Upper Limb Anatomy and Positioning
Collimation size for: 1st Digit (Thumb)
1 inch (2.5 cm) on all sides of digit 1 inch (2.5 cm) proximal to CMC joint
Collimation size for: Digits (2nd through 5th)
1 inch (2.5 cm) on all sides of digit 1 inch (2.5 cm) proximal to MCP joint
Collimation size for: Hand
1 inch (2.5 cm) on all sides of hand 1 inch (2.5 cm) proximal to ulnar styloid
Collimation size for: Humerus
2 inches (5 cm) distal to elbow joint and superior to shoulder 1 inch (2.5 cm) on sides
Collimation size for: Forearm
2 inches (5 cm) distal to the wrist joint and proximal to the elbow joint 1 inch (2.5 cm) on sides
Collimation size for: Wrist
2.5 inches (6 cm) proximal and distal to the wrist joint 1 inch (2.5 cm) on sides
Collimation size for: Elbow
3 inches (8 cm) proximal and distal to the elbow joint 1 inch (2.5 cm) on sides
How many proximal, middle, and distal phalanges are found in one hand?
5 proximal, 4middle, 5 distal
Which elbow projection does the evaluation criteria apply to: Proximal forearm will be greatly foreshortened
AP distal humerus projection (partially flexed elbow)
Which projection and position of the upper limb best demonstrates the coronoid process in profile and free of superimposition?
AP oblique of the elbow in medial rotation position
Which elbow projection does the evaluation criteria apply to: Radial head should be projected free of the ulna
AP oblique projection, lateral rotation position
Which elbow projection does the evaluation criteria apply to: Coronoid process should be seen in profile
AP oblique projection, medial rotation position
Which projection of the elbow best demonstrates the radial head free of bony superimposition?
AP oblique, lateral rotation position
Which elbow projection does the evaluation criteria apply to: Humeral epicondyles should not be rotated or superimposed
AP projection
Which elbow projection does the evaluation criteria apply to: Distal humerus will be foreshortened
AP proximal forearm projection (partially flexed elbow)
Carpal that articulates with third metacarpal
Capitate
Which carpal bone does not articulate with the radius?
Capitate
Portion of distal humerus that articulates with radial head
Capitulum
Round, marblelike structure found ont he distal humerus
Capitulum
Bones in the wrist
Carpals
What group of bones articulates with the bases of metacarpal bones?
Carpals
Which of the following types of upper limb joints are formed in part by the bases of the metacarpals?
Carpometacarpal
Process located on anterior, proximal ulna
Coronoid
What portion of the distal humerus is: Depression - located on the anterior surface
Coronoid fossa
What to look for in: Elbow (APO, Medial Rotation Position)
Coronoid process is seen in profile Medial epicondyle elongated
Central Ray for: Humerus (Lateral Recument)
Directed to center of IR, which exposes only distal humerus
End of bone on which ulnar head is located
Distal
Which description best explains how radial crossover occurs when the forearm is demonstrated?
During the AP projection, the hand is pronated
Bony prominence; easily palpated on the distal humerus
Epicondyle
Palpable landmarks on each side of distal humerus
Epicondyles
What to look for in: Humerus (AP)
Epicondyles are maximally seen and not rotated Humeral head and greater tubercle are both seen in profile Outline of lesser tubercle is located between head and greater tubercle
What is the centering point for the central ray on the AP projection of the first digit (thumb)?
First MCP joint
Types of movement for: Elbow joint (humeroulnar and humeroradial)
Flexion, Extension
Types of movement for: Interphalangeal
Flexion, Extension
Types of movement for: Metacarpophalangeal
Flexion, Extension, Abduction, Adduction, Circumduction
Types of movement for: Radiocarpal
Flexion, Extension, Abduction, Adduction, Circumduction
Depression on posterior surface of distal humerus, olecranon
Fossa
Types of movement for: Intercarpal
Gliding
Raised process on proximal, lateral humerus
Greater tubercle
Carpal bone with hook-like process
Hamate
What is the most distal portion of each metacarpal?
Head
What part of a metacarpal bone (base or head) forms part of each metacarpophalangeal joint?
Head
Central Ray for: Humerus (Lateromedial Recumbent)
Horizontal and perpendicular to mid-portion of humerus and center of IR
Upper armbone
Humerus
IP portion of DIP abbreviation
Interphalangeal
Which projection of the forearm requires that the elbow be flexed 90 degrees?
