Fingers, Hand, Wrist, Forearm, Elbow, Humerus, and Shoulder

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Which of the following projections of the elbow will demonstrate the radial head and neck free of superimposition?

AP oblique projection, lateral rotation

Which of the following bony structures is found on the distal aspect of the ulna?

Head

In radiography of the forearm, it is important to:

Include both bones in their entirety and their articulations

What is the name of the joint found between the proximal and distal phalanges of the first digit?

Interpharangeal

What is the name of the most common type of arthritis?

Osteoarthritis

Which of the following is located at the distal end of the radius?

Styloid process

Which of the following is located the distal end of the radius?

Styloid process

The smooth, depressed, center portion of the trochlea used for evaluating rotation on a lateral elbow is termed the trochlear:

Sulcus

For the AP projection of the forearm, the hand is:

Supinated

For the AP projections of the elbow, the hand is:

Supinated

What position should the hand be placed in for the AP projection of the humerus?

Supine

Which of the following positions of the hand will place the epicondyles parallel with the plane of the IR?

Supine

Which position of the hand will place the humerus in external rotation?

Supine

The area of the proximal humerus located directly below the tubercles, which is the site of many fractures, is called the:

Surgical neck

Where should the center of the IR be positioned for a transthroacic lateral projection of the proximal humerus?

Surgical neck

The respiration phase for an AP projection of the shoulder should be:

Suspended

Which of the following breathing techniques should be used for an AP projection of the humerus?

Suspended respiration

The scapulohumeral articulation is classified as a :

Synovial joint, ball and socket type

When radiographing the fingers, what anatomy should be included?

The distal portions of the metacarpal and all of the phalanges

Which surface of the hand should be in contact with the IR for the lateral projeciton of the 5th (pinky) digit?

The medial surface

Why is it recommended that the medial oblique projection be performed rather than the lateral oblique for the second digit of the hand?

To improve radiographic contrast

What is the purpose of performing the AP partially flexed projections of the elbow?

To provide an AP perspective if patient cannot fully extend elbow

Which carpal bone articulates with the first metacarpal?

Trapezium

Which two structures primarily form the hinge-like structure and movement of the elbow joint?

Trochlea and olecranon process

Carpal tunnel syndrome is more common in middle aged women than in middle-aged men.

True

Which bone of the forearm is located on the medial side?

Ulna

The forearm consists of which of the following bones?

Ulna and radius

The bending or forcing of the hand laterally with the hand pronated in a posteroanterior (PA) projection is known as:

Ulnar deviation

Which two structures form the distal radioulnar joint?

Ulnar notch and head of ulna

Which of the following is the best position to place the patient in for a transthroacic lateral projection of the proximal humerus?

Upright

Which of the following positioning strategies helps demonstrate the interphalangeal joints on the PA oblique projection of the hand?

Use of a stair-step sponge to support the fingers

Which of the following joints should be clearly demonstrated on the AP projection of the forearm?

Wrist and elbow

A patient enters the emergency dept (ED) with a Smith fracture. Which region of the upper limb must be radiographer to demonstrate this injury?

Wrist and forearm

Which of the following should b eon the same plane for a lateral projection of the elbow?

Wrist, elbow and shoulder joint

A patient with a fractured forearm had the fracture reduced and a fiberglass cast placed on the extremity. The orthopedic surgeon orders a postreduction study. The original kV was 60 kV. Which one of the following kV factors should be selected for the postreduction study?

63 kV

How many carpal bones are found in the wrist?

8

For the lateral projection of the elbow, the elbow joint should be e flexed:

90 degrees

For the lateral projection of the forearm, the elbow should be flexed:

90 degrees

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces if the patient can assume this position?

AP

Which of the following projections clearly demonstrates the glenoid cavity?

AP oblique (Grashey)

Which routine projection of the elbow best demonstrates the radial head and tuberosity free of superimposition?

AP oblique with lateral rotation

Which of the following projections of the elbow will demonstrate the olecranon process within the olecranon fossa?

AP oblique, medial rotation

The acromial extremity of the clavicle articulates with the:

Acromion process of the scapula

Which surface of the wrist is in contact with the IR for the PA projection of the wrist?

