Positioning Exam Upper Extremity

How many interphalangeal joints are found in one upper extremity?

9

Each proximal phalanx articulates with a:

Metacarpal bone

Which bones comprise the palm of the hand?

Metacarpals

Which joint is formed by the articulation of the proximal end of the middle phalanx with the distal end of the proximal phalanx of the ring finger?

The proximal interphalangeal joint of the fourth digit

Which joint is formed by the articulation of the distal end of the middle phalanx with the proximal end of the distal phalanx of the index finger?

The distal interphalangeal joint of the first digit

Which joint is a hinge-type joint?

Interphalangeal joint

How many metacarpal bones are found in one upper extremity?

5

Which of the following articulates with the bases of metacarpal bones?

Carpals

Which joint of the hand is formed by the articulation of the head of the metacarpal with a digit?

Metacarpophalangeal joint

Which joints of the hand are formed by the articulation of the bases of the metacarpals with the bones of the wrist?

Carpometacarpals joints

Which joint is an ellipsoidal joint?

Metacarpophalangeal joint

Which articulation of the upper extremity is a saddle joint that allows the thumb to oppose the fingers?

First carpometacarpal

Which bones are located in the proximal row of the wrist?

Scaphoid, lunate, pisiform, and triquetrum

Which bones are located in the distal row of the wrist?

Hamate, capitate, trapezium, and trapezoid

Where in the wrist is the scaphoid located?

Lateral side of the proximal row

Where in the wrist is the trapezium located?

Lateral side of the distal row

Where in the wrist is the hamate located?

Medial side of the distal row

What other name refers to the carpal bone known as the hamate?

Unciform

What other name refers to the carpal bone known as the capitate?

Os magnum

What other name refers to the carpal bone known as the trapezium?

Greater multangular

What other name refers to the carpals bone known as the trapezoid?

Lesser multangular

Which carpal bone has only one name?

Pisiform

Which bones are classified as short bones?

Carpals

Which joint is the most distal articulation of the wrist?

Carpometacarpal joint

Which joint is the most proximal articulation of the wrist?

Radiocarpal joint

Which 2 carpal bones are the most lateral bones of the wrist?

Scaphoid and trapezium

The lunate is situated between the:

Triquetrum and scaphoid

What other name refers to the carpal bone known as the scaphoid?

Navicular

Which carpal bone does not articulate with the radius?

Capitate

Which boney structures are located on the proximal end of the ulna?

Radial notch, olecranon process, and coronoid process

Which bony structures are located on the distal end of the ulna?

Ulnar head and styloid process

Which bony structure is located on the distal end of the radius?

Styloid process

Which bony structures are located on the proximal radius?

Head and tuberosity

Which bones comprise the forearm?

Radius and ulna

Which structure is located on the lateral aspect of the distal forearm?

Radial styloid process

Which large bony process is easily located by touching on the posterior aspect of the proximal forearm?

Olecranon process

Which structure is located on the medial side of the distal forearm?

Ulnar styloid process

Where is the trochlear notch located?

Proximal ulna

Which 2 structures articulate to form the proximal radioulnar joint?

Head of the radius and the radial notch of the ulna

Which 2 structures articulate to form the distal radioulnar joint?

Head of the ulna and ulnar notch of the radius

Which articulation do the trochlea and the trochlear notch form?

Humeroulnar

Which structure articulates with the capitulum?

Radial head

Which structure articulates with the trochlea?

Proximal ulna

In which joint is the capitulum located?

Elbow joint

In which joint is the trochlea located?

Elbow joint

Which type of joint is the elbow?

Hinge joint

Where is the capitulum located?

Lateral side of the distal humerus

With reference from the trochlea, where is the capitulum located?

Lateral

What is the roughened process of the humerus superior and lateral to the intertubercular groove?

Greater tubercle

Which bony process is located on the anterior surface of the proximal humerus?

Lesser tubercle

Which structure articulates with the ulna to form the humeroulnar joint?

Trochlea

How many articulations does the humerus have?

3

Which structure articulates with the radius to form the humeroradial joint?

Capitulum

Which depression is located on the anterior surface of the distal humerus?

Coronoid fossa

Which depression is located on the posterior surface of the distal humerous?

Olecranon fossa

Which depression is located between the lesser and greater tubercles of the proximal humerous?

Intertubercular groove

What is the appropriate collimated field for the PA projection of the second digit?

1 inch (2.5 cm) on all sides of the digit, including 1 inch (2.5 cm) proximal to the MCP joint

Which digit of the hand produces the greatest OID in the lateral projection of that digit?

Third Digit

For lateral projections of the second through fifth digits of the hand, through which joint should the central ray be directed?

Proximal interphalangeal joint

From the prone position, how many degrees should a finger be rotated for the PA oblique projection of that finger?

