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Image Analysis > Forearm and Humerus > Flashcards

Forearm and Humerus Flashcards

1
Q

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

A

Medial and lateral epicondyles

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2
Q

What is in profile in an AP forearm

A

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

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3
Q

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

A

The radial head

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4
Q

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

A

about 1/4 inch

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5
Q

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

A

Wrist at anode side
elbow at cathode side

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6
Q

For an AP forearm what should be included

A

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

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7
Q

What joint is partially or completely closed in an AP forearm

A

An partial or completely closed capitulum -radial joint

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8
Q

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

A

4th and 5th

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9
Q

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

A

radial styloid

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10
Q

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

A

Distal forearm

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11
Q

what should you use to determine rotation of an ap forearm

A

MC’s

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12
Q

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

A

Internal rotation( pisiform and hamate hook are better demonstrated)

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13
Q

what are superimposed if there is rotation of an ap forearm

A

Distal radius and ulna and MC bases are superimposed

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14
Q

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

A

position the area closest to the fracture in a true position

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15
Q

Proximal forearm rotation is due to :

A

poorly positioned humeral epicondyles

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16
Q

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

A

the elbow is internally rotated (medially)

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17
Q

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

A

the elbow is externally rotated (laterally)

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18
Q

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

A

when the proximal forearm is rotated internally or externally

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19
Q

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

A

Due to a diverged x-ray beam

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20
Q

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

A

IR long enough to extend one inch beyond both joint spaces

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21
Q

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

A
  • elbow in lateral position
    -humerus same horizontal plane
  • hand and wrist in lateral position
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22
Q

what should be in profile in a lateral forearm

A

ulnar styloid in profile

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23
Q

how is the distal scaphoid in the lateral forearm

A

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

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24
Q

where is the most common place for avulsion fracture

A

ulnar styloid process

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25
Q

where can you see floud build up, effussion or fractures

A

pronator, supinator, or anterior fat pad

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26
Q

what the most common to cut off in an lateral forearm

A

olecranon

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27
Q

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

A

divergence of the beam

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28
Q

how is the posterior fat pad if its not injured

A

it goes into the olecranon and you wont see it

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29
Q

how is the posterior fat pad if there is an injury

A

you will see it

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30
Q

what is the soft tissues of interest in a lateral forearm

A

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

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31
Q

how is the pronator fat stripe located

A

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

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32
Q

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

A

pushing proximal and posterior to the olecranon process

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33
Q

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

A

anterior to the distal scaphoid

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34
Q

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

A

ulna appears anterior to the radius

35
Q

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

A

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

36
Q

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

A

radius is anterior to the ulna

37
Q

in external rotation what happens to pisiform

A

push pisiform out, becoming more anterior

38
Q

what can displace the fat pads

A

poor elbow placement

39
Q

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

A

anteriorly

40
Q

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

A

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

41
Q

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

A

poor humeral position

42
Q

how is the radial head when the proximal humerus is elevated

A

The radial head is positioned posterior to the coronoid process

43
Q

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

A

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

44
Q

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

A

1/4 inch

45
Q

what is demonstrated in profile laterally in a AP humerus

A

greater tubercle

46
Q

what is demonstrated in medial profile in an AP humerus

A

Humeral head is demonstrated in medial profile

47
Q

what is visible halfway between greater tubercle and humeral head

A

Vertical cortical margin of lesser tubercle

48
Q

what aligns with thumb

A

greater tubercle

49
Q

what should be parallel in an AP humerus

A

epicondyles

50
Q

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

A

medial

51
Q

how will you determine amt of rotation needed

A

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

52
Q

what is a result of poor humeral epicondyle positioning

A

rotation of humerus as a result of poor humeral epicondyle positioning

53
Q

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

A

external (laterally)

54
Q

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

A

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

55
Q

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

A

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

56
Q

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

A

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

57
Q

how is the lesser tubercle in a Mediolateral Humerus

A

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

58
Q

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

A

humeral head and greater tubercle are superimposed

59
Q

how is the radial head demonstrated in the mediolateral humerus

A

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

60
Q

how is the radial tuberosity in the mediolateral humerus

A

in profile

61
Q

how are the epicondyles in the mediolateral humerus

A

Epicondyles are perpendicular to IR

62
Q

out of mediolateral humerus and lateromedial which one decreases distorition

A

mediolateral

63
Q

what is seen better in mediolateral humerus

A

radial head

64
Q

what is better in the lateromedial humerus

A

coronoid

65
Q

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

A

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

66
Q

how are the epicondyles in a lateromedial humerus

A

perp to ir

67
Q

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

A

turned up

68
Q

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

A

Lateromedial Humerus

69
Q

what are superimposed in a lateromedial humerus

A

radial head and coronoid process are superimposed,

70
Q

how is the capitulum in a lateromedial

A

capitulum is visible distal to the medial trochlea

71
Q

what two ways can you do the proximal humerus

A

scapular y and transthoracic

72
Q

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

A

Transthoracic lateral position

73
Q

is this internal rotation or external

A

-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

74
Q

what are some indications of internal rotation of a forearm

A

-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

75
Q

how should the anterior fat pad look like

A

a tear drop

76
Q

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

A

indication of a radial head fracture

77
Q

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

A
  • hand supinated
  • externally rotated
78
Q

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

A

-hand pronated
-internally rotated

79
Q

when the proximal forearm is elevated how is the capitulum

A

too anterior

80
Q

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

A

posterior

81
Q

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

A

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

82
Q

how should the hand be in an AP humerus

A

pronated

83
Q

in an AP humuerus, how should the lesser be?

A

lesser half way between greater and humeral head

Image Analysis (7 decks)

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