Anterior

Which projection best demonstrates pathology involving the first carpometacarpal joint?

Anteroposterior (AP) thumb, modified Robert's method

Where is the radial tuberosity located?

At the proximal end, distal to the head of the radius

Where is the central ray (CR) placed for a PA projection of the third digit?

At the proximal interpharangeal joint

Where is the CR centered for a PA projection of the hand?

At the third metacarpophalangeal joint

Which of the carpal bones is considered to be the largest?

Capitate

Which special projection of the wrist is ideal for demonstrating possible calcification in the dorsal aspect of the carpals?

Carpal bridge

The joint found between the base of the 3rd metacarpal and carpal bone is the:

Carpometacarpal

The joint found between the base of the third metacarpal and carpal bone is the:

Carpometacarpal

What is the position of the wrist for the PA oblique projection with lateral rotation?

Coronal plane of the wrist at a 45 degree angle to the IR with the anteromedial surface on the IR

Which of the following would be projected free of superimposition for an AP oblique projection of the elbow with medial rotation?

Coronoid process

A patient with a history of carpal tunnel syndrome comes to radiology. The physician wants to rule out abnormal calcification symptoms in the carpal sulcus. Which of the following projections would best demonstrate this region?

Coyle method

PA oblique projection of the shoulder (scapular Y) is performed to evaluate:

Dislocations

Which of the following must be clearly demonstrated on a lateral projection of the humerus?

Elbow and shoulder joint

The lateral projection of the forearm should clearly demonstrate which of the following?

Elbow joint, radius and ulna, proximal row of carpal bones

Which of the following must be clearly demonstrated on an AP projection of the humerus?

Elbow, and shoulder joint

The first metacarpophalangeal joint has a(n) ? Type of joint movement.

Ellipsoidal

The radiocarpal (wrist) joint possesses a(n) ? Type of joint movement

Ellipsoidal

A radiograph of an AP projection of the elbow reveals that there is complete separation of the proximal radius and ulna. What positioning error has been committed?

Excessive lateral rotation

A radiograph of an AP oblique elbow with medial rotation reveals that the radial head is superimposed over part of the coronoid process. What positioning error has been committed?

Excessive medial rotation

Which of the following positions of the humerus are commonly used when performing an AP projection of the shoulder?

External, neutral and internal rotation

The CR placement for an AP projection (modified Robert's method) of the thumb is at the:

First carpometacarpal joint

Which positioning strategy places the wrist in closer contact with the IR for the PA projection of the wrist?

Flexing the fingers into a loose fist

The interphalangeal joints have a(n) ? Type of joint movement

Ginglymus

The rounded head of the humerus fits into an oval depression on the lateral aspect of the scapula called the:

Glenoid cavity

Which of the following structures is not part of the proximal humerus?

Glenoid process

Which of the following shoulder projections best demonstrates the glenoid cavity in profile?

Grashey method

Which of the following is prominently shown "in profile" on an AP projection of the shoulder with the humerus in external rotation?

Greater tubercle

Which of the following is shown "in profile" on an AP projection of the humerus?

Greater tubercle

Which carpal articulates with both the fourth and fifth metacarpals?

Hamate

Which carpal bone has a characteristic hooklike process on its anterior surface?

Hamate

Which carpal bone is located in the distal row on the medial side?

Hamate

Which one fo the following structures is not part of the ulna?

Ulnar notch

A ginglymus joint can also be referred to as a ? Joint

Hinge

What two bony landmarks are palpated for positioning of the elbow?

Humeral epicondyles

Which of the following will be directly superimposed over the junction of the "Y" on the PA oblique (scapular Y) projection?

Humeral head

A radiograph of the PA scaphoid projection reveals extensive superimposition of the scaphoid and adjacent carpals. Which of the following factors can lead to this problem?

Insufficient ulnar deviation

For an AP projection of the shoulder, the CR should enter:

1 inch inferior to the coracoid process

Which of the following AP shoulder projections demonstrates the lesser tubercle in profile medially?

Internal rotation

Which rotation of the humerus will result in a lateral position of the proximal humerus?

