RTE-1513 Midterm Study Set
Osteochondromas (exotosis)
most common benign bone tumor; arises from the cortex and points away from the adjacent joint, most common at posterior knee, common at ages 10-20
Multiple myeloma
most common primary cancerous bone tumor; arising from bone marrow; fatal within a few years; typically affects ages 40-70
With Humeral neutral rotation ______ tubercle is on profile
neither
Tumor
new growth (neoplasm) that may be malignant or benign
If the sterility is in doubt, it is considered what?
non sterile
The anatomic neck of the proximal humerus surrounds the head at an _________.
oblique angle
the posterior depression is the
olecranon fossa
On a lateral, the _________ is seen on profile
olecranon process
the two beaklike processes of ther ulna are the
olecranon process and the coronoid process
Fat pads (fat bands, fat stripes) Located in the joint capsule but
outside the bursae
With Humeral external rotation the interepicondylar line is _________ to the IR
parallel
AC joint separation
partial or complete tear of the acromioclavicular and/or corococlavicular ligaments; ½ of athletic shoulder injuries; 6 classifications
The anterior surface of the scapula is the costal surface because of its what?
proximity to the ribs
The sterile area includes what 7 things?
pt surgical field surgeon surgical assistants surgical equipment tables carts
Ulnar deviation: (scaphoid projection) this opens up the _______ of the wrist
radial side
a lateral (external) rotation separates the
radius and ulna
Osteoperosis
reduction in the quantity of bone or atrophy of skeletal tissue(bone); leading cause of fx in post-menopausal women decrease technical factors
Snapshot or digital spot
static image with higher quality compared to a held fluoro image
Sterile gowns are _____ from the shoulder to the level of the sterile field, and at the sleeve from the cuff to just above the elbow
sterile
Only sterile items are allowed in the what?
sterile field
Only sterile personnel can touch what?
sterile objects
Non sterile personnel must not come in contact with what?
sterile personnel
What are located at the distal ends of both the radius and ulna
styloid processes
The middle of the costal surface of the scapula has a large depression called the what?
subscapular fossa
in an AP, the radius and ulna are partially
superimposed
Below the tubercles and head proximal humerus is the what?
surgical neck
OR tables are only sterile at the level of the ______
table top
Sellers left the party to
take Chip home
"Skier's thumb"
tear of the ulnar collateral ligament of the thumb from hyperextension
Surgical Asepsis
the absence of infectious organisms
Surgical asepsis
the absence of infectious organisms
Pulse mode
the fluoro beam can pulse to reduce patient dose
Distal radioulnar joint is formed by ______ and the __________
the head of the ulna, ulnar notch of the radius
An optimally positioned PA wrist projection demonstrates all of the following except a. an open radioulnar articulation. b. open second through fifth MC joint spaces. c. alignment of the long axis of the third metacarpal and midforearm. d. the pronator fat stripe.
the pronator fat stripe
An optimal AP elbow projection is obtained when a. an imaginary line connecting the humeral epicondyles is aligned perpendicular with the IR. b. the radial tuberosity is demonstrated in profile laterally. c. the radial head articulating surface is demonstrated. d. the radial head superimposes the lateral aspect of the proximal ulna by 0.25 inch (0.6 cm).
the radial head superimposes the lateral aspect of the proximal ulna by 0.25 inch (0.6 cm)
Bone metastases
the transfer of cancerous lesions by way of the bloodstream or lymphatic system; most common form of malignant bone tumors
To take advantage of the anode heel effect when imaging a forearm, a. a detailed screen is used. b. the elbow is positioned at the anode end of the x-ray tube. c. the wrist is positioned at the anode end of the x-ray tube. d. a 55- to 65-kVp technique is used.
the wrist is positioned at the anode end of the x-ray tube.
the radius is shorter and the only one directly involved in _______
the wrist joint
With Humeral neutral rotation the Palm is facing the what?
thigh
Colles' fracture
transverse fx of the distal radius where the distal fragment is displaced posteriorly
the first metacarpal articulates with the
trapezium
the second MC articulates with the
trapezoid
Rotator cuff tear
traumatic injury to one or all of the rotator cuff muscles; teres minor, supraspinous, infraspinous and subscapularis
Shoulder dislocation
traumatic removal of the humeral head from the glenoid cavity, 95% anterior
The ulnar collateral ligament goes from the styloid process of the ulna and attaches to the
triquetrum and pisiform
the large concave depression articulating with the distal humerus is the
trochlear or semilunar notch
The trochlea is medial, articulates with the ulna and has a groove in the center called the
trochlear sulcus (groove)
The distal radioulnar joint is
trochoid pivot
The proximal radioulnar joint is
trochoid pivot
The scapula extends form the___ posterior rib to the ____ posterior rib.
2nd, 7th
The clavicle has ___ parts
3
12 parts of ScapulaAnatomy
3 borders 3 angles Scauplar Notch Spine Crest of spine Glenoid cavity Subscapular fossa Supraspinous fossa Infraspinous fossa acromian corocoid process neck
Common Technical Factors: Fiberglass casts: Increase ___ kV.
3 to 4 kV
An internally rotated AP oblique elbow projection with accurate positioning demonstrates which of the following structures in profile? 1. Capitulum 2. Radial head 3. Medial trochlea 4. Coronoid process
3,4
How much and in which direction should the CR be angled for the trauma axial lateral projection (Coyle method) involving the coronoid process?
45° away from the shoulder.
What is the minimum amount of weight a large adult should have strapped to each wrist for the weight bearing phase of an AC joint study?
8 to 10 lbs
Which IR size should be used for a thumb projection?
8 x 10 inch
The scapula has how many parts?
8, (three borders, 3 angles and 2 surfaces)
What kV range should be use for a shoulder series on an average adult using a grid
80-90 kV
What is the amount of elbow flexion required for the trauma lateral projection (Coyle method) to demonstrate the coronoid process?
80° flexion
Elbow must be flexed ___ to see elevated fat pads
90°
The elbow generally should be flexed ___ ° for the routine positions of the wrist.
90°
The hand and wrist form a ___° angle to the forearm with the carpal bridge (tangential) projection?
90°
What an anatomic name of the armpit
Axilla
Inflammation of the fluid-filled sacs enclosing the joints.
Bursitis
True or False: For a forearm study, the technologist needs to include only the joint closest to the site of the injury.
False
True or False: The hand(s) is (are) placed in a true PA position when using the Norgaard method.
False
True or False: Trauma or infection makes the anterior fat pad more difficult to see on a lateral elbow radiograph.
False
True or False: Lead (gonadal) shielding is not required for upper limb radiographs if the patient can sit upright for these exams.
False
True or false a PA axial projection of the clavicle requires a 35 to 45° caudal central ray angle
False
True or false the male clavicle is shorter and less curved than the female clavicle.
False
True/False: Large focal spot setting should be selected for most adult shoulder studies
False
True/False: Low mA with short exposure times should be used for adult shoulder studies
False
True/False: MRI is an excellent modality for demonstrating bony injuries of the shoulder girdle
False
True/False: Radiology is more sensitive than nuclear medicine for demonstrating physiologic aspects of the shoulder girdle
False
True/False: Rheumatoid arthritis is more prevalent in men over women
False
True/False: The 72" source-image distance is recommended for most shoulder girdle studies
False
True/False: The affected arm must be placed into external rotation for the transthoracic lateral projection
False
True/False: The central ray angle of 10-15 degrees caudad me be used for the transthoracic lateral shoulder projection of the patient is unable to elevate the uninjured arm and shoulder sufficiently
False
True/False: The kV range for adult shoulder projections is between 60-70 kV for the analog and 100-110 kV for digital imaging systems
False
True/False: The lateral scapula and posterior oblique (Scapular Y) projections are the same projection
False
True/False: The scapular Y lateral (posterior oblique) position requires the body to be rotated 25-30 degrees anteriorly toward the affected side
False
True or False: If the posterior fat pad of the elbow is not visible radiographically, it suggests that a nonobvious radial head or neck fracture is present.
False (A nonvisible suggests a negative exam.)
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)
T/F 51. The arm should be abducted about 45° for an AP scapula.
False-90 degrees
Asthenic patient- clavicle projected in lung field below top of shoulder. Erect position, central ray angled 15° cephalad, what should be done on repeat?
Increase central ray angulation
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.
A routine radiograph of an AP oblique elbow with lateral rotation reveals that the radial tuberosity is superimposed on the ulna. In what way must this position be modified during the repeat exposure?
Increase lateral rotation of the elbow to separate the radius from the ulna.
37. A radiograph of an AP oblique projection for the glenoid cavity reveals that the anterior and posterior rims of the glenoid process are not superimposed. Which of the following modifications should produce a more acceptable image? Angle CR 5° to 10° caudad. Angle CR 5° to 10° cephalad. Increase rotation of the body. Abduct the arm slightly.
Increase rotation of the body
41. A radiograph of a scapular Y lateral position reveals that the scapula is slightly rotated (the vertebral and axillary borders are not superimposed). The axillary border of the scapula is determined to be more lateral compared with the vertebral border. Which of the following modifications should be made for the repeat exposure? Decrease rotation of thorax. Decrease CR angle. Increase rotation of thorax. Abduct the arm more and flex it at the elbow.
Increase rotation of thorax.
