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Monday-Rad Procedures > Chapter Four Wrist > Flashcards

Chapter Four Wrist Flashcards

1
Q

The _________ position will demonstrate the thumb in a oblique position

A

PA hand

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2
Q

The ______ is considered a medial carpal bone

A

Semi lunar/lunate

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3
Q

The CR should enter ________ for a PA projection of the wrist.

A

The posterior wrist at the mid carpal region

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4
Q

The proper SID for a mag series should be

A

40”

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5
Q

Why would you have the patient cup their hand for a PA wrist?

A

Laces the wrist closer to the IR

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6
Q

What is the best position to demonstrate the carpal interspaces?

A

AP Projection

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7
Q

When performing a mag wrist exam, where will the CR be directed for the lateral positions?

A

Perpendicular to wrist joints

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8
Q

List the routine for a routine wrist study at wheeling hospital

A
  • PA
  • Lateral
  • PA oblique w/medial rotation
  • PA oblique with lateral rotation
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9
Q

Proximal row of carpal bones starting at lateral surface.

A
  • scaphoid/navicular
  • lunate/semi lunar
  • triquetrum/triangular
  • pisiform/os pisforme
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10
Q

Largest carpal bone

A

Capitate

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11
Q

What is the correct OID for the mag study of the wrist?

A

6”

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12
Q

Proper degree of rotation for an oblique wrist?

A

45

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13
Q

Another name for boney detail?

A

Trabecular

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14
Q

What anatomy must be included within the collimation when performing any wrist study?

A

2 1/2 inches proximal and distal to wrist joint and 1 inch on sides

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15
Q

When performing a mag wrist in the lateral flexion position what specifically will be demonstrated?

A

Carpal boss

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16
Q

Explain what the term radial deviation is when performing the position for a mag wrist study.

A

Palm surface on IR, rotate wrist medially

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17
Q

If a pt. cannot assume the PA oblique with medial rotation due to his or her condition what is an alternative choice?

A

AP oblique w/medial rotation

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18
Q

What three parts should be in the same plane when performing all wrist studies?

A

Shoulder, elbow, wrist

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19
Q

PA oblique wrist with medial rotation, ulna up, will demonstrate

A

Pisiform without superimposition

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20
Q

Wheeling hospital typically performs __1__ oblique with medial or internal rotation rather than the __2__ oblique.

A
  1. PA

2. AP

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21
Q

The PA Oblique will magnify the ______ carpal bones due to a higher OID than the AP oblique.

A

Medial

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22
Q

Obliques are named for

A

Direction they are rolled in

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23
Q

Carpal boss is demonstrated best in a __1__ with the wrist in __2__

A
  1. Lateral position

2. Palmer Flexion

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24
Q

Deviation

A

Move away from normal

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25
Q

For a mag wrist exam (only at WH) there will be _____ shots

A

6

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26
Q

For a mag wrists utilize a __1__ sponge to obtain magnification of the wrist by utilizing the increased __2__ while maintains the 40” SID.

A
  1. 6”

2. OID

27
Q

The six positions requested for a mag view series are….

A
  1. Neutral PA
  2. Neutral Lateral
  3. PA with ulnar deviation
  4. PA with radial deviation
  5. Lateral with flexion
  6. Lateral with extension
28
Q

Lateral With Flexion:

Flex or bend the __1__ surface of the hand toward to the __2__ forearm.

A
  1. Anterior

2. Anterior

29
Q

For Lateral Extension: extend the __1__surface of the wrist to was the __2__ forearm.

A
  1. Posterior

2. Posterior

30
Q

PA Projection, Ulnar deviation:

  1. Turn wrist
  2. CR Directed at
  3. MAY angle __A__ proximally or __B__ for better demonstration.
  4. This will show foreshortening of the
A
  1. Ulna
  2. Perpendicular to the scaphoid
  3. A. 10-15 degrees
    B. Distally
  4. Scaphoid
31
Q

PA Projection with Radial Deviation:

  1. Wrist turned toward
  2. CR directed at
  3. This opens the interspaces between the carpals on the ______ side of wrist
    * *This is harder to do that ulnar deviation**
A
  1. radius
  2. Perpendicular to the midcarpal area
  3. Medial
32
Q

ULNAR VARIANCE:

  1. IR size
  2. SID
  3. All 4 “routine” wrist projections should be preformed with the arm abducted a full __A__ from the body with the elbow flexed __B__
  4. The CR is
  5. This projection is key position for proper diagnosis
  6. Will be specially ordered by what two doctors?
A
  1. 8x10
  2. 40”
  3. A. 90 Degrees
    B. 90 Degrees
  4. Perpendicular to the IR to the mid-carpal area
  5. PA
  6. Plastic Surgeon and/or orthopedic specialist
33
Q

What is the method name of the navicular view that uses an angled sponge to better demonstrate the navicular?

A

Stecher Method

34
Q

Wha is the degree of the angle sponge to be used in the Stecher Method?

A

20 Degrees

35
Q

The term “tangential” refers to what type of projection?

A

Skimming

36
Q

What’s the method name used to demonstrate the carpal canal of the wrist?

A

Gaynor Heart

37
Q

When performing the carpal bridge position, what is the PROJECTION of the CR?

