangential projection (gaynor-hart)

-carpals in arch arrangement

-pisiform in profile and free of superimposition

-hamulus of hamate

Central ray for AP forearm

Perpendicular to the midpoint of the forearm

Collimation for AP forearm

2 inches distal to the wrist joint and proximal to the elbow joint and 1 inch on the sides

Evaluation criteria for AP forearm

-Entire forearm(include wrist and distal humerus)

-slight superimposition of Radial head/neck/tuberosity over proximal ulna

-No elongation by seeing both epicondyles

-partially open elbow joint (arm on same plane)

-open radioulnar space

Central Ray for lateral forearm

Perpendicular to the midpoint of the forearm

Collimation for lateral forearm

2 inches distal to the wrist joint and proximal to the elbow joint and 1 inch on the sides

How many bones in the hand

27 bones

How many phalanges are there?

14 per hand

How many metacarpals are there?

5 in each hand

how many carpal bones are there

8 in each hand

How many articulations does the humerus have

three

What type of joint is the IP joint

hinge

What type of joint is the MCP joint

Ellipsoidal (condyloid)

What type of joint is the first digit (CMC)

saddle

what type of joint are digits 2-5 (CMC)

gliding

what type of joint is the intercarpal (CMC)

gliding

What type of joint is the radiocarpal? (CMC)

ellipsoid

What type of joint is proximal radioulnar

pivot

what type of joint is distal radioulnar

pivot

what type of joint is humeroulnar

hinge

what type of joint is humeroradial

hinge

When the elbow is flexed 90 degrees, which fat pads are visible?

anterior and supinator fat pads

What is the SID for all upper extremities

40 SID

What is the collimation for the digits

2"X6"

What is the collimation for the Hand PA

7"X8"

What is the collimation for the Hand oblique

7"X8"

What is the collimation for the Hand Lateral

6"X8"

What is the collimation for the Wrist (PA/ PA Oblique)

4"X8"

What is the collimation for the Wrist Lateral

3"X8"

What is the collimation for the Gaynor Hart

4X4"

What is the collimation for the forearm (AP/Lateral)

5X15"

What is the collimation for the Elbow (AP/Lateral)

5X9"

What is the collimation for the Humerus (AP/Lateral)

7X17"

What is the kVp for the digits

63

What is the kVp for the hand (PA, PA oblique)

66

What is the kVp for the hand (Lateral)

70

What is the kVp for the wrist (PA/ PA oblique)

66

What is the kVp for the wrist (Lateral)

70

What is the kVp for the Gaynor-Hart

70

What is the kVp for the forearm (AP/Lateral)

70

What is the kVp for the Elbow

70

What is the kVp for the Humerus

75

What is the mAs for the digits

0.6 h

What is the mAs for the Hand PA

0.71 h

What is the mAs for the Hand oblique

0.8 h

What is the mAs for the hand lateral

1.25 h

What is the mAs for the wrist (PA/ PA oblique)

0.9 h

What is the mAs for the wrist lateral

1.1 h

What is the mAs for the gaynor-hart

1.25 h

What is the mAs for the forearm (AP/lateral)

1.25 h

What is the mAs for the elbow (AP/lateral)

1.4 h

What is the mAs for the humerus (AP/lateral)

2.8 h

how much do you increase mAs or kVp for a cast (fiberglass)

increase mAs 25% or 4 kVp

how much do you increase mAs or kVp for a cast (plaster medium)

increase mAs 50% or 7 kVp

how much do you increase mAs or kVp for a cast (plaster large)

increase mAs 100% or 10 kVp

bone cyst

Fluid-filled cyst with wall of fibrous tissue

bursitis

inflammation of a bursa

Dislocation

displacement of a bone from its joint

fracture

disruption in the continuity of bone

bennett fracture

Fracture at base of first metacarpal

boxer fracture

fracture of metacarpal neck

Colles fracture

fracture of the distal radius with posterior displacement

Smith fracture

fracture of distal radius with anterior displacement

torus/buckle fracture

Impacted fracture with bulging of periosteum

gout

Hereditary form of arthritis in which uric acid is deposited in joints

joint effusion

Accumulation of fluid in joint associated with underlying condition

Metastases

Transfer of a cancerous lesion from one area to another

osteoarthritis

Form of arthritis marked by progressive cartilage deterioration in synovial joints and vertebrae