Bontrager's Workbook Chapter 4 Self-Test (f)

How many bones make up the phalanges of the hand?

14

How many bones make up the carpal region?

8

What is the total number of bones that make up the hand and wrist?

27

Which joint is between the two phalanges of the first digit (thumb)?

Interphalangeal Joint

Which joint is between the first metacarpal and the proximal phalanx of the thumb?

First Metacarpophalangeal

Which joint is between the middle and distal phalanges of the fourth digit?

Fourth Distal Interphalangeal

Which joint is between the carpals and the first metacarpal?

First Carpometacarpal

Which joint is between the forearm and the carpals?

Radiocarpal

Which joint is between the distal radius and ulna?

Distal Radialulnar

Which carpal contains a "hook-like" process?

Hamate

Which carpal articulates with the base of the thumb?

Trapezium

Which carpal is most commonly fractured?

Scaphoid

Which two carpal bones are located most anteriorly as seen on a lateral wrist radiograph?

Scaphoid and Trapezium

Which bone of the upper limb contains the coronoid process?

Ulna

Where are the coronoid and radial fossae located?

Anterior aspect of distal humerus

Which two bony landmarks are palpated to assist with positioning of the upper limb?

Lateral and medial epicondyle

Where is the coronoid tubercle located?

Medial aspect of coronoid process

In an erect anatomic position, which of the following structures is considered most inferior or distal?

A. Head of ulna

B. Olecranon process

C. Radial tuberosity

D. Head of radius

Head of ulna

Joint movement type for: Intercarpal Joints

Plane

Joint movement type for: Radiocarpal Joint

Ellipsoidal

Joint movement type for: Elbow Joint

Ginglymus

Joint movement type for: First CMC Joint

Sellar (saddle)

Joint movement type for: Third CMC Joint

Ellipsoidal

True or False:

To visualize fat pads surrounding the elbow, exposure factors must be adjusted to see both bony and soft tissue structures.

True

True or False:

Anterior and Posterior fat pads of the elbow are best seen on correctly positioned and correctly exposed AP elbow projections.

False (lateral)

Why should a forearm never be taken as a PA projection?

Causes the proximal radius to cross over the ulna

In what position should the hand be for an AP elbow projection?

Supinated

In what position should the hand be for an AP medial rotation oblique elbow position?

Pronated

Which projection of the elbow best demonstrates:

Coronoid process in profile

AP, medial rotation oblique

Which projection of the elbow best demonstrates:

Radial head and tuberosity without superimposition

AP, lateral rotation oblique

Which projection of the elbow best demonstrates: Olecranon process in profile

Lateral Elbow

Which projection of the elbow best demonstrates: Coronoid tubercle

AP Elbow

Which projection of the elbow best demonstrates:

Trochlear notch in profile

Lateral Elbow

Which projection of the elbow best demonstrates:

Capitulum and lateral epicondyle in profile

AP, lateral rotation oblique

Which projection of the elbow best demonstrates:

Olecranon process seated in olecranon fossa

AP Elbow

True or False:

Placing multiple images on the same digital IP is recommended as long as close collimation is applied for each projection.

False.

It is recommended that only one projection be placed on a digital IP. The anatomy should be centered on the IP.

The long axis of the anatomic part being imaged should be placed:

Parallel to long axis of the IR

Arthrography is a radiographic study of:

Soft-tissue structures within certain synovial joints

Accumulated fluid within the joint cavity.

Joint Effusion

A reduction in the quantity of bone or atrophy of skeletal tissue.

Osteoporosis

Local or generalized infection of bone or bone marrow.

Osteomyelitis

Reverse of a Colles' fracture.

Smith's Fracture

Inflammation of the fluid-filled sacs enclosing the joints.

Bursitis

Fracture of the base of the first metacarpal.

Bennett's Fracture

Sprain or tear of the ulnar collateral ligament.

Skier's Thumb

Painful disorder of hand and wrist from compression of the median resulting nerve.

Carpal Tunnel Syndrome

Where is the CR centered for a PA projection of the second digit?

Affected PIP joint

Why is it important to keep the long axis of the digit parallel to the IR?

- To reduce distortion of the phalanges.

- To properly visualize joints.

- To demonstrate small fractures.

Where is the CR placed for a PA projection of the hand?

Third MCP joint

What is the major disadvantage of performing a PA projection of the thumb rather than an AP?

Increased OID

What type of fracture is best demonstrated with a modified Robert's method?

Bennett's fracture

True or False:

Both hands are examined with one single exposure when using the Norgaard method.

True

True or False:

The hand(s) is (are) placed in a true PA position when using the Norgaard method.

False

A radiograph of a PA oblique of the hand reveals that the third, fourth, and fifth metacarpals are superimposed. What must be done to correct this positioning error on the repeat exposure?

Decrease obliquity of hand.

A radiograph of an AP elbow projection demonstrates total separation between the proximal radius and ulna. What must be done to correct this positioning error on the repeat exposure?

Rotate upper limb medially.

A radiograph of the carpal canal (inferosuperior) projection reveals that the pisiform and hamulus are superimposed. What must be done to correct this positioning error on the repeat exposure?

Rotate wrist laterally 5° to 10°.

A radiograph of an AP oblique-medial rotation reveals that the coronoid process is not in profile and the radial head is not superimposed over the ulna. What specific positioning error was involved?

Insufficient medial rotation.

A radiograph of a lateral projection of the elbow reveals that the epicondyles are not superimposed and the trochlear notch is not clearly seen. What must be done to correct this positioning error on the repeat exposure?

Place humerus/forearm in same horizontal plane.

Situation:

A patient with a possible Barton's fracture enters the emergency room. Which positioning routine should be performed to confirm the diagnosis?

Wrist

Situation:

A patient with a possible Smith's fracture enters the emergency room. Which positioning routine should be performed to confirm the diagnosis?

Wrist / Forearm

Situation:

A patient has a Colles' fracture reduced, and a large plaster cast is placed on the upper limb. The orthopedic surgean orders a postreduction study. The original technique, used before the cast placement, involved 60 kV and 5 mAs (analog system). How should the exposure factors be altered with a large plaster cast?

Increase kV by 8 - 10.

Situation:

A pediatric patient with a possible radial head fracture is brought into the emergency room. It is too painful for the patient to extend the elbow beyond 90° or rotate the hand. What type of special projection could be performed on this patient to confirm the diagnosis without causing further discomfort?

Coyle Method