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RADT308-HAND & WRIST

Review of radiographic anatomy, positioning and pathology

QuestionAnswer
transfer of disease or cancerous lesions from one organ or part that may not be directly connected. Most common of malignant bone tumors bone metastases
inflammation of the bursae or fluid-filled sacs that enclose the joints; involves the formation of calcification in associated tendons bursitis
common painful disorder of the wrist and hand that results from compression of the median nerve as it passes through the center fo the wrist carpal tunnel syndrome
break in the structure of bone caused by force fracture
fracture of the base of the first metacarpal bone extending into the CMC joint complicated by subluxation with some posterior displacement bennet's fracture
transverse fracture that extends through the metacarpal neck most commonly seen in the fifth metacarpal boxer's fracture
accumulated fluid in the joint cavity; sign of an underlying condition joint effusion
aka DJD; noninflammatory joint disease charachterized by gradual deterioration of the articular cartilagewith overgrown bone formation; most common type of arthritis osteoarthritis
local or gernalized infection of bone or bone marrow osteomyelitis
hereditary disease marked by abnormally dense bone; also known as marble bone osteopetrosis
reduction in the quantity of bone or atrophy of skeletal tissue; common in postmenopausal women and elderly men osteoporosis
chronic skeletal diseases; destructive bone disease followed by a reparitive process of overproduction of very dense yet soft bones that tend to fracture easily; most common in men older than 40 paget's disease
chronic systemic disease with inflammatory changes throughout the body's connective tissues; early bone erosions typically occur first at the 2nd and 3rd MCP joints or the 3rd proximal interphalangeal joint; 3 times more common in women than men rheumatoid arthritis
sprain or tear of the ulnar collateral ligament of the thumb near the MCP joint of the hyperextended thumb skier's thumb
most comon of the primary cancerous bone tumors; generally affects persons between the ages of 40 and 70; arise from bone marrow or marrow plasma cells; radiographic appearance of punched out osteolytic lesions scattered throughout the affected bones multiple myeloma
second most common type of primary cancerous bone tumor; affects ages 10-20 primarily osteogenic sarcoma
common primary malignant bone tumor in children and young adults; arises from bone marrow; symptoms similar to osteomyelitis with low-grade fever and pain; onion peel appearance on radiographs ewing's sarcoma
slow-growing malignant tumor of the cartilage chondrosarcoma
slow-grwoing benign cartilaginous tumor endochondroma
most common type of benign bone tumor osteochondroma
SID for hand positioning 40
phalanges should lie _______ to IR parallel
number of carpals in the hand and wrist 8
number of metacarpals in the hand and wrist 5
number of phalanx in the hand and wrist 14
joint between the phalanges and metacarpals MCP
joint between the proximal and middle phalanx PIP
joint between the middle and distal phalanx DIP
joint between the proximal and distal phalanx of 1st digit IP
joint between the metacarpal and carpals CMC
thumb articulates with this carpal trapezium
5th metacarpal articulates with this carpal hamate
IP joint movement type ginglymus
ginglymus is also known as this hinge type
all joints in the hand and wrist are classified as synovial
MCP joints movement type ellipsoidal
number of directions of movement for an ellipsoidal joint four - flex, ext, abd, add
1st MCP joint may also have what additional movement besides those of the ellipsoidal joint circumduction
CMC joints (2nd-5th) joint movement plane
CMC joint (1st) joint movement sellar
what rule states that you must have at least 30% of the IR covered for digital images? 30% rule
why does 30% of the IR need to be covered in digital imaging? for accurate EI reading
if doing more than one view per IR, what precautions should you take lead masking, collimation
true/false: you need a grid for hand imaging false
displacement from the joint dislocation
partial dislocation from the joint subluxation
rupture or tearing of connective tissues sprain
bruise without fracture contusion
type of fracture where fragments are driven into each other impacted
type of fracture where there is a splintering or crushed fracture fragments comminuted
a fracture that breaks through the skin compound
type of fracture that happens when a finger is extended and is jammed resulting in an avulsion fx occurring at the posterior base of the distal phalanx baseball or mallet fracture
centering point for PA hand third MCP
hand is in the position for the PA view prone
exposure factor for PA hand 55-65 kV
centering point for PA oblique third MCP
