Hands, Wrists, and Fingers
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!!
