TEST 3 Flashcards
1
Q
A hand is displaced correctly in supination or pronation? which position?
A
pronation - PA
2
Q
Among all 5 digits, which digit have 2 phalanges?
A
thumb - 1st digit
3
Q
Which digit has 3 phalanges?
A
2 to 5th
4
Q
A sesamoid bone is located near which digit?
A
1st digit
5
Q
What is the movement for 1st CMC joint?
A
Saddle
6
Q
List the 3 joints for 1st digit from proximal to distal
A
CMC - MCP - IP
7
Q
The head of the metacarpal articulates with the proximal phalanx makes up which joint
A
MCP
8
Q
The head of proximal phalanx articulates with the base of distal phalanx make up which joint?
A
1st IP joint
9
Q
The base of distal phalanx articulates with the head of middle phalanx make up which joint?
A
DIP joint (2-5)
10
Q
The base of the middle phalanx articulates with the head of the proximal phalanx make up which joint?
A
PIP ( 2- 5)
11
Q
Give the movement for the following joints:
1. IP
2. MCP
3. CMC
A
- ginglymus
- ellipsoidal
- sellar
12
Q
Is the movement for CMC joint different in each digit? If so, determine the movement for each of them.
A
YES
CMC in thumb: saddle (sellar)
CMC in 2-5: plane (gliding)
13
Q
List the techniques (SID, kVp, CR, patient position, collimation includes which anatomy) for PA HAND
A
SID: 40”
kVp: 50-60
CR: 3rd MCP
Pt position: pronate hand, slightly abduct digits
Collimate: include wrist + 1” of distal forearm
14
Q
When you are doing a PA for an AFFECTED DIGIT (2-5), where is the CR?
A
CR at PIP (2-5)
15
Q
Can you do a PA for 1st digit? If not, what is the alternative?
A
NO due to increased OID
AP
16
Q
Where is the CR for 1st digit
A
CR: MCP joint
17
Q
What anatomy you should include when collimating the digits?
A
distal metacarpal
18
Q
Which digits are taken in the Mediolateral projection?
A
2
19
Q
Which digit/s are taken in the Lateromedial PA Oblique projection?
A
3-5
20
Q
4 & 5th digits are taken in which projection
A
Lateromedial
21
Q
How do you distinguish normal PA from Oblique PA for HAND ?
A
Look at head and space of/between MCP joint
22
Q
What are the position for 1st digit
A
AP & Lateral
23
Q
List the techniques (SID, kVp, CR, IR size, patient position, collimation includes which anatomy) for 1st DIGIT
A
SID: 40
50-60 kVp
CR: MCP
IR: 8 x 10
position:
-internally rotate & place dorsal aspect on IR (AP)
-pronate hand & rotate till lateral (L)
Collimation: 1st metacarpal & trapezium
24
Q
What anatomy do you need to include when taking image for 1st digit
A
1st metacarpal & trapezium
25
What are 3 positions for HAND
PA
Oblique
Lateral
26
Where is the CR for Lateral Hand
2nd MCP Joint
27
Where is the CR when taking Oblique Hand
3rd MCP joint
28
2 positions for LATERAL HAND
OK SIGN
KARATE CHOP
29
List the carpals in the proximal row (from lateral to medial)
Scaphoid - Lunate - Triquetrum - Pisiform
Navicular - Semilunar - Triangular - Pisiform
30
List the carpals in the distal row (from lateral to medial)
Trapezium - Trapezoid - Capitate - Hamate
G Multangular - L Multangular - Os Magnum - Unciform
31
Which carpal bone is biggest?
Capitate
32
Which carpal/s articulate with the radius? ( name it from lateral to medial)
Scaphoid - Lunate
33
List the techniques (SID, kVp, IR size, CR) for wrist
SID: 40"
50 kVp
IR: 8 x 10
CR: mid carpals
34
Why CR for wrist is at mid-carpal
to see distal ulna & radius - identifying fracture of forearm
35
What are the positions for wrist ?
PA
Lateral
Oblique
Ulnar deviation
Carpal Tunnel
36
How do you tell if its a True PA for WRIST
separation of radius & ulna
equal space between proximal metacarpal
37
What anatomy do you need to include when collimating wrist
Distal radius & ulna
Mid metacarpals
38
How do you tell if its a TRUE 45 degree OBLIQUE for WRIST
distal radius partially superimpose ulna head
39
How do you tell if its a TRUE LATERAL for WRIST
Ulna head superimpose distal radius
40
What 3 carpals you can see in TRUE LATERAL
Capitate Trapezium Scaphoid
41
How is hand positioned for ulnar deviation?
evert hand toward ulna
42
What is the tube angled for ulnar deviation? Why?
10 - 15 proximal
elongate scaphoid
43
When patient cant perform ulnar deviation, what is the alternative?
