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Ch 5 Flashcards

1
Q

What are the divisions of the hand anatomy?

A

Phalanges (14 in each hand), Metacarpals (5 in each hand), Carpals (8 in each wrist)

Phalanges make up the digits, metacarpals compose the palm, and carpals form the wrist.

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2
Q

How many phalanges are in each hand and how are they classified?

A

14 phalanges, classified as long bones

Phalanges are numbered 1 to 5 laterally to medially.

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3
Q

What is the primary function of metacarpals?

A

Compose the palm of the hand and articulate with phalanges and carpals

Metacarpals are classified as long bones.

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4
Q

List the carpal bones in the proximal row from lateral to medial.

A

Scaphoid, Lunate, Triquetrum, Pisiform

The proximal row consists of four carpals.

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5
Q

List the carpal bones in the distal row from lateral to medial.

A

Trapezium, Trapezoid, Capitate, Hamate

The distal row also consists of four carpals.

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6
Q

What mnemonic can help remember the carpal bones?

A

Steve Left The Party To Take Carol Home

Each word corresponds to a carpal bone.

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7
Q

What type of joint are interphalangeal (IP) joints classified as?

A

Synovial, diarthrotic, hinge type

These joints articulate between phalanges.

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8
Q

What are metacarpophalangeal (MCP) joints?

A

Articulations between the heads of the metacarpals and the proximal phalanges, classified as synovial, diarthrotic, ellipsoidal type

Identified by numbers: first, second, third.

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9
Q

What type of joint is the first carpometacarpal (CMC) joint?

A

Synovial, diarthrotic, saddle type

The second to fourth CMC joints are classified as gliding types.

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10
Q

What is the radiocarpal joint?

A

Articulation between the carpals and the distal radius, classified as synovial, diarthrotic, ellipsoidal type

This joint allows for wrist movement.

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11
Q

True or False: The central ray for the PA projection of the digits enters at the proximal interphalangeal (PIP) joint.

A

True

The CR is perpendicular to the IR.

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12
Q

What is the recommended source-to-image receptor distance (SID) for hand imaging?

A

40 inches

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13
Q

What should be done to ensure radiation protection during hand imaging?

A

Remove artifacts, use gonadal shields, and ensure close collimation

Ethical radiation protection practices are critical.

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14
Q

How should patients be positioned for upper limb procedures?

A

Seated at the end of the x-ray table with the affected extremity resting on the IR placed on the tabletop

Nonambulatory patients require altered positioning for comfort and safety.

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15
Q

What is the central ray position for a lateral projection of the digits?

A

Perpendicular to the PIP joint of the affected digit

Proper positioning is crucial for accurate imaging.

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16
Q

What structures should be evaluated in a PA projection of the hand?

A

Anatomy from fingertips to distal radius and ulna, open MCP and IP joints, no rotation

Equal concavity of metacarpal and phalangeal bodies should be noted.

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17
Q

Where does the central ray enter for the PA projection of the thumb?

A

Perpendicular to the MCP joint

This positioning allows for accurate imaging of the thumb.

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18
Q

Fill in the blank: The _______ joints allow for flexion and extension of the fingers.

A

Interphalangeal (IP)

These joints are crucial for finger movement.

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19
Q

What is the purpose of using a 45-degree wedge sponge during PA oblique projections?

A

To open IP joint spaces and prevent soft tissue overlap

This technique enhances visualization of the digits.

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20
Q

What is required for patient instructions during digit, hand, and wrist procedures?

A

Explain positions and instruct to hold part still

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21
Q

What is the evaluation criteria for a lateral hand projection?

A

Anatomy from fingertips to distal radius and ulna, no rotation, open IP and MCP joint spaces

The first digit should be in a true lateral position.

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22
Q

What is the position for a Fan lateral x-ray?

A

Forearm on table with elbow flexed 90 degrees, hand resting on medial surface, radial and ulnar styloids superimposed and perpendicular to IR, palmar surface perpendicular to IR.

This position allows for a lateromedial projection.

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23
Q

Where is the Central Ray (CR) directed for a Fan lateral hand projection?

A

Perpendicular to the second MCP joint.

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24
Q

What structures are shown in a Fan lateral hand x-ray?

