M4: Upper Extremity (120 Rad Procedures)

How many phalanges are found in digits 2 through 5?

3 in each digit

What are the three parts of a phalanx?

Head, body, and base

What are the four parts of a metacarpal?

Head, neck, body, and base

Which part of a metacarpal is an important fracture location?

Neck

Which digit is referred to as the first digit?

Thumb

What is the total number of bones in the hand?

27

How many phalanges are found in the hand?

14

How many metacarpals are found in the hand?

5

How many carpal bones are found in the wrist?

8

How many phalanges does the thumb have?

2

Which digit is referred to as the second digit?

Index finger

Which digit is referred to as the third digit?

Middle finger

Which digit is referred to as the fourth digit?

Ring finger

Which digit is referred to as the fifth digit?

Small finger

Which carpal bone is the largest proximal-row carpal?

Scaphoid

Which carpal bone is located on the radial or thumb side of the proximal row?

Scaphoid

Which carpal bone is crescent-shaped?

Lunate

Which carpal bone is pyramidal-shaped?

Triquetrum

Which carpal bone is pea-shaped?

Pisiform

Which carpal bone is located on the palmar surface of the triquetrum?

Pisiform

Which carpal bone is associated with the first metacarpal?

Trapezium

Which carpal bone is a small carpal associated with the second metacarpal?

Trapezoid

Which carpal bone is the largest carpal and is centrally located?

Capitate

Which carpal bone is also called os magnum?

Capitate

Which carpal bone has a distinctive hook called the hamulus?

Hamate

What is the proximal row of carpal bones from lateral to medial?

Scaphoid, lunate, triquetrum, pisiform

What is the distal row of carpal bones from lateral to medial?

Trapezium, trapezoid, capitate, hamate

What structure is located beneath the anatomic snuff-box?

Scaphoid

What can tenderness in the anatomic snuff-box indicate?

Scaphoid fracture

What forms the roof of the carpal tunnel?

Flexor retinaculum

Which structures form the medial attachment of the flexor retinaculum?

Pisiform and hook of hamate

Which structures form the lateral attachment of the flexor retinaculum?

Scaphoid and trapezium tubercles

Which nerve passes through the carpal tunnel?

Median nerve

What type of joint is the interphalangeal joint?

Hinge

What type of joint is the MCP joint?

Ellipsoidal

What type of joint is the first CMC joint?

Saddle

What type of joint is the intercarpal joint?

Gliding

What type of joint is the radiocarpal joint?

Ellipsoidal

What type of joint is the radioulnar joint?

Pivot

What type of joint is the humeroulnar joint?

Hinge

What type of joint is the humeroradial joint?

Hinge

Which bone of the forearm is located on the lateral or thumb side?

Radius

Which bone of the forearm is located on the medial or pinky side?

Ulna

Which structure of the ulna forms the point of the elbow?

Olecranon process

Which depression of the ulna articulates with the trochlea of the humerus?

Trochlear notch

Which structure of the ulna articulates with the radius?

Radial notch

Which distal process of the ulna is located at the wrist?

Ulnar styloid process

Which proximal structure of the radius articulates with the capitulum?

Radial head

Which structure of the radius is located below the radial head?

Radial neck

Which structure of the radius provides an attachment site near the proximal portion of the bone?

Radial tuberosity

Which distal structure of the radius is located at the wrist?

Radial styloid process

Which distal humeral structure is located medially?

Trochlea

Which distal humeral structure is located laterally?

Capitulum

Which humeral structure articulates with the radial head?

Capitulum

Which humeral structure articulates with the trochlear notch of the ulna?

Trochlea

Which part of the humerus is a common fracture site?

Surgical neck

Which humeral tubercle is an insertion site for the subscapularis?

Lesser tubercle

Which projection is routinely performed for digits 2 through 5?

PA, lateral, and PA oblique

Where should the central ray be directed for a PA projection of digits 2 through 5?

PIP joint

How should the digits be positioned for a PA projection of digits 2 through 5?

Extended with the palmar surface on the IR

What is the standard rotation for a PA oblique projection of digits 2 through 5?

45 degrees

Where should the central ray be directed for a lateral projection of digits 2 through 5?

PIP joint

Which digits use a mediolateral lateral projection?

Second and third digits

Which digits use a lateromedial lateral projection?

Fourth and fifth digits

Where should the central ray be directed for the thumb projections?

MCP joint

Which routine projections are performed for the thumb?

AP, lateral, and PA oblique

How is the thumb positioned for an AP projection?

Extreme medial/internal rotation with the posterior thumb on the IR

Which thumb projection has more magnification?

PA thumb

Where should the central ray be directed for a PA projection of the hand?

Third MCP joint

What is the standard rotation for a PA oblique projection of the hand?

45 degrees

Where should the central ray be directed for a lateral projection of the hand?

Second MCP joint

Which lateral hand projection has the digits extended and superimposed?

Extension lateral

Which lateral hand projection has the digits fanned apart?

Fan lateral

Which lateral hand projection is best for localizing foreign bodies and metacarpal fracture displacement?

Extension lateral

Which lateral hand projection is best for demonstrating individual phalanges?

Fan lateral

How far should the radiation field extend around the hand?

2.5 cm (1 inch) on all sides, including 2.5 cm proximal to the ulnar styloid

Where should the central ray be directed for a PA projection of the wrist?

Midcarpal area

Where should the central ray be directed for a lateral projection of the wrist?

Radiocarpal joint

What is the standard rotation for a PA oblique projection of the wrist?

45 degrees

Which wrist projection uses extreme ulnar deviation?

Ulnar deviation projection

Which carpal bone is demonstrated by the ulnar deviation projection?

Scaphoid

How far proximal and distal should the radiation field extend for the PA wrist?

6 cm (2.5 inches)

What should be superimposed for a true lateral wrist?

Radial and ulnar styloid processes

What should be demonstrated on a PA wrist image?

Distal radius and ulna, carpals, and proximal metacarpals

What is the standard SID used for the procedures in Chapter 5?

102 cm (40 inches)

Where should the central ray be directed for an AP projection of the forearm?

Midpoint of the forearm

How should the hand be positioned for an AP forearm?

Supinated

What is the elbow position for an AP forearm?

Extended

How far proximal and distal should the radiation field extend for the forearm?

5 cm (2 inches)

Where should the central ray be directed for a lateral forearm?

Midpoint of the forearm

What is the elbow position for a lateral forearm?

Flexed 90 degrees

What should be superimposed on a lateral forearm?

Radial and ulnar styloid processes

Which projection is used to evaluate the elbow fat pads?

Lateral elbow

What three fat pads are evaluated around the elbow?

Anterior, posterior, and supinator

Which elbow fat pad normally has a teardrop appearance?

Anterior fat pad

What should happen to the posterior fat pad with the elbow flexed 90 degrees?

It should be depressed in the olecranon fossa

What does visualization of the posterior fat pad indicate?

Elbow pathology

Which elbow projection demonstrates the radial head and neck?

AP oblique with lateral rotation

Which elbow projection demonstrates the olecranon?

AP axial olecranon projection

Which special wrist method demonstrates the carpal canal?

Gaynor-Hart method