Internal rotation (epicondyles perpendicular to image receptor)

Which basic projection of the elbow best demonstrates the trochlear notch in profile?

Lateral

Which routine projection of the elbow best demonstrates the olecranon process in profile?

Lateral

Which of the following positions can be sued to perform a lateral projection of the humerus on a patient who has a suspected fracture?

Lateral recumbent

Which projection of the shoulder requires that the patient be rotated 45-60 degrees toward the IR from a PA position?

Lateral scapula projection

Which of the following is prominently shown "in profile" on an AP projection of the shoulder with the humerus in internal rotation?

Lesser tubercle

Which of the following is shown "in profile" on a lateral projection of the humerus?

Lesser tubercle

Which of the following is shown "in profile" on a lateral projection of the elbow?

Olecranon process

The second most common type of primary cancerous bone tumor is:

Osteogenic sarcoma

What term is used to denote inflammation of the bone, especially in the marrow, caused by a pathogenic organism?

Osteomyelitis

Which projection of the thumb results in a more magnified image because of the increase in OID?

PA

A patient arrives in radiology with a metal foreign body in the palm of the hand. Which of the following hand routines should be performed on this patient to confirm the location of the foreign body?

PA and lateral in extension projections

Which of the following special projections can be sued to demonstrate the scaphoid carpal bone?

PA projection (ulnar deviation position), PA axial projection (Stecher method)

How far above the humeral head should the upper margin of the IR be placed for lateral projection of the humerus?

1.5 inches

What CR angle is required with the modified Robert's method?

15 degrees proximally (toward the wrist)

If a patient is unable to extend the forearm for an AP projection of the elbow, how many projections are necessary to avoid distortion of the joint?

2

How much CR angulation to the long axis of the hand is require for the tangential, inferosuperior projection to demonstrate the Carpal sulcus (canal)?

25 to 30 degrees

How many bones are normally found in digits 2 to 5?

3

Where is the CR center point for the PA projection of the second digit?

Proximal interphalangeal joint

The PA oblique projection of the shoulder joint (Scapular Y) is performed in which of the following positions?

RAO or LAO

What is the name of the two small depressions found on the anterior aspect of the distal humerus?

Radial and coronoid fossa

Which special projection of the wrist will open up the inter spaces on the ulnar side of the wrist?

Radial deviation

The capitulum of the humerus articulates with the:

Radial head

Which of the following is demonstrated free of superimposition on an AP oblique projection of the elbow in lateral rotation?

Radial head and neck

The head of the radius articulates on the medial side with the:

Radial notch

The head of the radius fits into a depression on the lateral aspect of the coronoid process of the ulna. This depression is called the:

Radial notch

The bones of the forearm are the:

Radius and ulna

Which of the following general procedures should be observed when performing x-ray examinations of the upper limb?

Remove rings and watches, use an R or L maker on each image

Which of the following general procedures should be observed when performing x-ray examinations of the upper limb?

Remove rings and watches, use an R or L marker on each image

For a transthoracic lateral projection of the proximal humerus, lung detail may be blurred to better visualize the humerus. Which of the following techniques can be used to blue the lung structures?

3 seconds

How many degrees is the body rotated for the AP oblique projection (Grashey method) of the shoulder joint?

35 to 45 degrees toward the affected side

What is the center point of the CR for the PA projection of the hand?

3rd MCP joint

From a pronated position, which of the following is required for a PA oblique projection of the 4th digit of the hand?

45 degree lateral rotation

How many degrees should the elbow be angled for an AP oblique projection in medial rotation?

45 degrees

How many degrees should the elbow be angled for an PA oblique projection in lateral rotation?

45 degrees

How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the elbow?

45 degrees

For the PA oblique projection (Scapular Y) of the shoulder, the body is rotated so that the midcoronal plane is how many degrees from the IR?

45-60 degrees

A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamate is superimposed over the pisiform. Which of the following measures will correct this problem?

Rotate the wrist and hand 10 degrees internally

Which carpal bone is located in the proximal row on the lateral side?

Scaphoid

Which carpal bone, if fractured, can have serious complications?