A
  • Anatomy from fingertips to distal radius and ulna
  • Extended digits
  • Hand in a true lateral position
  • Superimposed phalanges
  • Superimposed metacarpals
  • Superimposed distal radius and ulna
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25
True or False: The lateral hand projection is best for localizing foreign bodies and metacarpal fracture displacement.
True
26
What is the essential projection for the wrist?
* PA * Lateral * PA oblique * PA projection in ulnar deviation position * PA axial (Stecher method) * Tangential (Gaynor-Hart method)
27
What is the patient position for a PA wrist x-ray?
Seat patient at the end of the radiographic table with axilla in contact with the table, aligning shoulder, elbow, and wrist joints in the same plane.
28
What is the Central Ray (CR) direction for a PA wrist projection?
Perpendicular to midcarpal area.
29
What structures are evaluated in a PA wrist x-ray?
* Distal radius and ulna * Carpals * Proximal half of metacarpals * No excessive flexion of digits * No rotation in carpals, metacarpals, radius, and ulna * Open radioulnar joint space * Bony trabecular detail and surrounding soft tissues
30
What is the part position for a lateral wrist x-ray?
Forearm and wrist resting on medial surface with radial and ulnar styloids superimposed and perpendicular to IR.
31
What is the Central Ray (CR) for a lateral wrist projection?
Perpendicular to wrist (radiocarpal) joint.
32
What is the required rotation for a PA oblique wrist projection?
45-degree rotation of anatomy.
33
What is the correct positioning for a PA projection in ulnar deviation position?
Upper extremity resting on table, wrist placed in center of IR, adjust IR to elevate finger end 20 degrees.
34
What structures are shown in a PA axial scaphoid (Stecher method)?
* Distal radius and ulna * Carpals * Proximal half of metacarpals * Scaphoid with adjacent articulations open * No rotation of wrist
35
What is the Central Ray (CR) direction for the Tangential Carpal Tunnel (Gaynor-Hart method)?
Angled 25 to 30 degrees toward palm of hand.
36
What structures are shown in the Tangential Carpal Tunnel x-ray?
* Carpals in an arch arrangement * Pisiform in profile * Hamulus of hamate * Bony trabecular detail and surrounding soft tissues
37
Which essential projection requires the Central Ray to be centered to the third MCP joint?
PA hand
38
What are the two long bones of the forearm?
* Ulna * Radius
39
Where is the olecranon process located?
Proximal and posterior part of the ulna.
40
What are the three joints enclosed in a common capsule at the elbow?
* Elbow joint proper * Proximal radioulnar joint * Humeroulnar joint * Humeroradial joint
41
What is the anatomical position of the radius in relation to the ulna?
Radius is on the lateral side, ulna is on the medial side.
42
What are the proximal structures of the humerus?
* Head * Anatomic neck * Surgical neck * Greater tubercle * Lesser tubercle
43
What is the standard SID for radiographic procedures?
40 inches.
44
What should be included on the IR for proper identification?
Right or left side markers.
45
What is the ideal position for the patient when obtaining a forearm x-ray?
Patient seated at the end of the x-ray table with the upper limb in the same plane as the shoulder.
46
What is the patient position for an AP forearm projection?
Elbow extended with hand supinated, humeral epicondyles equidistant from IR.
47
What structures are evaluated in an AP forearm x-ray?
* Entire forearm * Wrist and distal humerus * Proximal row of slightly distorted carpal bones * Open radioulnar space * Bony trabecular detail and surrounding soft tissues
48
What is the part position for a lateral forearm projection?
Elbow flexed 90 degrees, thumb side up, ulnar and radial styloid processes superimposed.
49
What is the required positioning for an AP elbow x-ray?
Upper extremity in the same plane with posterior surface in contact with IR, elbow extended and hand supinated.
50
What structures are shown in an AP elbow x-ray?
* Radial head, neck, and tuberosity slightly superimposed over proximal ulna * Elbow joint open * No rotation of humeral epicondyles * Bony trabecular detail and surrounding soft tissues
51
What is the central ray (CR) position for a lateral elbow projection?
Perpendicular to elbow joint ## Footnote This positioning is critical for obtaining a clear image of the elbow joint.
52
What structures are shown in a lateral elbow projection?
* Elbow joint open and centered to the CR * Superimposed humeral epicondyles * Radial tuberosity facing anteriorly * Radial head partially superimposing the coronoid process * Olecranon process in profile ## Footnote These criteria help evaluate the quality of the lateral elbow image.
53
Fill in the blank: The elbow should be flexed ______ degrees in a true lateral position.
90
54
What is the part position for the AP oblique elbow medial rotation?
* Extremity in same plane with elbow extended * Elbow centered to IR * Medially rotate the upper extremity * Humeral epicondyles 45 degrees from true anatomic position ## Footnote This positioning is essential to visualize the ulnar coronoid process.