Lateral
Which projection of the wrist requires that the radial styloid process be superimposed over the ulnar styloid process?
Lateral
Which of the following is best for demonstration of a foreign body in the hand?
Lateral in extension
Which elbow projection does the evaluation criteria apply to: Olecranon process should be seen in profile
Lateral projection
Which projection of the elbow best demonstrates the olecranon process in profile?
Lateral projection
Which bone classification are the metacarpals?
Long
Carpal between scaphoid and triquetrum
Lunate
Bones in the palm of the hand
Metacarpals
Which joint is an ellipsoidal joint?
Metacarpophalangeal
How are the metacarpals identified?
Numbered 1 through 5 from lateral (thumb side) to medial (little finger side)
Prominent process on proximal ulna
Olecranon
What portion of the distal humerus is: Depression - located on the posterior surface
Olecranon fossa
What to look for in: Elbow (Lateral)
Olecranon process is seen in profile Radial tuberosity facing anteriorly
Which projection of the wrist corrects foreshortening of the scaphoid carpal bone?
PA with ulnar deviation
Central Ray for: Hand (Lateral)
Perpendicular to 2nd MCP joint
Central Ray for: 1st Digit (Thumb)
Perpendicular to MCP joint
Central Ray for: Digits (2nd through 5th)
Perpendicular to PIP joint of affected digit
Central Ray for: Elbow (Proximal Forearm, Partial Flexion)
Perpendicular to elbow joint and long axis of forearm Adjust IR so CR passes to its midpoint
Central Ray for: Elbow (Distal Humerus, Partial Flexion)
Perpendicular to humerus, traversing the elbow joint Depending on the degree of flexion, angle the CR distally to the joint
Central Ray for: Humerus
Perpendicular to mid-portion of the humerus and center of IR, except for RECUMBENT and LATERAL RECUMBENT for suspected fractures
Central Ray for: Wrist (PA and PA, Radial Deviation)
Perpendicular to midcarpal area
Central Ray for: Hand
Perpendicular to the 3rd MCP joint; except for LATERAL
Central Ray for: Elbow
Perpendicular to the elbow joint
Central Ray for: Wrist (PA Oblique, Lateral Rotation)
Perpendicular to the midcarpal area; enters just distal to the radius
Central Ray for: Forearm
Perpendicular to the midpoint of the forearm
Central Ray for: Wrist (PA, Ulnar Deviation)
Perpendicular to the scaphoid; CR angulation of 10-15 degrees proximally or distally sometimes required for delineation
Central Ray for: Scaphoid (PA Axial, Stecher)
Perpendicular to the table Directed to enter the scaphoid
Central Ray for: Wrist (Lateral)
Perpendicular to the wrist joint
Finger bones
Phalanges
End of bone on which radial head is located
Proximal
For lateral projections of the second through fifth digits of the hand, through which joint should the central ray be directed?
Proximal interphalangeal
Which bones articulate with the heads of the metacarpal bones?
Proximal phalanges
What to look for in: Elbow (APO, Lateral Rotation Position)
Radial head, neck, and tuberosity free of ulna
Lateral bone of forearm
Radius
Types of movement for: Distal radioulnar
Rotational
Types of movement for: Proximal radioulnar
Rotational
Which bone classification are the carpal bones?
Short
For the PA projection of the wrist, which positioning maneuver should be used to place the anterior surface of the wrist in contact with the IR?
Slightly arch the hand
Distal process on radius and ulna
Styloid
What to look for in: Humerus (Lateral)
Superimposed epicondyles Lesser tubercle in profile Greater tubercle superimposed over humeral head
For the AP projection of the forearm, which positioning step should be taken to prevent radial crossover?
Supinate the hand
With reference to the plane of the IR, how is it determined that the humerus is properly positioned in true lateral position?
The humeral epicondylar coronal plane is perpendicular
Which evaluation criterion indicates that the humerus was properly positioned for the AP projection?
The humeral head and greater tubercle are both seen in profile
Which evaluation criterion indicates that the humerus was properly positioned for the lateral projection?
The lesser tubercle is seen in profile
Which digit of the hand produces the greatest OID in the lateral projection of that digit?
Third digit
Medial to trapezium
Trapezoid
Prominence on anterior surface of distal, medial humerus
Trochlea
What portion of the distal humerus is a spool-like structure
Trochlea