PA Axial (Stecher)
44
How to position patient for PA Axial
elevate hand 20 degree
Place IR & hand on angled sponge
ulnar deviate (if possible)
45
For PA axial (Stecher), do we angle the tube or the patient hand ? by how much?
patient hand angled at 20 degree
46
For PA axial (Stecher), why do we angle the hand 20 degree?
so scaphoid is parallel to IR
47
PA axial (Stecher) is used for taking _____
WRIST
48
How do you position patient for Carpal Tunnel
dorsiflex hand 90 degree
rotate hand & wrist 10 degree internally (tw radial side)
49
Why do we need to rotate hand & wrist 10 degree internally for Carpal Tunnel
prevent superimposition of pisiform and hamate
50
Carpal Tunnel is used to see which carpals
hamate, pisiform, trapezium
51
For carpal tunnel, do we angle the tube or the patient hand? how much?
Tube
25-30 proximal tube angle
52
Where is the CR for Gaynor-Hart
1" distal to base of 3rd metacarpal (center of palm)
53
Radioulnar joint is distal when ____
closest to the wrist
54
Radioulnar joint is proximal when ____
closest to elbow
55
What make up the distal radioulnar joint?
head of ulna & ulna notch (on radius)
56
What make up the proximal radioulnar joint?
Head of radius + ulna at radial notch
57
List the anatomy of Distal Radius?
styloid process
ulnar notch
body
58
List the anatomy of Proximal Radius?
Head
Neck
Radial Tuberosity
59
Bicep tendon attached to which anatomy part of forearm?
radial tuberosity
60
Why is it important to know the position of forearm joint?
to make sure elbow and wrist are included for AP & Lateral
61
Ulna notch is on ___ aspect of distal radius
medial
62
Head of radius is ____
Head of ulna is ___
proximal
distal
63
Styloid process is more prominent on ____ than ___
ulna - radius
64
List the anatomy of Distal ulna
styloid process
head
body
65
List the anatomy of Proximal ulna
radial notch
coronoid process
coronoid tubercle
trochlear notch
olecranon process
66
Which 2 anatomic structures allow the elbow to flex & extend
trochlea of humerus & trochlear notch of ulna
67
During pronation, rotation of forearm include which joints?
distal and proximal radioulnar joint
68
What are routines/positions for forearm
AP & Lateral
69
kVp for forearm
60+
70
Why do we supinate hand for AP Forearm
so humeral epicondyles are parallel to IR to avoid crossing of radius and ulna
71
What anatomy should be include when collimating forearm
wrist & elbow
72
Why is it important that arm extended and level with table for AP Forearm
decreased OID
73
supination and pronation of hand is what type of movement
pivot
74
Describe movement of forearm when hand pronated
radius cross over ulna
75
how do radius and ulna look in AP Forearm with NO rotation
radius & ulna partially superimposed
76
how do radius and ulna look in AP Forearm with lateral rotation
radius & ulna are separated
77
how do radius and ulna look in AP Forearm with medial rotation
radius & ulna are superimposed
78
How to position patient for Lateral Forearm
Flex elbow 90 degree, level with table
rotate wrist into lateral
79
Why do we do Lateral Forearm
to make wrist & elbow lateral so we can see all bones
80
what are the articulating surface of distal humerus called
epicondyles
81
What are the condyles of distal humerus? give its anatomic position
trochlea (medial)
capitulum (lateral)
82
capitulum articulates with _____
trochlea articulate with_____
give which type of joint/movement
radius
ulna
ginglymus
83
What are 3 fossa of distal humerus
radial fossa
coronoid fossa
olecranon fossa
84
Which elbow fossa are anterior
radial & coronoid
85
Olecranon fossa is located posteriorly or anteriorly
posterior
86
Describe mechanism of flexion of elbow
radial head +coronoid process slide into their fossa and rotate at trochlear notch
87
Describe mechanism of extending of elbow
olecranon process slide into olecranon fossa
88
What are fat pads
extrasynovial pads of fat, cushion between muscle and bone
89
the scaphoid fat stripe is best seen on which position of the wrist
PA & Oblique
90
what is the location of the scaphoid fat stripe for wrist
lateral to scaphoid and superior to radius
91
the pronator fat stripe is best seen on which position of the wrist
Lateral
92
what is the location of pronator fat stripe for wrist
anterior to radius
93
How can the fat pads indicate pathology?
if there are swelling/ edema fluid within joint, the normal position is altered
94
the anterior elbow fat pad is best seen on which position?
location?
lateral
anterior to distal humerus
95
the posterior elbow fat pad is best seen on which position?
location?
lateral on POSITIVE image
not seen on NEGATIVE image
within olecranon fossa
96
the supinator elbow fat pad is best seen on which position?
location?
lateral
anterior to radius
97
the Sail Sign corresponds to which fat pad
Anterior & posterior elbow fat pad
98
What happened to POSTERIOR elbow fat pad when there is trauma?
tricep push post fat pad out of olecranon fossa
99
4 positions for Elbow
AP
Lateral
Internal Oblique
External Oblique
100
kVp elbow
65+
101
how to position pt for AP ELBOW
arm extend, level with table
supinate hand ( epi parallel w IR)
102
what anatomy need to be included when collimating AP elbow
proximal forearm
distal humerus
103
If pt cant extend their arm for a regular AP, what 2 alternate AP positions to do instead to get the elbow?
