chapter 4 Flashcards
How many phalanges do humans have?
14
How many metacarpals do humans have?
5
How many carpals do humans have?
8
The name of the joint between the proximal and distal phalanges of the first digit is the:
IP joint
The joints between the metacarpals and the phalanges are the:
MCP joints
What is the largest carpal bone?
capitate
What bone is the trochlear notch on?
ulna
What bone is the radial notch on?
ulna
What bone is the olecrannon fossa on?
humerus
What bone is the trochlea on?
humerus
What bone is the coronoid tubercle on?
ulna
What bone is the coronoid process on?
ulna
What bone is the olecrannon process on?
ulna
What bone is the coronoid fossa on?
humerus
What joint permits the forearm to rotate during pronation?
proximal radioulnar joint
What is the first and smallest of the concentric arcs of the elbow?
trochlea sulcus
The intermediate double arc of the elbow, consisting of the outer ridges are the
capitulum and trochlea
The third arc of the elbow, which is part of the ulna is the:
trochlear notch
What type of articulation is an interphalangeal joint?
ginglymus
What type of articulation is a carpometacarpal of the first digit?
saddle
What type of articulation is an elbow joint?
ginglymus
What type of articulation is a metacarpophalangeal of the 2nd to 5th digit?
ellipsoidal
What type of articulation is a radiocarpal joint?
ellipsoidal
What type of articulation is an intercarpal joint?
plane
What type of articulation is a proximal radioulnar joint?
pivot
Ellipsoidal joints are classified as freely movable, or _________, and allow movement in ____ directions.
diarthroidial; 4
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
How does the forearm appear radiographically if pronated for a PA projection?
the proximal radius crosses over the ulna
The 2 important fat stripes or bands around the wrist joint are the:
scaphoid and pronator fat stripe
What projections best demonstrate the scaphoid fat pad?
PA and oblique wrist
What projection best demonstrates the pronator fat stripe?
lateral wrist
What kvp range is used for upper limp radiography?
60 to 80 kvp
In upper limb radiography, grids are used if the body part measures greater than:
10 cm
For small casts, increase kvp by:
5 to 7
For large casts, increase kvp by:
8 to 10
For fiberglass casts, increase kvp by:
3 to 4
______ is a radiographic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist, elbow and shoulder joint.
anthrography
What IR size should be used for a thumb projection?
8 x 10
A sesamoid bone is frequently found adjacent to the _______ joint of the thumb.
MCP
A bennett involves the:
base of the first metacarpal
What special position demonstrates the bennett fracture?
modified roberts method, 15 degrees proximal
A minimum of ___ inch of the forearm should be included radiographically for a PA projection of the hand
1
Which lateral projection of the hand best demonstrates a possible foreign body in the palm of the hand?
lateral in extension
What type of CR angle is required for the AP axial projection (brewerton method)?
15 degrees proximal towards ulna
The AP axial projection (brewerton method) is commonly used to evaluate for early signs of:
rheumatoid athritis
The hand is flexed ____ in relation to the IR for the AP axial projection
65 degrees
Which positioning error is involved if a majority of the carpal bones are superimposed in a PA oblique wrist projection?
excessive lateral rotation from PA
How much are the hand and wrist elevated from the IR for the modified stecher method?
20 degrees
During the PA axial scaphoid projection with CR angle and ulnar flexion, the CR ray must be angled ________
10 to 15 degrees
How much CR angulation to the long axis of the hand is required for the carpal canal projection?
25 to 30 degrees
Which special projection of the wrist best demonstrates the interspaces 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 calcifications in the carpal sulcus?
Gaynor-Hart projection
How much CR angulation from the long axis of the forearm is required for the carpal bridge projection?
45 degrees
The hand and wrist form a _____ angle to the forearm with the carpal bridge projection
90 degrees
Fracture and dislocation of the posterior lip of the distal radius:
barton fracture
Most common type of primary malignant tumor occuring in 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:
anchondroplasia
Travnsverse fracture extending through the distal aspect of the metacarpal neck, most often the 5th metacarpal:
boxer’s fracture
Hereditary condition marked by abnormally dense bone:
osteoporosis
Transverse fracture of the distal radius with posterior displacement of the distal fragment:
colles fracture
Narrowing of joint space with periosteal growths on the joint margins:
osteoarthritis
Fluid-filled jont space with possible calcification:
bursitis
Possible calcification in the carpal sulcus:
carpal tunnel syndrome
Soft tissue swelling and loss of fat-pad detail visibility:
osteomyelitis
Mixed areas of sclerotic and cortical thickening along with radiolucent lesions:
osteopetrosis
Does advanced paget disease have an increased, decresed or no manual exposure facture change?
increased
Does joint effusion have an increased, decresed or no manual exposure facture change?
no change
Does advanced rheumatoid athritis have an increased, decresed or no manual exposure facture change?
decreased
Does osteoporosis have an increased, decresed or no manual exposure facture change?
decreased
Does osteopetrosis have an increased, decresed or no manual exposure facture change?
increased
Does bursitis have an increased, decresed or no manual exposure facture change?
no change
Which routine projection of the elbow best demonstrates the radial head, neck, and tuberosity with slight superimposition of the ulna?
