Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Application of imaging > Upper limb imaging > Flashcards

Upper limb imaging Flashcards

1
Q

Why do fractures happen?

A
  • A fracture is the scientific and medical term for a break or crack in a bone

-They occur when there is a transfer of energy through a bone that exceeds what that bone can cope with

-Where a fracture occurs depends on two things – where the bone is weakest and where the majority of the force is applied

-This refers to the method by which an injury occurs

-Fall on outstretched hand, inversion, blunt trauma etc

-Fractures tend to follow patterns so the MOI can give us a hint as to what kind of fracture is most likely to have occurred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the SID (source image receptor distance) for upper limb x-rays?

A
  • 100cm is the distance from tube to detector
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Do we need to use grids for upper limbs?

A
  • No
  • Not a big enough area to generate enough scatter to justify the increased radiation dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

HAND – CLINICAL INDICATIONS

A

☢ OA/RA
☢ Trauma (Punch injury, FOOSH, stab wounds)
☢ Osteomyelitis
☢ ?Foreign Body (specific views – what are these?)
☢ Follow-up imaging
☢ Congenital abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hand projections

A

Standard:
-DP
-Oblique
-Lateral

Additional
-Finger views
-Thumb
-Ballcatchers (Norgaard method)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hand: DP patient position

A
  • Patient seated at the side of the x-ray couch
  • Elbow flexed; arm relaxed
  • Palmer aspect of the hand placed on the image receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hand: DP Centring points

A
  • Central ray vertical to the image receptor
  • Head of the 3rd metacarpal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hand: DP Collimation

A

Laterally- include skin margins

Proximally- include distal radioulnar joint

Distally- include the tips of the distal phalanges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fingers: DP Centring point

A
  • Central x-ray vertical to the image receptor
  • Between the heads of the two metacarpals (buddy fingers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fingers: DP Collimation

A

Laterally- lateral margins of both fingers and metacarpals

Proximally- include distal radioulnar joint

Distally- include the tips of the distal phalanges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hand: DP Oblique Patient position

A
  • Patient seated at the side of the x-ray couch
  • Elbow flexed; arm relaxed
  • Palmar aspect of the hand placed on the receptor image
  • Rotate the hand laterally 45 degrees, ensuring the medial aspect of the hand is still in contact with the image receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hand: DP Oblique Centring point

A
  • Central ray vertical to the image receptor
  • Head of the 3rd metacarpal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hand: DP Oblique Collimation

A

☢Laterally – include skin margins
☢Proximally – include distal radioulnar joint
☢Distally – include the tips of the distal phalanges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hand: Lateral Patient position

A

-Patient seated at the side of the x-ray couch
-Lateral aspect of affected hand in contact with the image receptor
-Palmar aspect of the hand 90 degrees to the image receptor
-Slightly abduct the thumb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hand: Lateral Centring point

A

☢Central ray vertical to the image receptor
☢Head of the 2nd metacarpal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hand: Lateral Collimation

A

Laterally- dorsal and palmar skin margins

Proximally- include distal radioulnar joint

Distally- include the tips of the distal phalanges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fingers: Lateral Centring point

A
  • Central ray vertical to the image receptor
  • Over the proximal interphalangeal joint of the affected finger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fingers: Lateral Collimation

A

Laterally- lateral soft tissue margins

Proximally- include metacarpophalangeal joint

Distally- include the tip of the distal phalanx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hand top tips: Common error- Interphalangeal joint spaces are not clearly demonstrated. Why?

A

Fingers may be flexed; extend to clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hand top tips: Common error- Superimposition of soft tissue outlines of fingers. Why?

A

Fingers not seperated adequately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hand top tips: Common error- Patients struggling to hold position, especially on the oblique view. Why?

A

Assist them with a small 30 degree sponge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hand top tips: Common error- Extensive superimposition of the metacarpals of the oblique view

A

The Hand is externally elevated too much

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is a ball catcher projection performed and what is its centring?

A

To see a different perspective of the joints.
-Anterior bilateral projection
-Centring: between the two hands at the level of the metacarpophalangeal joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Thumb: PA Patient position

A

☢Patient seated at the side of the x-ray couch
☢Elbow extended
☢Posterior aspect of the thumb on the image receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Thumb: PA Centring point

A
  • Central ray vertical to the image receptor
  • Over 1st metacarophalangeal joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Thumb: PA Collimation

A

Laterally- include all skin margins

Proximally- carpometacarpal joint

Distally- distal phalanx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Thumb: Lateral Patient position

A

☢Patient seated at the side of the x-ray couch
☢Elbow flexed; arm relaxed
☢Palmar aspect of the hand raised off the image receptor (can use pads to assist) so that thumb is lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Thumb: Lateral centring point

A
  • Central ray vertical to the image receptor
  • Over 1st metacarophalangeal joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Thumb: Lateral Collimation

