Workbook Ch4

14

How many phalanges (Fingers and thumb)

8

How many carpals(Wrist)

5

How many metacarpals (5)

Proximal phalanx

Middle phalanx

Distal phalanx

The three portions of each finger are the:

proximal phalanx

Distal phalanx

The two portions of the thumb are the

Head

Body

Base

The three parts of each phalanx , Starting distantly are the:

Base

Body

Head

The three parts of each metacarpal starting proximally

Capitate

What is the largest of the Carpal bones?

Hamulus or hamular process

What is the name of the hook like process, extending anteriorly from the hamate?

Scaphoid

What is the most commonly fractured carpal bone?

Pisiform

What is the smallest of the carpal bones?

Radius

In the anatomic position, which of the bones of the forearm is located on the lateral (thumb) side

Ulna

What bones of the forearm is located on the medial side?

Proximal radioulnar joint

What joint permits the forearm to rotate during pronation

Trochlea

The articular portion of the medial aspect of the distal humerus is called the:

Capitulum

The similar structure found on the lateral aspect of the distal humerus is called the:

Olecranon fossa

The deep depression located on the posterior aspect of the distal humerus is the:

Trochlear Sulcus

The first and smallest of the arcs:

Capitulum

The smaller are

Trochlea

The larger are:

Trochlear Sulcus

Capitulum

Trochlea

Trochlear notch

The criteria for evaluating a true lateral position of the elbow or the appearance of the three concentric arcs these arcs include:

Freely movable (Diarthrodial) And allow movement in four directions

Ellipsoidal joints are classified as

Radial collateral ligament

Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid And trapezium bones?

Ulnar deviation

Radial deviation

What is the name of the two special turning or bending positions of the hand and wrist that demonstrate medial and lateral aspects of the carpal region?.

Ulnar deviation

of the two positions listed in the previous question which is most commonly performed to detect a fracture of the scaphoid bone (unlearned deviation or radial deviation?)

Proximal radius crosses over the ulna

How does the forearm appear radiographically if pronated for a PA projection?

Scaphoid fat stripe

Pronator fat stripe

The two important fat, stripes or bands around the wrist joint or the

Elbow flexed 90°

Optimal exposure factors used

In a true lateral position

The fat pads around the elbow joint are Valuable diagnostic indicators if the following three technical/positioning requirements are met with the lateral position

False

True or false. If the posterior fat pad of the elbow is not visible radiographically, it suggests that a non-obvious radial head or neck fracture is present

True

True or false. Excessive KVP may obscure the visibility of a fat pad

False

True or false. Trauma or infection makes the anterior fat pad more difficult to see on a lateral elbow radiograph

PA and oblique wrist

Which routine projections best demonstrate the scaphoid fat stripe?

Lateral wrist

Which routine projection best demonstrates the pronator fat stripe

Low to medium (60 to 80 KVP)

KVP range for upper limb radiography

Short exposure time

Long or short exposure time for upper limb radiography?

Small focal spot

Large or small focal spot for upper limb radiography?

40 inches

SID For upper limb radiography?

4 inches

Grids are recommended if the body part measures greater than

Collimation borders should be visible on all four sides if the IR is large enough to allow this without cutting off central anatomy

The general role for collimation for upper limb, radiography states

True

True or false. Trauma patients can be radiographed directly on the stretcher

True

True or false. Guardians of young pediatric patients who are undergoing upper limb studies can be asked to hold their child during the radiographic study?

Arthrography

A radiologic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist, elbow and shoulder joints?

Distal aspect of metacarpals

How much of the metacarpals should be included for PA projection of the digits?

PA, PA oblique, And lateral

What is the positioning routine for the second through fifth digits of the hand?

Symmetric appearance of both side sides of the shafts of phalange

Equal amounts of tissue on each side of the phalanges

List the two radiographic criteria used to determine whether rotation is present on the PA projection of the digits

PA oblique projection :Medial oblique rather than lateral two decrease OID

Lateral side :Perform a thumb down lateral to decrease OID

Identify which positioning modifications should be used for a study of the second digit to reduce distortion for each of the following.

PA oblique projection: ?

Lateral position: ?

Proximal interphalangeal joint

Where is the central ray center for a PA oblique projection of the second digit

The AP position produces a decrease in OID and increased resolution

Why is AP Projection of the thumb recommended instead of PA?

PA oblique

What projection of the thumb is achieved naturally by placing the Palmer surface of the hand in contact with the IR?

8X10 inch

What is recommended field size should be used for a thumb projection?

Metacarpophalangeal joint Of the thumb

A sesamoid bone is frequently found adjacent to the

First metacarpophalangeal joint

Where is the central ray center for an AP projection of the thumb?

Base of first metacarpal

A Bennett fracture involves:

Modify Robert’s method

Which special positioning method can be performed to better delineate a possible beet fracture?

15° proximal

What degree of central rate and angulation is required For the modified Robert method

1 inches (2.5 cm)

A minimum of what inches of the forearm should be included radiographically for a PA projection of the hand?

True

True or false. Slight superposition of the distal third, Fourth, And fifth metacarpal’s may occur with a well-positioned PA oblique projection of the hand?

Fan lateral

Which preferred lateral position of the hand best demonstrates the phalanges without excessive super imposition?

Lateral in extension

Which lateral projection of the hand best demonstrates a possible foreign body and the palm of the hand?

15° proximal towards the ulnar

What type of CR angle is required for the AP axial projection? (Brewtons method).

Rheumatoid arthritis

The AP axial projection is commonly used to evaluate for early signs of:

PA stress

Which projection best demonstrates possible scapholunate ligament tears?