AP proximal forearm (forearm // IR)
AP distal humerus (humerus // IR)
104
when patient cant extend their elbow fully for oblique position, what is the alternative ?
Coyle (Lateromedial & Mediolateral)
105
Why do we do axial lateromedial for elbow
to see radial head
106
How to position pt in axial lateromedial for elbow
flex elbow 90
pronate hand
107
What is the tube angle for axial lateromedial (elbow)
45 degree toward shoulder
108
What is the tube angle for axial mediolateral (elbow)
45 degree from shoulder
109
How to position pt in axial mediolateral for elbow
flex elbow 80
pronate hand
110
why do we do Coyle?
when pt cant extend elbow fully for M/L oblique
111
why do we do 45 degree tube angle
distort distal humerus to see radial head better (?)
112
which one replaced external oblique for elbow
mediolateral (Coyle)
113
Why do we do axial mediolateral for elbow
to see coronoid process
114
What anatomy should be seen for ELBOW internal oblique
trochlea & coronoid process
115
What anatomy should be seen for ELBOW external oblique
capitulum & radial head/neck w/o superimpose
116
when we are in anatomic position, which position is the elbow
internal oblique
117
What happened to epicondyles when we pronate hand for internal oblique
epicondyles 45 degree to IR
118
To see medial aspect of elbow, which position should the patient be in
internal oblique
119
[Ex OB] TRUE lateral 45 degree of elbow is when ____
radial head/neck/tuberosity are seen
no superimposition of ulna
proximal radioulnar joint is open
120
[Int OB] TRUE medial 45 degree of elbow is when ___
radial head superimpose proximal ulna
trochlear notch partially opens
121
What are the anatomy for proximal humerus (8)
Head
Anatomic Neck
Greater & Lesser Tubercle
Surgical Neck
Intertubercular groove
deltoid tuberosity
body
122
What is the groove between greater and lesser tubercle
intertubercular groove
123
which part of the upper arm that articulate with the scapula to make up the shoulder joint
proximal humerus
124
Where is lesser tubercle located
directly below the anatomic neck on the anterior surface
125
A humerus is in a true AP when taken with ___ rotation
external
126
in a true AP projection, the greater tubercle is located ____
laterally
127
2 positions for humerus
AP & lateral
128
SID & kVP for humerus
40
70-85
129
What do we need to include when taking humerus imaging
Shoulder & elbow
130
when epicondyles are parallel to IR, elbow is in which position
AP
131
when epicondyles are perpendicular, elbow is in which position
Lateral
132
Condyle of distal humerus that articulate with the radius ?
capitulum
133
If patient have possible fractures of the arm, which 3 lateral positions would you do?
Erect Mediolateral
X-table lateral
Transthoracic
134
in a neutral rotation, where are the G & L tubercles located
both are anterior
135
In an internal rotation, where are the G & L tubercles located
G: lateral
L: medial
136
In an external rotation, where are the G & L tubercles located
G: lateral
L: just medial to greater tubercle
137
Patient is in _____ oblique for erect mediolateral position
anterior
138
A true erect mediolateral would show the lesser tubercle ____
medially
139
Why do we do X-table lateral
to see mid to distal humerus
140
When do we do X-table lateral
when patient cant stand
141
Cons of X-table lateral
cant get the whole humerus
142
Where is the IR for X-table lateral
between body & arm (fig 5.34)
143
Do you use a grid for X-table lateral
NO
144
kVp for humerus
70-85
145
Why do we do transthoracic lateral
to see proximal humerus
146
How do you position patient for transthoracic?
