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Positioning Final > Fingers & Hand > Flashcards

Fingers & Hand Flashcards

1
Q

What should be clearly seen in the evaluation criteria for imaging digits 2-5?

A

Evidence of proper collimation and presence of side marker placed clear of anatomy of interest

Proper collimation ensures that the image captures only the area of interest, reducing unnecessary exposure and improving image quality.

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2
Q

What is the required positioning of the digit in imaging?

A

Entire digit from fingertip to distal portion of the adjoining metacarpal

This ensures complete visualization of the digit and its relationship with adjacent structures.

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3
Q

What should be avoided to ensure clarity in imaging?

A

No soft tissue overlap from adjacent digits

Overlapping soft tissues can obscure important details and lead to misinterpretation.

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4
Q

What indicates that there is no rotation in the imaging of digits?

A

Equal concavity on both sides of the phalangeal bodies

This ensures that the digit is properly positioned and not rotated, which is crucial for accurate assessment.

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5
Q

What should be equal on both sides of the phalanges in imaging?

A

Equal amount of soft tissue on both sides of the phalanges

This indicates proper alignment and positioning of the digit during imaging.

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6
Q

Where should the fingernail be centered in an imaging evaluation?

A

Centered over the distal phalanx

Centering the fingernail provides a visual reference for proper positioning of the digit.

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7
Q

What joint spaces should be open in the imaging of digits?

A

Open IP and MCP joint spaces

Open joint spaces are essential for assessing joint health and potential injuries.

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8
Q

What detail should be visible in the imaging of digits?

A

Bony trabecular detail and surrounding soft tissues

This detail helps in evaluating the integrity of the bone and associated soft tissues.

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9
Q

True or False: Digits that cannot be extended can only be examined in whole sections.

A

False

Digits that cannot be extended can be examined in small sections for better assessment.

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10
Q

What type of projection is recommended when joint injury is suspected?

A

AP projection instead of a PA projection

The AP projection may provide a clearer view of the joint and surrounding structures in cases of suspected injury.

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11
Q

What are the three main divisions of the hand anatomy?

A

Phalanges, Metacarpals, Carpals

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12
Q

How many phalanges are in each hand?

A

14

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13
Q

How many metacarpals are in each hand?

A

5

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14
Q

How many carpals are in each wrist?

A

8

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15
Q

What are phalanges classified as?

A

Long bones

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16
Q

What is the composition of the digits?

A

Phalanges

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17
Q

How are the phalanges numbered?

A

1 to 5 laterally to medially

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18
Q

How many phalanges are in the first digit (thumb)?

A

2

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19
Q

What are metacarpals classified as?

A

Long bones

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20
Q

What do the heads of the metacarpals articulate with?

A

Phalanges

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21
Q

What do the bases of the metacarpals articulate with?

A

Carpals

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22
Q

What are carpals classified as?

A

Short bones

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23
Q

Name the mnemonic to remember the names and locations of carpals.

A

Steve Left The Party To Take Carol Home

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24
Q

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

A

Synovial, diarthrotic, hinge type

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25
Q

What do metacarpophalangeal (MCP) joints articulate between?

A

Heads of metacarpals and proximal phalanges

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26
Q

What type of joints are carpometacarpal (CMC) joints classified as?

A

First CMC joint: synovial, diarthrotic, saddle type; Second to fourth CMC joints: gliding types

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27
Q

What type of joint is the radiocarpal joint classified as?

A

Synovial, diarthrotic, ellipsoidal type

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28
Q

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

A

40 inches

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29
Q

Which artifacts should be removed from the anatomy of interest?

A
  • Watches
  • Rings
  • Bracelets
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30
Q

What is the recommended patient position for ambulatory patients during imaging?

A

Seated at end of x-ray table

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31
Q

What is the appropriate collimation size for hand imaging?

A

10 × 12 inches (24 × 30 cm) or 14 × 17 inches (35 × 43 cm)

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32
Q

What is the purpose of using ID markers in imaging?

A

To indicate right or left side of anatomy

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33
Q

What instructions are not required for digit, hand, and wrist procedures?

A

Breathing instructions

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34
Q

What is the central ray (CR) direction for PA projection of digits 2 to 5?

A

Perpendicular to IR

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35
Q

What should be demonstrated in the PA projection of digits 2 to 5?

A

Entire digit from fingertip to distal portion of the adjoining metacarpal

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36
Q

What is the central ray entry point for the lateral projection of digits 2 to 5?

A

PIP joint of affected digit

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37
Q

What is the required position for the thumb in an AP projection?

A

Hand in extreme medial (internal) rotation

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38
Q

What structures should be visible in the AP projection of the thumb?