45°

How much rotation is required for an oblique projection of the wrist?

AP

Which alternative projection to the routine PA wrist best demonstrates the intercarpal joint spaces and wrist joints?

Potts

Which of the following fractures is not demonstrated in a wrist routine?

Barton

Smith

Colles

Potts

20°

How much are the hand and wrist elevated from the IR for the modified stetcher method?

10 to 15° proximately

During the PA axial scaphoid projection with the central ray angle and ulnar flexion, the central Ray must be angled:

Excessive lateral rotation from PA

Which Positioning error is involved if a majority of the carpal bones are superimposed in a PA oblique wrist projection?

25 to 30°

How much central ray angulation to the long axis of the hand is required for the carpal Canal projection?

PA projection with radial deviation

Which special projection of the wrist best demonstrates the interface is on the other side of the wrist between the lunate triquetrum, pisiform, and hemate bones?

45 degrees

How much Central ray angulation from the long access of the forearm is required for the carpal bridge projection?

90°

The hand and wrist form what degree angle to the forearm with the carpal bridge projection?

AP/lateral

Which routine projections are required for the study of the forearm?

False

True or false. For a forearm study, the technology needs to include only the joint closest to the site of the injury?

Parallel

To position the patient properly for an AP projection of the elbow, the epicondyles must be___ To the IR

Two AP projections

One with humorous parallel to IR

And one with forearm parallel to IR

If the patient cannot fully extend the elbow for the AP projection what alternative project projections should be performed?

AP oblique with 45° lateral rotation

Which routine projection of the elbow best demonstrates the radial head, Neck, And two velocity with slight superimposition of the ulna?

Palm up

To position a patient properly for an AP forearm, the hand should be

AP oblique with 45° lateral rotation

The best position to evaluate the posterior fat pads of the elbow joint is:

Two projections

Central Ray perpendicular to humorous

CR perpendicular to forearm

Which special projections of the elbow should be performed instead of the routine AP if the patient’s elbow is tightly flexed and cannot extend at all?

45° laterally

How much is the upper limb rotated for a lateral oblique projection of the elbow?

80° of flexion

What is the amount of elbow flexion required for the trauma lateral projection to demonstrate the coronoid process?

The rotational position of the hand and wrist

What is the only difference among the four Radiohead lateral projections of the elbow?

45° towards shoulder

How much and in which direction should the central ray be angle for the trauma axial lateral projection involving the coronoid process??

Small focal spot

Minimum 40 inch SID

A three projection study of the hand was taking using the following exposure factors: 64KVP, 1000 MA, 1/100 Second, Large focal spot and 36 inch SID. Which of these factors should be changed on future hand studies to produce more optimal images?

Rotation

A radiograph of a PA projection of the second digit shows that the phalanges are not symmetric on both sides of the bony shaft. What specific positioning error is involved?

Excessive lateral rotation

A radiograph of a PA oblique projection of the hand shows that the fourth and fifth metacarpals are super imposed. Which specific positioning error is involved?

PA forearm projection was performed rather than AP

In a radiographic study of the forearm, the proximal radius crossed over the ulna in the frontal projections. Which specific positioning error led to this radiographic outcome?

CR needs to be angled 15° proximally towards the elbow

A PA axiel scaphoid projection of the wrist using a 15° distal central ray angle and ulnar flexion was performed. The resultant radiograph shows that the scaphoid bone is foreshortened. How must this projection be modified to produce a more diagnostic image of the scaphoid?

The elbow is rotated medially

A radiograph of an AP elbow projection shows considerable superimposition between the proximal radius and unla. which specific positioning error is involved

Coyle method for radial head

A patient with a possible fracture of the radial head enters the emergency room. When the technologist attempt attempts to place the arm in the AP oblique with lateral rotation, But the patient is unable to extend or rotate the elbow laterally. Which Other positions can be used to demonstrate the radial head and neck without superimposition on the proximal ulna?

PA and lateral-in-extension projection

A patient with a trauma injury enters the ER with an evident Colles Fracture. Which positioning routine should be used to determine the extent of the injury?

two AP projections

acute flexion

a lateral projection

A patient with a dislocated elbow enters the ER. The patient has the elbow tightly flexed and is careful not to move it. Which specific positioning routine can be used to determine the extent of the injury?

modified Robert method

A patient with a possible fracture of the trapezium enters the ER. The routine projections do not clearly demonstrate a possible fracture. What other special projection can be taken?

Carpal canal position

A patient with a history of carpal tunnel syndrome comes to the radiology department. The orthopedic physician suspect that bony changes in the carpal sulcus Maybe causing compression of the median nerve. Which special projection best demonstrate this region of the wrist?

AP axial projection

A patient comes to the radiology department for a hand to evaluate early evidence of rheumatoid arthritis. Which special position can be used in addition to the routine hand projections to evaluate this patient?

PA stress

A patient is referred to radiology with a possible injury to the ulnar collateral ligament. The patient complains of pain near the first metacarpal joint initial radiographs of the hand do not indicate any fracture or dislocation. Which special projection can be performed to rule out an injury to the ulnar collateral ligament?

Tangential projection- Carpal Bridge projection

A patient enters the ER with a possible foreign body and the dorsal aspect of the wrist. Initial wrist radiographs are inconclusive and demonstrating the location of the foreign body. Which additional projection can be performed to demonstrate this region of the wrist?

Trauma axial lateral projection- coyle Method for coronoid process

A patient has a routine elbow series performed. The AP projection indicates a possible deformity or a fracture of the coronoid process. However, the patient is unable to pronate the upper limb for the AP oblique medial rotation projection because of an arthritis condition. What other projections could be performed to demonstrate the coronoid process??