Ch. 4: Self-Test (Page 102)
Which two bony landmarks are palpated to assist with positioning of the upper limb?
Lateral and medial epicondyle
Which projection of the elbow best demonstrates: Trochlear notch in profile
Lateral Elbow
Which projection of the elbow best demonstrates: Olecranon process in profile
Lateral Elbow
Where is the coronoid tubercle located?
Medial aspect of coronoid process
Why is it important to keep the long axis of the digit parallel to the IR?
- To reduce distortion of the phalanges. - To properly visualize joints. - To demonstrate small fractures.
What is the total number of bones that make up the hand and wrist?
27
How many bones make up the carpal region?
8
Accumulated fluid within the joint cavity.
Joint Effusion
How many bones make up the phalanges of the hand?
14
Which projection of the elbow best demonstrates: Olecranon process seated in olecranon fossa
AP Elbow
Which projection of the elbow best demonstrates: Coronoid tubercle
AP Elbow
Which projection of the elbow best demonstrates: Capitulum and lateral epicondyle in profile
AP, lateral rotation oblique
Which projection of the elbow best demonstrates: Radial head and tuberosity without superimposition
AP, lateral rotation oblique
Which projection of the elbow best demonstrates: Coronoid process in profile
AP, medial rotation oblique
Where is the CR centered for a PA projection of the second digit?
Affected PIP joint
Where are the coronoid and radial fossae located?
Anterior aspect of distal humerus
Fracture of the base of the first metacarpal.
Bennett's Fracture
What type of fracture is best demonstrated with a modified Robert's method?
Bennett's fracture
Inflammation of the fluid-filled sacs enclosing the joints.
Bursitis
Painful disorder of hand and wrist from compression of the median resulting nerve.
Carpal Tunnel Syndrome
Why should a forearm never be taken as a PA projection?
Causes the proximal radius to cross over the ulna
Situation: A pediatric patient with a possible radial head fracture is brought into the emergency room. It is too painful for the patient to extend the elbow beyond 90° or rotate the hand. What type of special projection could be performed on this patient to confirm the diagnosis without causing further discomfort?
Coyle Method
A radiograph of a PA oblique of the hand reveals that the third, fourth, and fifth metacarpals are superimposed. What must be done to correct this positioning error on the repeat exposure?
Decrease obliquity of hand.
Which joint is between the distal radius and ulna?
Distal Radialulnar
Joint movement type for: Radiocarpal Joint
Ellipsoidal
True or False: The hand(s) is (are) placed in a true PA position when using the Norgaard method.
False
True or False: Anterior and Posterior fat pads of the elbow are best seen on correctly positioned and correctly exposed AP elbow projections.
False (lateral)
True or False: Placing multiple images on the same digital IP is recommended as long as close collimation is applied for each projection.
False. It is recommended that only one projection be placed on a digital IP. The anatomy should be centered on the IP.
Which joint is between the carpals and the first metacarpal?
First Carpometacarpal
Which joint is between the first metacarpal and the proximal phalanx of the thumb?
First Metacarpophalangeal
Which joint is between the middle and distal phalanges of the fourth digit?
Fourth Distal Interphalangeal
Joint movement type for: Elbow Joint
Ginglymus
Which carpal contains a "hook-like" process?
Hamate
Situation: A patient has a Colles' fracture reduced, and a large plaster cast is placed on the upper limb. The orthopedic surgean orders a postreduction study. The original technique, used before the cast placement, involved 60 kV and 5 mAs (analog system). How should the exposure factors be altered with a large plaster cast?
Increase kV by 8 - 10.
What is the major disadvantage of performing a PA projection of the thumb rather than an AP?
Increased OID
A radiograph of an AP oblique-medial rotation reveals that the coronoid process is not in profile and the radial head is not superimposed over the ulna. What specific positioning error was involved?
Insufficient medial rotation.
Which joint is between the two phalanges of the first digit?
Interphalangeal Joint
Local or generalized infection of bone or bone marrow.
Osteomyelitis
A reduction in the quantity of bone or atrophy of skeletal tissue.
Osteoporosis
The long axis of the anatomic part being imaged should be placed:
Parallel to long axis of the IR
A radiograph of a lateral projection of the elbow reveals that the epicondyles are not superimposed and the trochlear notch is not clearly seen. What must be done to correct this positioning error on the repeat exposure?
Place humerus/forearm in same horizontal plane.
Joint movement type for: Intercarpal Joints
Plane
Joint movement type for: Third CMC Joint
Plane
In what position should the hand be for an AP medial rotation oblique elbow position?
Pronated
Which joint is between the forearm and the carpals?
Radiocarpal
A radiograph of an AP elbow projection demonstrates total separation between the proximal radius and ulna. What must be done to correct this positioning error on the repeat exposure?
Rotate upper limb medially.
A radiograph of the carpal canal (inferosuperior) projection reveals that the pisiform and hamulus are superimposed. What must be done to correct this positioning error on the repeat exposure?
Rotate wrist laterally 5° to 10°.
Which carpal is most commonly fractured?
Scaphoid
Which two carpal bones are located most anteriorly as seen on a lateral wrist radiograph?
Scaphoid and Trapezium
Joint movement type for: First CMC Joint
Sellar
Sprain or tear of the ulnar collateral ligament.
Skier's Thumb
Reverse of a Colles' fracture.
Smith's Fracture
Arthrography is a radiographic study of:
Soft-tissue structures within certain synovial joints
In what position should the hand be for an AP elbow projection?
Supinated
Where is the CR placed for a PA projection of the hand?
Third MCP joint
Which carpal articulates with the base of the thumb?
Trapezium
True or False: Both hands are examined with one single exposure when using the Norgaard method.
True
True or False: To visualize fat pads surrounding the elbow, exposure factors must be adjusted to see both bony and soft tissue structures.
True
Which bone of the upper limb contains the coronoid process?
Ulna
Situation: A patient with a possible Barton's fracture enters the emergency room. Which positioning routine should be performed to confirm the diagnosis?
Wrist
Situation: A patient with a possible Smith's fracture enters the emergency room. Which positioning routine should be performed to confirm the diagnosis?
Wrist / Forearm