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Upper Xtremities

Upper Extremities

kV for AP or AP Axial Clavicle 65-75kV
Centering for Clavicle perpendicular to mid clavicle
kV for AP or Lateral Scapula 70-80kV
AP Axial of Clavicle, the CR is angled _____? 15-30 degrees cephalad
Bilateral AC joints require what two positions? with and without 5-8lbs of weights
Name the three angles of the Scapula Superior, Inferior, and Lateral angles
Name the two fossa on the Dorsal Scapula Supraspinous and Infraspinous Fossa
The two views of the Scapula AP and Lateral
Criteria for good Scapula image entire scapula, lateral border free of ribs and lungs, optimal exposure factors
SID for Scapula and Clavicle 40 inches
SID for AC Joints 72 inches
Centering for AC Joints 1 inch above Jugular Notch
True/False: Bilat. AC joints require markers- R, L, with, without TRUE
True/False: Bilat. AC Joints can be done WITHOUT a grid TRUE
Name the 3 arm positions that can be used for a lateral scapula behind back, across chest, over head.
True/False: Humerus should be superimposed over the scapula FALSE
Name Criteria for lateral Scapula entire scapula,in profile,separated from ribs, humerous not superimposed over area of interest.
True/False: Respiration is not important for a AP Scapula False - Should be slow respiration
True/False: Respiration is not important for a Lateral Scapula False - Should be suspended respiration
Name the Trauma Shoulder positions AP neutral rotation, Transthoracic lateral or the Scapular Y view
Name the Routine Shoulder positions AP with external and internal rotation
Another name for Inferosuperior axial (Shoulder) Lawrence method
Another name for Superoinferior axial (Shoulder) Hobbs modification
Another name for Posterior Oblique- glenoid cavity (Shoulder) Grashey method
Another name for Tangential projection - intertubercal groove(Shoulder) Fisk modification
Another name for Transthoracic lateral (Shoulder) Lawrence method
Routine positions for the Humerus are: AP and Lateral
Trauma positions for the Humerus are: Lateral for distal Humerus, Transthoracic lateral for proximal Humerus, Y-view for proximal Humerus
Criteria for good AP Humerus entire Humerus, Greater tubercle in profile, epicondyles in profile, exposure factors.
Criteria for good Lateral Humerus entire Humerus, Lesser tubercle in profile, epicondyles are superimposed, exp. factors.
Type of joint: Scapulohumeral Spheroidal (ball and socket)
Type of joint: Sternoclavicular Plane (gliding)
Type of joint: Acromioclavicular Plane (gliding)
Describe epicondyles and tubercles with Shoulder AP External rotation Epicondyles are parallel to IR, Greater tub in profile laterally, Lesser tub anterior
Describe epicondyles and tubercles with Shoulder AP Internal rotation Epicondyles are perpendicular to IR, Greater tub anterior, Lesser tub in profile medially
Centering point for AP shoulder? 1" inferior of Coracoid process (Scapulohumeral joint)
Where is the Coranoid Process? The proximal end of the Ulna, articulates with the Trochlea of the Humerus
Where is the Coracoid Process? Superior border of Scapula and inferior to the Distal end of the Clavicle
What carpal bone articulates with the radius? Scaphoid
What carpal bone articulates with the radius and the capitate? Lunate
Which carpal bone is proximal to the first metacarpal (thumb)? Trapezium
Which carpal bone is proximal to the 2nd metacarpal? Trapezoid
Which carpal bone is proximal to the 3rd metacarpal? Capitate
Which carpal bone is proximal to the 4th and 5th metacarpal? Hamate
The metacarpals are concave on the anterior and convex on the posterior. True
The wrist joint is an ellipsoidal joint which is the most freely moveable of synovial joints. True
What is the joint called where the radius articulates with the scaphoid and the lunate? radiocarpal joint
What is the average range of kV for the fingers hand and wrist? 50-65 kV
Where do you center for a PA hand and an oblique hand? 3rd MCP
Where do you center for a lateral of the hand? 2nd MCP
What is another name for the Norgaard Method and what is it used to diagnose? Ball Catcher's Position - diagnoses rheumatoid arthritis
Where do you center for a PA and oblique wrist? mid carpal area
WHere do you center for a lateral wrist? Perpendicular to wrist joint
How much of a CR angle is used for the Stecher Method (Scaphoid)? 20 degrees up hand centered over the scaphoid
Where do you ceneter on the thumb? At 1st MCP joint
What position is used for an oblique of the thumb? PA hand
WHat needs to be demonstrated on an exam of the thumb? Entire thumb including the 1st MCP
Where do you center for the 2nd-5th digits? PIP joint
The radial head is proximal/near the elbow on the lateral or thumb side. True
The ulnar head is distal/near the wrist on the medial side. True
When does the radius cross over the ulna? during pronation
When do the radius and ulna show no superimposition? external rotation (oblique with lateral rotation)
What does a true lateral show? THe proximal head and neck of the radius, the radial tuberosity, and the trochlear notch.
