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IMAG 301- Positioning Princ. I > Ch. 4 Upper Limb > Flashcards

Ch. 4 Upper Limb Flashcards

1
Q

How many phalanges are in each hand?

A

14

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2
Q

How many metacarpals are in each hand?

A

5

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3
Q

How many carpal bones are in the wrist?

A

8

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4
Q

How many phalanges re contained in the thumb?

A

Only 2

*digits 2-5 have 3 digits

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5
Q

Which digit is most lateral?

A

The thumb

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6
Q

What are the two names of the phanlanges in the thumb?

A

Proximal phalanx and distal phalanx

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7
Q

What are the metacarpals?

A

The bones that compose the palm of the hand

-identified by numbers

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8
Q

Are the heads of the metacarpals distal or proximal to the point of attachment?

A

Distal

-Base of metacarpals are proximal (articulate with carpals)

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9
Q

What are the four wrist bones that are proximal?

A

Scaphoid, lunate, triquetrum, pisiform

lateral-medial

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10
Q

What are the four wrist bones that are distal?

A

trapzium, trapezoid, capitate, hamate

Lateral-medial

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11
Q

What does IP stand for?

A

Interphalangeal (IP) joints

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12
Q

Where are IP joints located?

A

between phalanges

DIP, PIP, IP

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13
Q

What is MCP?

A

Metacarpophalangeal joints

-Articulations between the head of the metacarpals and the proximal phalanges

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14
Q

What are MCP joints classified as?

A

Synovial, diarthrotic, or ellipsoidal joints

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15
Q

What are IP joints classified as?

A

Synovial, diarthrotic, (freely movable joint), and hinge joint

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16
Q

Where are the Carpometacarpal joints (CMC) located?

A

Articulations between the bases of the metacarpals and the carpal bones

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17
Q

Intercarpal joints?

A

Between carpal bones

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18
Q

Radiocarpal joint

A

Between carpals and distal radius

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19
Q

If a patient can not remove their ring, what do you do?

A

Make a note saying that the patient has a ring on their finger

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20
Q

What size IR is used for hand, wrist, and finger xrays?

A

10x12

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21
Q

What is critical when imaging the hand, wrist, and fingers?

A

Collimation!

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22
Q

What is the SID for imaging of the hands, fingers, and wrists?

A

40 in SID, to the IR (which is placed on top of the table)

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23
Q

What are the essential projections for Digits 2-5?

A

PA, Lateral, and PA Oblique

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24
Q

What is the collimation field size for hand, wrist, and finger images?

A

1 in. on all sides of hand, wrist, or finger

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25
Q

What should you also included in the collimation field in finger images?

A

Include 1 in. proximal to the MCP (half way down metacarpals)

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26
Q

Where is the centering for a finger image?

A

PIP joint for whatever finger you are imaging (middle knuckle)

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27
Q

Lateral Digit 2-5 projection conditions

A

Separate digit of interest using a cotton swab or tape, and fold other digits into fist

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28
Q

What digits for the lateral projections are positioned on their lateral surface? (mediolateral)

A

digits 2 and 3

this is done to demonstrate fractions and dislocations

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29
Q

What digits for the lateral projection should be positioned on their medial surface? (lateromedial)

A

digits 4 and 5

30
Q

PA Oblique digits 2-5 conditions

A
  • Extend w. palm surface resting at 45 degrees on a sponge (if necessary)
  • centering at PIP for particular digit
31
Q

What is the more comfortable position for PA oblique of the fingers?

A

PA External Oblique where patient moves hands to 45 degrees towards the outside

32
Q

Essential projections of the Thumb?

A

AP, Lateral, and PA Oblique

33
Q

Centering point for Thumb projections?

A

MCP and include entire metacarpal of thumb

34
Q

AP thumb projection conditions

A
  • Rotate hand exteriorly

- Centering point, MCP

35
Q

Oblique Thumb

A

Hand is flat on IR, centering at MCP

36
Q

Lateral Thumb

A
  • Have patient curl fingers (makes it comfortable for them)
  • thumb nail perpendicular to IR
  • center line in the center of the thumb, center at MCP
37
Q

PA hand

A
  • Center at 3rd MCP

- light field 1 in above hand and below wrist

38
Q

Centering Point for all Hand projections

A

3rd MCP for PA and PA oblique, 2nd MCP for both Lateral projections (fan and extended)

39
Q

Essential Projections for the Hand?

