Forearm and Humerus

Question 1

In an AP forearm what should be parallel and in profile at extreme medial and lateral edges of distal humerus

Answer 1

Medial and lateral epicondyles

Question 2

What is in profile in an AP forearm

Answer 2

The radial styloid is in profile.
Radial tuberosity in profile medially

Question 3

In an AP, what is superimposed over the lateral aspect of the ulna by about ¼ inch

Answer 3

The radial head

Question 4

How much does the radial head superimpose over the ulna in an AP forearm

Answer 4

about 1/4 inch

Question 5

Use of anode- heel effect
what body part is at which side

Answer 5

Wrist at anode side
elbow at cathode side

Question 6

For an AP forearm what should be included

Answer 6

Both joints on IR. The IR should extend one inch beyond wrist and elbow

Question 7

What joint is partially or completely closed in an AP forearm

Answer 7

An partial or completely closed capitulum -radial joint

Question 8

if the forearm is rotated externally in an AP forearm what MC’s are superimposed

Answer 8

4th and 5th

Question 9

when there is rotation in an ap forearm what is no longer in profile

Answer 9

radial styloid

Question 10

In an AP, what rotation occurs from inaccurate positioning of the hand and wrist

Answer 10

Distal forearm

Question 11

what should you use to determine rotation of an ap forearm

Answer 11

MC’s

Question 12

if the 1st and 2nd MC are superimposed what kind of rotation is it

Answer 12

Internal rotation( pisiform and hamate hook are better demonstrated)

Question 13

what are superimposed if there is rotation of an ap forearm

Answer 13

Distal radius and ulna and MC bases are superimposed

Question 14

Pt. with known or suspected fractures
If they are unable to place arm in position, what should you do

Answer 14

position the area closest to the fracture in a true position

Question 15

Proximal forearm rotation is due to :

Answer 15

poorly positioned humeral epicondyles

Question 16

When more than ¼ of head is over ulna, how is the elbow rotated?

Answer 16

the elbow is internally rotated (medially)

Question 17

When less than ¼ of head is over ulna, how is the elbow rotated

Answer 17

the elbow is externally rotated (laterally)

Question 18

when does the Radial head demonstrates more or less than ¼ superimposition on ulna

Answer 18

when the proximal forearm is rotated internally or externally

Question 19

what causes the radioscaphoid and radiolunate joint spaces to be open in the AP projection when CR is at the midfoream

Answer 19

Due to a diverged x-ray beam

Question 20

how much of each joint should be on the image for a lateral forearm

Answer 20

IR long enough to extend one inch beyond both joint spaces

Question 21

how should the elbow, humerus, hand, and wrist be positioned for a lateral forearm

Answer 21

• elbow in lateral position
  -humerus same horizontal plane
• hand and wrist in lateral position

Question 22

what should be in profile in a lateral forearm

Answer 22

ulnar styloid in profile

Question 23

how is the distal scaphoid in the lateral forearm

Answer 23

The distal scaphoid slightly distal to the pisiform and anterior to the capitate and lunate

Question 24

where is the most common place for avulsion fracture

Answer 24

ulnar styloid process

Question 25

where can you see floud build up, effussion or fractures

Answer 25

pronator, supinator, or anterior fat pad

Question 26

what the most common to cut off in an lateral forearm

Answer 26

olecranon

Question 27

why is there a open elbow joint space in a lateral forearm

Answer 27

divergence of the beam

Question 28

how is the posterior fat pad if its not injured

Answer 28

it goes into the olecranon and you wont see it

Question 29

how is the posterior fat pad if there is an injury

Answer 29

you will see it

Question 30

what is the soft tissues of interest in a lateral forearm

Answer 30

Soft tissues of interest are the anterior and posterior fat pads and the supinator fat stripe at the elbow

Question 31

how is the pronator fat stripe located

Answer 31

The pronator fat stripe is located anterior surface of the distal radius

Question 32

The posterior fat pad is pushed out with injury, what does it do to the olecranon

Answer 32

pushing proximal and posterior to the olecranon process

Question 33

If there is distal external (supinated) wrist rotation how is the pisiform

Answer 33

anterior to the distal scaphoid

Question 34

If there is distal external (supinated) wrist rotation how is the ulna

Answer 34

ulna appears anterior to the radius

Question 35

if the hand is pronated for a forearm, how is the distal scaphoid

Answer 35

distal scaphoid is anterior to the pisiform and the radius is anterior to the ulna

Question 36

if the hand is pronated for a forearm how is the radius

Answer 36

radius is anterior to the ulna

Question 37

in external rotation what happens to pisiform

Answer 37

push pisiform out, becoming more anterior

Question 38

what can displace the fat pads

Answer 38

poor elbow placement

Question 39

in rotation of the forearm if the elbow is still lateral how is the radial tuberosity facing ?