A

Area from distal tip of the thumb to the trapezium

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39
Q

What is the evaluation criterion for the PA thumb projection?

A

Open IP and MCP joint spaces without overlap of bones

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40
Q

Where does the central ray enter for the PA projection of the third digit?

A

Third PIP joint

41
Q

What is the evaluation criterion for the PA hand projection?

A

Anatomy from fingertips to distal radius and ulna

42
Q

What is the correct positioning for a lateral hand projection?

A

Palmar surface perpendicular to IR

43
Q

What should be done to prevent soft tissue overlap in hand imaging?

A

Extend and separate digits

44
Q

Which joints should be open in a PA oblique hand projection?

A

Open MCP joints and open IP joints

45
Q

What is the part position for the fan lateral projection of the hand?

A

Forearm on table with elbow flexed 90 degrees, hand resting on medial surface with thumb side up

46
Q

What is the central ray (CR) direction for the fan lateral projection of the hand?

A

Perpendicular to the second MCP joint

47
Q

Which structures are evaluated in the fan lateral projection of the hand?

A
  • Anatomy from fingertips to distal radius and ulna
  • Extended digits
  • Hand in true lateral position
  • Superimposed phalanges
  • Superimposed metacarpals
  • Superimposed distal radius and ulna
48
Q

What is the primary benefit of the lateral ‘fan lateral’ projection?

A

Best to show all the individual phalanges

49
Q

What is the patient position for the PA wrist projection?

A

Seat patient at the end of the radiographic table with axilla in contact with the table

50
Q

What is the CR direction for the PA wrist projection?

A

Perpendicular to midcarpal area

51
Q

Which structures are shown in the PA wrist projection?

A
  • Distal radius and ulna
  • Carpals
  • Proximal half of metacarpals
  • Open radioulnar joint space
52
Q

What is the part position for the lateral wrist projection?

A

Forearm and wrist resting on medial surface with radial and ulnar styloid superimposed

53
Q

Which structures are evaluated in the lateral wrist projection?

A
  • Distal radius and ulna
  • Carpals
  • Proximal half of metacarpals
  • Superimposed metacarpals
54
Q

What is the central ray (CR) for the PA oblique wrist projection?

A

Perpendicular to midcarpal area, just distal to radius

55
Q

What is the purpose of the PA projection in ulnar deviation position?

A

To visualize the scaphoid with adjacent articulations open

56
Q

What is the CR direction for the PA axial (Stecher method) projection of the scaphoid?

A

Perpendicular to the table and enters at scaphoid

57
Q

What is the positioning for the tangential carpal tunnel projection (Gaynor-Hart method)?

A

Hyperextend wrist to place long axis of hand as vertical as possible

58
Q

What is the CR angle for the tangential carpal tunnel projection?

A

Angled 25 to 30 degrees toward palm of hand

59
Q

Which essential projection requires the central ray to be centered to the third MCP joint?

A

PA of the third digit

60
Q

What is the anatomy of the forearm composed of?

A
  • Ulna
  • Radius
61
Q

Which bone is on the medial side of the forearm?

A

Ulna

62
Q

What are the three joints enclosed in the common capsule of the elbow?

A
  • Humeroulnar joint
  • Humeroradial joint
  • Proximal radioulnar joint
63
Q

What is the distal end of the humerus involved in?

A

Part of the elbow joint

64
Q

What is the positioning for the AP forearm projection?

A

Elbow extended with hand supinated

65
Q

What is the CR direction for the AP forearm projection?

A

Perpendicular to IR, entering at midpoint of forearm

66
Q

What structures are shown in the AP forearm projection?

A
  • Entire forearm
  • Wrist
  • Distal humerus
  • Proximal row of slightly distorted carpal bones
67
Q

What is the patient position for the lateral forearm projection?

A

Elbow flexed 90 degrees with thumb side up

68
Q

What is the central ray (CR) direction for the lateral forearm projection?

A

Directed perpendicular to the IR, entering at midpoint of forearm

69
Q

What structures are evaluated in the lateral forearm projection?

A
  • Entire forearm
  • Wrist
  • Distal humerus in true lateral position
  • Superimposition of radius and ulna
70
Q

What is the purpose of the axiolateral (Coyle method) projection?

A

To demonstrate the elbow joint and radial head

71
Q

What should be removed from the anatomy of interest during patient preparation?

A
  • Watches
  • Rings
  • Bracelets
  • Bras (for humerus procedures)
72
Q

What is the standard SID for upper extremity procedures?

A

40 inches

73
Q

What is necessary for radiation protection during imaging?