A

PA, Lateral (2 - extended and fan), PA Oblique

40
Q

Where does the central ray enter the 3rd digit for the PA projection ?

A

3rd PIP (PA of 3rd digit)

41
Q

PA External Obliqye of Hand

A

-Can support digits w. sponge, digits are extended so we can see joint spaces better

42
Q

What should be flexed 90 degrees during the Lateral Hand projection?

A

Elbow should be flexed 90 degrees

43
Q

Why is a PA lateral done for a hand?

A

To look for foreign bodies (needle, or a wood chip stuck in the hand)

44
Q

Essential projections for the Wrist

A

PA, Lateral, PA oblique, AP oblique, and Ulnar deviation

45
Q

What position is most comfortable regarding an oblique projection of the hand?
A. AP Oblique
B. PA Oblique

A

A. AP Oblique

46
Q

What projection of the wrist is done to see fractures of the scaphoid of the wrist?

A

PA Oblique

47
Q

Essential Projection to view Scaphoid

A

PA axial (Stecher method)

48
Q

The PA axial projection is also known as what?

A

The Stecher method

49
Q

Essential Projection to view the carpal canal

A

Tangential (Gaynor-Hart method)

50
Q

The Tangential projection is also known as what?

A

The Gaynor-Hart method

51
Q

Collimated field size for Wrist projections

A

2.5 in. proximal and distal to the wrist joint

Including all metacarpals and centering at wrist joint

52
Q

What should the patient do with their wrist in order to get it closer to the IR for a PA wrist projection?

A

Flex digits

53
Q

What part of the body needs to be flexed 90 degrees for a Lateral Wrist projection?

A

Elbow must be flexed 90 degrees

54
Q

PA Oblique Wrist

A

Rotate palmar surface toward IR until wrist forms 45 degrees

-can use sponge to support wrist

55
Q

AP Oblique

A

Where wrist is rotated medially at 45 degrees to the IR (wrist should be in a semisupinated position)

56
Q

PA Projection of Ulnar Deviation

A
  • Upper limb rests on table
  • Elbow flexed 90 degrees
  • CR is perpendicular to the scaphoid
  • CR angulation of 10-15 degrees proximally or distally
57
Q

PA Axial Scaphiod (Stecher Method)

A
  • Upper limb resting on table
  • finger end of IR is supported to elevate it 20 degrees
  • CR perpendicular to table and enters at scaphoid
58
Q

Tangential Carpal Tunnel (Gaynor-Hart Method)

A
  • Hyperextended wrist
  • Center IR to joint at level of radial styloid
  • Have patient grasp digits with other hand in order to maintain extended position
  • CR is angled 25-30 degrees toward the palm of the hand and centered about 1 in. distal to the base of the 3rd metacarpal
59
Q

Which essential projections requires the CR to be centered to the 3rd MCP joint

A

PA Hand, PA Oblique Hand,

60
Q

Collimated field for PA projection of the hand extends 1 in. on all sides of the hand, including 1 in. proximal to the what?

A

Radial Styloid

61
Q

How far proximal and distal to the wrist joint should the collimated field extend for the PA projection of the wrist?

A

2.5 in.

62
Q

What tells you that a digit is parallel to the IR?

A

When you see the joint spaces are the same all the way up the finger

63
Q

When is a PA thumb done?

A

When a patient can’t put their thumb in the AP projection

64
Q

AP Forearm positioning

A
  • Elbow is extended w. hand supinated
  • Upper limb in same plane
  • CR centered at midpoint of forearm
65
Q

Lateral Forearm positioning

A
  • Entire upper limb is in the same plane w. forearm
  • elbow flexed 90 degrees
  • CR enters at midpoint of forearm
66
Q

What position is done if patient can’t extend their arm fully?

A

AP Partial Flexion

67
Q

AP Elbow

A
  • Upper limb in same plane
  • Elbow extended and hand supinated
  • Humeral epicondyles parallel to IR
  • CR centered to elbow joint
68
Q

Collimation for Elbow projections?

A

3 in. proximal and distal to the elbow joint and 1 in. on all sides

69
Q

Collimation for Forearm projections?

A

2 i n. distal to the wrist joint and proximal to the elbow joint

70
Q

Lateral Forearm positioning?

A

Flex elbow 90 degrees, place medial aspect of forearm against IR
-Centering at midpoint of forearm

71
Q

What does the Capitulum articulate with?

A

Radius

72
Q

What does the Trochlea articulate with?

A

Ulna

IMAG 301- Positioning Princ. I (8 decks)

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