64. A radiograph of an AP axial projection of the clavicle demonstrates that the clavicle is within the midaspect of the lung apices. What should the technologist do to correct this error? Do nothing; this is an acceptable AP axial clavicle projection. Increase the caudal CR angle during repeat exposure. Increase the cephalic CR angle during repeat exposure. Make the exposure upon complete inspiration.
Increase the cephalic CR angle during repeat exposure
Common Technical Factors: Large or Small focal spot
Small Focal Spot
Mixed areas of sclerotic and cortical thickening along radiolucent lesions.
Osteopetrosis
A reduction in the quantity of bone or atrophy of skeletal tissue.
Osteoporosis
Atrophy of skeletal tissue
Osteoporosis
Reduction in the quantity of bone
Osteoporosis
Reduction in the quantity of bone or atrophy of skeletal tissue.
Osteoporosis
Thin bony cortex
Osteoporosis
What clinical indications require a decrease in manual exposure factors
Osteoporosis
What is the routine positioning routine for the Second through Fifth digits of the hand?
PA PA Oblique Lateral
Which projection of the thumb is achieved naturally by placing the palmar surface of the hand in contact with the cassette?
PA Oblique
Which routine projections best demonstrate the scaphoid fat pad?
PA and Oblique wrist
Situation: A patient with a metallic foreign body in the palm of the hand enters the emergency room. Which specific positions should be used to locate the foreign body?
PA and lateral-in-extension projection
the scaphoid fat stripe is seen on
PA and oblique views
What is a Bone Age Survey?
PA of the left hand/wrist Used to measure growth rates of children *normal 9 year-old hand
In a radiographic study of the forearm, the proximal radius crossed over the ulna in the frontal projection. Which specific positioning error led to this radiographic outcome?
PA projection was performed instead of the AP.
Which special projection of the wrist best demonstrates the interspaces on the ulnar side of the wrist between the lunate, triquetrum, pisiform, and hamate bones?
PA projection with radial deviation.
True/False: The shoulder is the most common joint to develop bursitis due to repetitive motion
True
True/False: The transthoracic lateral projection can be performed for possible fractures or dislocations of the proximal humerus
True
True/False: The use of a breathing technique can be performed for the transthoracic lateral humerus projection
True
True/False: The use of a grid is not required for shoulder studies that measure less than 10 cm
True
True/False: The use of contrast shields over the breast, lung, and thyroid regions is recommended for most shoulder projections
True
T/F 7. All of the joints of the shoulder girdle are diarthrodial.
True freely movable
True or False: Guardians of young pediatric patients who are having upper limb studies can be asked to hold their child during the radiographic study.
True.
Situation: A patient with a dislocated elbow enters the ER. The patient has the elbow tightly flexed and is careful not to move it. Which specific positioning routine can be used to determine the extent of the injury?
Two AP projections with acute flexion and a lateral projection.
If the patient cannot fully extend the elbow for the AP projection, what alternative projection(s) should be performed?
Two AP projections: (partially flexed) 1. Humerus parallel to the IR 2. Forearm parallel to the IR
Which special projection(s) of the elbow should be performed instead of the routine AP if the patient's elbow is tightly flexed and cannot be extended at all?
Two AP projections: (partially flexed) 1. Humerus parallel to the IR 2. Forearm parallel to the IR
Coronoid Process Part of the Radius, Ulna, or Distal Humerus?
Ulna
Coronoid Tubercle Part of the Radius, Ulna, or Distal Humerus?
Ulna
In the anatomic position, which of the bones of the forearm is located on the medial side?
Ulna
Olecranon Process Part of the Radius, Ulna, or Distal Humerus?
Ulna
Trochlear Notch Part of the Radius, Ulna, or Distal Humerus?
Ulna
Which bone of the upper limb contains the coronoid process?
Ulna
Which special turning or bending position of the hand and wrist is most commonly performed to detect a fracture of the scaphoid bone?
Ulnar Deviation
What imaging modality or procedure provides a functional or dynamic study of the shoulder joint?
Ultrasound
38. A radiograph of a transthoracic lateral projection reveals that it is difficult to visualize the proximal humerus due to the ribs and lung markings. The following analog exposure factors were used: 75 kV, 30 mAs, 40-inch (102 cm) SID, grid, and suspended respiration. Which of the following changes will improve the visibility of the proximal humerus? Make the exposure on second inspiration. Use a compression band to prevent patient movement. Use a 72-inch (183 cm) SID. Use an orthostatic (breathing) technique.
Use an orthostatic breathing technique
Two best demonstrate the hills Sachs defect on the inferiosuperior axial projection, which additional positioning maneuver must be used?
Use exaggerated external rotation
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
Garth method with poor visibility of shoulder joint. Patient erect, facing x-ray tube, 45° of rotation of affective shoulder toward IR, 45° cephalad angle, and CR centered to scapulohumeral joint. What went wrong?
Wrong direction of CR angle
The thin scapula appears as a ___from a lateral view.
Y
Where is the CR for an AP projection of the thumb?
1st MCP Joint
The joint between the 1st metacarpal and the proximal phalanx is the
1st MCP joint
The three portions of each finger (second through fifth digits) are the:
1. Proximal Phalanx 2. Middle Phalanx 3. Distal Phalanx
Coordinate exposures with the surgical team by announcing _____before exposure
"x-ray"
What is Orthoroentgenography?
(Long Bone Measurement) Study of length of upper & lower limbs "A straight or right angle Radiograph" Used to determine limb length discrepancies
Osteoarthritis
(degenerative joint disease -DJD); deterioration of the articular cartilage with hypertrophic bone formation; normal part of aging process
Smith's fracture
(reverse Colles)- transverse fx of the distal radius where the distal fragment is displaced anteriorly
What technique adjustment is needed for Small to medium plaster cast
+ 5-7 kV
What technique adjustment is needed for Large plaster cast
+ 8-10 kV
What technique adjustment is needed for Fiberglass cast
+3-4 kV
Which fractures are demonstrated in a wrist routine?
- Barton's - Smith's - Colles'
Common Technical Factors for: Correctly exposed radiographs: Visualize ___ margins and ___ markings of all bones.
- Soft Tissue Margins - Trabecular Markings
Why is it important to keep the affected digit parallel to the image receptor (IR) for the PA oblique and lateral projections?
- To prevent distortion of the phalanx. - To prevent distortion of the joints. - To demonstrate small, nondisplaced fractures near the joint.
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.
A minimum of ___ inch(es)/( ___ cm) of the forearm should be included radiographically for a PA projection of the hand.
1 inch (2.54 cm)
36. Where is the CR centered for the bilateral acromioclavicular (AC) joint projection on a single 14- × 17-inch (35 × 43 cm) image receptor? At the affected AC joint 1 inch (2.5 cm) above jugular notch At the level of the thyroid cartilage At the sternal angle
1 inch above the jugular notch
Where is the central ray centered for an AP projection - external rotation of the shoulder?
1 inch inferior to coracoid process
The two important fat stripes or bands around the wrist joint are the:
1. Scaphoid fat stripe 2. Pronator fat stripe
A lateral forearm projection with accurate positioning demonstrates 1. the distal scaphoid slightly distal to the pisiform. 2. the ulnar styloid in profile. 3. an open elbow joint space. 4. the radial tuberosity in profile.
1,2,3
A lateral hand projection obtained with the hand in slight external rotation demonstrates the 1. shortest of the second through fourth metacarpals anteriorly situated. 2. radius posterior to the ulna. 3. second metacarpal posterior to the other metacarpals. 4. pisiform posterior to the distal scaphoid.
1,2,3
An AP elbow projection with accurate positioning demonstrates 1. the medial and lateral humeral epicondyles in profile. 2. the radial tuberosity in profile medially. 3. an open capitulum-radial joint. 4. the ulna free of radial head and radial tuberosity superimposition.
1,2,3
A PA hand projection obtained with the hand flexed demonstrates 1. foreshortened phalanges. 2. the thumb in a lateral projection. 3. closed IP joint spaces. 4. foreshortened metacarpals.
1,2,3,4
A PA wrist projection obtained with the wrist in a neutral position demonstrates 1. the scaphoid in partial foreshortening. 2. the center of the lunate positioned distal to the radioulnar articulation. 3. closed CM joints. 4. alignment of the long axis of the third metacarpal and radius.
1,2,4
An AP forearm projection with accurate positioning demonstrates the 1. radial styloid in profile laterally. 2. radial head superimposing the ulna by 0.25 inch (0.6 cm). 3. ulnar styloid in profile laterally. 4. humeral epicondyles in profile.
1,2,4
For an externally rotated AP oblique elbow projection with accurate positioning, the 1. capitulum is in profile. 2. capitulum-radial joint space is open. 3. coronoid process is in profile. 4. ulna is demonstrated without radial head superimposition.
1,2,4
Sharply recorded details are demonstrated on extremity images when 1. motion is controlled. 2. a large focal spot is used. 3. a small IR is used for computed radiography images. 4. a large OID is used.
1,3
An externally rotated PA oblique wrist projection with accurate positioning demonstrates 1. the trapezoid and trapezium without superimposition. 2. an open radioulnar articulation. 3. the ulnar styloid in profile. 4. superimposition of the medially located carpals.
1,3,4
When the patient ulnar-deviates for a PA axial, ulnar-deviated wrist projection, the 1. first metacarpal and radius are aligned. 2. distal scaphoid shifts anteriorly. 3. lunate is demonstrated distal to the radius. 4. distal scaphoid shifts posteriorly.
