forearm and elbow study guide from worksheet

The forearm consists of which bones?

radius and ulna

Which bones make up the palm of the hand?

metacarpals

Which digit has only two phalanges?

first digit (thumb)

What is the name of the two small depressions found on the anterior aspect of the distal humerus?

radial fossa and coronoid fossa

What action will lead to the proximal radius crossing over the ulna?

pronation

Which bones make up the digits of the hand?

phalanges

The joints between the metacarpals and the carpals are the?

carpometacarpal joints

What type of joints are all IP joints?

hinge

What is the average KV for an upper limb radiograph

65-75

What does the capitulum articulate with

radial head

Is the radius located lateral or medial when in anatomical position

lateral

What type of movement does the elbow joint allow?

hinge

How many total bones are in the hand and wrist?

27 total. 8 carpals, 5 metacarpals, 14 phalanges

Why should the hand be slightly arched for a PA projection of the wrist?

to decrease OID of the wrist

The ulna articulates with what portion of the humerus to help form the elbow joint?

trochlea

What is the minimum number of exposures required for the frontal projection of the elbow when in acute flexion?

two

1.     Which carpal bone is the smallest and largest

pisiform, capitate

What is the bending or forcing of the hand toward the lateral side of the forearm known as?

radial deviation

What projection best demonstrates the pronator fat pad?

lateral projection

In which type of fracture are the splintered ends of the bone forced through the skin?

compound fracture

What bony structures are located on the distal ulna?

  Ulnar head, styloid process, distal radioulnar joint

How many bones are the digits composed of?

24 phalanges

What type of movement does the radiocarpal joint possess?

Ellipsoid/condyloid. Flexion, extension, radial and ulnar deviation (biaxial)

Where does the posterior fat pad lie?

olecranon fossa

At what measurement of the upper limb would a grid be required?

over 10 cm

Where should the long axis of the anatomical part being imaged be placed in reference to the IR?

parallel

What is the routine for a radiographic examination of the forearm?

AP and lateral

How should the humeral epicondyles be during an AP projection of the elbow?

parallel to the IR

How many carpal bones are found in the wrist?

eight

Which carpal articulates with both the fourth and fifth metacarpal?

hamate

The joints of the upper limb belong to which structural joint classification?

synovial

What are the two fat stripes of the wrist demonstrated radiographically?

scaphoid and pronator fat stripe

What is a soft tissue radiograph of a lateral elbow used to demonstrate?

anterior and posterior fat pads

What are some general procedures when performing x-ray examinations of the distal upper limb?

AP and lateral image, humeral epicondyles should be parallel to the IR

What projection best demonstrates pathology involving the first carpometacarpal joint?

modified roberts method

Where is the centering point for a PA projection of the hand?

3rd metacarpophalangeal joint

What pathology is the AP oblique bilateral hands projection (Norgaard Method) used to demonstrate

rheumatoid arthritis

What is the centering point for a PA oblique projection of the wrist?

midcarpal

What criteria should be utilized when evaluating a true lateral thumb radiograph?

1. make sure the interphalangeal joints and metacarpophalangeal joints are open

2. make sure the thumb is in a true lateral

What is the name of the distal rounded portion of the metacarpal?

head

What type of movement does the proximal radioulnar joint allow?

pivot (prontation and supination)

What carpal bone articulates with the 1^st   metacarpal?

trapezium

What joints should be clearly demonstrated on the AP projection of the forearm?

the elbow and wrist joint

What is the centering point for a PA projection of the third digit?

third proximal interphalangeal joint (PIP)

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

PA wrist with radial deviation

What modality is the most sensitive for assessing bones of the upper limb for either metastatic bone lesions or stress fractures?

nuclear medicine

Which position of the elbow will best demonstrate the fat pads of the elbow?

lateral

How much rotation of the distal humerus is required for the AP medial projection of the elbow?