A

Gonadal shield should be used according to state regulations

74
Q

What is the recommended size for the IR used in upper extremity procedures?

A

10 x 12 inches (24 x 30 cm) or 14 x 17 inches (35 x 43 cm)

75
Q

Which structure must be seen on the AP projection of the thumb?

A

Trapezium

76
Q

What is the Central Ray (CR) for the elbow joint?

A

Perpendicular to elbow joint

77
Q

What is the radiation field for the elbow joint radiography?

A

3 inches (8 cm) proximal and distal to the elbow joint and 1 inch (2.5 cm) on the sides

78
Q

What structures are shown on an AP elbow projection?

A
  • Radial head, neck, and tuberosity slightly superimposed over the proximal ulna
  • Elbow joint open and centered to the central ray
  • No rotation of humeral epicondyles
  • Coronoid and olecranon fossae approximately equidistant to epicondyles
  • Bony trabecular detail and surrounding soft tissues
79
Q

What is the required part position for an AP elbow projection?

A
  • Extremity in same plane with long axis parallel to IR
  • Elbow flexed 90 degrees and placed in center IR
  • Forearm resting on ulnar surface (thumb side up)
  • Wrist in true lateral
  • Humeral epicondyles perpendicular to IR
80
Q

In a lateral elbow projection, what is the positioning of the elbow joint?

A

True lateral position

81
Q

What are the key structures shown in a lateral elbow projection?

A
  • Elbow joint open and centered to the central ray
  • Superimposed humeral epicondyles
  • Radial tuberosity facing anteriorly
  • Olecranon process in profile
  • Bony trabecular detail
82
Q

What is the required part position for an AP oblique elbow with medial rotation?

A
  • Elbow centered to IR
  • Elbow flexed 90 degrees
  • Upper extremity medially rotated to place humeral epicondyles 45 degrees from true anatomic position
83
Q

What structures are shown in an AP oblique elbow with medial rotation?

A
  • Coronoid process in profile
  • Elongated medial humeral epicondyle
  • Ulna superimposed by the radial head and neck
  • Bony trabecular detail
84
Q

What is the central ray direction for the AP oblique elbow with lateral rotation?

A

Perpendicular to elbow joint

85
Q

What structures are evaluated in an AP oblique elbow with lateral rotation?

A
  • Radial head, neck, and tuberosity projected free of the ulna
  • Elongated lateral humeral epicondyle
  • Bony trabecular detail
86
Q

What is the positioning for a partial flexion position of the distal humerus?

A
  • Humerus in same plane with posterior surface resting on IR
  • Support elevated forearm
  • Supinate hand, if possible
87
Q

What structures are shown in the AP elbow—distal humerus partial flexion position?

A
  • Distal humerus without rotation or distortion
  • Proximal radius superimposed over the ulna
  • Closed elbow joint
88
Q

What is the purpose of the axiolateral projection (Coyle method)?

A

To demonstrate radial head and coronoid process on patients who cannot fully extend the elbow

89
Q

What is the central ray angle for the axiolateral projection to demonstrate the radial head?

A

Angled 45 degrees toward the shoulder

90
Q

What structures are shown in the axiolateral projection for the radial head?

A
  • Open joint space between radial head and capitulum
  • Radial head, neck, and tuberosity in profile
  • Bony trabecular detail
91
Q

What is the required hand position for the axiolateral projection of the coronoid process?

A

Hand pronated

92
Q

What structures are shown in the axiolateral projection for the coronoid process?

A
  • Open joint space between coronoid process and trochlea
  • Coronoid process in profile and elongated
  • Radial head and neck superimposed by ulna
93
Q

What is the positioning for the AP projection of the humerus?

A
  • Top border of IR approximately 1½ inches (3.8 cm) above humeral head
  • Slightly abduct humerus from body and supinate hand
94
Q

What are the evaluation criteria for the AP humerus projection?

A
  • Elbow and shoulder joints
  • Humeral epicondyles without rotation
  • Humeral head and greater tubercle in profile
95
Q

What is the central ray direction for a lateral projection of the humerus?

A

Perpendicular to midportion of humerus and centered to IR

96
Q

Which projection demonstrates the olecranon in profile?

A

Lateral

97
Q

What is the CR angle and direction for demonstrating the radial head with the axiolateral projection (Coyle method)?

A

Angled 45 degrees toward the shoulder

98
Q

Which structure is in profile on the lateral side of the proximal humerus on the AP projection of the humerus?

A

Greater tubercle

99
Q

Which projections require the humeral epicondyles to be positioned parallel with the IR?

A
  • AP forearm
  • AP elbow
  • PA wrist

Positioning Final (13 decks)

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