Test 3 Flashcards
How many total bones are found in the adult hand and wrist?
27
What is the third bone in the proximal row of the carpals?
Triquetrum
What is the largest of the carpal bones?
Capitate
Which carpal bone forms an aspect of the first carpometacarpal (CMC) joint?
Trapezium
Which of the carpal bones is most commonly fractured?
Scaphoid
What is the 3rd bone on the distal row of the carpal bones?
capitate
What is the joint classification and type of movement (if it applies) of the 3rd PIP joint.?
Diarthrodial with ginglymus movement
What is the joint classification and type of movement (if it applies) of the radiocarpal joint?
Diarthrodial with ellipsoidal movement
Which joint possesses saddle type of movement? Please be specific.
1st carpometacarpal joint
What is the joint classification and type of movement for the distal radioulnar joint?
Diarthrodial-pivot
Which of the following structures contains the trochlea?
Distal humerus
Which of the following is located most inferior?
Ulna head
Radial head
Radial tuberosity
Coronoid process
Ulna head
Which of the following structures is located on the proximal ulna?
Trochlea
Capitellum
Coronoid process
Head of ulna
Coronoid process
What is the term for the lateral articulating surface of the distal humerus?
Capitulum
What is the large fossa on the posterior, distal humerus termed?
Olecranon fossa
Which specific aspect of the forearm/elbow contains the ulnar notch?
Distal radius
What is the name of the small depression located on the anterior aspect of the distal humerus?
Coronoid fossa
Which specific region of the following bones contains the olecranon fossa?
Distal humerus
Which specific region of the following bones contains the trochlear notch?
Proximal ulna
Which joints of the forearm permits pivot movement of it?
Proximal and distal radioulnar joint
what 4 fractures involve the wrist or forearm.
Chauffeur’s
Smith
Barton’s
Colles’
Situation: A patient comes into radiology with a suspected Barton’s fracture. Which positioning routine would be recommended to best demonstrate this possible fracture?
Wrist or forearm series
Situation: A patient radiographed earlier had a Boxer’s fracture. A small plaster cast is placed on his hand and wrist. A complete hand series was performed using 64 kV at 2.5 mAs, 40” SID, table-top, He returns to radiology for a post-reduction hand series. Part One: Which specific region of the hand is injured with a Boxer’s fracture? Part Two: What type of positioning routine would be performed on this patient? Part Three: Would you alter your original exposure factors? If yes, what would you change?
Part One: Head of the 5th metacarpal. Part Two: Post-reduction series is a two projection study, PA and lateral. Part Three: Increase kVp 5 to 7 kVp. The exposure factors would be 69 to 71 kV, 2.5 mAs, 40” SID and table-top.
Situation: A patient enters the ER with a wrist injury. The routine wrist projections demonstrates an elevated scaphoid stripe but no fractures are detected. Which follow-up position would be indicated with this finding?
An ulnar deviation projection
Which one the following technical considerations does not apply to radiography of the hand and wrist?
High speed screens
Small focal spot
40-44” SID
Table-top procedure
High speed screens
Situation: A three-projection study of the thumb has been performed. The radiologist believes there is a Bennett’s fracture present. The 25 y/o male is the star short-stop on a local baseball team and jammed it on a hard-hit ball. The AP thumb projection is inconclusive in demonstrating the base of the 1st metacarpal. What projection would be indicated for this region and diagnose a possible Bennett’s fracture?
Modified Robert’s projection
Which of the following injuries often results in an avulsion fracture involving the PIP or DIP joint?
Tendon tear
Identify the second carpal of the distal row
Trapezoid
Where would you center the CR for an AP projection of the thumb?
1st MCP joint
Which one of the following fractures are described as a fracture of the radial articular surface due to hyper-extension of the hand/wrist?
Barton’s fracture
What specific positioning routine would be performed on a study of the 4th digit. Please be specific on the type of lateral projection performed?
PA, PA oblique, and lateromedial projection
Another term for a dislocation is
Luxation
What is the chief advantage of an AP projection of the wrist over a PA?
Better delineation and less distortion of the intercarpal joints
Situation: A patient comes to radiology with a injured elbow. He is holding it at a 90 degree flexion. When positioning it, he tells you he can’t extend it beyond 90 degrees. The doctor needs a complete, four projection study. What is your positioning routine?
AP, partially flexed AP-2 projections, lateral, and Coyle method for both radial head and coronoid process.
Situation: A child comes to radiology with a Colles’ fracture. He is in a splint that was placed on by the ER. She will only move it slightly. Part one: What is your positioning routine for this child? Part two: Do you remove the splint?
AP and horizontal beam lateral of the forearm. Leave the splint on because the emergency room placed it on the arm.
Which positioning landmarks are palpated for an AP elbow projection?
Medial and lateral epicondyles
What postion is being performed with the elbow in a 90 degree angle flexion, a 45 degree CR angle and it is directed away from the patient’s shoulder?
