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radiographic procedures and positioning > Fingers, Hand, Wrist > Flashcards

Fingers, Hand, Wrist Flashcards

1
Q

How many bones are in a hand?

A

27 bones

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2
Q

The hand is divided into what groups?

A
  1. Phalanges
  2. Metacarpals
  3. Carpals
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3
Q

What are phalanges? How many bones does it consist of?

A

Bones of the digits (fingers and thumbs), (14)

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4
Q

What are metacarpals? How many bones does it consist of?

A

Bones of the palm (5)

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5
Q

What are carpals? How many bones does it consist of?

A

Bones of the wrist (8)

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6
Q

What is each finger called?

A

First digit (thumb)

Second digit (index finger)

Third digit (middle finger)

Fourth digit (ring finger)

Fifth digit (small finger)

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7
Q

What is a tuft?

A

Tip of phalanx

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8
Q

Define displacement

A

Removal from normal or usual position

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9
Q

A minimum of how many exposures is necessary to demonstrate displacement?

A

2 minimum

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10
Q

Define dislocation

A

Displacement of a bone from the joint space

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11
Q

Define fracture

A

A disruption in the continuity of the bone

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12
Q

Define joint effusion

A

Accumulation of fluid in the joint associated with an underlying condition

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13
Q

Identify the lateral and medial side as well as the tuft, distal interphalangeal joint, proximal interphalangeal joint, and metacarpophalangeal joint in the picture

A
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14
Q

Which digit is on the lateral side and which digit is on the medial side?

A

First digit= lateral side

Fifth digit= medial side

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15
Q

Identify the anatomy of the hand

A
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16
Q

Identify the anatomy of the hand

A
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17
Q

Identify the anatomy of the finger

A
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18
Q

What bone is circled?

A

Sesmoid bone

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19
Q

What are the routine projections for the first digit/thumb?

A

AP, obliques (internal and external), and lateral

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20
Q

What is the SID and KVP for a first digit/thumb x-ray?

A

SID= 40”

KVP= 60

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21
Q

In what position does a patient turn their hand for an AP projection of their thumb?

A

Extreme internal rotation (the extended digits may need to be held with the patient’s other hand)

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22
Q

Where do you direct the central ray and where do you cone to when doing an AP thumb x-ray?

A

AP thumb CR= directed to the first metacarpophalangeal (MCP) joint

AP thumb coning= entire first digit

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23
Q

What does an AP thumb projection demonstrate and what does it open?

A

Demonstrates 2 phalanges and opens IP and MCP joint space

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24
Q

How do you position the patient for an internal oblique x-ray of their thumb?

Where is the CR directed?

A

From the AP position, rotate hand inward so that second digit is resting on IR

CR directed to first MCP joint

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25
Q

How is the patient placed for an external oblique position?

A

Patient places hand in a naturally arched position with palmar surface in contact with IR

(This placement of hand positions thumb in oblique position)

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26
Q

How is the patient positioned for a lateral thumb x-ray?

A

The hand is positioned in a natural arched position with palmar surface down – adjust arch of hand until a true lateral position of thumb obtained

CR directed to first MCP joint

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27
Q

Where is the CR directed in all thumb x-rays?

A

First MCP joint

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28
Q

What are the routine projections for digits 2-5?

A

PA, PA obliques (internal, external), lateral

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29
Q

What is the SID and KVP for a digits 2-5 x-ray?

A

SID= 40”

KVP= 60

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30
Q

How is the patient positioned for a PA x-ray of digits 2-5?

A

A) Affected finger in the center of IR with palmar surface down

B) Fingers fanned

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31
Q

Where is the CR directed on a PA x-ray of digits 2-5?

A

CR directed to proximal interphalangeal joint (PIP)

32
Q

What does a PA x-ray of digits 2-5 demonstrate?

A

Demonstrates the 3 phalanges and distal portion of adjoining metacarpal

33
Q

How is a patient positioned for an oblique x-ray of digits 2-5?

A

From pronated position, rotate hand externally (elevate thumb side) 45° for lateral rotation and 45° for internally (elevate 5th digit side) for medial rotation

(Then separate digits and place affected digit in center of IR)

34
Q

In an oblique of digits 2-5, why must the digits be parallel to the IR?

A

So that interphalangeal (IP) joint spaces are open

35
Q

What joint do you direct the CR to on an oblique x-ray of digits 2-5?

A

PIP joint

36
Q

How is a patient positioned for a lateral x-ray of digits 2-5?

A

Patient extends affected finger and closes the rest of the fingers into a fist

37
Q

How do you place the affected finger in a true lateral position in center of IR?

A

Hand rests on radial surface for second and third fingers

Hand rests on ulnar surface for fourth and fifth finger

(A support - sponge, balsa wood, pen, can be used on palmar surface of affected finger if adjacent fingers obscure proximal phanalx of the affect finger)

38
Q

Where is the CR directed to in all digits 2-5 x-rays?

