Procedures Chapter 4 quiz

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hinge joint between the humerus and ulna hinge joint between humerus and radius proximal radioulnar joint

3 parts of the elbow joint

radius, ulna

During the act of pronation, the _____ crosses over the ______ near the upper third of the forearm

humeral condyle

Expanded distal end of the humerus

Centering for the thumb is an exception...where do center?

First MCP joint..get trapezium

Trochlear sulcus

First and smallest of the arcs:

hamular process

Hook like process extending anteriorly from the hamate

2

How many exposures (minimum) are required for the AP elbow acute flexion study?

2

How many phalanges in thumb

medial aspect of the distal radius

The ulnar notch is located at the: a) proximal end of the radius b) medial aspect of the distal radius c) proximal end of the ulna d) distal end of the ulna

osteopetrosis (additive disease)

abnormally dense bone

carpometacarpal joint

at the proximal end, the metacarpals articulate with the respective carpals and are called

ulnar collateral ligament

attaches to the styloid process of the ulna and fans out to attach the treiquetrum and the pisiform

carpals

bones of the wrist

metacarpals

bones that make up the palm of the hand

coronoid tubercle

medial margin of the coronoid process, opposite the radial notch

flexion, extension, abduction, adduction. Circumduction also happens at these joints....

metacarpophalangeal joints are ___ that allow movement in all ___ directions: ___, ___, ___, and ___.

phalanges

most distal bones of the hand

scaphoid

most frequently fractured carpal bone

coronoid and radial fossa

the distal humerus has specific depressions on both anterior and posterior surfaces. the 2 shallow anterior depressions are the ___ and ___

True

the distal radius will cross over the ulna when the hand is pronated T/F

diarthrodial, ginglymus

the elbow joint is classified as _____, and is considered ____

saddle, sellar

the first carpometacarpal joint of the thumb is classified as a ____ joint. Allows great ROM

metacarpophalangeal joint

the joint between the metacarpal and the proximal phalanx of the thumb

interphalangeal joint

the joint between the two phalanges of the thumb

trochlear notch

the large convcave depression, or notch, that articulate with the distal humerus

bone metastases

transfer of disease or cancerous lesions from one organ or part that may not be directly connected

45

Obliques of extremities are ___ degrees

proximal radius; elbow

Where is the neck and head of the radius located?

anterior fat pad posterior fat pad (NOT visible on a negative elbow exam) supinator fat stripe

3 fat pads of elbow

smaller-capitulum (lateral) larger- trochlea (medial)

Intermediate arc... Smaller- Larger-

Capitate

Largest carpal bone?

radial notch

Small, shallow depression located on the lateral aspect of the proximal ulna

fat pads

Soft tissue detail as depicted by ____ located within the deep olecranon fossa is important in trauma diagnosis of the elbow joint.

accurate lateral, 90 degree, fat pads

Specific positions, such as an ___ with___ flexion, along with possible associated visualization of ___, are essential for evaluation of joint pathology of the elbow.

plane, least

The 2nd-5th carpometacarpal joints are ___ which allow the ____ amount of movement of the synovial class joints

head

The ____ of the radius articulates with the ulna at the radial notch, forming the proximal radioulnar joint

radial, ulnar

The ____ styloid process extends more distally than the _____ styloid process

trochlea

The _____ is located more medially and articulates with the ulna

olecranon fossa

The deep posterior depression of the distal humerus is the _____. The olecranon process of the ulna fits into this depression when the arm is fully extended.

Trochlear notch

The large concave depression or notch that articulates with the distal humerus

medial epicondyle

The larger and more prominent than the lateral epicondyle and is located on the medial edge of the distal humerus

metacarpophalangeal joint

The metacarpals articulate with the phalanges at their distal ends are called

radial/lateral, scaphoid

Ulnar deviation best demonstrates the carpals on the ___ side... best demonstrates the ___ carpal

15 degrees proximal

What type of CR angle is required for the AP axial projection? (Modified Roberts method?)

25-30 degrees

What type of CR angle is required for the tangential gaynor-hart method?

Lunar collateral ligament injury

What type of injury is diagnosed most often with the PA stress (folio method) projection?