Answer 39

anteriorly

Question 40

for a lateral forearm if the proximal forearm is elevated how is the capitulum and trochlea positioned

Answer 40

capitulum- too far anteriorly medial trochlea - too posteriorly resulting in closing the elbow joint space

Question 41

this position results in the capitulum and medial trochlea misalignment and also the radial head and coronoid process

Answer 41

poor humeral position

Question 42

how is the radial head when the proximal humerus is elevated

Answer 42

The radial head is positioned posterior to the coronoid process

Question 43

how are the medial and lateral humeral epicondyles in a AP humerus

Answer 43

Medial and lateral humeral epicondyles are in profile ( parallel with the IR

Question 44

how much are the radial head and tuberosity superimposed over the lateral aspect of the proximal ulna

Answer 44

1/4 inch

Question 45

what is demonstrated in profile laterally in a AP humerus

Answer 45

greater tubercle

Question 46

what is demonstrated in medial profile in an AP humerus

Answer 46

Humeral head is demonstrated in medial profile

Question 47

what is visible halfway between greater tubercle and humeral head

Answer 47

Vertical cortical margin of lesser tubercle

Question 48

what aligns with thumb

Answer 48

greater tubercle

Question 49

what should be parallel in an AP humerus

Answer 49

epicondyles

Question 50

how is the radial tuberosity when the hand is supinated in AP humerus

Answer 50

medial

Question 51

how will you determine amt of rotation needed

Answer 51

Determine amount of rotation needed by looking at the radial tuberosity superimposition of the ulna

Question 52

what is a result of poor humeral epicondyle positioning

Answer 52

rotation of humerus as a result of poor humeral epicondyle positioning

Question 53

if there is less than 1/4 of radius and ulna overlapping, what is the rotation

Answer 53

external (laterally)

Question 54

if there is more than 1/4 inch of the tuberosity is shown on ulna , how is the rotation

Answer 54

If more than ¼ inch of the tuberosity is shown on ulna, the elbow and humerus as been medially rotated

Question 55

what can excessive rotating due of there is a fracture of the humerus

Answer 55

When a fracture is suspected or follow-up image is taken the forearm should not be externally rotated excessively , this may cause an increase risk of RADIAL NERVE DAMAGE

Question 56

how should you position someone with an injury that is unable to move

Answer 56

Joint closest to the injury should be aligned in the true AP position

Question 57

how is the lesser tubercle in a Mediolateral Humerus

Answer 57

Lesser tubercle is in profile medially and the humeral head and greater tubercle are superimposed

Question 58

how is the humeral head and greater tubercle in a mediolateral humerus

Answer 58

humeral head and greater tubercle are superimposed

Question 59

how is the radial head demonstrated in the mediolateral humerus

Answer 59

Mediolateral projection most of the radial head is demonstrated anterior to the coronoid process, radial tuberosity is in profile

Question 60

how is the radial tuberosity in the mediolateral humerus

Answer 60

in profile

Question 61

how are the epicondyles in the mediolateral humerus

Answer 61

Epicondyles are perpendicular to IR

Question 62

out of mediolateral humerus and lateromedial which one decreases distorition

Answer 62

mediolateral

Question 63

what is seen better in mediolateral humerus

Answer 63

radial head

Question 64

what is better in the lateromedial humerus

Answer 64

coronoid

Question 65

what happens when there is over rotation of the mediolateral projection of the humerus

Answer 65

If there is to much rotation of the patient (pt. is no longer in a PA position) This would cause a decrease in density of the proximal humerus compared to the distal humerus

Question 66

how are the epicondyles in a lateromedial humerus

Answer 66

perp to ir

Question 67

for a good lateral elbow in a lateral humerus how should the hand be

Answer 67

turned up

Question 68

in this view, the radial head and coronoid process are superimposed, the radial tuberosity is not in profile and the capitulum is visible distal to the medial trochlea

Answer 68

Lateromedial Humerus

Question 69

what are superimposed in a lateromedial humerus

Answer 69

radial head and coronoid process are superimposed,

Question 70

how is the capitulum in a lateromedial

Answer 70

capitulum is visible distal to the medial trochlea

Question 71

what two ways can you do the proximal humerus

Answer 71

scapular y and transthoracic

Question 72

use a 3 second breathing technique, proximal humerus is halfway between the sternum and the thoracic vertebrae

Answer 72

Transthoracic lateral position

Question 73

is this internal rotation or external

Answer 73

-radial tuberosity more than 1/4 inch over ulna -MC are not flat more superimposition on the bases than others -see pisiform - hand rotated internally - radial styloid out of profile - MC bases superimposed -pisiform our by itself

Question 74

what are some indications of internal rotation of a forearm

Answer 74

-radial tuberosity more than 1/4 inch over ulna -MC are not flat more superimposition on the bases than others -see pisiform - hand rotated internally - radial styloid out of profile - MC bases superimposed -pisiform our by itself

Question 75

how should the anterior fat pad look like

Answer 75

a tear drop

Question 76

if anterior fat pad is not in proper position what does that indicate

Answer 76

indication of a radial head fracture

Question 77

in a forearm, if the pisiform is more anterior than scaphoid , how is the hand

Answer 77

- hand supinated - externally rotated

Question 78

in a forearm, if the scaphoid is more anterior how is it rotated and how is the hand

Answer 78

-hand pronated -internally rotated

Question 79

when the proximal forearm is elevated how is the capitulum

Answer 79

too anterior

Question 80

if the capitulum is anterior in a forearm how is the trochlea

Answer 80

posterior

Question 81

if there is poor humeral position and the radial head is anterior how is the capitulum, ulna, and trochlea

Answer 81

radial head anterior (more over on ulna) capitulum distally ulna posterior trochlea superior or proximal

Question 82

how should the hand be in an AP humerus

Answer 82

pronated

Question 83

in an AP humuerus, how should the lesser be?

Answer 83

lesser half way between greater and humeral head