Chapter 4 Exam Review Upper Limb

14

how bones are in the phalanges

8

how many carpals bones are there

trapezium

the first metacarpal articulates

trapezoid

the second metacarpal articulates with the

capitate

the third metacarpal articulates with the

hamate

the forth and fifth metacarpal articulates with the

scaphoid

the most frequently fractures carpal bones

lunate

the second carpal in proximal row, articulates with the radius

capitate

the largest of the carpal bones

hamulus

the hooklike process on the hamate is called

carpal sulcus

the concave area or groove is called

radial styloid process

does the radial or ulnar styloid process extend more distally

trochlea

shaped like a pulley or spool has two rimlike outer margins and a smooth depressed center portion called a trochlear sulcus or groove

trochlea ; ulna

the _____ is located more medially and articulated with _____

capitulum

“little head” is located on the lateral aspect and articulates with the head of the radius

coronoid fossa and radial fossa

two shallow anterior depressions

olecranon fossa

deep posterior depression of the distal humerus is the

trochlear sulcus

the first and smallest arc

ginglymus

interphalangeal joints

ellipsoidal

metacarpophalangeal joints

saddle and plane

carpometacarpal joints

ellipsoidal

wrist

posterior fat pad

located deep within the olecranon fossa

-visualization of the fat pad on a 90* flexed lateral elbow radiograph indicates presence of a joint pathologic process

anterior fat pad, posterior fat pad, and supinator fat pad

three significant fat pads or stripes of the elbow are visual on the lateral projection

barton fracture

fracture and dislocation of the posterior lip of the distal radius

bennett fracture

fracture of the base of the first metacarpal bone

boxer fracture

transverse fracture that extends through the metacarpal neck; most commonly in fifth metacarpal

colles fracture

transverse fracture of the distal radius , the distal fragment is displaced posteriorly

smith fracture

transverse fracture of the distal radius with distal fragment displaced anteriorly

joint effusion

accumulated fluid in joint cavity

osteoarthritis

degenerative joint disease

osteomylitis

local or generalized infection of the bone or bone marrow

osteopetrosis

hereditary disease marked by abnormally dense bone

“marble bone”

-

osteoporosis

-reduction in the quantity of bone or atrophy

paget disease

-common skeletal disease

-bone destruction followed by reparative process of overproduction of dense yet soft bones that tend to fracture easily

rheumatoid arthritis

-chronic systemic disease with inflammatory changes throughout connective tissue

-three times more common in women than in men

skiers thumb

-sprain or tear of the ulnar collateral ligament of the thumb near the MCP joint of the hyperextended thumb

multiple myeloma

-most common primary cancerous bone tumor

-persons between ages 40-70 yo

osteogenic sarcoma (osteosarcoma)

-second most common type of primary cancerous bone tumore

ewing sarcoma

-common primary malignant bone tumor in children and young adults that arises from bone marrow

chondrosarcoma

-slow growing malignant tumor of the cartilage

osteochrondroma

-most common type of benign bone tumor

-persons age 10-20 yo

carpometacarpal

the joint found between the base of the third metacarpal and carpal bone

scaphoid

which carpal articulates with the radius

interphalangeal

what is the name of the joint found between the proximal and distal phalanges of the first digit

head of ulna

which of the following bony structures is found on the distal aspect of the ulna

ulnar notch

which of the following structures is not part of the ulna

olecranon process

which is considered to be most proximal

capitulum

which structure is considered to be most lateral

olecranon process

which structure is considered to be most posterior

styloid processes

which structure is considered to be most distal

trochlea and olecranon process

two structures primarily from the hinge like structure and movement of the elbow joint

radial and coronoid fossa

names of the two small depressions found on the anterior aspect of distal humerus

ulnar notch and head of ulna

two structures form the distal radioulnar joint

humeral epicondyles

two bony landmarks are palpated for positioning the AP elbow

sulcus

the smooth, depressed, center portion of the trochlea used for evaluating rotation on a lateral elbow is termed the trochlear