A

Superoinferior/tangential

38
Q

When performing any view of the navicular, the wrist should be placed in the _______ position

A

Ulnar deviation

39
Q

When performs the carpal bridge, what surface of the wrist will be in contact with the IR

A

Dorsal

40
Q

When performing the navicular series the CR should be directed to the ________

A

Anatomic Snuffbox

41
Q

When performing the carpal bridge view of the wrist, the CR should be angled ______ degrees

A

45

42
Q

When performing the Gaynor Hart Method (alternative) for carpal canal, the projection is ______

A

Superoinferior

43
Q

What should you do if you are performing a specific navicular view and there is no sponge available to use?

A

CR directed 20 degrees toward the elbow and directed to scaphoid

44
Q

List the WH routine for navicular:

A
  1. Stecher Method OR Stetcher Variation
  2. PA projection with ulnar deviation
  3. PA projection with ulnar deviation and slight elevation of navicular
  4. PA projection with ulnar deviation and depression of navicular
45
Q

Name the carpal bones with processes

A
  1. Navicular
  2. Greater Multangular
  3. Hamate
46
Q

When performing the Gaynor Hart view of the wrist the CR should be directed __1__ degrees to the __2__.

A
  1. 25-30

2. Long axis of the hand

47
Q

List the distal row of the appeals beginning with the medial surface.

A
  1. Hamate
  2. Capitate
  3. Trapezoid
  4. Trapezium
48
Q

What position of the wrist will best demonstrate the carpal interspaces?

A

AP

49
Q

Describe the procedure for the ulnar variance study of the wrist.

A
  • 8x10 IR
  • 40” SID
  • 4 Routine wrists w/arm abducted a full 90 degrees from body
  • Flex 90 Degrees
  • CR perp to IR and midcarpal area
50
Q

What pathology is being demonstrated when the ulnar variance is performed?

A

Post trauma alterations of radius and ulna

51
Q

Two structures that pass through the carpal canal

A
  • tendons

- nerves

52
Q

Two articulating structures of the navicular

A
  • radial styloid process

- trapezoid

53
Q

Very important to utilize __1__ deviation for all views of the scaphoid; it will demonstrate the navicular without __2__.

A
  1. Ulnar

2. Foreshortening

54
Q

Navicular View:

  1. ________ Projection (essential)
  2. Stecher ______
  3. Place IR on a __A__ so that fingers are __B__
  4. Position wrist in _______
  5. CR __A__ to the IR and enter at __B__
  6. The _____ will be projected without self-superimposition
A
  1. PA Axial
  2. Method
  3. A: 20 Degree Sponge
    B: elevated
  4. Ulnar deviation
  5. A: Perpendicular
    B: Scaphoid
  6. Scaphoid
55
Q

The term axial means

A

Angled at least 10 degrees

56
Q

If unable to do the Stecher Method you would do the __1__. The use of a CR __2__ is acceptable is not preferred. CR may be directed __3__ degrees toward the __4__ directed to the __5__.

A
  1. Stecher Variation
  2. Angle
  3. 20
  4. Elbow
  5. Scaphoid
57
Q

Ulnar deviation=ulnar flexion=_____

A

Radial extension

58
Q

Radial deviation=ulnar extension=

A

Radial flexion

59
Q

Radial deviation best demonstrates __1__ and ulnar deviation best demonstrates __2__ bones.

A
  1. Medial carpal

2. Lateral carpal

60
Q

Scaphoid fractures account for ______ of all carpal injuries.

A

60%

61
Q

Carpal Bridge:

  1. ________ (skimming) projection
  2. (________) surface of wrist
  3. Place __A__ surface of the wrist on the IR with the __B__ up and the wrist at a __C__ to the IR
  4. CR directed to a point __A__ proximal to the wrist joint with a __B__ CR angle of __C__ degrees.
A
  1. Tangential
  2. Posterior
  3. A: posterior
    B: Palm
    C: right angle
  4. A: 1 1/2”
    B: caudal
    C: 45
62
Q

If a patient is in too much pain to do the norm carpal bridge routine then they can elevate the __1__ on a sandbag or other supports; flex wrist in a __2__ position and place __3__ surface against a __4__ IR.

A
  1. Forearm
  2. Right angle
  3. Posterior
  4. Vertical
63
Q

Carpal Canal (carpal tunnel):

  1. ______ Projections
  2. ______ Method (infernosuperior)
  3. Forearm parallel to table. __A__ the wrist and center the IR to the joint level of the __B__
  4. Adjust the hand to make its long axis as ______ as possible
  5. CR directed to the palm of the hand at a point approx __A__ distal to the base of the __B__ metacarpal with a CR angle of __C__ degrees to the long axis of the hand.
A
  1. Tangential
  2. Gaynor Heart
  3. A: Hyperextend
    B: radial styloid process
  4. Vertical
  5. A: 1”
    B: 3rd
    C: 25-30
64
Q

If a patient cannot do the Gaynor Heart Method (inferiorsuperior) then have the patient do the __1__ Method (__2__). __3__ the wrist as much as tolerated and lean forward to place carpal canal __4__ to IR. CR angled toward the __5__ at approx __6__ degrees from the long axis of the __7__.

A
  1. Gaynor Heart
  2. Superoinferior
  3. Dorsiflex
  4. Tangent
  5. Hand
  6. 20-35
  7. Forearm

Monday-Rad Procedures (14 decks)

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