1,3,4
A lateral elbow projection demonstrates the radial head situated anterior and proximal to the coronoid process. How was the patient positioned for such an image to be obtained? 1. The distal forearm was too high. 2. The distal forearm was too low. 3. The proximal humerus was too high. 4. The proximal humerus was too low.
1,4
The IP joint spaces on finger projections are open and demonstrated without distortion when the 1. central ray is aligned parallel with the IP joint spaces. 2. central ray is aligned perpendicular to the IP joint spaces. 3. IP joints are aligned parallel with the IR. 4. IP joints are aligned perpendicular to the IR.
1,4
List the three parts of each metacarpal, starting proximally:
1. Base 2. Body (shaft) 3. Head
What are the 8 parts of the Distal humerus
1. Coronoid fossa 2. Radial fossa 3. lateral epicondyle 4. Medial epicondyle 5. Capitulum 6. Trochlea 7. Trochlear sulcus 8. Olecranon fossa
The fat pads around the elbow joint are valuable diagnostic indicators if the following three technical/positioning requirements are met with the lateral position.
1. Elbow flexed 90° 2. Optimal Exposure Factors 3. True lateral position
The three parts of each phalanx, starting distally, are the:
1. Head 2. Body (shaft) 3. Base
What are the 8 parts of the Ulna?
1. Olecranon process 2. Semilunar(trochlear) notch 3. Coronoid process 4. Radial notch 5. Coronoid tubercle 6. Shaft 7. Head 8. Styloid process
Identify which positioning modification(s) should be used for a study of the second digit to reduce distortion for: PA oblique projection
1. Perform the medial oblique rather than lateral oblique to decrease OID.
The two portions of the thumb (first digit) are the:
1. Proximal Phalanx 2. Distal Phalanx
List the two radiographic criteria used to determine whether rotation is present on the PA projection of the digits.
1. Symmetric appearance of both sides of the shafts of phalanges, and distal metacarpals. 2. Equal amounts of tissue on each side of the phalanges.
What is the name of the two special turning or bending positions of the hand and wrist that demonstrate medial and lateral aspects of the carpal region?
1. Ulna Deviation 2. Radial Deviation
What are the 6 parts of the Radius?
1. head 2. Neck 3. Tuberosity 4. Shaft 5. Ulnar notch 6. Styloid process
Carpals Proximal row
1. scaphoid Starting on the lateral (thumb) side Largest in the proximal row Articulates with the radius proximally Most frequently fractured carpal 2. lunate Articulates with the radius 3. triquetrum 4. pisiform Smallest of the carpals Anterior to the triquetrum
Carpals Distal row
1. trapezium 2. trapezoid Smallest bone in the distal row 3. capitate Largest of the carpals 4. hamate Has a "hooklike" process called the hamulus projecting from the palmar surface
What are the 3 ways to maintain sterile fields with C-arm?
1.Draping the II, tube and C-arm 2.Drape the pt 3.Shower curtain (picture shown)
To see elbow fat pads on x-ray
1.Must be flexed 90 ° 2.Must be true lateral 3.Optimum technique
Grids are used if the body part measure greater than ___ cm.
10 cm
23. How much posterior CR angulation is required for the supine version of the tangential projection for the intertubercular (bicipital) groove? 20° to 30° 30° to 40° 10° to 15° No angle is used for this projection.
10 to 15
What central ray angulation is required for the tangential projection supraspinatus outlet (Neer method)?
10 to 15° caudad
For the erect version of the tangential projection for the intertubercular sulcus, the patient leans forward
10 to 15° from the vertical
The supine version of the tangential projection of the intertubecular sulcus requires that the central ray be angled _________________ degrees posteriorly from the horizontal plane
10-15
During the PA axial scaphoid projection with CR angle and ulnar flexion, the CR must be angled ___ °, ___ (distally or proximally)?
10° to 15° proximally
How many bones make up the phalanges of the hand?
14
Identify the number of bones for: - Phalanges (fingers and thumb).
14
How many phalanges are there?
14 per hand
What CR angle is required for the AP axial projection (Alexander method) for AC joints
15 degrees cephalad
What type of CR angle is required for the Alexander method for AC joint
15 degrees cephalad
What degree of CR angulation is required for the projection of a Bennett's fracture?
15° proximal.
68. Where is the CR centered for the posterior oblique position for the glenoid cavity? Acromion 2 inches (5 cm) medial and inferior to the superolateral border of shoulder Coracoid process 1 inch ( 2.5 cm) superior to the coracoid process
2 inches medial and inferior to the superolateral border of shoulder
A PA wrist projection obtained in slight external rotation demonstrates 1. superimposition of the laterally located carpal bones. 2. a closed radioulnar articulation. 3. open lateral carpal joint spaces. 4. the radial styloid in profile.
2,3
A lateral finger projection obtained with the finger in a 45-degree PA oblique projection demonstrates 1. equal soft tissue width on both sides of the phalanges. 2. more midshaft concavity on one side of the phalanges than on the opposite side. 3. twice as much soft tissue on one side of the phalanges as on the opposite side. 4. convexity on one side of the phalanges and concavity on the opposite side.
2,3
What is the central ray angulation used for the PA axial, ulnar-deviated wrist projection: a scaphoid wrist fracture is suspected, and the patient is unable to ulnar-deviate the wrist? a. 15 degrees b. 20 degrees c. 5 to 10 degrees d. 20 to 25 degrees
20 degrees
How much are the hand and wrist elevated from the IR for the modified Stecher method?
20°
18. What medial central ray (CR) angle is required for the inferosuperior axial shoulder (Lawrence method)? 5° to 10° 40° to 45° 25° to 30° 10° to 15°
25 to 30
What type of central ray angulation is requires for the inferosuperior axial projection of the shoulder
25-30 degrees medially
How much central ray angulation to the long axis of the hand is required for the carpal canal (tunnel) projection?
25° to 30°
What type of central ray angle should be used for the inferiosuperior axial projection for the scapulohumeral joint space?
25° to 30° medially
How many bones on each hand and wrist?
27
Identify the number of bones for: - Total: (Phalanges, Metacarpals, and Carpals)
27
What is the total number of bones that make up the hand and wrist?
27
35. How much CR angulation is required for an asthenic patient for an AP axial projection of the clavicle? 15° 30° 45° No CR angulation should be used for this projection.
30
What type of CR angle is required for the Apical AP Axial Shoulder projection
30 degrees caudad
What type of CR angle is required for the apical AP axial shoulder projection?
30° caudad
Where is the CR for a PA projection of the hand?
3rd MCP Joint.
Common Technical Factors: Most common minimum SID
40 inches
Which of the following technical factors should be chosen when 20 mAs is desired and the patient being imaged has difficulty remaining still? a. 200 mA at 0.1 sec b. 400 mA at 0.05 sec c. 100 mA at 0.4 sec d. 100 mA at 0.2 sec
400 mA at 0.05 sec
How much CR angulation from the long axis of the forearm is required for the carpal bridge (tangential) projection?
45°
How much rotation is required for an oblique projection of the wrist?
45°
With Humeral neutral rotation the interepicondylar line is at a ______° angle to the IR?
45°
How much is the upper limb rotated for a lateral (rotation) oblique projection of the elbow?
45° laterally
How much and in which direction should the CR be angled for the trauma axial lateral projection (Coyle method) involving the radial head?
45° toward the shoulder.
Identify the number of bones for: - Metacarpals (palm).
5
How many metacarpals are there?
5 per hand
If the patient cannot fully abduct the affected arm 90° for the inferiosuperior axial projection (Clements modification), the technologist can angle of the CR what degree toward the axilla?
5 to 15°
Common Technical Factors: Small to Medium dry plaster casts: Increase ___ kV.
5 to 7 kV
34. The inferosuperior axial projection (Clements modification) requires a CR angle of ____ toward axilla if a patient cannot fully abduct extremity 90°. 35° none 40° to 45° 5° to 15°
5-15
How much is the CR angled for the inferosuperior axial projection (Clements modification) if the patient cannot fully abduct the arm 90 degrees
5-15 degrees
How many bones make up the carpal region?
8
Identify the number of bones for: - Carpals (wrist).
8
How many carpal bones are there?
8 per hand
Common Technical Factors: Large plaster casts: Increase ___ kV.
8 to 10 kV
Which anatomy is best demonstrated by the Alexander method?
AC joints
External rotation of the humerus is an _____ projection.
AP
Which alternative projection to the routine PA wrist best demonstrates the intercarpal joint spaces and wrist joint?
AP (hand slightly arched)
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 routine projections are required for a study of the forearm?
AP and Lateral
What is a Bone Survey?
AP and Lateral of every bone in body Diagnosing bone metastasis, mostly multiple myeloma
59. A patient enters the ED with multiple injuries including a possible fracture of the left proximal humerus. Which positioning rotation should be performed to determine the extent of the humerus injury? AP neutral shoulder rotation and carefully rotated internally proximal humerus AP shoulder as is; show radiograph to the ED physician before attempting a rotational lateral projection AP and horizontal beam transthoracic lateral shoulder projection AP and apical oblique shoulder without any arm rotation
AP and horizontal beam transthoracic lateral shoulder projection
Situation: A patient with a trauma injury enters the ER with an evident Colles' fracture. Which positioning routine should be used to determine the extent of the injury?
