Hands, Wrists, and Fingers

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How is the tube angled in a Scaphoid series?

0 degrees, 10 degrees, 20 degrees, and 30 degrees.

Where do you center for a carpal bridge?

1 and a half inches proximal to the wrist joint

Where do you center for the Gaynor-Hart Method?

1 inch distal to the base of the 3rd metacarpal

What size cassette do you use for fingers?

10 X 12

What size cassette do you use for wrists?

10 X 12

If the carpals are superimposed over the scafoid in an Ulnar Deviation, how can you angle the tube?

10-15 degrees proximal

How many phalange bones are there?

14

What size cassette do you use for hands?

14 X 17

What is the centering point for a thumb?

1st MCP joint

How many rows of carpals are there?

2

How do you angle the tube for a Stetcher Method if you do not use the 20 degree sponge?

20 degrees towards the elbow

How do you angle the tube for a Gaynor-Hart method?

25-30 degrees towards the long axis of the hand.

How many bones are included in the hand and wrist?

27

What is the SID for fingers, hands, and wrists?

40"

What degree of rotation do you need to have your fingers, hand, or wrist in for it to be an oblique projection?

45 degree rotation

How do you place the tube for a Carpal Bridge?

45 degrees caudal, at 40"

How do you angle the tube on a Clements-Nakayama?

45 degrees distally, with a 40" SID to teh middle of the cassette.

How many metacarpal bones are there?

5

How many projections does the scaphoid have?

7

How many carpal bones are there?

8

What does each phalanx consist of?

A head (distal), body, and base (proximal)

What is another name for the Norgaard Method (Ball Catcher)?

AP Oblique Bilateral Hand

What do you need for a good finger projection?

All anatomy shown, no rotation, fingers fully extended, and away from the other fingers so tissue doesn't overlap.

What are you looking at/for in a Gaynor-Hart method?

Anterior aspect of the carpals, and calcification.

Where do you center for a Noraard Method?

Between hands, at the level of the MCP joints

Which carpal is the largest of all the carpal bones?

Capatate

What is a bony outgrowth of the 3rd carpal metacarpal? It can be seen by doing a lateral projection of the wrist with acute palmar flexion.

Carpal Bossu

What is the projection where you have the patient standing?

Carpal Bridge

What is the joint between the carpal and metacarpal joints called?

Carpal Metacarpal Joint

What is another name for Carpal Tunnel?

Carpal Sulckus

What does the Gaynor-Hart method demonstrate?

Carpal tunnel (carpal Canal), pisiform and hook of the hamate free of superimposition.

Which joint is between the distal and middle phalanx?

Distal Itnerphalangeal Joint (DIP)

What is the end of the finger called?

Distal Phalanx

What is the top row of the carpals called? The bottom row?

Distal Row. Proximal Row

What is the Norgaard Method used for?

Early detection of Rheumatoid Arthritis.

Where does a lateral projection of a hand, finger, or wrist always need to be?

Facing off of the cassette.

What is a phalange?

Finger

How can you tell if a fracture is a boxers fracture?

Fracture on the shaft of the 5th metacarpal and neck of the 5th metacarpal. Usually brought on by punching.

How do the fingers need to be for a good lateral projection?

Fully extended and superimposed

What is another name for the Trapezium?

Greater Moltangular

Do you angle the central ray for a thumb Xray?

HECK NO!

What anatomy needs to be included for a good wrist xray?

Half of the metacarpals to 1/4 of the radius and ulna.

How do you hang a film of your hand, finger, or wrist?

Hand and fingers up

What does a metacarpal consist of?

Head, neck, body, and base.

How does your hand need to be for a wrist xray?

In a loose fist

What is another two names for the Gaynor-Hart Method (GAAAAINNNERRRRRR!!)

Inferior-Superior Projection, and Tangential Projection

What is the joint between the distal and proximal phalanx on the thumb called?

Interphalangeal Joint

Why is the Gaynor-Hart method known as a Tangential Projection?

It scans over the affected area.

What kind of projection is a lateral pinky finger?

Lateral Medial Projection

What kind of projection is a lateral hand?

Lateral medial projection. with medial side against the cassette.

What is another name for the Trapezoid?

Lesser Moltangular

What kind of projection is the lateral index finger?

Medial Lateral Projection

Which joint is between the Metacarpals and Proximal phalanx of the phalange?

Metacarpal Phalangeal Joint (MCP)

Which bones make up the palm of the hand?

Metacarpals

Where do you center for a Radial Deviation?

Mid carpals

Where do you center for a wrist xray?

Mid carpals

What is the middle of the phalanx called?

Middle Phalanx

Is stair stepping ok?

No guys...just no.

How does your thumb need to be placed for a good PA hand?

Oblique

Where do you need to mark a 3 view hand, finger, or wrist projection?

On the lateral view, on the anterior of the part.

What is another name for the Clements-Nakayama Method?

PA Axial Oblique Projection

What is the projection for the Stetcher Method?

PA Axial Projection

Which carpal is the most anterior? You can also palpate this carpal on the wrist.

Pisiform

Which joint is between the middle and proximal phalanx called?