AP oblique, 45 degree lateral rotation
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 90 degrees
Which special projection of the elbow should be performed instead of the routine AP if the patient’s elbow is tightly flexed and cannot extend at all?
2 acute flexion projections
How much is the upper limb rotated for a lateral rotation oblique projection of the elbow?
45 degrees laterally
How much and in which direction should the CR be angled for the trauma axial lateral projection (coyle method) involving the coronoid process?
45 degrees away from shoulder
What is the amount of elbow flexion required for the trauma lateral projection to demonstrate the coronoid process?
80 degrees of flexion
What is the only difference among the 4 radial head lateral projections of the elbow?
rotational position of the hand and wrist
How much and in which direction should the CR be angled for the trauma axial lateral projection involving the radial head
45 degrees toward shoulder
A radiograph of a PA oblique projection of the hand shows that the 4th and 5th metacarpals are superimposed. Which specific positioning error is involved?
excessive lateral rotation
In a radiographic study of the forearm, the proximal radius crossed over the ulna in the frontal projection. Which specific positioning error led to this radiographic outcome?
should have been AP
A PA axial scaphoid projection of the wrist using a 15 degree distal CR angle and ulnar flexion was performed. The resultant radiograph shows that the scaphoid bone is foreshortened. How must this projection be modified to produce a more diagnostic image of the scaphoid?
CR needs a 15 degree angle toward elbow
A radiograph of an AP elbow projection shows considerable superimposition between the proximal radius and ulna. Which specific positioning error is involved?
elbow rotated medially
A routine radiograph of an AP oblique elbow with lateral rotation shows that the radial tuberosity is superimposed on the ulna. In what way must this position be modified during the repeat exposure?
increase lateral rotation
A radiograph of a lateral projection of the elbow shows that the humeral epicondyles are notsuperimposed and the trochlear notch is not clearly demonstrated. Which specific type of positioning error is involved?
forearm and humerus are not on same horizontal plane
Situation: A patient with a possible fracture of the radial head enters the emergency room. When the technologist attempts to place the arm in the AP oblique-lateral rotation position, the patient is unable to extend or rotate the elbow laterally. Which other positions can be used to demonstrate the radial head and neck without superimposition on the proximal ulna?
coyle method
Situation: A patient with a metallic foreign body in the palm of the hand enters the emergency room. Which specific positions should be used to locate the foreign body?
PA and lateral
Situation: A patient with a trauma injury enters the ER with an evident Colles fracture. Which positioning routine should be used to determine the extent of the injury?
AP and lateral
Situation: A patient with a dislocated elbow enters the ER. The patient has the elbow tightly flexed and is careful not to move it. Which specific positioning routine can be used to determine the extent of the injury?
2 AP: acute flexion, lateral
Situation: A patient with a possible fracture of the trapezium enters the ER. The routine projections do not clearly demonstrate a possible fracture. Which other special projection can be taken?
modified robert method
Situation: A patient with a history of carpal tunnel syndrome comes to the radiology department. The orthopedic physician suspects that bony chnages in the carpal sulcus may be causing compression of the median nerve. Which special projection best demonstrates this region of the wrist?
Gaynor-Hart method
Situation: A patient comes to the radiology department for a hand series to evaluate early evidence of rheumatoid arthritis. Which special position can be used in addition to the routine hand projections to evaluate this patient?
AP axial
Situation: A patient is referred to radiology with a possible injury to the ulnar collateral ligament. The patient complains of pain near the first MCP joint. Initial radiographs of the hand do not indicate any fracture or dislocation. Which special projection can be performed to rule out an injury to the ulnar collateral ligament?
PA stress
Situation: A patient enters the ER with a possible foreign body in the dorsal aspect of the wrist. Initial wrist radiographs are inconclusive in demonstrating the location of the foreign body. What additional projection can be performed to demonstrate this region of the wrist?
tangential projection
Situation: A patient has a routine elbow series performed. The AP projection indicates a possible deformity or fracture of the coronoid process. However, the patient is unable to pronate the upper limb for the AP oblique-medial rotation projection because of an athritic condition. What other projection could be performed to demonstrate the coronoid process?
coyle method