AP and lateral forearm projections to include the wrist.
Which positioning routine would demonstrate the entire humerus without excessive movement of limb?
AP and transthoracic lateral of humerus
Garth method is also known as
AP apical oblique axial
Where is the CR centered for a PA projection of the second digit?
Affected PIP joint
17. Which of the following shoulder positions is considered a trauma projection (can be performed safely for a possible fracture or dislocation)? AP apical oblique axial (Garth method) projection Inferosuperior axial (Clements modification) projection AP projection-internal rotation None of the above
AP apical oblique axial (Garth method)
A neutral AP projection has been taken, confirming dislocation. What additional projection should be taken?
AP apical oblique axial (Garth method)
Garth method
AP apical oblique axial projection
Which special projection of the shoulder requires that the affected side be rotated 45 degrees toward the cassette and uses a 45 degree caudad central ray angle
AP apical oblique axial projection
Which routine projection of the elbow best demonstrates the radial head, neck, and tuberosity with slight (if any) superimposition of the ulna?
AP oblique with 45° lateral rotation.
Which projection of the elbow best demonstrates the coronoid process in profile?
AP oblique with 45° medial rotation.
25. Which of the following projections can be performed using a breathing technique? Scapular Y lateral projection Inferosuperior axiolateral projection AP clavicle AP scapula
AP scapula
46. A patient enters the ED with multiple injuries. The physician is concerned about a dislocation of the left proximal humerus. The patient is unable to stand. Which of the following routines is advisable to best demonstrate this condition? AP shoulder and inferosuperior axiolateral projection AP shoulder and 35° to 45° LPO position (Grashey method) AP shoulder and Neer projection AP shoulder and recumbent AP oblique scapular Y projection
AP shoulder and recumbent AP oblique scapular Y projection
Which two routine shoulder projections are taken for a shoulder (with no traumatic injury) and proximal humerus
AP, external rotation and AP, internal rotation
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
An abnormality of the cartilage affecting long bones.
Achondroplasia
The three aspects of the clavicle are
Acromial extremity, Body (Shaft), and Sternal extremity
What are the ABC's of the Lateral scapula?
Acromian Body Coracoid process
Superior displacement of distal clavicle
Acromioclavicular joint dislocation
Abnormal widening of the acromioclavicular joint space
Acromioclavicular joint separation
Patient with possible right shoulder separation, which routine should be used?
Acromioclavicular joint series: non-weight bearing and weight-bearing projections
Which is considered the most posterior? Scapular notch, coracoid process, acromion, Glenoid process
Acromion
Which specific joint is found on the lateral end of the clavicle?
Acromionclavicular
Why is the AP projection of the thumb recommended instead of the PA?
An AP produces less OID, and increased resolution.
Common Technical Factors: kV range (analog and digital)
Analog: 50 to 70 kV Digital: 60 to 80 kV
Who is responsible for administering anesthesia and monitoring physiologic functions and fluid levels during surgery (are they sterile)
Anesthesiologist, no
63. An inferosuperior axial projection (Clements modification) is performed on a patient with a nontraumatic shoulder injury. The patient cannot fully abduct the upper limb 90°. Which of the following modifications of the position should be performed for this patient? Angle CR 30° toward the axilla. Angle CR 5° to 15° toward the axilla. Angle CR 45° toward the elbow AC joint separation. Rotate shoulder slightly anterior to open joint space.
Angle CR 5 to 15 degrees to the axilla
61. A patient enters the ED with a dislocated shoulder. The technologist attempts to position the patient into the transthoracic lateral projection, but the patient is unable to raise the unaffected arm over his head completely. What can the technologist do to compensate for the patient's inability to raise his arm completely? Perform the Grashey method instead. Use a breathing technique. Increase kV to penetrate through both shoulders. Angle the CR 10° to 15° cephalad.
Angle the CR 10-15 cephalad
With Humeral internal rotation the Greater tubercle is located __________
Anterior (A)
Where are the coronoid and radial fossae located?
Anterior aspect of distal humerus
What are the 3 fat pads in the elbow?
Anterior fat pad, posterior fat pad and supinator fat stripe
Which projection requires the CR to be centered 2 inches inferior and medial from the superiolateral border of the shoulder?
Anterior oblique (Grashey method)
Grashey method is also known as
Anterior oblique for glenoid cavity
The _________________________ projection of the shoulder produces an image of the glenoid process in profile. This projection is also referred to as the __________________________ method
Anterior oblique, Grashey
Which position best demonstrates signs of impingement syndrome in the acromiohumeral space?
Apical AP axial projection
31. Which of the following modalities best demonstrates shoulder joint pathology such as rotator cuff tears using dynamic evaluation techniques during joint movements? Ultrasound Magnetic resonance imaging (MRI) Computed tomography (CT) Arthrography
Arthrography
___ is a radiographic procedure that uses contrast media injected into the joint capsule to visual soft tissue pathology of the wrist, elbow, and shoulder joints.
Arthrography
Fluid-filled joint space with possible calcification.
Bursitis
Fluid-filled joint space
Bursitis
Scapulohumeral is a _______________ movement type joint
Ball and Socket
What is the type of joint moved for the scapulohumeral joint?
Ball and socket
Avulsion fracture of the glenoid rim
Bankart lesion
Injury to the anterior inferior glenoid labrum
Bankart lesion
Fracture and dislocation of the posterior lip of the distal radius.
Barton's Fracture
A Bennett's fracture involves:
Base of the 1st Metacarpal
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
What type of compensating filter is recommended for use on an HP shoulder projection for a hypersthenic patient?
Boomarang
What device permits good visualization of soft-tissue and bony anatomy for adult shoulder radiography
Boomerang compensating filter
Transverse fracture extending through the distal aspect of the metacarpal neck, most often the fifth metacarpal.
Boxer's Fracture
Proximally, the metacarpals articulate with the carpals at the
CMC joints
A PA axial scaphoid projection of the wrist using a 15° distal CR angle and ulnar flexion was performed. The resultant radiograph reveals that the scaphoid bone is foreshortened. How must this projection be modified to produce a more diagnostic image of the scaphoid?
CR angled 15° proximally toward the elbow.
66. What type of CR angle is required for the superoinferior axial projection (Hobbs modification)? CR is perpendicular to IR 5° to 15° toward axilla 25° away from axilla 10° toward shoulder
CR is perpendicular to IR
Where is the CR centered for the AP Scapula projection
CR perpendicular to midscapula, 2 inches inferior to coracoid process, or to the level of the axilla, and approximately 2 inches medial from lateral border of the patient
Who is responsible for preparing the OR with supplies and instruments, preps pt for surgery, maintains sterile field: (are they sterile)
CST (certified surgical tech), Yes
Scrub is who and what are they responsible for? ( are the sterile)
CST or RN that prepares the sterile field scrubs, gowns members of team, prepares instruments, Yes
24. Which ionization chamber(s) for the AEC should be used for a tangential projection for an intertubercular groove? Center chamber Both outside chambers Left chamber Cannot use AEC with this projection
Cannot use AEC with this projection
Which is the largest of the carpal bones?
Capitate
The similar structure found on the lateral aspect of the distal humerus is called the ___?
Capitulum
Situation: A patient with a history of carpal tunnel syndrome comes to the radiology department. The orthopedic physican suspects that bony changes in the carpal sulcus may be causing compression of the median nerve. Which special projection best demonstrates this region of the wrist?
Carpal Canal position (Gaynor-Hart method)
Painful disorder of hand and wrist from compression of the median resulting nerve.
Carpal Tunnel Syndrome
Possible calcification in the carpal sulcus.
Carpal Tunnel Syndrome
Why should a forearm never be taken as a PA projection?
Causes the proximal radius to cross over the ulna
What is the alternative CR centering technique for an AP shoulder projection on an obese patient if unable to palpate the coracoid process?
Center 2 inches below AC joint
CR perpendicular to the IR, directed 1" inferior to the coracoid process
Central ray for an AP projection of the shoulder
Who is responsible for recording info, retrieving items, connecting non sterile equipment. (are they sterile)
Circulatornon, No
The shoulder girdle consists of
Clavicle, Scapula and Proximal humerus
Transverse fracture of the distal radius with posterior displacement of the distal fragment.
Colles' Fracture
The general rule for collimation for upper limb radiography states:
Collimation borders should be visible on all four sides if the IR is large enough to allow this without cutting off essential anatomy.
Impingement syndrome
Compression between the greater tuberosity and soft tissues on the coracoacromial ligamentous and osseous arch
43. A patient comes to the emergency department (ED) with a possible right AC joint separation. Right clavicle and AC joint exams are ordered. The clavicle is taken first, and a small linear fracture of the midshaft of the clavicle is discovered. What should the technologist do in this situation? Perform the weight-bearing phase as ordered. Reduce the amount of weight that would normally be given to the patient and perform the weight- bearing study. Consult with the ED physician before continuing with the AC joint study. Slowly give the patient more weight to hold until he begins to complain and then complete the AC joint study.
Consult with the physician before continuing with the AC joint study.
Which structures of the scapula extends most anteriorly? Glenoid cavity, acromion, scapular spine, coracoid process.
Coracoid process
4. The anterior surface of the scapula is referred to as the: scapular surface. dorsal surface. supraspinous and infraspinous fossa. costal surface.