degree of obliquity for PA oblique 45
if fourth and fifth metacarpals are superimposed on the PA oblique radiograph, what happened? rotated more than 45 degrees
exposure factors for PA oblique 55-65 kV
what happens if you do not maintain parallel fingers on the oblique view? foreshortening of phalanges and obscuration of IP joints
centering point for fan lateral hand second MCP
why do a fan lateral compared to a normal lateral? demonstrates phalanges better
exposure factors for fan lateral 60-70 kV
what position of the hand places the thumb in a PA position lateral
why should a lateral hand be done in a hand series? metacarpal alignment and FB localization (extension lateral)
if patient presents with FB, what type of lateral would you perform? extension lateral
what position has the 2nd-5th metacarpals superimposed with the 1st digit lightly touching the 2nd digit? flexion lateral
where is the centering point for an extension lateral 2nd MCP
where is the centering point for a flexion lateral 2nd MCP
what exposure factors are used for extension/flexion laterals? 60-70 kV
what degree oblique is used for the norgaard method? 45
norgaard is also known as the ____ position ball-catchers
centering point for the norgaard method level of the fifth MCP joints
exposure factors for norgaard method 55-65 kV
why perform the norgaard method? early detection of RA
fracture and dislocation of the posterior lip of the distal radius involving the wrist joint Barton's fracture
transverse fracture of the distal radius in which the distal fragment is displaced poseteriorly; an associated ulnar styloid fracture seen in 50-60% of cases Colles' fracture
reverse of colles' fracture, or transverse fracture of the distal radius with distal fragment displaced anteriorly smith's fracture
where is the centering point for a PA wrist midcarpal
where is the centering point for a PA oblique wrist midcarpal
where is the centering point for a Lateral wrist midcarpal
where is the centering point for a pa radial deviation midcarpal area
where is the centering point for a pa ulnar deviation scaphoid (3/4" distal and medial to radial styloid)
where is the centering point for a pa scaphoid modified stetcher scaphoid (3/4" distal and medial to radial styloid)
where is the centering point for a carpal canal? 1" distal to base of 3rd metacarpal
where is the centering point for a carpal bridge 1.5" proximal to wrist joint
kv for digital system for a PA wrist 55-65
kv for digital system for a PA oblique 60-70
kv for digital system for a lateral wrist 60-70
kv for digital system for a pa scaphoid 55-65
kv for digital system for a radial deviation 55-65
kv for digital system for a carpal canal 55-65
kv for digital system for a carpal bridge 55-65
another name for a carpal canal view tangential inferosuperior or gaynor-hart method
what is the CR angle for the carpal bridge? 45 degrees to long axis of forearm
what is the CR angle for the carpal canal? 25-30 degrees to the long axis of the hand
what is the flexion of wrist for the carpal bridge 90
what is the extension of the hand for the carpal canal 90
how much is the hand elevated for a modified stetcher 20 degrees
why do the modified stetcher vs. pa axial scaphoid? places scaphoid parallel to IR
why do ulnar deviation for scaphoid? decreases superimposition of scaphoid with adjacent carpal bones
what alternative can you do for a modified stetcher if you do not have a 20 degree wedge? Have patient clench their fist
what degree of obliquity is necessary for PA oblique wrist 45 degrees
what benefit does an AP wrist have over a PA wrist? places wrist and carpals in close contact with IR demonstrating intercarpal spaces more parallel to the divergent rays.
why arch hand for a PA wrist? places wrist joint and carpals in close contact with IR
position that opens the lateral side of the carpal bones? ulnar deviation
position that opens the medial side of the carpal bones radial deviation
position that is ideal for demonstrating calcification in the dorsal aspect of the carpals? carpal bridge
position that is ideal for demonstrating the carpal sulcus? carpal canal, Gaynor Hart method
position that will demonstrate the pisiform and hamate the best? carpal canal, Gaynor Hart method
carpals that articulate with the radius? scaphoid, lunate
smallest of the carpal bones pisiform
largest of the carpal bones capitate
proximal row of carpals scaphoid lunate triquetrum pisiform
distal row of carpals trapezium, trapezoid, capitate, hamate
type of movement for the radiocarpal joint ellipsoidal
cast conversion for small to medium dry plaster cast +5-7kV
cast conversion for large or wet plaster cast +8-10 kV
cast conversion for fiberglass cast +3-4 kV
evert hand means to move the hand toward which bone? ulna
invert hand means to move the hand toward which bone radius
Created by: hschmuck1