affected side against IR
raise unaffected arm across thorax
can be either erect or supine
147
Where is the CR for transthoracic
surgical neck
148
Which lateral position MAINLY required the breathing technique
Transthoracic
149
Why is it important to do breathing technique for Transthoracic
short, shallow breaths to blur out ribs & pulmonary markings
150
how do you position patient for X-table lateral
supine
elbow flexed 90 degree
151
what is the projection for X-table lateral
lateromedial
152
What are the two bones of shoulder girdle
clavicle & scapula
153
What is the function of clavicle & scapula
connect upper limb to axial skeleton
154
if you do transthoracic, you got ____ of humerus
AP
155
A scapula has
____ borders
____ angles
____ surfaces
3
3
2
156
[scapula] The vertebral border is _
medial
157
[scapula] The superior border is _
uppermost margin of scapula
158
[scapula] The axillary border is _
lateral
159
[scapula]
The costal surface is ____
The dorsal surface is ____
anterior
posterior
160
The head of the scapula sometimes called___
lateral angle
161
The humeral head articulates with ___
glenoid cavity of scapula
162
What is the notch that formed by the base of coracoid process
suprascapular notch
163
What 2 fossa served as an attachment for shoulder muscle
infraspinous & supraspinous fossa
164
What is the movement type for SC & AC joint
gliding
165
What 4 structures you can see in dorsal scapula
scapular spine
acromion
supraspinous fossa
infraspinous fossa
166
What 2 structures you can see in costal scapula
coracoid process
scapular notch
167
What make up the scapulohumeral joint
scapula and proximal end of humerus
168
What make up the Ball & Socket for shoulder
Ball: head of humerus
Socket: glenoid fossa of scapula
169
Majority of dislocation for shoulder happened _____
anteriorly
170
What are the main 3 positions for shoulder & 3 alternative position
AP internal rotation
AP external rotation
Scapular Y
Axial
Glenoid Fossa
Transthoracic Lateral
171
SID & kVp for shoulder
40
75 kV
172
Epicondyle parallel to IR, you will see ____
AP of entire upper extremity ( humerus, elbow, shoulder)
173
Epicondyles perpendicular to IR, you will see ____
Lateral view
174
Epicondyles parallel to IR in AP ____ rotation
external
175
Where is the CR for AP internal & external rotation of the shoulder
1" inferior to coracoid
176
how do you position patient for AP external rotation
supinate hand
suspend respiration
177
how do you position pt for AP internal rotation
pronate hand
suspend respiration
178
AP external rotation will show ___ in profile
greater tubercle
179
AP internal rotation will show ___ in profile
lesser tubercle
180
If we put the epicondyles perpendicular to the IR, we will see _____ tubercle
lesser
181
If we put the epicondyles parallel to the IR, we will see _____ tubercle
greater
182
Where is the CR for scapula Y
throuh scapulohumeral joint
183
What make up the two upper arm of the Y
lateral: acromion
medial. coracoid process
184
[scapular Y] how do you know if there is no dislocation of the humerus
humeral head superimposed base of the Y
185
Which projection start in Anterior Oblique Y
Tangential Projection - Supraspinatus outlet (Neer)
186
[Neer] which structures are needed to be perpendicular to IR
superior scapular angle and AC joint
187
[Neer] the superior scapular angle and AC joint need to be ____ to IR
perpendicualr
188
Where is the. CR for Neer
through superior humeral head
1" superior to medial aspect of scapular spine
189
What is the tube angle for Neer?
10 -15 caudal angle
190
Why do we do Neer
to see the supraspinatus outlet without superimposition of humeral head
191
What is the Grashey method
AP oblique to show glenoid cavity in profile w/o superimposition of humeral head
192
How to position pt for Grashey
rotate body 30-45 degree posterior oblique
arm neutral with slight abduction
193
Where is CR for Grashey
2" inferior & 2" medial from superiolateral border of shoulder
scapulohumeral join t
194
Collimation of Grashey includes ___
upper & lateral soft tissue margins
195
In neutral, you will have ____ oblique of elbow
internal
196
WIth AP external rotation, epicodyles are ____ to IR
parallel
197
with AP internal rotation, epicondyles are ____ to IR
perpendicular
198
What can u see in Inferiosuperior axial projection
coracoid
lesser tubercle
scapular spine
humeral head
199
where is the CR for Lawrence
through axilla
200
how do you position pt for Lawrence
supine
abduct arm 90 degree with external rotation
201
which projection is used to show the proximal humerus
transthoracic lateral
202
2 positions for scapula imaging
AP & Lateral Y
203
Where is the CR for AP Scapula
2" inferior to coracoid process
204
how to position pt for AP Scapula
supinate hand
abduct arm 90
suspend respiration
"salute"
205
2 positions for clavicle imaging
Ap & AP axial
206
where is cr for ap clavicle
mid clavicle
207
how is arm position in AP Clavicle
neutral
208
where is cr for AP axial for clavicle
15-30 cephalad to midclavicle
209
Suspended respiration for AP and AP Axial clavicle is ___
inspiration
210
Why do we inhale for AP Clavicle
to elevate clavicle
211
why is it important to abduct arm 90 degree for AP scapula
move scapula toward lateral margin
prevent superimposition of ribs & thorax
212
kvp for clavicle
75