45 degrees

Which digit of the hand produces the least OID in the lateral projection of that digit?

Second digit

How should the hand be positioned for the PA oblique projection of the hand?

From the prone position, rotate the hand radial side up

What is the centering point for the central ray for the PA projection of the third finger?

Proximal interphalangeal joint of the 3rd digit

What is the centering point for the central ray on the AP projection of the first digit (thumb)?

First MCP joint

What is the appropriate collimated field for all projections of the first digit (thumb)?

1 inch (2.5 cm) on all sides of the digit, including 1 inch (2.5cm) proximal to CMC joint

From the prone position, how many degrees should a finger be rotated for the lateral projection of that finger?

90 degrees

What is the appropriate collimated field for the PA projection of the hand?

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

For the PA projection of the hand, where should the central ray be directed?

Third metacarpophalangeal joint

From the prone position, how many degrees should a hand be rotated for the PA oblique projection of that hand?

45 degrees

Which of the following is the best to demonstrate a foreign body in the hand?

Lateral in extension

Which wrist-positioning maneuver opens the carpal interspaces on the lateral side of the wrist?

Ulnar deviation

Which wrist projection requires that the IR be inclined toward the elbow at an angle of 20 degrees from horizontal?

PA axial (Stecher method)

Which projection of the wrist corrects foreshortening of the scaphoid carpal bone?

PA with ulnar deviation

Which projection of the wrist requires that the radial styloid process be superimposed over the ulnar styloid process?

Lateral

What is the appropriate collimated field for the PA projection of the wrist?

2\.5 inches (6cm) proximal and distal to the wrist joint and 1 inch (2.5 cm) on the sides

For the PA projection of the wrist, which positioning maneuver should be used to place the anterior surface of the wrist in contact with the IR?

Slightly arch the hand

How should the hand and wrist be positioned for the PA oblique projection of the wrist?

With the hand pronated, rotate the wrist radial side up

Which projection of the wrist best demonstrates the scaphoid carpal bone and its related articulations?

PA Projection, ulnar deviation position

How should the hand be positioned for the AP projection of the forearm?

Supinated

What is the appropriate collimated field for all projections of the forearm?

2 inches (5cm) distal to the wrist and proximal to the elbow and 1 inch (2.5 cm) on the side

Which description best explains how radial crossover occurs when the forearm is demonstrated?

During the AP projection, the hand is pronated

For the AP projection of the forearm, which is positioning step should be taken to prevent radial crossover?

Supinate the hand

Which projection of the forearm requires that the elbow be flexed 90 degrees?

Lateral

When performing an image of a forearm in a fiberglass cast, approximately which compensation to exposure technique should occur?

Increase mAs 25% or 4 kVp

How much should the elbow be flexed for the lateral projection of the elbow?

90 degrees

Which projection of the elbow best demonstrates the radial head free of bony superimposition?

AP oblique, lateral rotation position

Which of the following should be used to image the radial head on a trauma patient?

Axiolateral projection (Coyle method) of elbow joint

What is the direction and amount of central ray angulation for the axiolateral projection (Coyle method) to demonstrate the radial head and capitulum?

45 degrees toward the shoulder

Which projection and position of the upper extremity best demonstrates the coronoid process in profile and free of superimposition?

AP oblique of the elbow in medial rotation position

What is the appropriate collimated field for the AP projection of the elbow?

3 inches (7.6cm) proximal and distal to the elbow joint and 1 inch (2.5 cm) on the sides

With reference to the plane of the IR, how should the humeral epicondylar coronal plane be positioned for the AP projection of the elbow?

Parallel

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

Lateral projection

For the axiolateral projection (Coyle method) of the elbow to demonstrate the coronoid process, the elbow is:

Flexed 80 degrees

What is the central ray orientation for the axiolateral projection of the elbow (Coyle method) to demonstrate the coronoid process when the patient is seated?

Angled 45 degrees away from the shoulder

Which positioning characteristic best indicates that the humerus is properly positioned for the AP projection of the humerus?

The humeral epicondylar coronal plane is parallel with the IR

Which evaluation criterion indicates that the humerus was properly positioned for the AP projection?

The humeral head and greater tubercle are both seen in profile

One way that the lateral image of a humerus, produced with the patient in the lateral decubitus position and the IR placed between the arm and thorax, appears different from the lateral position with the patient standing is that the former demonstrates:

less than the entire humerus

With reference to the plane of the IR, how is it determined that the humerus is properly positioned in true lateral position?

the humeral epicondylar coronal plane is perpendicular

Which evaluation criterion indicates that the humerus was properly positioned for the lateral projection?

the lesser tubercle is seen in profile

What is the appropriate collimated field for the AP and lateral projection of the humerus?

2 inches (5 cm) distal to the elbow and superior to the shoulder and 1 inch (2.5cm) on all sides