Does the forearm need to show both joints? YES
What exam shows the coronoid process free of superimposition? AP oblique (medial rotation)
Acute flexion is also called? Jones method
Technical factors for the Shoulder? (kV/mAs) Medium kV (70-80) High mA/low exposure time
The lesser tuberosity of the humerus is seen in profile with the arm in ________ . Internal rotation
Which part of the scapula does the humerus articulate with? glenoid fossa
To demonstrate the shoulder and upper humerus in anatomical position, the arm should be rotated __________ Externally
The AP internal rotation of the shoulder places the humerus _______ in the position Lateral
What is the centering point for AP shoulder WITH external rotation? 1" inferior of the coraCoid process
Which shoulder position shows the lesser tubercle in profile? AP with internal rotation
Another name for inferosuperior, axial projection of the shoulder is? Lawrence method
In the inferiosuperior, axial projection of the shoulder, the ______ tubercle is in profile Lesser
The AP shoulder with neutral rotation is done for? Trauma
When doing the humerus how many, and which joints are demonstrated? 2, Scapulohumeral and elbow joint (includes humeralulna, humeralradial, and proximal radioulnar joints.)
When doing a dislocated shoulder exam, what positions would be performed? AP shoulder with neutral rotation and the Y view
What is the centering point for a transthoracic lateral of the humerus? surgical neck
What is the Grashey method and how much is the patient rotated? AP oblique of the shoulder, 35degrees toward the affected side
What is the position of the scapula when doing a Y view? Lateral
The Grashey method is used to demonstrate? profile of the glenoid cavity
For the oblique of the Hand, what do you use to measure your rotation and what is the degree? The styloid processes should be at a 45degree angle
Why are the fingers parallel to the IR and not bent in a hand exam? to show joint spaces
What should you do with the fingers in a wrist projection? curl them, to move the carpals closer to the IR
What is the name of the furthest lateral carpal on the proximal row? Schapoid
Name the carpals in order, proximal row first. Schaphoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapazoid, Capitate, Hamate
Ok Hotshot, what are the OLD names the carpals in order ? Navicular, Semilunar, Triangular, Pisiform, Greater Multiangular, Lesser Multiangular, Os magnum, Unciform
WOW, you are good! Yeah, I know you know.
In the anatomical position, what is it called when the hand is moved medially, but the arm is kept straight? Ulnar deviation
R______ A_______ is a common pathology that hand and wrist exams are ordered for. Rhumatoid Artharitis
How many bones are in the hand? 27
How many bones in the Phalanges? 14
How many carpals? 8
What kind of joint is the 1st MCP? Sellar (saddle)
What kind of joint is the DIP? Ginglymus (hinge)
What kind of joint are the intercarpals? Plane (Gliding)
What kind of joint is the Wrist (carpal to ulna and radius)? Ellipsoid (condyloid)
What ind of joint is the proximal and distal radioulnar joints? Trochoid (pivot)
What kinda of joint is the elbow? Ginglymus (hinge)
kV AP hand? 50-60
kV Lateral hand? 55
kV Oblique hand 55-65
kV wrist and trauma wrist? 55-65 and 50-70
Define Subluxion partial dislocation
Define Sprain rupture or tearing of ligaments
Define Contusion bruise without fracture
Define Greenstick incomplete fracture
fx means? fracture
Baseball mallet fx is? fx of distal phalynx
Boxer's fx is? broken knuckle
Name the fat pads of the elbow anterior fat pad, posterior fat pad, supinator fat stripe.
