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Chapter 5-Upper Limb
Chapter 5-Upper Limb-Positioning Workbook
| Question | Answer |
|---|---|
| Identify the number of bones...Phalanges (fingers and thumb) | 14 |
| Identify the number of bones...Metacarpals (palm) | 5 |
| Identify the number of bones...Carpals (wrist) | 8 |
| Identify the number of bones...Total | 27 |
| The two portions of the thumb (first digit) are the: | proximal phalanx distal phalanx |
| The three portions of each finger (second through fifth digits) are the: | proximal phalanx middle phalanx distal phalanx |
| The three parts of each phalanx, starting distally, are the: | head body (shaft) base |
| List the three parts of each metacarpal, starting proximally: | base body (shaft) head |
| The name of the joint between the proximal and distal phalanges of the first digit is the: | interphalangeal joint |
| The joint between metacarpals and phalanges are the: | metacarpophalangeal (MCP) joint |
| Which is the largest of the carpal bones? | capitate |
| What is the name of the hooklike process extending anteriorly from the hamate? | Hamulus |
| Which is the most commonly fractured carpal bone? | Scaphoid |
| In the anatomic position, which of the bones of the forearm is located on the lateral (thumb) side? | Radius |
| In the anatomic position, which of the bones of the forearm is located on the medial side? | Ulna |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Trochlear Notch | Ulna |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Radial notch | Ulna |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Olecranon Fossa | Distal humerus |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Trochlea | Distal humerus |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Coronoid tubercle | Ulna |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Coronoid process | Ulna |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Olecranon process | Ulna |
| Indicate whether the following structures are part of the radius, ulna, or distal humerus....Coronoid fossa | Distal humerus |
| Which two joints of the forearm allow it to rotate during pronation? | proximal and distal radioulnar joints |
| The articular portion of the medial aspect of the distal humerus is called the? | trochlea |
| Structure found on the lateral aspect of the distal humerus is called the? | capitulum |
| The deep depression located on the posterior aspect of the distal humerus is the? | olecranon fossa |
| List the correct joint movement for each type...Interphalangeal | Ginglymus |
| List the correct joint movement for each type...Carpometacarpal of first digit | Sellar |
| List the correct joint movement for each type...Elbow Joint | Ginglymus |
| List the correct joint movement for each type...Metacarpophalengeal of second to fifth digits | Ellipsoidal |
| List the correct joint movement for each type...Radiocarpal | Ellipsoidal |
| List the correct joint movement for each type...Intercarpal | Plane |
| List the correct joint movement for each type...Proximal and distal radioulnar joint | Trochoidal |
| Ellipsoidal joints are classified as freely movable, or...., and allow movement in....directions | Diarthrodial 4 |
| List all ligaments important to stability of the wrist joint...7 | ulnar radial, radial ligaments, dorsal radiocarpal, palmar radiocarpal, triangular fibrocartilage complex (TFCC), scapulolunate, lunotriquetral |
| Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid and trapezium bones? | radial collateral ligament |
| What is the name of the two special turning or bending positions of the hand and wrist that demonstrate medial and lateral aspects of the carpal region? | Ulnar deviation, radial deviation |
| What position is the most commonly performed to detect a fracture of the scaphoid bone? | Ulnar deviation |
| How does the forearm appear radiographically if pronated for a PA projection? | The proximal radius crosses over the ulna |
| The two important fat strips or bands around the wrist joint are the: | Scaphoid fat stripe, pronator fat strip |
| The fat pads around the elbow joint are valuable diagnostic indicators if the following three technical/positioning requirements are met with the lateral position? | 1.)elbow flexed 90 degrees 2.)optimal exposure techniques 3.)in the true lateral position |
| If the posterior fat pad of the elbow is not visible radiographically, it suggests that a non obvious radial head or neck fracture is present? (T or F) | False - A non visible fat pad suggests a negative exam |
| If the elbow is flexed correctly at 90 degrees, the posterior fat pad is visible if pathological elbow trauma is present? (T or F) | True |
| Trauma or infection makes the anterior fat pad more difficult to see on a lateral elbow radiograph? | False |
| Which projection best demonstrate the scaphoid fat pad? | PA and oblique wrist |
| Which projection best demonstrates the pronator fat stripe? | lateral wrist |
| Kilovoltage (kV) range? | 50-70 kV |
| Long or short exposure time? | short exposure time |
| Large or small focal spot? | Small focal spot |