When joints are of interest

When do we do obliques of extremities?

c) anterior to the distal radius

Where is the pronator fat stripe located? (wrist) a) anterior to the elbow joint b) posterior to the elbow joint c) anterior to the distal radius d) anterior to the radial head

Lateral

Which of the following projections demonstrated a possible elevated fat pad near the elbow joint?

barton's fracture

fracture and dislocation of the posterior lip of the distal radius

27

how many bones on each hand

8

how many carpals

5

how many metacarpals

14

how many phalanges

osteomylelitis

infection of bone or bone marrow

bursitis

inflammation of the bursae or fluid-filled sacs that enclose the joints; the process generally involves the formation of calcification in associated tendons, which causes pain and limited movement

plane (gliding)

intercarpal joints have only a ___ movement

ginglymus, hinge-type, 2 directions, flexion, extension

interphalangeal joints are ___, or ___-type. Movement happens in ___ directions, ___ and ___ only.

head of radius

located and the proximal end of radius, near the elbow

ulnar; lunate, treiquetrum, pisiform, hamate

radial deviation movement that opens and best demonstrates the carpals on the ___ side, best demonstrates the ___ carpals

fat pads, fat bands, or stripes

radiographs of the upper and lower limbs are taken not only to evaluate for disease or trauma to bony structures, but also to assess associated soft tissues, such as certain accumulations of fat called: ___

osteoperosis

reduction in the quantity of bone or atrophy

ulnar notch

small depression of medial aspect of distal radius

ulnar notch

small depression on the medial aspect of the distal radius (head of ulna fits into the ulnar notch)

radial notch

small shallow depression located on the lateral asepct of the ulna

colles fracture

transverse fracture of the distal radius in which the distal fragment is displaced POSTERIORLY

boxer's fracture

transverse fracture that extends through the metcarpal neck, 5th metacarpal

carpal

tunnel syndrome is a common painful disorder of the wrist and hand that results from compression oft he median nerve as it passes through the center of the wrist

anteriorly located pisiform and the hamular process of the hamte

what is visible on the tangential projection of the wrist

capitulum

which is located on the distal humerus? a) styloid process b) olecranon process c) capitulum d) coronoid process

synovial, diarthrodial

All joints in this chapter are classified as ___, or _____. Only the movement types differ

trochlea & capitulum

Articular portion of the humeral condyle is divided into two parts:

Capitulum

Articular portion of the lateral portion of the distal humerus

Trochlea

Articular portion of the medial aspect of the distal humerus

Trapezium

Carpal that articulated with the thumb

scaphoid fat stripe- visualized on PA it is elongated and slightly convex in shape and is located between the radial collateral ligament and adjoining muscle tendons *absence of fat stripe indicates fracture on radial aspect of wrist pronator fat stripe- visualized on the lateral view of the wrist *displacement of fat stripe can indicate subtle fractures

2 fat stripes on wrist

first and smallest arc- trochlear sulcus the second intermediate arc appears double-lined as the outer ridges or rounded edges of the capitulum and trochlea (smaller of the double-lined is the capitulum; the larger is the trochlea third arc- trochlear notch of the ulna

3 concentric arcs

distal interphalangeal joint proximal interalphalangeal joint metacarpophalangeal joint

3 joints of digits 2-5

lateral

3 significant fat pads or stripes of the elbow are visualized only on the ___ projection

Dorsal radiocarpal Palmar radiocarpal Triangular fibrocartilage complex Scapulolunate Lunotriquetral

5 ligaments that stabilize the wrist

3 concentric arcs.. if the elbow is not in a true lateral, the 3 arcs will not show

A good criterion by which to evaluate a true lateral position of the elbow when it is flexed 90-degrees is the appearance of the _____

Lateral epicondyle

A small projection on the lateral aspect of the distal humerus above the capitulum

Trochlear sulcus

Depression of trochlea, which begins anteriorly and continues inferiorly and posteriorly , appears circular on a lateral end-on view; on a lateral elbow radiograph...it appears as a less dense (more radiolucent)

1. lower to medium kV (55-70-analog, 60-80 digital 2. short exposure time 3. small focal spot 4. adequate mAs for sufficient density

Exposure factors for upper limbs (4)

Styloid process

Extreme distal ends of both the radius and ulna (can be palpated on the thumb side of the wrist)

fluid, effusion

Fat pads...Most often, such changes result from ___ accumulation aka, ____ within the joint, which indicates the presence of an injury involving the joitn.

from the distal phalanx to the base of the first metacarpal

For radiographic procedures, the first metacarpal is considered part of the thumb and must be included in its entirety in a radiograph of the thumb..from ____ to ____

80

How much is the elbow flexed for a trauma axial lateral projection (Coyle method) to demonstrate the coronoid process?

1st view- as patient presents 2nd view- 90-degrees from first view

How to x Ray a trauma patient

head of radius

Located at proximal end of the radius near the elbow joint

head of ulna

Located near the wrist at the distal end of the ulna (pinky side-can be felt when hand is pronated)

head of ulna

Located near the wrist at the distal end of the ulna. Can be seen when hand is pronated.

Ulna

Longer of the forearm bones, primarily involved in the elbow joint

Capitulum

Means "little Head" and is located on the lateral aspect and articulates with the head of the radius

Send Letter To Peter To Tell 'em (to) Come Home

Mnemonic for carpals

Scaphoid

Most commonly fractured carpal bone?

radius, scaphoid, lunate, radiocarpal joint

Of the two bones in the forearm, only the ____ articulates directly with the two carpal bones...the ____ and the ____. the wrist joint is called the ___ joint.

