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Image Analysis > Chapter 4: Finger and Hand > Flashcards

Chapter 4: Finger and Hand Flashcards

1
Q

Where do you center at for a finger

A

center at pip

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2
Q

what do you need to include in a finger

A

need to include joint between carpal and
metacarpal

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3
Q

what is the CR perpendicular to in a finger

A

CR perp to the IR

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4
Q

what is the CR parallel to in a finger

A

Cr parallel to joint to open up joint spaces

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5
Q

what other view can you try to open up joint spaces of a finger

A

AP

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6
Q

what do you need to make sure you do when taking a finger or hand xray

A

fully extend

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7
Q

should see twice as much soft tissue on one side than the other

A

oblique positioning of a finger

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8
Q

for what finger view should you place finger parallel to maintain open joint space

A

oblique

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9
Q

What should be in profile for a lateral finger

A

finger nail

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10
Q

what should be superimposed in a lateral finger

A

head of phalanges should be superimposed

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11
Q

For the AP thumb what should be flat on the IR

A

finger nail should be flat on the ir

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12
Q

what should be in profile for a lateral thumb

A

thumb nail in profile.

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13
Q

what should be included in a ap thumb or lateral thumb

A

down to joint

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14
Q

what should be superimposed in a lateral thumb

A

heads of phalanges should be superimposed

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15
Q

Proper positioning or criteria for PA hand

A

Soft tissue outline is uniformed 2nd through 5th
Distance between the MC heads is equal
Midshaft concavity is equal on 2nd through 5th digit
No soft tissue overlap
IP, MP and CM joints are open
Thumb 45 degree oblique
Should show one inch of radius and ulna

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16
Q

how is the thumb in a pa hand

A

thumb 45 degree oblique

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17
Q

how much of the radius and ulna should be shown in a pa hand

A

should show one inch of the radius and ulna

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18
Q

criteria for oblique hand

A

45 degree rotation

2nd-5th MC show more concavity on one side than other

Slight space between 4th and 5th MC shafts

Thumb varies from lateral to oblique

2nd and 3rd MC heads are not superimposed

3rd to the 5th are slightly superimposed

One inch of radius and ulna

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19
Q

why is a true later of the hand usually done?

A

to check for foreign bodies of the palm, completely extend the fingers

20
Q

in the fan lateral, what has zero superimposition ?

A

No superimposition of thumb (vary from oblique to PA)

21
Q

this will show the 5th metacarpal anterior to the 2nd-4th MC

A

external rotation of the hand

22
Q

Which MC is the shortest?

A

5th MC

23
Q

which MC is the longest

A

2nd MC

24
Q

this will show the 2nd MC anterior to the 3rd-5th MC

A

Internal Rotation

25
Q

what MC’s should be superimposed in a lateral view of the hand

A

Superimpose the 2nd through the 5th MC, placing the knuckles one on top of the other

26
Q

in what view will you not always get a true lateral wrist

A

lateral hand

27
Q

how is the ulna usually in a lateral hand

A

Instead the ulna is demonstrated slightly posterior to the radius

28
Q

what should you judge your lateral hand off of

A

Therefore judge your lateral by the superimposition of the 2nd -5th MC

29
Q

fully extend the fingers and use same analysis as for the lateral fan hand

Reason- this is done to demonstrate foreign bodies of the palm

It makes for better localization of foreign body in extension

A

Lateral hand in extension-

30
Q

what is flexion and extension usually done for

A

Mobility

31
Q

flex the 2nd -5th fingers until they meet the first finger but do not superimpose it

A

Lateral hand in Flexion-

32
Q

Reason- distinguish the degree of anterior or posterior displacement of a fracture MC

A

Lateral hand in Flexion-

33
Q

Density of 2nd-5th digit and MC is uniform, but the 1st MC density is overexposed

A

Lateral hand in Flexion-

34
Q

what hand do you usually do of a pediatric bone age

A

none dominant hand

35
Q

obtained to assess the skeletal versus the chronological age

A

Pediatric Bone Age

36
Q

Must be assess from infancy through adolescence

Reasons-illness, metabolic or endocrine dysfunction, certain meds and therapies

Left PA hand and wrist are normally taken

A

Pediatric Bone Age

37
Q

Analysis
The side of the digit facing the thumb demonstrates greater phalangeal midshaft concavity and soft tissue width. The finger was externally rotated for the projection.
What is the correction:

A

Internally rotate the finger, placing it flat against the IR.

38
Q

If the patient is unable to extend their finger, what is the best thing to do

A

Do an AP

39
Q

Analysis
The IP and MP joints are closed, and the phalanges are foreshortened. The finger was flexed.
what is the correction

A

Extend the finger, and place the palm flat against the IR. If the patient is unable to extend the finger, position it in an AP projection, aligning the phalanx of interest parallel with the IR or affected joint space perpendicular to the IR.

40
Q

for a PA oblique projection,
If the phalangeal midshaft concavity and soft tissue width on both sides of the digit are more nearly equal, the finger was rotated more or less

A

less than the required 45 degrees

41
Q

for a pa oblique projection,
If the soft tissue width on one side of the digit is more than twice as much as that on the other side, and when one aspect of the phalangeal midshaft is concave but the other aspect is slightly convex, the finger was rotated more or less

A

rotated more than the required 45 degrees

42
Q

Analysis
The soft tissue width and midshaft concave are nearly equal on both sides of the phalanx. The finger was positioned at less than 45 degrees of obliquity for the projection. The IP and MP joints are closed. The finger was not aligned parallel with the IR.
what is the correction

A

correction:
Increase the finger obliquity to 45 degrees. Keep finger parallel with the IR.

43
Q

Analysis
The proximal aspect of the affected finger is obscured. The fifth finger was fanned posteriorly and the third finger was fanned anteriorly.
what is the correction

A

Draw all of the unaffected fingers into a fist

44
Q

Analysis
The midshafts of the proximal phalanx and the MC demonstrate some degree of concavity on both sides, indicating a PA oblique projection. The hand was not flexed enough.
what is the correction

A

correction:
Flex the hand until the thumb rolls to a lateral projection with the thumbnail in profile.

45
Q

Analysis
in a pa oblique thumb
The IP and MCP joints are closed, and the phalanges are foreshortened. The palm surface was not positioned flat against the IR, and the thumb was tilting down toward the IR.
what is the correction

A

Correction
Place the palmar surface and thumb flat against the IR.

46
Q

in a pa hand
Analysis
There is unequal midshaft concavity on either side of the phalanges and MCs, and uneven spacing of the MC heads. The hand was in slight external rotation. Less than 1 inch (2.5cm) of the distal forearm is included on the projection.
what is the correction

A

Correction
Internally rotate the hand and place the palm and fingers flat against the IR. Open the longitudinal collimation 0.5 inch (1.25cm).

47
Q

in a pa hand
Analysis
The IP and CM joints are closed, and the phalanges and MCs are foreshortened. The thumb demonstrates a lateral projection. The hand and fingers were flexed for this projection.
what is the correction

A

Fully extend the hand and fingers, and place them flat against the IR. If the patient is unable to extend the hand and fingers, position the hand in an AP projection with the MC aligned parallel with the IR. If the phalanges are of interest, tilt the hand until the bony structure of greatest interest is parallel with the IR

Image Analysis (7 decks)

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