| Source image receptor distance? | 40 inches |
| Grids are used if the body part measures more than...cm | 10 |
| Type of intensification screens most commonly used? | detail screens |
| Small to medium dry plaster case: Increase....kV | 5 to 7 kV |
| Large plaster cast: increase....kV or.....% mAs | 8-10 kV, 100% mAs |
| Fiberglass casts: increase....kV or.....% mAs | 3-4 kV, 25-30% |
| The general rule for collimation for upper radiography states: | collimation borders should be visible on all 4 sides of the IR, and there is to be no anatomy cut off |
| List factors that help control distortion during upper limb radiography: | 40 to 44 inches SID, Minimal OID, Correct central ray placement, Use a small focal spot |
| Gonadal shielding is especially important for upper limbs on all person who are: | of child-bearing years or younger |
| Guardians of your pediatric patients who are having upper limb studies can be asked to hold their child during the radiographic study? (T or F) | True |
| Radiographic procedure that uses contract media injection into the joint capsule to visualize soft tissue pathology of the wrist, elbow, and shoulder joints? | Arthrography |
| What is the basic positioning routine for the second through fifth digits of the hand? | PA, PA oblique and lateral |
| How much of the metacarpals should be included for PA projection of the digits? | Distal half of metacarpals |
| List two radiographic criteria used to determine whether rotation is present on the PA projection of the digits? | 1.)symmetric appearance of both sides of the shafts of phalanges and distal metacarpals 2.)equal amounts of tissue on each side of the phalanges |
| Identify which positioning modifications may be used for a study of the second digit to improve definition for each of the following.....PA oblique projection | Medial oblique rather than lateral oblique to decrease OID |
| Identify which positioning modifications may be used for a study of the second digit to improve definition for each of the following.....Lateral Position | Thumb-down lateral to decrease OID |
| Where is the central ray centered for a PA oblique projection of the second digit? | proximal interphalangeal (PIP) joint |
| Why is it important to keep affected digit parallel to the IR for the PA oblique and lateral projections? A.)to prevent distortion of the phalanx B.)to prevent distortion of the joints C.)to demonstrate small, non displaced fractures near the joint | all of the above |
| Why is the AP position of the thumb recommended instead of the PA? | the AP position produces a decrease in OID and increase resolution |
| Which projection of the thumb is achieved naturally by placing the palmar surface of the hand in contact with cassette? | PA oblique |
| Which IR size should be used for a thumb routine? | 8 X 10 inch |
| A sesamoid bone is frequently found adjacent to the..... joint of the thumb | Metacarpophalangeal |
| The entire metacarpal and trapezium must be demonstrated on all projections of the thumb? (T or F) | True |
| Where is the central ray centered for an AP projection of the thumb? | First metacarpophalangeal (MCP) joint |
| A Bennett's fracture involves: A.)base of first metacarpal B.)trapezium bone C.)scaphoid bone D.)fracture extending through first IP joint | A. |
| Which special positioning method can be performed to demonstrate a Bennett's fracture? | modified robert's method |
| Which central ray angulation is required for the modified robert's method? | 15 degree proximal (toward the wrist) |
| Where is the central ray centered for a PA projection of the hand? A.)third MCP joint B.)midaspect of third metacarpal C.)second MCP joint D.)third PIP joint | A. |
| A minimum of.....of the forearm should be included radiographically for a PA projection of the hand? | 1 inch |
| Some superimposition of the distal third,fourth, and fifth metacarpals is expected with a well-positioned PA oblique projection of the hand? (T or F) | True |
| Which preferred lateral position of the hand best demonstrates the phalanges without excessive superimposition? | fan lateral |
| Which lateral projection of the hand best demonstrates a possible foreign body in the palm of the hand? | lateral in extension |
| What is the proper name for the position referred to as the "ball-catcher's position"? | norgaard method |
| The "ball-catcher's position" is commonly used to evaluate fro early signs of: a.)osteoporosis b.)osteomyelitis C.)osteropetrosis d.)rheumatoid arthritis | D. |
| The elbow generally should be flexed...degrees for the basic position of the wrist? | 90 |
| How much rotation is required for an oblique projection of the wrist? | 45 degrees |
| Which alternative projection to the routine PA wrist best demonstrates the intercarpal joint spaces and wrist joint? | AP projection |
| Which positioning error is involved if significant aspects of the third, fourth, and fifth metacarpals and superimposed in an oblique wrist projection? | excessive lateral rotation from PA |