Costal surface
The anterior surface of the scapula is referred to as the
Costal surface
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
Situation: A patient with a possible fracture of the radial head enters the emergency room. When the technologist attempts to place the arm in the AP oblique-lateral rotation position, the patient is unable to extend or rotate the elbow laterally. Which other positions can be used to demonstrate the radial head and neck without superimposition on the proximal ulna?
Coyle method for radial head. (lateral elbow, CR 45° toward the shoulder.)
Sprain or tear of the ulnar collateral ligament.
Skier's Thumb
The 2nd through 5th digits have what 3 types of joints?
DIP, PIP and MCP
Should the technologist Increase, Decrease, or Not Change the manual exposure factors for: Advanced Rheumatoid Arthritis
Decrease
Should the technologist Increase, Decrease, or Not Change the manual exposure factors for: Osteoporosis
Decrease
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.
A poorly positioned PA oblique wrist projection demonstrates superimposition of the trapezoid and trapezium, and the capitate is superimposed by more than one fourth of the trapezoid. How should the positioning setup be adjusted to obtain an optimal projection? a. Align the third metacarpal and midforearm, decreasing radial flexion. b. Increase the degree of external wrist rotation. c. Decrease the degree of external wrist rotation. d. Increase hand extension.
Decrease the degree of external wrist rotation.
6. What is the name of the insertion point for the deltoid muscle located on the anterolateral surface of the humerus? Surgical neck Deltoid protuberance Deltoid tuberosity Intertubercular groove
Deltoid tuberosity
Common Technical Factors: Type of intensification screens most commonly used for analog imaging
Detail screen (analog)
Ellipsoidal joints are classified as freely movable, or ___ , and allow movement in ___ directions.
Diarthrodial; 4
Coronoid Fossa Part of the Radius, Ulna, or Distal Humerus?
Distal Humerus
Olecranon Fossa Part of the Radius, Ulna, or Distal Humerus?
Distal Humerus
Trochlea Part of the Radius, Ulna, or Distal Humerus?
Distal Humerus
Which joint is between the distal radius and ulna?
Distal Radialulnar
How much of the metacarpals should be included for a PA projection of the digits?
Distal aspect of metacarpals.
Joint movement type for: Radiocarpal Joint
Ellipsoidal
What type of joint movement is the articulation of the Metacarpophalangeal of the Second to Fifth Digits?
Ellipsoidal (condyloid)
What type of joint movement is the articulation of the Radiocarpal?
Ellipsoidal (condyloid)
Which positioning error is involved if a majority of the carpal bones are superimposed in a PA oblique wrist projection?
Excessive lateral rotation from PA.
A radiograph of a PA oblique projection of the hand reveals that the fourth and fifth metacarpals are superimposed. Which specific positioning error is involved?
Excessive lateral rotation.
Which routine projection of the shoulder requires that the humeral epicondyles be parallel to the IR?
External rotation
9. Which view and projection of the proximal humerus is represented in the figure? External rotation, anteroposterior (AP) projection Neutral rotation, AP projection Internal rotation, AP projection External rotation, lateral projection
External rotation, AP projection
T/F 12. Part 10 refers to the vertebral border of the scapula.
False
T/F 21. A radiograph of the inferosuperior axial projection (Lawrence method) demonstrates the acromion process of the shoulder to be located most superiorly (anteriorly).
False
T/F 22. For a Grashey method projection of the shoulder, the CR is centered to the acromion.
False
T/F 32. PA transaxillary (Hobbs modification) requires a 5° to 15° CR cephalic angle.
False
T/F 50. The Hill-Sachs defect is a fracture of the articular surface of the glenoid cavity.
False
T/F 54. A posterior dislocation of the shoulder occurs more frequently than an anterior dislocation.
False
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.
True or False: Lead shielding is only required for upper limb studies performed on patients who are child-bearing age or younger.
False. Good practice is to shield all patients.
Which preferred lateral position of the hand best demonstrates the phalanges without excessive superimposition?
Fan Lateral
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
62. A patient is scheduled for an arthrogram. During the course of the study, the radiologist requests a projection to demonstrate the intertubercular groove. Which one of the following projections would best demonstrate this structure? Fisk modification Garth method Grashey method Pearson method
Fisk modification
Which projection produces a tangential projection of the intertubercular sulcus
Fisk modification
Which joint is between the middle and distal phalanges of the fourth digit?
Fourth Distal Interphalangeal
Which type of injury must be ruled out before weight bearing phase of an AC joint study?
Fractured clavicle
69. What is the common term for idiopathic chronic adhesive capsulitis? Bankart lesion Tendinitis Bursitis Frozen shoulder
Frozen shoulder
Joint movement type for: Elbow Joint
Ginglymus
What type of joint movement is the articulation of the Elbow Joint?
Ginglymus (hinge)
What type of joint movement is the articulation of the Interphalangeal?
Ginglymus (hinge)
What type of joint movement is the articulation of the Elbow Joint (humeroulnar and humeroradial)?
Gingylmus (hinge)
1. Which of the following structures is not part of the proximal humerus? Lesser tubercle Glenoid process Intertubercular groove Anatomic neck
Glenoid process
20.Which of the following shoulder projections best demonstrates the glenoid cavity in profile? Grashey method Clements modification Garth method AP shoulder, neutral rotation
Grashey method
Which special projection of the shoulder places the glenoid cavity in profile for an "open" scapulohumeral joint?
Grashey method
Which carpal contains a "hook-like" process?
Hamate
What is the name of the hook-like process extending anteriorly from the hamate?
Hamulus (Hamular process)
48. A patient enters the ED with a possible bony defect of the midwing area of the scapula. The patient is able to stand and move the upper limb freely. In addition to the routine AP scapula projection with the arm abducted, which of the following would best demonstrate the involved area? Take an apical oblique projection of the shoulder. Take a transthoracic lateral projection of the shoulder region. Have the patient reach across the chest and grasp the opposite shoulder for a lateral scapula projection. Have the patient drop the affected arm behind him or her and take a lateral scapula projection.
Have the patient reach across the chest and grasp the opposite shoulder for a lateral scapula projection.
7 parts of Proximal humerus Anatomy
Head Greater tubercle Intertubercular groove (bicipital groove) Lesser tubercle Anatomic neck Surgical neck Deltoid tuberosity
Which analog technical considerations DO you apply for adult shoulder radiography?
High speed IR, 40-44 inch SID, 70 to 80 kV
Compression fracture of humeral head
Hills Sachs defect
44. A patient enters the ED with a midshaft humeral fracture. The AP projection taken on the cart demonstrates another fracture near the surgical neck of the humerus. The patient is unable to stand or rotate the humerus because of the extent of the trauma. What other projection should be taken for this patient? Scapular Y lateral-AP oblique projection Apical oblique projection Horizontal beam transthoracic lateral projection for humerus Rotational lateral projection for humerus
Horizontal beam transthoracic lateral projection for humerus
The joint between the phalanges of the first digit is the
IP joint
Disability of the shoulder joint caused by chronic inflammation in and around the joint
Idiopathic chronic adhesive capsulitis
Subacromial spurs
Impingement syndrome
Should the technologist Increase, Decrease, or Not Change the manual exposure factors for: Advanced Paget's Disease
Increase
Should the technologist Increase, Decrease, or Not Change the manual exposure factors for: Osteopetrosis
Increase
What is the major disadvantage of performing a PA projection of the thumb rather than an AP?
Increased OID
29. An AP apical oblique projection for an anteriorly dislocated scapulohumeral joint will project the humerus _____ to the glenoid cavity. superior inferior lateral medial
Inferior
53. Which one of the following projections/positions should NOT be performed for a possible shoulder dislocation? AP axial oblique (Garth method) Transthoracic lateral (Lawrence method) Inferosuperior axial (Clements modification) Scapular Y
Inferosuperior axial (Clements modification)
Lawrence method is also known as
Inferosuperior axial or Transthoracic lateral
Clements modification
Inferosuperior axial projection
Tendonitis
Inflammatory condition of the tendon
What are the names of the two fossae located on the posterior scapula
Infraspinous and supraspinous
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.
14. Which rotation of the humerus will result in a lateral position of the proximal humerus? Internal rotation (epicondyles perpendicular to image receptor) Neutral rotation (epicondyles 45° to the image receptor) External rotation (epicondyles parallel to the image receptor) None of the above
Internal rotation
58. Which of the following AP shoulder projections demonstrates the lesser tubercle in profile medially? External rotation Internal rotation Neutral rotation None of the above
Internal rotation
Which position of the shoulder and proximal humerus projects the lesser tubercle in profile medially?
Internal rotation
A tangential, inferosuperior carpal canal wrist projection with poor positioning demonstrates superimposition of the pisiform and hamulus of the hamate. How should the positioning setup be adjusted for an optimal image to be obtained? a. Externally rotate the hand. b. Internally rotate the hand. c. Decrease the central ray angulation. d. Increase the central ray angulation.
Internally rotate the hand.
The name of the joint between the proximal and distal phalanges of the first digit is the ___.
Interphalangeal Joint
Which joint is between the two phalanges of the first digit?
Interphalangeal Joint
Digital consideration for for Upper Limbs
It is important to be sure that the body part is centered to the IR because of the way the image plate reader scans the plate With a DR imaging system, the grid may not be able to be removed, and may be used on a small body part Evaluate the exposure indicator to ensure that exposure factors were in range with the least dose to the patient
Accumulated fluid within the joint cavity.