45

Are the styloid processes of the radius and ulna located at the proximal or distal ends of the bones?

distal

Does the olecranon process fit into the olecranon fossa when the arm is flexed or fully extended?

fully extended

What structure is considered to be the most lateral of the distal humerus?

lateral epicondyle

What is the centering point for a PA projection of the thumb? For the AP projection (Robert’s Method)?

first metacarpophalangeal joint for both

What projection can be performed to confirm an injury to the ulnar collateral ligament?

folio method

What position should be performed to confirm a scaphoid fracture if the patient is not able to perform ulnar deviation?

modified stretcher position

What projection best demonstrates the carpal sulcus?

gaynor hart method

What depression does the head of the radius fit into on the lateral aspect of the coronoid process of the ulna?

radial notch

How much of the wrist and elbow joint is recommended to be included on the IR on an AP projection of the forearm?

One to one and a half inches on each side

What are valid criteria for a lateral projection of the forearm?

1.   Humeral epicondyles and phalanges are superimposed

2. There are carpals and the elbow joint showing

What CR angulation is required for the carpal canal projection?

25-30 degrees

How much rotation of the hands is required for the Norgaard Method?

45 degrees

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

perpendicular to IR

In what type of fracture does the bone crack and the fragments still remain adjoined together?

incomplete fracture

What projection of the elbow will demonstrate the olecranon process within the olecranon fossa?

lateral

How many projections are necessary for an AP projection of the elbow to avoid distortion of the joint if the patient is able to only partially extend the forearm?

two

What does a non-visible posterior fat pad on a well exposed, correctly positioned lateral elbow radiograph suggest?

the patient is uninjured (negative result)

What is the CR angulation for both axiolateral trauma projections of the elbow?

45 degrees

How much is the elbow flexed for a trauma axial lateral projection (Coyle Method) to demonstrate the coronoid process?

80 degrees

What projection will result in superimposed humeral epicondyles?

lateral

What structure would be projected free of superimposition for an AP oblique projection of the elbow with medial rotation?

coronoid process of the ulna

Which projection of the elbow demonstrates the lateral epicondyle and capitulum elongated?

AP oblique with lateral rotation

How should an AP projection be obtained when imaging a patient whose elbow is in partial flexion?  

foramen parallel to IR, humerus parallel to IR

Chalky white or opaque bony appearance

osteoporosis

“Cotton wool” appearance

pagets disease

“Onion peel” bony appearance from stratified new bone formation

ewing sarcoma

Fracture of the distal radius with posterior displacement

colles fracture

Intra-articular fracture involving the base of the first metacarpal bone

bennetts fracture

Fracture of the distal radius with anterior displacement

smiths fracture

Fracture and dislocation of posterior lip of distal radius

bartons fracture

Transverse fracture extending through the 5^th metacarpal

boxers fracture

When do you use Modified Strechers Method?

to visualize the scaphoid bone

What modality is the most sensitive for assessing bones of the upper limb for either metastatic bone lesions or stress fractures?

nuclear medicine

The capitulum articulates with the

radial head

 For a PA oblique projection of the hand the phalanges need to be kept _____ to the IR so that the _____________ and ____________ are open

parallel, metacarpophalangeal joints, interphalangeal joints

1.     An ellipsoidal (condylar) joint allows movement in _____ directions

two

1.     The first carpometacarpal joint is classified as a _____ joint.

saddle

What two bony landmarks are palpated for positioning of the elbow?

lateral and medial epicondyle

What two structures primarily form the hinge-like structure and movement of the elbow joint?

trochlea, Olecranon process, trochlear notch

Which carpal bones articulate with the radius?

scaphoid and lunate

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

AP oblique with lateral rotation

What carpal bone is the most commonly fractured of the carpal bones?

scaphoid

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

interphalangeal joints

What two structures form the distal radioulnar joint?

ulnar notch and head of the ulna

For a PA oblique projection of the hand, it is important to keep the phalanges parallel to the IR to

prevent foreshortening