| Which on of the following fractures is not demonstrated in a wrist routine? A.)barton B.)pott c.)smith D.)colles | b. |
| During the PA axial scaphoid projection with central ray angle and ulnar flexion, the central ray must be angles ....., (proximally, distally)? | 10-15 degrees, proximally |
| How must are the hand ans wrist elevated from the IR for the modified Stecher method? A.)none B.)10 degrees C.)20 degrees D.)15 degrees | C. |
| How much central ray angulation to the long axis of the hand is required for the carpal canal projection? | 25-30 degrees |
| Which special projection of the wrist best demonstrates the inter spaces on the ulnar side of the wrist between the lunate, triquetrum, pisiform, and hamate bones? | PA projection with radial deviation |
| Which special projection of the wrist helps rule out abnormal calcification's in the carpal sulcus? | carpal canal or Gaynor-Hart projection |
| How much central ray angulation from the long axis of the forearm is required for the carpal bridge projection? | 45 degrees |
| What is the approximate difference in mrad between skin and mid-line doses for the hand and wrist? | no difference |
| Fracture and dislocation of the posterior lip of the distal radius? | Barton's fx |
| Most common type of primary malignant tumor occurring in the bone? | multiple myeloma |
| Reduction in the quantity of bone or atrophy of skeletal tissue? | osteoporosis |
| Sprain or tear of the ulnar collateral ligament? | skier's thumb |
| an abnormality of the cartilage affecting long bones? | achondroplasia |
| transverse fracture extending through the distal aspect of the metacarpal neck? | Boxers fracture |
| Hereditary condition marked by abnormally dense bone? | osteopetrosis |
| Transverse fracture of the distal radius with posterior displacement of the distal fragment? | Colles fx |
| Indicate whether the manual exposure factors should be increase (+), decrease (-), or remain the some (0)....advanced Paget's disease | increase (+) |
| Indicate whether the manual exposure factors should be increase (+), decrease (-), or remain the some (0)....Joint effusion | same 0 |
| Indicate whether the manual exposure factors should be increase (+), decrease (-), or remain the some (0)....advanced rheumatoid arthritis | decrease (-) |
| Indicate whether the manual exposure factors should be increase (+), decrease (-), or remain the some (0)....osteoporosis | decrease (-) |
| Indicate whether the manual exposure factors should be increase (+), decrease (-), or remain the some (0)....osteopetrosis | increase (+) |
| Indicate whether the manual exposure factors should be increase (+), decrease (-), or remain the some (0)....bursitis | same (0) |
| which basic projections are required for a study of the forearm? | AP and lateral |
| For a forearm study, the technologist needs to include only the joint closest to the site of the injury? (T or F) | False |
| To properly position patient for an AP projection of the elbow, the epicondyles must be....to the IR | parallel |
| If the patient cannot fully extend the elbow for the AP project, what alternative projection should be performed? | two AP projections, one with humerus parallel to IR and one with forearm parallel to IR |
| Which basic projection of the elbow best demonstrates the radial head, neck, and tuberosity without any superimposition of the ulna? | AP oblique with 45 degree lateral rotation |
| Gonadal shielding is not required for upper limb radiographs if the patient can sit upright for these exams (T or F) | False |
| Which projection of the elbow best demonstrates the coronoid process in profile? | AP oblique with 45 degree medial rotation |
| The best position to evaluate the posterior fat pads of the elbow joint is? | lateral, flexed at 90 degrees |
| Which special projections of the elbow should be performed instead of the basic AP if the patients elbow is tightly flexed and cannot be extended at all? | two projections-CR perpendicular to humerus, CR perpendicular to forearm |
| How much is the upper limb rotated for a lateral (rotation) oblique projection of the elbow? | 45 degree laterally |
| What is a proper name for the acute flexion projection of the elbow? | Jones method |
| How must and in which direction should the central ray be angles for the Coyle method involving the radial head? | 45 degree toward shoulder |
| How much and in which direction should the central ray be angled for the Coyle method involving the coronoid process? | 45 degree away from shoulder |
| What is the only difference among the four radial head lateral projection of the elbow? | the rotational position of hand and wrist |
| The nearest skin dose for each of the following...PA finger | 5 mrad |
| The nearest skin dose for each of the following...AP forearm | 25 mrad |
| The nearest skin dose for each of the following...Lateral humerus | 30 mrad |
| The nearest skin dose for each of the following...Lateral hand | 15 mrad |
| The nearest skin dose for each of the following...Carpal canal wrist | 20 mrad |
| The nearest skin dose for each of the following...PA hand | 10 mrad |
Created by:
brahoi