ginglymus

the interphalangeal joint have a ____ type of joint movement

ellipsoidal

the radiocarpal wrist joint possesses a ____ type of joint movement

ellipsoidal

the first metacarpophalangeal joint has a ___ type of joint movement

hinge

a ginglymus joint can also be referred to as a ______ joint

saddle

the first carpometacarpal joint is classified as a _____ joint

four

an ellipsoidal joint allows movement in ____ directions

ulnar deviation

the bending or forcing of the hand outwardly with the hand pronated in a PA is known as

pronator

the two fat stripes of the wrist demonstrated radiographically are known as the scaphoid fat stripe and the ______ fat stripe

negative study for injury

a nonvisible posterior fat pad on a well-exposed, correctly positioned lateral elbow radiograph generally suggests

parallel

A general positioning rule is to place the long axis of the part ____ to the long axis of the image receptor.

increase 3 to 4 kVp

How should the original analog kVp range be changed with a fiberglass cast applied for a wrist or forearm radiographic procedure?

10

Grids are generally not required unless the anatomy measures greater than _____ cm in thickness.

At the proximal interphalangeal joint (PIP)

Where is the central ray (CR) placed for a PA projection of the third digit?

ulnar collateral ligament.

A “skier’s thumb” is an injury of the:

osteogenic sarcoma.

The second most common type of primary cancerous bone tumor is:

45* lateral rotation

from a pronated position, which of the following is required for a PA oblique projection of the fourth digit of the hand

Minimizes object image–receptor distance (OID).

Why is it recommended that the PA oblique (with medial rotation) projection be performed rather than the PA oblique (with lateral rotation) for the second digit of the hand?

At the third metacarpophalangeal joint

Where is the CR centered for a PA projection of the hand

Prevents foreshortening of phalanges and obscuring of interphalangeal joints.

Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?

phalanges

Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?

AP axial (modified Robert method)

Which projection best demonstrates pathology involving the first carpometacarpal joint and trapezium?

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces?

first carpometacarpal joint.

The CR placement for an AP axial projection (modified Robert’s method) of the thumb is at the:

15-degree proximally (toward the wrist)

What CR angle is required with the modified Robert’s method?

45 degrees

How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the

65 degrees

How much flexion of the hand (in relationship to the IR) is required for the Brewerton method

Radial deviation

Which special projection of the wrist will open up the interspaces on the ulnar side of the wrist?

25-30 degrees

How much CR angulation to the long axis of the hand is required for the tangential, inferosuperior projection to demonstrate the carpal sulcus (canal)?

carpal bridge

Which special projection of the wrist is ideal for demonstrating possible calcification in the dorsal aspect

Pronation of the hand

Which of the following actions will lead to the proximal radius crossing over the ulna

To provide an AP perspective if the patient cannot fully extend the elbow

What is the purpose of performing the AP partially flexed projections of the elbow?

AP oblique with external rotation

Which routine projection of the elbow best demonstrates the radial head and tuberosity free of superimposition?

Lateral

Which routine projection of the elbow best demonstrates the olecranon process in profile?

lateral

Which basic projection of the elbow best demonstrates the trochlear notch in profile?

Perpendicular to image receptor

How should the humeral epicondyles be aligned for a lateral projection of the elbow?

Medial (internal) rotation oblique

A radiograph of the elbow demonstrates the radius directly superimposed over the ulna and the coronoid process in profile. Which projection of the elbow has been performed?

True lateral with 90-degree flexion

Which routine projection of the elbow will best demonstrate an elevated or visible posterior fat pad?

The position of the hand and/or wrist

With the radial head-lateromedial projections, what is the only difference between the four projection

Elbow flexed 90 degrees, CR angled 45 degrees toward shoulder

Which of the following best demonstrates the radial head using the trauma lateral Coyle method routine?

two

How many projections are required for the AP-acute flexion study of the elbow?

Wrist and forearm

A patient enters the emergency department (ED) with a Smith fracture. Which region of the upper limb must be radiographed to demonstrate this injury?

Rotate the wrist and hand 10 degrees internally.

A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamular process is superimposed over the pisiform. Which of the following measures will correct this problem?

Thumb

A patient enters the ED with a possible Bennett’s fracture. Which of the following routines should be performed to confirm this diagnosis?