Coyle method for coronoid process
How many projections do you do for a foreign body
2
What is the primary growth center
diaphysis
what is the secondary growth center
epiphysis
What classification are carpal bones
diarthrodial - plane
what classification are phlanges and the elbow
diarthrodial - ginglymus
What classification is the radioulnar joint
diarthrodial - Pivot (
what classification is the DIP and PIP
diarthrodial - ginglymus
what classification is the MCP
diarthrodial - ellipsoidal
what classification is the IP
diarthrodial - ginglymus
what classification is the CMC
diarthrodial - plane
what classification is the 1st CMC joint
diarthrodial - saddle
what classification is the radiocarpal joint
ellipsoidal
what is the name of the hook on the hamate?
haumlar process
Name the carpal bones in order from proximal row to distal row
Scaphoid, lunate, triqieum, pisiform, trapezium, trapezoid, capitate, hamate
what joint classification of joint does the trapezium joint form with the first metacarpal?
saddle
what is the name of the very end of the distal phalynx
tuft
how much do you increase kVp with a fiberglass cast?
3-4
how much do you increase kVp with a small plaster cast?
5-7
how much do you increase kVp with a large plaster cast?
8-10
What lateral do you use to see the individual phalanges
fan lateral
what lateral do you use to see a foreign body
extension lateral
what lateral do you use if the patient keeps complaining of hand pain
flexion lateral
When you see an avulsion what other complication is likely to have occurred
tendon tear
where is the CR aligned in a oblique projection
radiostilar process
How can you isolate the pisiform in a lateral projection of the wrist
rotate 10 degrees posterior
what projection can be done to replace the ulnar deviation
stetchers method
what angulation is used during the stetchers method? is the angulation of the CR or the body part?
20 degrees of the body part, the CR is perpendicular
What position has the fingers pulled back
gaynard hart method
if the pisisform is superimposed over the hamate process what did you forget to do during positioning in the gaybard hart method
rotation of the hand towards the thumb (radially) 10 degrees
What is the name of the projection that is used to diagnose rheumatoid arthritis
norgarr method or ball catchers
why do you not do a PA projection for a forearm study
the proximal radius will cross over the ulna
what rotation separates the ulna and radius
lateral
what rotation superimposes the ulna and radius
medial
what amount should the radius superimpose the ulna on an AP projection
1/3-1/2
if the radial head is not sharp in the medial rotation the problem is what?
the arm is under obliqued
what projection can be done if the patient is unable to straighten their arm from an AP of the elbow
partial flexion AP
what projection can you do to replace the obliques of a elbow
coyle method
what degree of angulation do you do for the CR for coyles method
45 degrees
Coyles methode: CR is angled proximal what anatomy will be demonstrated
radial head
coyles method: CR is angled distal what anatomy will be demonstrated
coronoid process
what is the problem is the capitulum superimposed the radial head
flexion
what is another name for an acute flexion projection
jones method
determine if the part is on the ulna or radius or humerus
- trochlear notch
- radial notch
- olecronon fossa
- trochlea
- coronoid tubercle
- coronoid process
- olecranon process
- cornoid fossa
- u
- u
- h
- h
- u
- u
- u
- h
which joint permits the forearm to rotate during pronation
proximal radioulnar joint
the articular portion of the medial aspect of the distal humerus is called the
trochlea
the similar structure found on the lateral aspect of the distal humerus is called the
capitulum
the deep depression located on the posterior aspect of the distal humerus is the
olecranon fossa
what is one of the most used projections to identify if there has been a fracture of the scaphoid bone
ulnar deviation
the two main fat stripes around the wrist are
scaphoid and pronator
where is the pronator fat pad located?
palm side of wrist
where is the scaphoid fat pad located?
to the left of the scaphoid bone
which routine projections best demonstrate the scaphoid fat pad
PA and oblique wrist
which routine projection best demonstrates the pronator fat stripe
lateral wrist
where is the CR centered for a PA oblique of the second digit
PIP
what fracture happens to the finger that commonly results in avulsions
mallet
fracture of the distal end of the 5th metacarpal
boxers
what series would you perform for a boxers fracture
hand or digit series
what series would you perform for a mallet fracture
digit
Linear fracture along the base of the 1st metacarpal
Bennetts
what series would you perform for a bennetts fracture
thumb
is the base of the 1st metacarpal is unable to be seen during a thumb series, and a bennets fracture is suspected what additional projection could you perform
modified roberts
how much angulation of the tube is done on a modified roberts projections
10-15 degrees
Fracture of the distal radius with a free floating fragment posterior
colles
fracture of the distal radius with a free floating fragment anterior
smiths
distal radius styloid fracture
chauffers
fracture of the articulating surface of the radius due to hyperextension. Generally a result of the scaphoid slamming into the wrist
bartons
what series is done for a bartons fracture
wrist
a routine wrist shows a possible scaphoid fracture what 2 projections can be done
ulnar deviation, or stetchers