Joint Effusion
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
Which two bony landmarks are palpated to assist with positioning of the upper limb?
Lateral and medial epicondyle
Which lateral projection of the hand best demonstrates a possible foreign body in the palm of the hand?
Lateral in Extension
30. Which projection of the shoulder requires that the patient be rotated 45° to 60° toward the IR from a PA position? Inferosuperior axiolateral projection AP oblique projection Lateral scapula projection None of the above
Lateral scapula projection
Which routine projections best demonstrate the pronator fat stripe?
Lateral wrist
The best position to evaluate the posterior fat pads of the elbow joint is ___.
Lateral, flexed 90°
27. Where is the CR centered for a transthoracic lateral projection for proximal humerus? 1 inch (2.5 cm) inferior to the acromion Level of the greater tubercle Level of surgical neck Midaxilla
Level of the surgical neck
A sesamoid bone is frequently found adjacent to the ___ joint of the thumb.
MCP
Magnification mode
Magnifies
Which of the following is not an angle found on the scapula?
Medial angle
Where is the coronoid tubercle located?
Medial aspect of coronoid process
What is the kV range for the Humerus and Shoulder Girdle?
Medium kV 75-90
MC stands for
Metacarpal
The joints between metacarpals and phalanges are the ___.
Metacarpophalangeal (MCP) Joints
Which special positioning method can be performed to demonstrate a Bennett's fracture?
Modified Robert's Method
Situation: A patient with a possible fracture of the trapezium enters the ER. The routine projections do not clearly demonstrate a possible fracture. Which other special projection can be taken?
Modified Robert's method
Properties of mobile radiography
Move 2.5 - 3 MPH Maximum incline of 7° Takes 8 hours to fully charge and can last 10 hours Say "X-ray" before exposure and allow sufficient time for other personnel to move away (hospital room, OR or post op)
Most common type of primary malignant tumor that may occur in bone.
Multiple Myeloma
33. Which of the following best demonstrates the coracoacromial arch? Neer method West Point method Fisk method Garth method
Neer method
15. Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh? Internal rotation Neutral rotation External rotation AP axial
Neutral rotation
Hereditary condition marked by abnormally dense bone.
Osteopetrosis
Is the RT sterile?
No
26. How much CR angulation should be used for a scapular Y projection? No CR angle should be used. 10° to 15° 20° to 30° 35° to 45°
No CR angle should be used
Should the technologist Increase, Decrease, or Not Change the manual exposure factors for: Bursitis
No Change
Should the technologist Increase, Decrease, or Not Change the manual exposure factors for: Joint Effusion
No Change
What analog technical considerations does not apply for adult shoulder radiography?
Non-grid
47. A patient enters the ED with a possible AC joint separation. The patient is paraplegic; therefore, the study cannot be done erect. Which of the following routines would be performed to diagnose this condition? Non-weight-bearing and weight-bearing type of projections performed with the patient recumbent by pulling down on the shoulders Recumbent AP and AP axial projection of the clavicles to include AC joints AP projections of shoulders with external and internal rotation performed recumbent AP and AP apical oblique projection of the shoulder performed recumbent
Non-weight-bearing and weight-bearing type of projections performed with the patient recumbent by pulling down on the shoulders.
What type of CR angle is required for the lateral scapula position
None
10. Part 5 refers to the coracoid process. superior border of scapula. lateral angle of scapula. none of the above.
None of the above
57. Which of the following AP shoulder projections demonstrates the greater tubercle in profile medially? External rotation Internal rotation Neutral rotation None of the above
None of the above
What is the proper name for the position referred to as the "ball-catcher's position"?
Norgaard Method
Situation: A patient comes to the radiology department for a hand series to evaluate early evidence of rheumatoid arthritis. Which special position can be used in addition to the routine hand projections to evaluate this patient?
Norgaard method - ball catcher's position.
Which modality for procedure best demonstrates osteomyelitis?
Nuclear medicine
Narrowing of joint space
Osteoarthritis
Narrowing of joint space with periosteal growths on the joint margins.
Osteoarthritis
Which pathologic condition often produces narrowing of the joint space?
Osteoarthritis
Local or generalized infection of bone or bone marrow.
Osteomyelitis
Soft tissue swelling and loss of fat-pad detail visibility.
Osteomyelitis
45. A referring physician suspects that a subacromial spur may be the cause for a patient's arm numbness. She asks the technologist for a projection that would best demonstrate any possible spurs. Which of the following projections would accomplish this objective? PA scapular Y lateral with 10° to 15° caudal angle PA scapular Y lateral with 10° to 15° cephalad angle AP oblique shoulder with 45° caudal angle AP shoulder with 10° to 15° caudal angle
PA scapular Y lateral with 10 to 15 degrees caudal angle
Situation: A patient is referred to radiology with a possible injury to the ulnar collateral ligament. The patient complains of pain near the first MCP joint. Initial radiographs of the hand do not indicate any fracture or dislocation. Which special projection can be performed to rule out an injury to the ulnar collateral ligament?
PA stress (Folio method) projection
Hobbs modification
PA transaxillary projection
Which nontrauma projection can be performed erect to provide a lateral view of the proximal humerus in relationship to the scapulohumeral joint
PA transaxillary projection (Hobbs modification)
60. The AP humerus requires that the humeral epicondyles are _____ to the IR. set at a 45° angle parallel perpendicular slightly oblique
Parallel
To properly position the patient for an AP projection of the elbow, the epicondyles must be ___ to the IR.
Parallel
The long axis of the anatomic part being imaged should be placed:
Parallel to long axis of the IR
General positioning guidelines for Upper Limbs
Patient must be seated sideways (away from scatter)* Always shield 40" SID * raise tube for 3-4" difference between table and bucky Exposure factors: Low to medium kV 55-80 Small focal spot short exposure time Adequate mAs collimation should be seen on all 4 borders if possible More than one exposure on one cassette is not recommended with digital Place long axis of part to long axis of cassette Keep all body parts in same direction if placing more than one image on the same IR Place marker where least likely to superimpose anatomy
Identify which positioning modification(s) should be used for a study of the second digit to reduce distortion for: Lateral position
Perform a thumb-down lateral (mediolateral projection) to decrease OID.
19. What additional maneuver must be added to the inferosuperior axial shoulder (Lawrence method) projection to best demonstrate a possible Hill-Sachs defect? Increase medial CR angulation. Angle the CR 10° to 15° downward or posteriorly in addition to the medial angle. Perform exaggerated external rotation of the affected upper limb. Increase abduction of the affected upper limb.
Perform exaggerated external rotation of the affected upper limb
Patient unable to stand, Hobbs modifications needed, what should be done next?
Perform the projection with the patient's upper chest prone on the table
How are the humeral epicondyles aligned for the rotational lateromedial projection of the humerus?
Perpendicular to IR
What is the projection for the lateral finger? a. Phalanges demonstrate equal concavity. b. Phalanges demonstrate more concavity on one side than on the other. c. Phalanges demonstrate concavity on one side and convexity on the other.
Phalanges demonstrate concavity on one side and convexity on the other
What is the projection for the PA oblique finger? a. Phalanges demonstrate equal concavity. b. Phalanges demonstrate more concavity on one side than on the other. c. Phalanges demonstrate concavity on one side and convexity on the other.
Phalanges demonstrate more concavity on one side than on the other.
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.
Acromioclavicular is a _______________movement type joint
Plane
Joint movement type for: Intercarpal Joints
Plane
Joint movement type for: Third CMC Joint
Plane
Sternoclavicular is a ______________ movement type joint
Plane
What type of joint movement is the articulation of the Intercarpal?
Plane (gliding)
39. A radiograph for an AP projection with external rotation of the proximal humerus reveals that the greater tubercle is profiled laterally. What should be changed to improve this image for a repeat exposure? Rotate epicondyles so they are perpendicular to the image receptor. Move the patient obliquely 10° to 15° toward the affected side. Rotate the arm to place palm of the patient's hand against the thigh. Positioning is acceptable; do not repeat it.
Positioning is acceptable, do not repeat it
42. A patient comes to radiology for treatment of an arthritic condition of the right shoulder. The radiologist orders AP internal/external rotation projections and an inferosuperior axiolateral projection of the scapulohumeral joint. However, the patient cannot abduct the arm for this projection. Which other projection will best demonstrate the scapulohumeral joint space? Posterior oblique (Grashey method) Scapular Y lateral Transthoracic lateral AP projection-neutral rotation
Posterior oblique (Grashey)
What projection best demonstrates a possible dislocation of the proximal humerus
Posterior oblique (scapular y) projection
Grashey method
Posterior oblique, Glenoid cavity projection.
In what position should the hand be for an AP medial rotation oblique elbow position?
Pronated
Which joint permits the forearm to rotate during pronation?
Proximal Radioulnar Joint
Radial Notch Part of the Radius, Ulna, or Distal Humerus?
Proximal Ulna
Where is the CR for a PA oblique projection of the second digit?
Proximal interphalangeal (PIP) Joint
The non sterile area includes what 3 things
RT anesthesiologist circulator
Which side of the arm is positioned against the IR for the lateral second finger projection? Select one: a. Ulnar b. Radial
Radial
Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid and trapezium bones?
Radial Collateral Ligament
Which joint is between the forearm and the carpals?