Capitulum, epicondyles

This structure becomes significant in the evaluation for a true lateral position of the elbow, as does the direct superimposition of the ____

supinated for an AP projection

To prevent superimposition of the radius and ulna that may result from these pivot-type rotational movements, the forearm is radiographed with the hand ___

PIP

Where is the CR centered fro a PA projection of the second digit

small to medium: increase 5kv to 7kv large plaster cast: increase 8kv to 10kv fiberglass: increase 3kv to 4kv

cast conversion chart: small to medium plaster cast: larger plaster cast: fiberglass cast:

carpal sulcus

concave area or groove of carpals

osteoarthritis

degenerative joint disease, noninflammatory joint disease characterized by gradual deterioration of the articular cartilage

bennetts fracture

fracture of the base of the first metacarpal bone

fracture

is a break in the structure of the bone caused by a force

rheumatoid arthritis

is a chronic systemic disease with inflammatory changes throughout the connective tiessues; the earliest change is soft tissue swelling that is most prevalent around ulnar styloid and wrist

capitate

large of all carpal bones, identified by its large rounded head that fits proximally into a concavity formed by the scaphoid and lunate bones

scaphoid

largest carpal in the proximal row and articulates with the radius proximally

which 2 bony landmarks are palpated to assist with positioning of the upper limb?

lateral and medial epicondyles

head, neck, radial tuberosity, trochlear notch

on a lateral view of the elobw, the ___ and ___ of the radius are well demonstrated, as are the ___ and the large concave ____

joint effusion

refers to accumulated fluid in the joiny cavity

smith's fracture

reverse of colles fracture, or fracture of the distal radius (ANTERIOR)

lunate

second carpal in the proximal row, it articulates with the radius. it is distinguished by the deep concavity on its distal surface, where it articulates with the capitate on the distal row of the carpals

first mc with trapezium second mc with trapezoid third mc with capitate fourth and fifth mc with hamte

the 5 metacarpals articulate with the specific carpals:

ellipsoidal

the MCP joints are classified as:

triquetral, articular, distal radioulnar joint.

the ___ bone is also part of the wrist joint in that it is opposite the ____ disk. the articular disk is part of the total wrist articulation, including a joint between the distal radius and ulna of the forearm...the ___ joint

trochlea, trochlear sulcus

the ___ is shaped like a pulley or spool; it has two rimlike outer margins and a smooth depressed center portion called the _____, or groove.

olecranon process

the ____ can be easily palpated on the posterior aspect of the elbow

radius

the ____ is the only one of the two bones that is directly involved in the wrist joint

radius, wrist joint

the ____ is the shorter of the 2 bones and is directly involved in the ____

ulna

the ____, is the longer of the 2 bones and is primarily involved in the elbow joint

PA, because there is a cross-over when hand is pronated, results from unique pivot-type rotational movements of the forearm that involve both the proximal and distal radioulnar joint

the forearm should not be radiographed in a ___ position because___

ginglymus/hinge

the interphalangeal joints are classified as:

hamate, hamulus

the last carpal in the distal row on the medial aspect is the ___, easily distinguished by the hook-like process called the ___ which projects from its palmar surface.

radius and ulna

the lateral view of the elbow clearly shows specific parts of the proximal ____ and _____

elbow, pivot/trochoid

the proximal radioulnar joint is considered part of the ___ joint, and is a ____ type of joint.

lateral, medial

the radius and ulna can be separated through ___ rotation of the elbow, where as ___ position completely superimposes them

radial tuberosity

the rough oval process on the medial and anterior side of the radius, distal to the neck is the ____

trapezium

the second, more distal row of four carpals articulates with the 5 metacarpal bones...starting on the lateral, or thumb, is the ___ a 4-sided, irregularly shaped bone that is located medial and distal to the scaphoid and proximal to the first metacarpal

pisiform

the smallest of the carpal bones, is located anterior to the triquetrum and is most evident in the carpal canal or tangential projection

carpal sulcus, concave anterior (or palmer) aspect of the carpals

the tangential projection down the wrist and arm from the palm of a hyperextended wrist. this view demonstrates the ___ ___ formed by the ____

thumb, first MCP joint

the thumb is classified as _____ although it has a very limited abduction and adduction movement because of the wider and less rounded head of the first metacarpal.

ellipsoidal, freely, diarthroidal

the wrist joint is _____ -type joint and is the most ___ movable, or ______ of the synovial classification

triquetrum

third carpal bone on the proximal row?

triquetrum

third carpal is the ______, which has 3 articular surfaces and is distinguished by its pyramidal shape and anterior articulation with the small pisiform

olecranon and coronoid process

two beak-like processes on the proximal ulna are called the ___ & ____

trapezoid

wedge-shaped, 4-sided, smallest bone in distal row

Olecranon fossa

Deep depression located on posterior aspect of the distal humerus is the


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