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rtintern- upper extremities > HAND > Flashcards

HAND Flashcards

1
Q

PP: Hand palmar surface down; spread finger slightly
RP: 3rd MCP joint
CR: ┴
SS: PA oblique projection of the thumb
AP Projection:
Hand cannot be extended because of injury and pathologic conditions
For metacarpal bones and MCP joints

A

PA PROJECTION

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2
Q

PP: Hand pronated; palmar surface down; MCP joints 45o to IR; 45o foam wedge
RP: 3rd MCP joint
CR: ┴
SS: PA oblique projection of the hand
ER: To investigate fractures and pathologic conditions
Foam Wedge: For interphalangeal joints
Fingertips Touching The Cassette: For metacarpal bones
Index Finger Elevation:
Use of radiolucent material
Opens joint spaces
Reduces the degree of foreshortening of phalanges

A

PA OBLIQUE PROJECTION

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3
Q

PP: Hand rotated 45o internally
RP: 3rd MCP joint
CR: ┴
ER: To demonstrate severe metacarpal deformities fractures

A

REVERSE OBLIQUE PROJECTION
Lane-Kennedy-Kuschner Recommendations

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4
Q

PP: Hand in PA position; hand rotated 40-45o toward ulnar surface & 40-45oforward; MCP joints flexed 75-80o; hand dorsum resting on IR
RP: MCP joint of interest
CR: ┴
ER: To demonstrate metacarpal head fractures

A

TANGENTIAL OBLIQUE PROJECTION
Kallen Recommendation

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5
Q

PP: Hand in lateral position; digits extended; ulnar aspect down (lateromedial projection); radial aspect down (mediolateral projection; more difficult to assume); thumb 90o to palm
RP: 2nd MCP joint
CR: ┴
SS: Lateral projection of the hand in extension
ER: To localize foreign bodies and metacarpal fracture displacement
Fan Lateral Position: Eliminates superimposition of all phalanges (except proximal phalanges)

A

LATERAL PROJECTION
In Extension

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6
Q

PP: Hand rotated 5o posteriorly from true lateral position (removes superimposition of 2nd-4th metacarpals); thumb extended;
RP: Midshaft of 5th metacarpal
CR: ┴
ER: To better demonstrate fractures of 5th metacarpal

A

LEWIS METHOD

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7
Q

PP: Hand in natural arch position; digits relaxed
RP: 2nd MCP joint
CR: ┴
SS: Lateral projection of the hand in flexion
ER: To demonstrate anterior or posterior displacement in fractures of metacarpals

A

LATERAL PROJECTION
In Flexion

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8
Q

PP: Hand supinated; medial aspect against IR; 45o sponge support
RP: b/n level of 5th MCP joints of both hands
CR: ┴
SS: AP oblique projection of both hands
ER: To diagnose rheumatoid arthritis

A

NORGAARD METHOD
AP OBLIQUE PROJECTION

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9
Q

PP: Hand slightly arch (places wrist in close contact with IR)
RP: Midcarpal area
CR: ┴
SS: Slightly oblique rotation of ulna (AP should be taken if ulna is under examination)

A

PA PROJECTION

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10
Q

PP: Hand slightly arch (places wrist in close contact with IR)
RP: Midcarpal area
CR: 30o toward the elbow; 30o toward the fingertips
SS: Elongated scaphoid & capitate (toward the elbow); elongated capitate only (toward the fingertips)
ER: To better demonstrate the scaphoid & capitate

A

Daffner-Emmerling-Buterbaugh Recommendation

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11
Q

PP: Hand supinated; digits elevated (places wrist in close contact with IR)
RP: Midcarpal area
CR: ┴
SS: Carpal interspaces better demonstrated; no rotation of ulna

A

AP PROJECTION

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12
Q

PP: Elbow flexed 90o; hand & forearm in lateral position; ulnar surface against IR; radial surface against IR (for comparison)
RP: Midcarpal area
CR: ┴
SS: Proximal metacarpals & distal radius & ulna; trapezium & scaphoid (more anterior)
ER: To demonstrate anterior or posterior displacement in fractures

A

LATERAL PROJECTION
Lateromedial

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13
Q

PP: Wrist in palmar flexion (rotates the scaphoid in dorsovolar position)
RP: Scaphoid
CR: ┴
SS: Lateral position of the scaphoid

A

Burman & et al. Suggestions

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14
Q

-First to describe carpe bossu (carpal boss), a small bony growth occurring on the dorsal surface of the 3rd CMC joint
-Best demonstrated in a lateral position of wrist in palmar flexion