Proximal Interphalangeal Joint (PIP)

What is the bottom of the phalanx called?

Proximal Phalanx

What is the joint called where the scaphoid, lunate, and radius meet?

Radial Carpal Joint

Which bone is bigger, the radius or the ulna?

Radius

Which bone (radius or ulna), is located of the thumbs side? Pinky side?

Radius. Ulna.

What is another name for a Scaphoid Series?

Rafert-Long Method

What is the center point for a scaphoid series?

Scaphoid

Which carpal is most commonly fractured?

Scaphoid

Which two carpals articulate with the radius?

Scaphoid and Lunate

What does the Scaphoid series demonstrate?

Scaphoid with minimal superimposition.

Which carpals make up the proximal row? (In order from thumb to pinky)

Scaphoid, Lunate, Triquetrum, Pisiform

What are the small round bones by the thumb called?

Sesemoid Bones

How does your thumb need to be for a lateral projection of the hand?

Slightly separated from the hand, in a PA projection

How does the radius and ulna always need to be positioned on the cassette?

Straight up and down the cassette.

What is the point at the end of the ulna called. The radius has the same thing.

Styloid Process

How do the radius and Ulna need to be positioned in a lateral wrist projection?

Superimposed over each other.

What is another name for the Carpal Bridge?

Tangential Projection

Where do you center for a lateral hand projection?

The 2nd MCP joint

Where do you center for a hand Xray?

The 3rd MCP joint (knuckle)

What is the joint on the third digit between the proximal phalanx and metacarpal called?

The 3rd Metacarpal Phalangeal Joint

Where do you center on a Clements-Nakayama?

The Anatomical Snuff Box

What does a carpal bridge demonstrate?

The Carpal Bridge, which is the dorsal aspect of the scaphoid, lunate, and triquetrum.

What does the thumb consist of?

The Distal and Proximal Phalanx

Which carpal has a hook like process?

The Hamate

What is another name for the Scaphoid?

The Navicular

Where do you center for a projection of the digits 2-5?

The PIP joint

Which is the largest carpal in the proximal row?

The Scaphoid

How can you tell which way a finger is rotated?

The curved part of the phalanx is away from the board.

What can a lateral projection tell you?

The depth and placement of a fracture, if its anterior or posterior.

What anatomy needs to be included in a thumb xray?

The distal phalanx all the way down to the trapezium.

What anatomy needs to be involved for a good hand xray?

The distal phalanx all the way to an inch of the radius and ulna.

What anatomy needs to be included for digits 2-5?

The distal phalanx to half of the metacarpals.

What needs to be superimposed for a good lateral projection of the hand?

The fingers, metacarpals, and head of radius and ulna.

How do the metacarpals need to be for a good oblique hand? This also shows that it is not over, or under-rotated.

The heads of 3-5 need to be superimposed, with spaces between the bodies.

For a finger projection, how can you tell if your finger wasn't parallel to the cassette?

The joint space will be closed.

How do you place your index finger for a lateral projection?

The lateral side should be against the cassette.

What does a Radial Deviation demonstrate?

The medial carpals, and the inter spaces on the medial side of the wrist.

How do you place your pinky finger for a lateral projection?

The medial side should be against the board.

What does an AP projection o the wrist demonstrate?

The pisiform, the triquetrum, and hook of the hamate.

Where do you center for an Ulnar Deviation

The scaphoid

Where do you center for the Stetcher Method?

The scaphoid

What is demonstrated in an Ulnar Deviation?

The scaphoid in full without foreshortening, and all of the carpals.

What does the stetcher method demonstrate?

The scaphoid with minimal self superimposition.

What needs to happen for the joint spaces for the thumb to be open?

The thumb needs to be fully extended.

How can you tell if a thumb is rotated?

The thumb needs to have equal concavity on both sides of the proximal phalanx.

What does an oblique projection of the wrist demonstrate?

The trapezium and scafoid

How do you mark a PA and oblique projection?

To the outside of the body

Which way do you turn your hand for an Ulna Deviation?

Towards the ulna

What are the 3 things that need to be included for a fracture to be a Colles Fracture?

Transverse fracture of distal radius, fracture is posteriorly displaced, and has a chip fracture of the styloid process of the ulna ( evulsion fracture)

How can you tell if a fracture is a Smiths Fracture?

Transverse fracture of the radius, anterior displacement of the fracture (fracture points away from pisiform)

Which carpals make up the distal row? (In order from thumb to pinky)

Trapezium, Trapezoid, Capatate, Hamate.

What is demonstrated in a Clements-Nakayama?

Trapezium, first carpal metacarpal joint, and joints between the trapezium and the trapezoid.

How is the wrist placed in all views of the scaphoid series?

Ulnar deviation

What are the 4 projections for the Scaphoid series? There will be no angle on these projections. This is the second way you could do the scaphoid series.

Ulnar deviation, radial deviation, PA wrist projection, PA oblique wrist projection.

How do you place your hand for a Clements-Nakayama?

Wrist up on a 45 degree sponge, in Ulnar Deviation.

Does there need to be space between the metacarpals on a PA wrist xray?

Yes DUH!!


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