Scaphoid

Which is the most commonly fractured carpal bone?

Scaphoid

Which of the following carpals articulates with the radius?

Scaphoid

Which of the following structures is projected in "lateral profile" on a PA oblique (Scapular Y) projection?

Scapula

Which of the following bones makes up the shoulder girdle?

Scapula and clavicle

The articulation between the glenoid cavity and head of the humerus is called the:

Scapulohumeral joint

The first carpometacarpal joint is classified as a ? Joint.

Sellar

How many degrees is the central ray angled for the AP forearm?

0

What is the CR angulation for the AP oblique projection (Grashey method) of the shoulder joint?

0 degrees

What is the central-ray angulation for the AP elbow when the forearm is partially flexed?

0 degrees

What's is the CR angle for the PA oblique projection (scapular Y) of the shoulder joint?

0 degrees

Where is the CR center point for the AP projection of the thumb?

MCP joint

Which surface of the hand is in contact with the IR for the lateral projection of the hand?

Medial

A radiograph of the elbow demonstrates the radius directly superimposed over the ulna and the coronoid process in profile. Which projection of the elbow has been performed?

Medial rotation oblique

What is the proper position of the wrist for the lateral projection?

Medial surface of the wrist on the IR with the coronal plane perpendicular to the IR

The bones that are located in the palm of the hand are called:

Metacarpals

Where is the central ray directed for an AP projection of the humerus?

Midpoint of humerus

Where is the central ray directed for a lateral projection of the humerus?

Midpoint of the humerus

A patient enters the ED with a possible scaphoid fracture. The patient is unable to assume the ulnar deviation position. Which of the following positions should be performed to confirm the diagnosis?

Modified Stecher

Which one of the following is the most common primary malignant bone tumor?

Multiple myeloma

Which of the following methods best demonstrates the supraspinatus "outlet" (coracoacromial arch)?

Neer

If the patient places the palm of the hand against the thigh, the humerus will be in:

Neutral position

Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh?

Neutral rotation

How much CR angulation should be used for scapular Y projection?

No CR angle should be used

A lateral elbow radiograph demonstrates about half of the radial head superimposed by the coronoid process of the ulna. Which of the following occurred?

No positioning errors occurred

Which of the following AP shoulder projections demonstrates the greater tubercle in profile medially?

None

What is the position of the thumb on a PA projection of the hand?

Oblique

Which position of the hand will place of the humerus in neutral position?

Palm against the thigh

A general positioning rule his to place the long axis of the part ? To the long axis of the image receptor.

Parallel

For the AP projeciton of the elbow, the humeral epicondyles are:

Parallel to the IR

To demonstrate the interphalangeal joint spaces, how must the finger be positioned for the PA oblique and lateral projections?

Parallel to the IR

In order to demonstrate the greater tubercle of the humerus on an AP projection of the shoulder, the epicondyles must be:

Parallel with the plane of the IR

How should the humeral epicondyles be aligned for a lateral projection of the elbow?

Perpendicular to image receptor

For a transthroacic lateral projection of the proximal humerus the epicondyles should, unless contraindicated, be positioned:

Perpendicular to the IR

For an AP projection of the shoulder, the central ray should be directed:

Perpendicular to the IR

For an AP projection of the shoulder with the humerus in internal rotation, the epicondyles of the humerus should be:

Perpendicular to the plane of the IR

Rotating the arm medially for a lateral projection of the humerus will place the epicondyles:

Perpendicular with the plane of the IR

What is the name of the bones that comprise the digits of the hands?

Phalanges

Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?

Phalanges

Which carpal bone is the smallest?

Pisiform

A radiograph for an AP projection with external rotation of the shoulder reveals that the greater tubercle is profiled laterally. What should be changed to improve this image for a repeat exposure?

Positioning is acceptable: do not repeat it

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?

Positioning is acceptable; do not repeat it

Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?

Prevents foreshortening of phalanges and obscuring of interphalangeal joints

Which of the following actions will lead to the proximal radius crossing over the ulna?

Pronation of the hand

The two fat stripes of the wrist demonstrated radiographically are known as the scaphoid fat stripe and the ? Fat stripe

Pronator


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