Chap 4 upper extremity Flashcards
what kind of joints are in the hand
Diarthrodial (Have a joint capsule)
What type of joints are the 1st-5th MCP joints
Ellipsoidal (condyloid type)
What type of joints are the 2nd-5th CMC joints
Plane (gliding) type
What type of joint is the 1st CMC joint
Sellar (saddle) type
what type of joint are the 1st-5th IP joints
Ginglymus (hinge) type
what type of joint are the intercarpals
Plane (gliding) type
What type of joint is the elbow
Ginglymus (hinge) type
what type of joint is the proximal radioulnar joint
Trochoidal (pivot) type
describe bone metastases
cancer that originated in bone, or has spread (metastasized) from a different origin
Where does a Bennet’s Fx occur
Base of 1st metacarpal
where does a Boxer’s Fx occur
Transverse Fx running through the neck of the 5th metacarpal
where does a Colles Fx occur
Distal radius which is displaced posteriorly
where does a Smith’s Fx occur
Transverse Fx of distal radius that is displaced anteriorly
Describe Osteoarthritis
degenerative joints and common with age
Cartilage degenerates and enlarged bone growth
Ex. Bone spurring (loss of joint capsule)
Describe Osteroporosis
Reduction in the quality of bone
(Poor bone quality, breakdown due to loss of bone density and lack of calcium)
Common in Postmenopausal women and the elderly
Fx may occur secondary to osteoporosis
What is Hand protocol projections
PA
PAO
Lateromedial “Fan lateral”
Tech Factors for PA Hand
IR 10x12
SFS
40” SID (44 on readout)
55-60 kV
2-3 mAs
CR @ 3rd MCP joint
Tech Factors for PAO Hand
IR 10x12
SFS
40” SID (44 on readout)
55-60 kV
2-3 mAs
CR @ 3rd MCP joint
Tech Factors for Lateromedial “fan lateral” Hand
IR 10x12
SFS
40” SID (44 on readout)
Increase kV by 5 from PA
3 mAs
CR @ 2nd MCP joint
What are the specialty orders for hand
Flexion and Extension Hand Laterals
What is the purpose of Flexion and Extension Hand laterals
Looking for foreign objects or fractures & anterior/posterior fracture displacement
*If glass or wood in hand, decrease tech factors
*If metal, no tech changes
What is Digits 2-5 protocol projections
PA Hand
PAO of digit in question
(2-medial rotation, 3-5 lateral rotation)
Mediolateral (Digit 2) or Lateromedial (Digits 3-5)
Tech Factors for PAO digit 2-5
IR 10x12
SFS
40” SID (44 on readout)
55-60 kV
2 mAs
CR @ PIP joint of digit in question
Tech Factors for Mediolateral or Lateromedial Digit 2-5
IR 10x12
SFS
40” SID (44 on readout)
55-60 kV
2 mAs
CR @ PIP joint of digit in question
What is Thumb protocol projections
PA Hand (gets oblique view)
Lateral
AP
Tech Factors for lateral thumb
IR 10x12
SFS
40” SID (44 on readout)
55-60 kV
2-3 mAs
CR @ 1st MCP joint
Tech Factors for AP thumb
IR 10x12
SFS
40” SID (44 on readout)
55-60 kV
2-3 mAs
CR @ 1st MCP joint
Wrist protocol projections
PA
PAO
Lateromedial
Tech Factors for PA wrist
IR 10x12
SFS
40” SID (44 on readout)
60 kV
3 mAs
CR @ mid carpals (bend of wrist)
Tech Factors for PAO wrist
IR 10x12
SFS
40” SID (44 on readout)
60 kV
3 mAs
CR @ mid carpals (bend of wrist)
Tech Factors for Lateromedial Wrist
IR 10x12
SFS
40” SID (44 on readout)
65 kV
3 mAs
CR @ mid carpals (bend of wrist on lateral surface)
What are the specialty views for wrist
Radial and Ulnar Deviation
What is radial deviation
1st digit flexed toward radius
(looking at carpals on ulnar side of wrist)
What is ulnar deviation
AKA scaphoid view
5th digit flexed toward ulna
(see carpals (scaphoid) on radial side of wrist)
*more common bc scaphoid is most commonly fractured bone
Forearm protocol projections
AP
Lateromedial
Tech factors for AP forearm
IR 14x17 LW
SFS
40” SID (44 on readout)
60 kV
4 mAs
CR @ Mid Forearm (collimation includes wrist and elbow joints)
Tech factors for Lateromedial Forearm
IR 14x17 LW
SFS
40” SID (44 on readout)
65 kV
4 mAs
CR @ Mid Forearm (Collimation includes wrist and elbow joints)
Elbow Protocol Projections
AP
APO (45 degree Lateral/External rotation)
Lateromedial
Tech factors for AP elbow
IR 10x12
SFS
40” SID (44 on readout)
60 kV
4-6 mAs
CR @ Mid Elbow Joint (elbow crease)
Tech factors for APO elbow
IR 10x12
SFS
40” SID (44 on readout)
60 kV
4-6 mAs
CR @ Mid elbow joint (elbow crease)
Tech factors for Lateromedial elbow
IR 10x12
SFS
40” SID (44 on readout)
65 kV
4 mAs
CR @ Mid elbow joint (elbow crease)
What is the specialty view for elbow
APO with 45 degree medial/internal rotation
*replace the APO in routine protocol w/ this one if ordered
What anatomy is in profile for the APO 45 degree Lateral/External rotation elbow
Capitulum
(Radial head, neck, and tuberosity should be free of ulnar superimposition)
what anatomy is in profile for the APO 45 degree Medial/Internal rotation elbow
Coronoid process
(Radial head should be near centered over proximal ulna)
What anatomy is in profile for the lateromedial elbow
Olecranon process
Trauma elbow protocol
2 views 90 degrees from each other
-Do 2 AP projections
1. place humerus flat
2. place forearm flat
(may avoid oblique, so do lateromedial-may have to use horizontal beam)
Non-Trauma humerus projection protocol
AP
Lateromedial (rotational lateral)
Tech factors for AP Humerus No Grid
Part is <10cm so: Tabletop
IR 14x17 LW
SFS
40” SID (44 on readout)
65 kV
6-8 mAs
CR @ Mid shaft of humerus
(1/2 between elbow and shoulder, collimation must include elbow and shoulder joints)
Tech Factors for Lateromedial (Rotational Lateral) Humerus No Grid
Part is <10cm so: Tabletop
IR 14x17 LW
SFS
40” SID (44 on readout)
65 kV
6-8 mAs
CR @ Mid shaft of humerus
(1/2 between elbow and shoulder, collimation must include elbow and shoulder joints)
Tech factors for AP Humerus Grid
Part is >10cm so: Bucky/Grid
IR 14x17 LW
SFS
40” SID
70 kV
6-10 mAs
CR @ Mid shaft of humerus
(1/2 between elbow and shoulder, collimation must include elbow and shoulder joints)
Tech factors for Lateromedial (rotational lateral) humerus Grid
Part is >10cm so: Bucky/Grid
IR 14x17 LW
SFS
40” SID
70 kV
6-10 mAs
CR @ Mid shaft of humerus
(1/2 between elbow and shoulder, collimation must include elbow and shoulder joints)