Radiocarpal
In the anatomic position, which of the bones of the forearm is located on the lateral (thumb) side?
Radius
What is the major advantage of a supine, tangential version of the intertubercular sulcus projection over the erect version?
Reduced OID
40. A radiograph of an AP clavicle reveals that the sternal extremity is partially collimated off. What should the technologist do? Repeat the AP projection and correct collimation. Make sure the sternal extremity is included on the AP axial projection. Only repeat it if the patient's pain/symptoms involve the sternal extremity. Ask the radiologist whether he or she wants the projection repeated.
Repeat the AP projection and correct collimation.
Closed joint space
Rheumatoid Arthritis
The "ball-catcher's position" is commonly used to evaluate for early signs of:
Rheumatoid Arthritis
Chronic systemic disease with arthritic inflammatory changes throughout the body
Rheumatoid arthritis
Which pathologic condition may require a reduction in manual exposure factors?
Rheumatoid arthritis
To best demonstrate a possible Hill-Sachs defect , which additional technique can be done
Rotate affected arm externally approximately 45 degrees
Radiograph of Grashey method shows anterior and posterior glenoid rims are not superimposed. Erect position rotated 25 to 30° toward affected side. What will superimpose the glenoid rims during next exposure?
Rotate body more toward affected side
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°.
A radiograph of a PA projection of the second digit reveals that the phalanges are not symmetric on both sides of the bony shafts. Which specific positioning error is involved?
Rotation
Traumatic injury to one or more of the supportive muscles of the shoulder girdle
Rotator cuff tear
Trumatic injury to one or more muscles of the shoulder joint
Rotator cuff tear
The Proximal humerus has a _____ head.
Rounded
Which carpal is most commonly fractured?
Scaphoid
Which is the most commonly fractured carpal bone?
Scaphoid
Which two carpal bones are located most anteriorly as seen on a lateral wrist radiograph?
Scaphoid and Trapezium
Which bony structure separates the supraspinous and infraspinous fossae?
Scapular spine
Which clinical indication is best demonstrated with the Garth method?
Scapulohumeral dislocations
8. Which of the following joints is considered to have a spheroidal type of movement? Acromioclavicular joints Sternoclavicular joints Bicipital joint Scapulohumeral joint
Scapulohumeral joint
Which anatomy of the shoulder is best demonstrated with a PA transaxillary projection (Hobbs modification)?
Scapulohumeral joint space
What terms correctly describe the shoulder joint
Scapulohumeral, glenohumeral
Joint movement type for: First CMC Joint
Sellar
What type of joint movement is the articulation of the Carpometacarpal of the First Digit?
Sellar (saddle)
Properties of a mobile C-arm
Shaped like the letter "C" with and x-ray tube at one end and an image intensifier (IR) at the other end Most commonly used during OR Very maneuverable Usually uses 2 monitors so one image is active and one image is held for reference
Common Technical Factors: Long or Short exposure time
Short Exposure
A three-projection study of the hand was taken using the following analog exposure factors: 64 kV, 1000 mA, .01 sec, large focal spot, 36-inch SID, and high speed screens. Which of these factors should be changed on future hand studies to produce more optimal images?
Small focal spot 40 inch SID Detail (Analog) speed screens.
Reverse of a Colles' fracture.
Smith's Fracture
Arthrography is a radiographic study of:
Soft-tissue structures within certain synovial joints
2. Which term describes the medial end of the clavicle? Acromial extremity Acromion Sternal extremity Acromial tuberosity
Sternal extremity
What is Arthrography?
Study of synovial joints and related soft tissue structures using contrast media Hip, knee, ankle, shoulder, elbow and wrist
65. What is a possible radiographic sign for impingement syndrome of the shoulder? Calcified tendons Fluid-filled joint space Fracture of the glenoid rim Subacromial spurring
Subacromial spurring
5. What is the name of the large fossa found within the anterior surface of the scapula? Supraspinous fossa Infraspinous fossa Subscapular fossa Glenoid fossa
Subscapular fossa
Which two positioning landmarks are aligned perpendicularly to the IR for the lateral scapula projection?
Superior angle and AC joints
Which two landmarks are placed perpendicular to the IR for the scapular Y lateral projection
Superior angle of the scapula and the AC joint articulation
Acromioclavicular joint dislocation
Superior displacement of the distal clavicle
The three angles of the scapula include the
Superior, Lateral (head), and Inferior
In what position should the hand be for an AP elbow projection?
Supinated
The most common injury to the rotator cuff is to the _________________________ tendon
Supraspinatus
Neer method is also known as
Supraspinous outlet tangential
Who is responsible for the entire surgical procedure and of the well being of the patient: (are the sterile)
Surgeon, yes
What is the most common clinical indication to perform the Alexander method for the AC joint
Suspected AC joint subluxation
All of the joints in the shoulder girdle are classified as being
Synovial
Fisk modification is also known as
Tangential for intertubecular (bicipital) sulcus
Which special projection of the wrist helps rule out abnormal calcifications in the carpal sulcus?
Tangential inferosuperior projection. (Gaynor-Hart Method).
Which projection best demonstrates calcification of tendon within the intertubercular sulcus?
Tangential projection ( Fisk modification)
Which projection best demonstrates the supraspinatus outlet region?
Tangential projection ( Neer method)
Situation: A patient enters the ER with a possible foreign body in the dorsal aspect of the wrist. Initial wrist radiographs are inconclusive in demonstrating the location of the foreign body. What additional projection can be performed to demonstrate this region of the wrist?
Tangential projection -- Carpal Bridge projection
The _____________________________________projection is the special projection of the shoulder that best demonstrates the acrominohumeral space for possible subacromial spurs, which create shoulder impingement symptoms (more than one answer is possible)
Tangential projection-Supraspinatus Outet; Neer method or Apical AP axial
Fisk modification
Tangential, intertubercular groove projection
Neer method
Tangential, supraspinatus outlet projection
Calcified tendons
Tendonitis
Barton's fracture
fx and dislocation of the posterior lip of the distal radius
Which projection can in orthostatic (breathing) technique be used?
Transthoracic lateral for humerus
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
Situation: A patient has a routine elbow series performed. The AP projection indicates a possible deformity or fracture of the coronoid process. However, the patient is unable to pronate the upper limb for the AP oblique-medial rotation projection because of an arthritic condition. What other projection could be performed to demonstrate the coronoid process?
Trauma axial lateral projection -- Coyle method for coronoid process.
The articular portion of the medial aspect of the distal humerus is called the ___?
Trochlea
The deep depression located on the posterior aspect of the distal humerus is the ___?
Trochlear Sulcus (groove)
What type of joint movement is the articulation of the Proximal Radioulnar Joint?
Trochoidal (pivot)
T/F 13. Part 3 refers to the greater tubercle.
True
T/F 16. The use of a grid during shoulder radiography will result in higher patient dose over nongrid procedures.
True
T/F 28. The PA transaxillary projection (Hobbs modification) is performed to rule out possible shoulder dislocation.
True
T/F 3. The female clavicle is usually shorter and less curved than that of the male.
True
T/F 49. The recommended SID for AC joints is 72 inches (183 cm).
True
T/F 52. An orthostatic (breathing) technique can be performed for the AP projection of the scapula.
True
T/F 55. The Alexander method for AC joints requires a 15° cephalic CR angle.
True
T/F 56. For AC joint weight-bearing studies, patients should not be asked to hold on to the weights with their hands; rather, the weights should be attached to the wrists.
True
T/F 67. Sonography is an effective diagnostic tool in studying the shoulder joint.
True
True or False: Excessive kV (analog imaging) may obscure the visibility of a fat pad.
True
True/False: The PA transaxillary (Hobbs modification) requires no CR angle
True
A radiograph of an AP elbow projection reveals considerable superimposition between the proximal radius and ulna. Which specific positioning error is involved?
The elbow is rotated medially.
A radiograph of a lateral projection of the elbow reveals that the humeral epicondyles are not superimposed and the trochlear notch is not clearly demonstrated. Which specific type of positioning error is involved?
The forearm and humerus are not on the same horizontal plane.
What are the names of the 3 angles of the scapula?
The lateral angle (head of the scapula) The superior angle The inferior angle
What are the names of the 3 borders of the scapula?
The medial or vertebral border The lateral or axillary border The superior border contains the scapular notch
Elements of Radiation protection during surgery
The patient is the largest source of dose to the tech Time- use intermittent Fluoroscopy Minimize boost exposures- (used to increase mA for thicker patients) Place tube under the table, away from surgical teams head Shielding- wear a thyroid shield, provide aprons for all personnel, intermittently check aprons for cracks Communicate- clearly announce "x-ray or x-ray on" The operator and all persons in the room should wear a lead apron (0.5mm pb/eq); reduces dose to tech by 50% The least amount of radiation is at the II and behind the Radiologist The most radiation is located at the x-ray tube Use Inverse square law !! Check dosimetry report
What is the interepicondylar line?
The point on the anterior arm in which the elbow flexes.
How does the forearm appear radiographically if pronated for a PA projection?
The proximal radius crosses over the ulna.
What is the only difference among the four radial head lateral projections of the elbow?
The rotational position of hand and wrist.
Where is the CR placed for a PA projection of the hand?