A

Laterally- include skin margins

Proximally- Carpometacarpal joint

Distally- distal phalanx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Wrist- Clinical indications

A

☢ OA/RA
☢ Trauma (FOOSH)
☢ Osteomyelitis
☢ ? Foreign Body
☢ Follow-up imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Wrist- projections

A

Standard projections
☢ DP
☢ Lateral
Additional projections
☢ Scaphoid projections – oblique/zitters or banana
☢ Oblique Wrist

32
Q

Wrist- PA Patient position

A

☢ Patient seated at the side of the x-ray couch
☢ Elbow flexed; arm relaxed
☢ Palmar aspect of the hand placed on the image receptor but place fingers slightly curled (or over the top edge of the image receptor if not using a wallstand)

33
Q

Wrist- PA Centring point

A
  • Central ray vertical to the image receptor
  • Midway between the radial & ulna styloid processes
34
Q

Wrist- PA Collimation

A

Laterally- include skin margins

Proximally- distal 1/3 radius and ulna

Distally- heads of metacarpals

35
Q

Carpal bones

A

scaphoid
lunate
triquetrum
pisiform
trapezium
trapezoid
capitate
hamate

36
Q

Wrist: lateral Patient position

A

☢ From the PA position, externally rotate the arm until the ulnar aspect of the hand/wrist is in contact with image receptor
☢ Extend fingers
☢ Palmar aspect of the hand is perpendicular to the image receptor

37
Q

Wrist: lateral Centring point

A
  • Central ray vertical to the image receptor
  • radial styloid process
38
Q

Wrist: lateral Collimation

A

☢ Laterally – dorsal and palmar skin margins
☢ Proximally – distal 1/3 radius and ulna
☢ Distally – heads of metacarpals

39
Q

PA wrist with ulnar deviation

A

☢ Position as for a PA wrist.
☢ Ulnar deviation of the wrist (laterally) as far as possible

40
Q

PA Axial (Zitters/banana projection)

A
  • Position as for PA wrist, angle tube 30degrees towards elbow
  • Centre to the anatomical snuff box
  • Ensure ulnar deviation
  • 10 days after initial presentation – blood supply
41
Q

Wrist- PA Oblique Patient position

A
  • From the DP position externally rotate arm until ulnar aspect of the hand/wrist is in contact with the image receptor

-Palmar aspect of the hand/wrist 45degrees to the image receptor

  • Support with 45degree radiolucent pad if necessary
  • Extend fingers
42
Q

Wrist- PA Oblique Centring point

A
  • Central ray vertical to the image receptor
  • Midway between the radial & ulnar styloid processes
43
Q

Wrist- PA Oblique Collimation

A

☢ Laterally – include skin margins
☢ Proximally – distal 1/3 radius and ulna
☢ Distally – heads of metacarpals

44
Q

RADIUS & ULNA – CLINICAL INDICATIONS

A

☢ Trauma (FOOSH, guarding)
☢ Osteomyelitis
☢ ? Foreign Body
☢ Follow-up imaging
☢ Imaging for fracture alignment

45
Q

RADIUS & ULNA - PROJECTIONS

A

Standard projections
☢ AP/PA
☢ Lateral
Additional projections
☢ Joint specific projections if unclear from initial imaging

46
Q

RADIUS & ULNA – AP Patient position

A

☢ Patient seated with affected side next to the x-ray couch without placing legs underneath
☢ Affected arm abducted and extended and placed on image receptor
☢ Arm supinated with wrist and elbow and shoulder in same horizonal plane
☢ Humeral epicondyles and styloid processes equidistant from imaging plate

47
Q

RADIUS & ULNA – AP Centring point

A
  • Central ray vertical to the image receptor
  • Midway between the elbow and wrist
48
Q

RADIUS & ULNA – AP Collimation

A

Laterally – include skin margins

Proximally – elbow joint

Distally – wrist joint

49
Q

RADIUS & ULNA – LATERAL Patient position

A

☢ From the AP position, flex the elbow 90 degrees and medially rotate the arm so that the ulnar aspect is in contact with the imaging receptor
☢ Ensure wrist, elbow and shoulder are in the same transverse plane
☢ Palmar aspect of the hand should be 90 degrees to the image receptor
☢ Humeral epicondyles and styloid processes superimposed

50
Q

Radius and ulna- lateral Centring point

A
  • Central ray vertical to the image receptor
  • Midway between the elbow and wrist
51
Q

Radius and ulna- lateral Collimation

A

Laterally – include skin margins

Proximally – elbow joint

Distally – wrist joint

52
Q

ELBOW – CLINICAL INDICATIONS

A

☢ OA/RA
☢ Trauma
☢ Pain & swelling
☢ Osteomyelitis
☢ ? Foreign Body
☢ Follow-up imaging
☢ Inability to straighten