A

PIP joint

39
Q

What are the routine projections for a hand x-ray?

A

PA, oblique, and lateral

40
Q

What is the SID and KVP for a hand x-ray?

A

SID= 40”

KVP= 60

41
Q

How do you position a patient for a hand x-ray?

A

Place patient’s hand at center of IR with palmar surface downward and digits slightly spaced

42
Q

What do you direct the CR to on a PA hand x-ray?

A

The third metacarpophalangeal (MCP) joint

43
Q

What does the hand x-ray demonstrate?

A

Phalanges, metacarpals, carpals, and distal radius and ulna

44
Q

How do you position the patient for an oblique hand x-ray?

A

Oblique the hand externally by elevating the thumb side so that the metacarpophalangeal joints form an angle of approximately 45° with the plane of film

45
Q

What do you direct the CR to in an oblique hand x-ray?

A

To the third MCP joint

46
Q

What will an oblique hand x-ray demonstrate?

A

Displacement

47
Q

How do you position the patient for a lateral hand x-ray?

A

Place patient’s hand in a lateral position with the ulnar surface down then extend fingers and fan them (to prevent superimposition of the phalanges)

48
Q

What do you direct the CR to for a lateral hand x-ray?

A

To the second digit MCP joint

49
Q

What does a lateral hand x-ray demonstrate?

A

Displacement

50
Q

What type of x-ray of the hand is the customary position for localization of foreign bodies?

A

Lateral hand

51
Q

Where is the CR directed to in hand x-rays?

A

Third MCP joint for PA and oblique

Second MCP joint for lateral

52
Q

What is the SID and KVP for a wrist x-ray?

A

SID= 40”

KVP= 60

53
Q

What are the routine projections for a wrist x-ray?

A

PA, oblique, and lateral

54
Q

How do you position a patient for a PA wrist?

A

Place wrist in center of IR, palmar surface down and cup fingers to bring carpals in close contact with IR

55
Q

What do you direct the CR to in a wrist x-ray?

A

To carpals

56
Q

What does a PA wrist x-ray demonstrate?

A

Carpals, distal radius and ulna, and proximal metacarpals

57
Q

How do you position the patient for an oblique wrist?

A

Prom the pronated position, rotate wrists laterally until it forms an angle of 45° with plane of IR

58
Q

What do you direct the CR to in a wrist x-ray?

A

To carpals

59
Q

What will an oblique wrist x-ray demonstrate?

A

The scaphoid and trapezium without self-superimposition

60
Q

What is the most commonly fractured carpal bone?

A

Scaphoid

61
Q

How do you position a patient for a lateral wrist?

A

Place wrist in a lateral position with ulnar surface parallel to IR and fingers extended

62
Q

What do you direct the central ray to in a lateral wrist?

A

Carpals

63
Q

If properly positioned, how should the distal radius and ulna look on a lateral wrist?

A

Superimposed

64
Q

What does a lateral wrist demonstrates?

A

Anterior or posterior displacement in fractures

65
Q

What are the other additional wrist positions

A
  • Ulnar deviation
  • Radial Deviation
  • Carpal Canal - Gaynor Hart Method
  • Stretcher Method
66
Q

How do you position the patient for an ulnar deviation? What do you direct the CR to?

A

Wrist in center of IR, palmar surface down then turn hand outward (bend toward ulna) until wrist is in extreme ulnar deviation

CR= Carpals

67
Q

What does the ulnar deviation position do?

A

Shows the scaphoid and opens spaces between lateral carpals

68
Q

How do you position the patient for a radial deviation? What do you direct the CR to?

A

Wrist center of IR palmar surface down then turn hand medially (bend towards radius) until wrist is in external radial deviation

CR= Carpals

69
Q

What does the radial deviation position do?

A

Opens the interspaces between medial carpals, specifically the pisiform

70
Q

How do you position the patient for a carpal canal or gaynor hart method? What do you direct the CR to?

A

Wrist in center of IR, palmar surface down and have patient grasp fingers with opposite hand and hyperextend the wrist make palm as vertical as possible

CR= Direct at palm at an angle of 25° toward elbow

71
Q

What does the carpal canal/gaynor hart method demonstrate?

A

Carpal canal and entire pisiform

72
Q

How do you position the patient for the stretcher method? What do you direct the CR to?

A

Place the IR on a 20° angled sponge and position hand at center of IR palmar surface down

CR= perpendicular to table through carpals

73
Q

How can you achieve the stretcher method without an angled sponge?

A

Place IR and wrist horizontally

CR= Directed at 20° towards elbow

74
Q

What does the stretcher method demonstrate?

A

The scaphoid without self-superimposition

75
Q

Cheat-Cheat

A

radiographic procedures and positioning (22 decks)

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