To obtain a lateral forearm: Thumb side must be up & forearm & humerus must be in the same plane
To clearly see the olecranon process in profile, which position should be used? AP Oblique w/medial rotation
For some soft tissue injuries the lateral elbow is only flexed: 30-35 degrees
The proximal radioulnar joint is considered a: pivot joint and is diarthrodial
For a lateral view of the elbow to be accurate, what should be superimposed? epicondyles of the humerus
For a trauma elbow, how many AP projections should be taken 2
Which projection of the elbow superimposes the forearm and the humerus? AP projection;acute flexion
Are both joints usually visualized when taking a forearm on an 11 x 14? YES
Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid & trapezium bones? radial collateral ligament
The two important fat stripes around the wrist joint are: scaphoid fat stripe & pronator fat stripe
Pathology revealed in a AP forearm? Fractures, dislocations,and pathologic processes such as osteomyelitis or arthritis.
Describe Positioning for an AP forearm Entire limb in the same planeShoulder at table levelAlign and centre forearm to long axis of IRSupinate hand (2nd to 5th metacarpal heads against IR)Elbow fully extendedCheck the humeral epicondyles are equidistant from the IR
A forearm film is hung from which end? from the fingers...or wrist end.
A shoulder is hung from which end? from the shoulder.
You are _______ Amazing!
Rotation of the forearm is shown by ? separation of ulna and radius(lat. rot.) or MORE THAN SLIGHT superimposition (med. rot.) or pronation- if radius is rotated across ulna (hand not supinated)
Name wrist fat pads? scaphoid fat stripe and pronator fat stripe
Name Elbow fat pads? Anterior fat pad, posterior fat pad, supinator fat stripe.
Define Bursitis Inflammation of the bursae (fluid filled sacs that enclose joints)
Define Osteroarthritis degenerative joint disease
Define Osteoporosis reduction in quantity of bone or atrophy of skeletal tissue
Define Rheumatoid Arthritis systemic chronic inflammation of connective tissue.
Detect rotation on AP thumb or fingers by? should be symmetric concave sides of phalanges and equal soft tissue.
Detect rotation of AP hand. should be symmetric concavity of sides of metacarpals and phalanges 2 thru 5.
Detect rotation of Oblique hand true 45degree oblique will have some overlap of 3rd, 4th, and 5th metacarpal head only.
Detect rotation for lateral hand radius and ulna should be superimposed. metacarpals should also be superimposed.
Detect rotation AP wrist should be equal concavity of proximal metacarpals and near equal distance between proximal carpals.
Detect rotation of Lateral wrist true lateral ulnar head will be superimposed over distal radius 2-5 metacarpals aligned and superimposed.
Detect rotation for AP Forearm should be humeral epicondyles in profile. radial head, neck, and tuberosity slightly superimposed by ulna.
Detect rotation for Lateral Forearm head of ulna and radius SHOULD be superimposed and humeral epicondyles should be superimposed.
the wrist joint is also called the radiocarpal joint
ellipsoidal joints move in how many directions 4
cast conversions fiberglass-^25-30%ma or kV^3-4, sm to dry- ^mas 50-60% or kV^5-7, heavy or wet- ^mas 100% or kV ^8-10
CR for carpal canal-tangential inferiorsuperior projection for carpal tunnel syndrome 25-30deg 1 inch distal to base of third metacarpal
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