53
Q

ELBOW – PROJECTIONS

A

Standard projections
☢ DP
☢ Lateral
Additional projections
☢ Radial head views

54
Q

ELBOW– AP Patient position

A

☢ Patient seated with their affected side next to the x-ray table without placing legs underneath
☢ Affected arm abducted and extended and placed on image receptor
☢ Arm supinated with wrist, elbow and shoulder in the same horizontal place
☢ Humeral epicondyles equidistant from image receptor

55
Q

ELBOW– AP Centring point

A

Central ray vertical to the image receptor

Midway between humeral epicondyles and 2.5cm distally

56
Q

ELBOW– AP Collimation

A

Laterally- include all skin margins

proximally- distal 1/3 of humerus

Distally- proximal 1/3 of radius and ulna

57
Q

Elbow- Lateral Patient position

A

☢ From the AP position, flex the elbow to 90 degrees and medially rotate the arm so that the ulnar aspect is in contact with the image receptor
☢ Ensure the wrist, elbow and shoulder are in the same transverse plane
☢ Palmar aspect of the hand should be 90 degrees to the image receptor
☢ Humeral epicondyles superimposed

58
Q

Elbow- Lateral Centring point

A

Central ray vertical to the image receptor

Over the lateral humeral epicondyle

59
Q

Elbow- Lateral Collimation

A

Laterally- include all skin margins

proximally- distal 1/3 of humerus

Distally- proximal 1/3 of radius and ulna

60
Q

HUMERUS – CLINICAL INDICATIONS

A

☢ Trauma
☢ Osteomyelitis
☢ ? Foreign Body
☢ Follow-up imaging

61
Q

HUMERUS – PROJECTIONS

A

Standard projections
☢ DP
☢ Lateral
Additional projections
☢ Joint specific projections if unclear from initial imaging

62
Q

HUMERUS – AP Patient position

A

☢ Patient is stood with their back to the image receptor.
☢ The arm is in the true anatomical position, palm facing forwards
☢ The posterior aspect of the upper arm should be in contact with the image receptor to reduce movement and magnification

63
Q

HUMERUS – AP Centring point

A

Central ray horizontal to the image receptor

Middle of the humerus on the anterior aspect of the upper arm, midway between the shoulder and elbow joints

64
Q

HUMERUS – AP Collimation

A

Laterally- include skin margins

Superiorly- The skin margin above the glenohumeral joint

Inferiorly- include the distal humerus including the elbow joint

65
Q

HUMERUS – Lateral (PA) Patient position

A

☢ Patient is stood facing the image receptor
☢ The elbow is flexed so that the palm of the hand rests on the anterior abdominal wall
☢ The anterior aspect of the upper arm should be in contact with the image receptor to reduce movement and enlargement
☢ The patient should be rotated so that the lateral aspect of the shoulder of the affected side, the upper arm and elbow are all in contact with the image receptor

66
Q

HUMERUS – Lateral (PA) Centring point

A

Central ray horizontal to the image receptor

(PA) Middle of the humerus shaft, on the medial aspect of the upper arm, midway between the shoulder and elbow joints

(AP) Middle of the humerus shaft, on the lateral aspect of the upper arm, midway between the shoulder and elbow joints

67
Q

HUMERUS – Lateral (PA) Collimation

A

Laterally- include skin margins

Superiorly- The skin margin above the glenohumeral joint

Inferiorly- include the distal humerus including the elbow joint

68
Q

SHOULDER – CLINICAL INDICATIONS

A

☢ Trauma
☢ Osteomyelitis
☢ ? Foreign Body
☢ Follow-up imaging
☢ OA
☢ Obvious deformity
☢ Limited ROM

69
Q

SHOULDER - PROJECTIONS

A

Standard projections
☢ AP
☢ Axial
Additional projections
☢ Modified Axial
☢ Y-view Scapula
☢ Clavicle
☢ Acromioclavicular joint views

70
Q

Shoulder- AP Patient position

A

☢ Patient is stood with their back to the image receptor
☢ The arm is in the true anatomical position with the palm facing forwards
☢ The patient is rotated 5-10 degrees towards the affected side (straight for trauma)
☢ The posterior aspect of the shoulder is in contact with the image receptor to reduce movement and magnification

71
Q

Shoulder- AP Centring point

A

Central ray horizontal to the image receptor

Corocoid process

72
Q

Shoulder- AP Collimation

A

Laterally- include skin margins

Superiorly- skin margins

inferiorly- include 1/3 of the proximal humerus

73
Q

SHOULDER – Axial Patient position

A

☢ Patient is seated with the affected arm nearest to the image receptor
☢ The affected arm is abducted and ”stretched” across the image receptor
☢ The image receptor is underneath the axilla (the gleno-humeral joint over the image receptor)
☢ Legs should not be underneath the image receptor
☢ The head should be tucked towards the unaffected shoulder

74
Q

SHOULDER – Axial Centring point

A

Central ray vertical to the image receptor

Head of the humerus

75
Q
A

Application of imaging (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions