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Image Eval R216 > Upper Extremity (non-shoulder) > Flashcards

Upper Extremity (non-shoulder) Flashcards

1
Q

what are the 8 carpal bones?

*in order from lateral to medial, bottom row first

A

bottom: scaphoid, lunate, triquetrum, pisiform
Top: trapezium, trapezoid, capitate, hamate

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2
Q

what are the 8 carpal bones?

*in order from lateral to medial, bottom row first

A

bottom: scaphoid, lunate, triquetrum, pisiform
Top: trapezium, trapezoid, capitate, hamate

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3
Q

PA, Lateral, and PA Oblique 2nd-5th digits centering point

A

Proximal Interphalangeal Joint of digit of interest

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4
Q

AP and PA Oblique 1st digit centering point

A

1st Metacarpophalangeal joint

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5
Q 
PA Digit (2nd-5th)
Image Eval
A
  • distal metacarpal included
  • biconcavity of phalangeal bodies
  • open IP and MCP joints
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6
Q

PA Oblique Digit (2nd-5th)

Image Eval

A
  • distal metacarpal included
  • anterior concavity of phalanx
  • open IP and MCP joints
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7
Q

PA Lateral Digit (2nd-5th)

Image Eval

A
  • distal metacarpal included
  • anterior concavity of phalanx
  • superimposed condyles
  • open IP and MCP joints
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8
Q

What anatomy should be included in a projection of the 1st digit?

A

both phalanges and all of the adjacent metacarpal

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9
Q

PA and PA Oblique Hand

Positioning

A
  • anterior surface of hand flat on IR (laterally rotated 45 degrees for Oblique)
  • collimate to include the fingers, carpals, metacarpals, and distal radius and ulna
  • center at 3rd MCP joint
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10
Q

PA hand

Image Eval

A
  • all of hand to distal radius and ulna included
  • biconcavity of phalanges
  • metacarpals equidistant
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11
Q

PA Oblique Hand

A
  • all of hand to distal radius and ulna included
  • anterior concavity of phalanges
  • minimal overlap of 3-5 metacarpals
  • 2nd-3rd metacarpals separated
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12
Q

Lateral Hand
Positioning
Image Eval

A
  • center at 2nd MCP joint
  • position for either fingers on top of each other (karate chop) or “okay” symbol (fan)
  • collimate to include distal radius and ulna
  • metacarpals should be superimposed
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13
Q

AP Oblique Hand(s)

A
  • ball-catcher’s position
  • 45 degrees rotated medially from supinated position
  • separate digits best as possible
  • similar image eval as PA oblique
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14
Q

Why do AP Wrist instead of PA?

A
  • done as part of carpal series

- shows carpal interspaces better

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15
Q

PA Wrist

Positioning and Image Eval

A
  • place elbow, shoulder, and wrist in same plane; flex elbow 90 degrees
  • abduct fingers into palm (pushes wrist into IR)
  • collimate to 2.5” above and below wrist joint
  • image should show open radioulnar joint space
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16
Q

Lateral Wrist

Positioning and Image Eval

A
  • place elbow, shoulder, and wrist in same plane; flex elbow 90 degrees
  • rotate forearm and hand into true lateral position
  • image should show superimposed: radius and ulna; and metacarpals
17
Q

PA Oblique Wrist (lateral rotation)

Positioning and Image Eval

A
  • rotate laterally until wrist is 45 degrees from IR
  • center at midcarpals
  • image should show lateral carpals
  • trapezium and lateral half of scaphoid free of superimposition
18
Q

Why do AP Oblique Wrist?

A
  • shows medial carpal bones
  • triquetrum, hook of hamate, and pisiform free of superimposition
  • especially pisiform*
19
Q

Why do PA Wrist with Ulnar deviation?

A

done to image scaphoid free of superimposition

20
Q

Why is PA Axial Wrist done and how is it different than normal PA?

A
  • done to better view the scaphoid; often done with ulnar deviation
  • IR or part is elevated 20 degrees (or CR is angled 20 degrees toward the wrist
21
Q

AP Forearm

Positioning and Image Eval

A
  • supinate forearm until humeral epicondyles are parallel to IR
  • Pt may have to lean laterally to get true supination
  • collimate to include 2” above elbow and 2” below wrist
  • image should show elbow, wrist, and open radioulnar space
22
Q

Lateral Forearm

Positioning and Image Eval

A
  • position shoulder, elbow, and wrist in same plane
  • flex elbow to 90 degrees and point thumb side up
  • image should include 2” above elbow and 2” below wrist
  • image should show superimposition of distal radius and ulnar
  • and superimposed humeral epicondyles
23
Q

AP Elbow

Positioning and Image Eval

A
  • positioning is nearly identical to AP Forearm; however centering point is at the joint
  • most important: humeral epicondyles must be parallel to IR
  • Radial head, neck and tuberosity are slightly superimposed over ulna
  • olecranon and coranoid fossae nearly equidistant from epicondyles
24
Q

Lateral Elbow

Positioing and Image Eval

A
  • positioning nearly the same as Lateral Forearm; however centering point is at the joint
  • most important: humeral epicondyles must be perpendicular to IR
  • olecranon process seen in profile
  • elbow joint is open
25
Q

What is the difference between the AP Obliques of the Elbow? Lateral and Medial rotations

A
  • both rotate 45 degrees medial or lateral
  • MEDIAL rotation shows open olecranon fossa, trochlea, and superimposed radius and ulna
  • LATERAL rotation shows open radioulnar space and capitulum
26
Q

What is the tube angle used for a “Trauma Elbow”? What is the method and anatomy of interest?

A
  • 45 degrees cephalad for radial head and capitulum (similar to AP Oblique lateral rotation)
  • 45 degrees caudad for coronoid process and trochlea (similar to AP Oblique medial rotation)
  • Coyle Method
27
Q 
AP Humerus (Upright)
Positioning and Image Eval
A
  • position so that humerus is free of superimposition of torso
  • supinate hand (unless contraindicated) and abduct arm
  • humeral epicondyles should be parallel with IR
  • greater tubercle should be in profile
  • should have 2” inches above and below humerus on image
28
Q 
Lateral Humerus (Upright)
Positioning and Image Eval
A
  • internally rotate arm until epicondyles are perpendicular to IR
  • adduct arm, flex elbow 90 degrees, and place hand on hip
  • can be PA if pt cannot adduct arm

Image Eval R216 (8 decks)

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