55
What is the CR direction for the AP oblique elbow medial rotation?
Perpendicular to elbow joint
56
What structures are evaluated in a medial rotation position of the AP oblique elbow?
* Coronoid process in profile * Elongated medial humeral epicondyle * Ulna superimposed by radial head and neck * Trochlea * Olecranon process within the olecranon fossa * Bony trabecular detail and surrounding soft tissues ## Footnote These details help in assessing the quality of the image.
57
What is the CR direction for the AP oblique elbow lateral rotation?
Perpendicular to elbow joint
58
What structures are shown in the AP oblique elbow lateral rotation position?
* Radial head, neck, and tuberosity free of the ulna * Elongated lateral humeral epicondyle * Capitulum * Bony trabecular detail and surrounding soft tissues ## Footnote This projection is important for evaluating the lateral aspect of the elbow.
59
What is the purpose of the AP elbow—distal humerus partial flexion position?
To image the distal humerus and proximal forearm separately when the elbow cannot be fully extended
60
What is the CR position for the AP elbow—proximal forearm partial flexion?
Perpendicular to elbow joint and long axis of forearm
61
What structures are shown in the AP proximal forearm partial flexion position?
* Proximal radius and ulna without rotation or distortion * Radial head, neck, and tuberosity slightly superimposed over proximal ulna * Partially open elbow joint * Foreshortened distal humerus * Bony trabecular detail of proximal radius and ulna ## Footnote This view is crucial in trauma cases.
62
What is the central ray angle and direction for the radial head using the axiolateral (Coyle) method?
Angled 45 degrees toward the shoulder
63
What is the part position for the coronoid process using the axiolateral (Coyle) method?
* Elbow flexed 80 degrees * Hand pronated ## Footnote This positioning allows for a clear view of the coronoid process.
64
What structures are shown in the axiolateral (Coyle) projection for the radial head?
* Open joint space between radial head and capitulum * Radial head, neck, and tuberosity in profile * Humeral epicondyles distorted due to central ray angulation * Bony trabecular detail and surrounding soft tissues ## Footnote This projection is useful for assessing fractures.
65
What is the position of the elbow for the axiolateral (Coyle) projection of the coronoid process?
Elbow flexed 80 degrees
66
What is the CR direction for the axiolateral projection of the coronoid process?
Angled 45 degrees away from the shoulder
67
What structures are shown in the axiolateral (Coyle) projection for the coronoid process?
* Open joint space between coronoid process and trochlea * Coronoid process in profile * Radial head and neck superimposed by ulna * Bony trabecular detail and surrounding soft tissues ## Footnote This projection helps evaluate the coronoid process specifically.
68
What is the patient position for the AP humerus projection?
Standing, seated, or supine
69
What is the central ray (CR) position for the AP humerus projection?
Perpendicular to midportion of humerus and centered to IR
70
What structures are shown in the AP humerus projection?
* Elbow and shoulder joints * Humeral epicondyles without rotation * Humeral head and greater tubercle in profile * Outline of the lesser tubercle * Bony trabecular detail and surrounding soft tissues ## Footnote These criteria ensure an accurate representation of the humerus.
71
What is the part position for the lateral humerus projection in non-trauma cases?
* Place top border of IR approximately 1½ inches above humeral head * Internally rotate humerus, flex elbow 90 degrees, and rest palm of hand on hip ## Footnote This positioning helps visualize the lateral aspect of the humerus.
72
What structures are shown in the lateral humerus projection?
* Elbow and shoulder joints visible * Superimposed humeral epicondyles * Lesser tubercle in profile on medial aspect * Greater tubercle superimposed over the humeral head * Bony trabecular detail and surrounding soft tissues ## Footnote This view is often used for trauma assessments.
73
Which projection of the elbow demonstrates the olecranon in profile?
Lateral
74
What is the CR angle and direction to demonstrate the radial head with the axiolateral projection (Coyle method)?
Angled 45 degrees toward the shoulder
75
What structure is in profile on the lateral side of the proximal humerus on the AP projection of the humerus?
Greater tubercle
76
Which projections require the humeral epicondyles to be positioned parallel with the IR?
* AP forearm * AP elbow ## Footnote Correct positioning is essential for accurate imaging.
77
How should the patient be positioned for an AP thumb?
supinate the thumb with the hand internally rotated
78
What is the position of the patients hand for a lateral thumb?
Fingers curled out of the way
79
Where does the central ray enter for the lateral projection of the thumb?
1st MCP

rad procedures (5 decks)

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