A

Foille

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15
Q

PP: Palmar surface against IR; hand pronated & rotated 45olaterally; wrist ulnar deviation (for scaphoid only)
RP: Midcarpal area
CR: ┴
SS: Carpals on the lateral side (Scaphoid & Trapezium)

A

PA OBLIQUE PROJECTION
Lateral Rotation

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16
Q

PP: Dorsal surface against IR; hand supinated & rotated 45omedially
RP: Midcarpal area
CR: ┴
SS: Carpals on the medial side (Pisiform, Triquetrum & Hamate)

A

AP OBLIQUE PROJECTION
Medial Rotation

17
Q

PP: Hand pronated; wrist in extreme ulnar deviation
RP: Scaphoid
CR: ┴; 10-15o proximally/distally (clear delineation)
SS: Scaphoid; opens carpal interspaces on lateral side
ER: To correctscaphoid foreshortening

A

PA PROJECTION
In Ulnar Deviation

18
Q

PP: Hand pronated; wrist in extreme radial deviation
RP: Midcarpal area
CR: ┴
SS: Opens carpal interspaces on medial side

A

PA PROJECTION
In Radial Deviation

19
Q

VARIATIONS:
-IR elevated 20 DEGREES
-CR 20 DEGREES toward elbow
- CR 20 DEGREES toward digits
-Fracture line that angles superoinferiorly
-Close the fist
RP: Scaphoid
CR: ┴
SS: Scaphoid
ER (20o Angulation):
To place scaphoid at right angles to the CR
To project scaphoid w/o self-superimposition
Bridgman Method: Stecher Method with ulnar deviation

A

STECHER METHOD
PA AXIAL PROJECTION

20
Q

PP: Hand pronated; wrist in extreme ulnar deviation
RP: Scaphoid
CR: ┴; 10o; 20o; 30ocephalad
SS: Scaphoid with minimal superimposition
ER: To diagnose scaphoid fractures

A

RAFERT-LONG METHOD
PA & PA AXIAL PROJECTIONS
In Ulnar Deviation

21
Q

PP: Palmar surface against 45o sponge; hand in ulnar deviation; rotate elbow end of IR & arm 20o away from CR (unable to achieve ulnar deviation)
RP: Anatomical snuffbox
CR: 45 DEGREES distally
SS: Trapezium
ER: To demonstrate trapezium fractures

A

CLEMENTS-NAKAYAMA METHOD
PA AXIAL OBLIQUE PROJECTION

22
Q

PP: Hand palm upward; hand 90o to forearm
RP: 1.5 in. (3.8 cm) proximal to wrist joint
CR: 45ocaudad
SS: Carpal bridge
ER: To demonstrate fractures of scaphoid, lunate dislocation, dorsum of wrist calcifications and foreign bodies & dorsal aspect of carpal bones chip fractures

A

LENTINO METHOD
TANGENTIAL PROJECTION

23
Q

PP: Wrist hyperextended; hand rotated slight toward the radial side (to prevent superimposition of hamate & pisiform shadows); digits grasp w/ opposite hand
RP: 1 in. distal to 3rd MCP base
CR: 25-30o to long axis of hand
SS: Carpal canal/tunnel (Carpal sulcus+Flexor retinaculum)

ER:
To demonstrate carpal tunnel syndrome
To demonstrate fractures of hook of hamate, pisiform & trapezium

A

GAYNOR-HART METHOD
TANGENTIAL PROJECTION

24
Q

For wrist that cannot be extended to w/in 15o of vertical
CR aligned // to palmar surface
Angled an additional 15o toward the palm

A

Mcquillen Martensen Suggestion

:GAYNOR-HART METHOD
TANGENTIAL PROJECTION

25
Q

PP: Dorsiflex the wrist; lean forward (to place carpal canal tangent to IR)
RP: Midpoint of the wrist
CR: ┴
SS: Carpal canal/tunnel
ER: Taken when patient cannot assume/maintain Gaynor-Hart Method

A

SUPEROINFERIOR PROJECTION

26
Q

For limited dorsiflexion of the wrist
Placed 45o sponge under palmar surface of the hand
Slightly elevates the wrist to place the carpal canal tangent to CR
With slight degree of magnification due to increased OID

A

Marshall Suggestion

:SUPEROINFERIOR PROJECTION

rtintern- upper extremities (24 decks)

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