Third MCP joint
Lateral projection to demonstrate the entire humerus for a patient with a midhumeral fracture
Transthoracic lateral
True or False: In addition to the ulnar and radial collateral ligaments, the following five additional ligaments are also important in stability of the wrist joint. - Dorsal Radiocarpal - Palmar Radiocarpal - Triangular Fibrocartilage Complex (TFCC) - Scapulolunate - Lunotriquetral
True
True or False: Slight superimposition of the distal third, fourth, and fifth metacarpals may occur with a well-position PA oblique projection of the hand.
True
True or False: The entire metacarpal and trapezium must be demonstrated on all projections of the thumb.
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
True or false a 72 inch SID is recommended for adult acromioclavicular joint studies
True
True or false even though the amount of radiation exposure is minimal for most shoulder projections, gonadal shielding should be used for children and adults of childbearing age.
True
True or false the greatest technical concern during a pediatric shoulder study is voluntary motion.
True
True/False: A high-speed screen-IR system is recommended for analog shoulder studies when using a grid
True
True/False: CT arthrography of the shoulder joint often requires the use of iodinated contrast media injected into the joint space
True
True/False: It is recommended to perform shoulder positions on obese patients in the erect position when possible
True
True/False: Nuclear medicine bone scans can demonstrate signed of osteomyelitis and cellulitis
True
True/False: Orthostatic (breathing) technique is recommended for the AP projection of the scapula
True
True/False: Sonography (ultrasound) can provide a functional (dynamic) evaluation of joint movement that MRI cannot
True
Fx stands for
a break in the structure of a bone
Bankart lesion
fx of the anteroinferior glenoid rim; often caused by anterior dislocation of the humerus
Bennett's fracture
fx of the base of the first metacarpal
What are the 3 parts of the clavicle?
acromial extremity sternal extremity and Body
The scapular spine continues laterally to form the what?
acromian
The upper 2 portions of the scapula "Y" are the what?
acromian and the coracoid process
The acromial extremity of the clavicle articulates with the _______ of the scapula at the __ joint
acromian, AC
Auto/manual exposure control
allows for uses of AEC or a manually set technique
Roadmapping
an image is held on one monitor in combination with fluoro on another
To properly position an AP humerus, place the elbow at the _____ end of the tube, _____ the hand and wrist, and align the humeral condyles _____ with the IR. a. anode; supinate; parallel b. cathode; supinate; perpendicular c. anode; pronate; perpendicular d. cathode; supinate; parallel
anode; supinate; parallel
The lesser tubercle of the proximal humerus is located ________ in anatomical position.
anterior
With Humeral external rotation the Lesser tubercle is located __________
anterior and on profile (B)
The coracoid process of the scapula projects ______ beneath the clavicle.
anteriorly
Where are the soft tissue structures that can be used to indicate joint effusion located on the lateral wrist projection? a. Anteriorly b. Medially c. Laterally d. Posteriorly
anteriorly
The deltoid tuberosity is on the _________ surface
anterolateral
The shoulder girdle attaches the upper limb to the what?
axial skeleton
The bottom of the scapula "Y" is the _____ of the scapula
body
Osteo-
bone
Boxer's fracture
fx transverse fx trough the metacarpal neck, most common in the 5th metacarpal
With Humeral internal rotation the Lesser tubercle is located __________
medial and on profile (B)
the third MC articulates with the
capitate
The intercarpal joints are located between each
carpal
The base of the metacarpal articulates with the
carpals
Chondro-
cartilage
The Shoulder girdle consists of what 2 bones?
clavicle and scapula
Ewing's Sarcoma
common primary malignant tumor in children that arises from bone marrow, prognosis is poor by the time it is evident on radiographs
Hill-Sachs defect
compression fx of the articular surface of the humeral head; often caused by anterior dislocation of the humerus
If a sterile drape is touched by a non sterile object, it must be what?
considered contaminated
The two anterior depressions on the distal humerus are the
coronoid fossa and the radial fossa
The medial portion of the coronoid process is the
coronoid tubercle
The ______ is the thick ridge on the scapular spine
crest of spine
Diarthrodial (synovial) joints
freely moveable joints
The CMC joint of the 1st digit is sellar or saddle-type which allows
flexion, extension, adduction, abduction, circumduction, opposition and rotation
Joint effusion
fluid in the joint cavity; usually a sign of an underlying condition such as fx
What is the site for deltoid muscle attachment?
deltoid tuberosity
All are structurally classified as synovial and the mobility type is
diarthrodial (freely moveable)
Each finger is called a _______
digit
Idiopathic chronic adhesive capsulitis (frozen shoulder)
disability of the shoulder joint caused by chronic inflammation
Fat pads (fat bands, fat stripes) Displacement may be the only indication of
disease or significant injury or fx within a joint
Carpal tunnel syndrome
disorder of the wrist and hand caused from a compression of the median nerve; most common in middle aged women
the head of the ulna is located at the _______ end of the ulna
distal
AC dislocation
distal clavicle displaced superiorly
The lateral epicondyle is on the lateral portion of the
distal humerus
The posterior surface of the scapula is also called the what?
dorsal surface
Surgical assistant is who and what are they responsible for? ( are the sterile)
either a physician, a PA, CST or RN. May include suctioning, tying and clamping vessels and assisting cutting and suturing: Yes
The ulna is the only one involved in the
elbow joint
Sesamoid bones are located at the head of the
first metacarpal
The IP joints are ginglymus or hinge-type that allow only
flexion and extension.
The MCP joints are ellipsoidal or condyloid-type the allow
flexion, extension, abduction and adduction.
The elbow joint is a
ginglymus hinge-type
The humeral head articulates with the scapula at the glenoid cavity (fossa) at the what?
glenohumeral joint
6 other attributes when x-raying Humerus and Shoulder Girdle
grid if > 10cm Short exposure time * Small focal spot Adequate mAs Shield gonads *Boomerang filter may be needed
the fourth and fifth MC's articulates with the
hamate
The acromion extends laterally over the what?
head of the humerus
The capitulum is lateral and articulates with the
head of the radius
Proximal radioulnar joint is formed by the _______ and radial _______
head of the radius, notch of the ulna
What are the 3 parts of each metacarpal
head, body and base
What are the 3 parts of each phalanx
head, body and base
the expanded end of the distal humerus is the
humeral condyle
The surgical neck is the site for the most what?
humeral fxs
Osteomyelitis
infection of bone or bone marrow; could be caused by infection from surgery or diabetic foot ulcer
Rheumatoid arthritis (RA)
inflammation in the body's connective tissues, usually in the wrist and fingers; more common in women
Bursitis
inflammation of the bursae causing calcifications in ligaments
The groove in between lesser and greater tubercle of the proximal humerus is called the what?
intertubercular groove or bicipital groove
Internal rotation of the humerus is a _____ projection.
lateral
The greater tubercle of the proximal humerus is located _______ in anatomical position.
lateral
With Humeral external rotation Greater tubercle is located __________
lateral and on profile (A)
the radial notch is located on the __________ of the proximal ulna
lateral side
3 fat pads can only be seen on a
lateral view
The pronator fat stripe is seen on a
lateral view
The clavicle on a _________________ tends to be thicker and more curved in shape
male
The sternal extremity of the clavicle articulates with the _______ of the sternum at the __ joint
manubrium, SC
With Humeral internal rotation the interepicondylar line is _______________ to the IR
perpendicular
Each digit has 3 ________
phalanges (phalanx for singular)
AC joint is what type of joint?
plane or gliding joint
SC joint is what type of joint?
plane or gliding joint
The intercarpal joints are
plane or gliding-type
the 2nd thru 5th CMC joints are
plane or gliding-type
Cover IR with a _____cover
plastic
The scapular spine is located on the ______surface
posterior
the medial epicondyle is on the medial side and is more
prominent
the head of the radius is located at the _________ end of the radius
proximal
The thumb only has 2 phalanges what are they called?
proximal and distal
The radius is lateral the ulna is medial and they articulate with each other at the
proximal radioulnar joint and the distal radioulnar joint
The 3 phalanges are called what?
proximal, middle and distal
A "break" in the sterile field MUST be what?
reported
Any contaminated object must be what?
reported and replaced
The radial collateral ligament goes from the styloid process of the radius to the lateral side of the
scaphoid and the trapezium
The wrist joint is ellipsoidal or condyloid-type ; the radiocarpal joint consists of the
scaphoid, lunate and the radius
The superior border contains the what?
scapular notch
The female clavicle is _____ and _____compared to that of the male clavicle?
shorter and less curved
The scapulohumeral joint is ______ or _____ (flexion, extension, abduction, adduction, circumduction, medial and lateral rotation)
spheroidal or ball and socket
The body of the clavicle is located between the what?
two extremities
Radial deviation: demonstrates ______ of wrist
ulnar side
medial rotation crosses them over at the
upper 1/3(superimposes)
Subtraction
used to remove stationary structures while leaving only moving parts (contrast filled vessels)
Fat pads (fat bands, fat stripes) Difficult to
visualize
A less than optimal AP elbow projection demonstrating the ulna without radial head superimposition a. was obtained with the elbow in external rotation. b. will also demonstrate the radial head articulating surface. c. was obtained with the hand pronated. d. was obtained with the elbow in internal rotation. d. was obtained with the elbow in internal rotation.
was obtained with the elbow in external rotation
Fat pads (fat bands, fat stripes) Most common in wrist and elbow joint
wrist and elbow joint