Upper Limb

where is the central ray centered for an AP projection of the thumb??

First metacarpophalangeal (MCP) joint

should exposure factors increase, decrease or remain the same? bursitis

remain the same

true/false: guardians of young pediatric patients who're undergoing upper limb studies can be asked to hold their child during the radiographic study

true

fluid filled joint space with possible calcification

bursitis

for upper limb fiberglass cast increase kV how much?

3-4kV

upper limb later of small focal spot?

small

True/false- In the addition to the ulnar and radial collateral ligaments, the following five additional ligaments are also important in stabilizing the wrist joint.

True: dorsal radiocarpal palmar radiocarpal triangular fibrocartilage complex (TFCC) scapulolunate lunotriquetral

true/false- the entire metacarpal and trapezium must be demonstrated on all projections of the thumb?

false

true/false: for a forearm study, the technologist needs to include only the joint closest to the site of the injury

false

true/false: lead (protective) shielding is only required for upper limb studies performed on patients who are of child bearing age or younger

false

true/false: trauma or infection makes the anterior fat pad more difficult to see on a lateral elbow radiograph.

false

which lateral projection of the hand best demonstrates a possible foreign body in the palm of the hand?

lateral in extension

which routine projection best demonstrates the pronator fat stripe?

lateral wrist

best position to evaluate the posterior fat pads of the elbow joint

lateral, flexed 90 degree

which joint permits the forearm to rotate during pronation?

proximal radioulnar joint

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

in the anatomic position, which of the bones of the forearm is located on the lateral (thumb) side?

radius

should exposure factors increase, decrease or remain the same? joint effusion

remain the same

the ball catcher position is commonly used to evaluate for early signs of?

rheumatoid arthritis

upper limb long or short exposure time?

short exposure time

sprain or tear of the ulnar collateral ligament

skier's thumb

correctly exposed radiography of the upper limb show?

soft tissue margins and trabecular markings of all bones

total # of bones in hand and wrist

27

# of carpals in wrist

8

a minimum of ____ inches of the forearm should be included radiographically for a PA projection of the hand

1 in

the pertinent factors that help reduce image distortion during upper limb radiography?

1. 40-44 in SID 2. minimal object image receptor distance (OID) 3. correct central ray placement and angulation 4. use of small focal spot

Three portions of the finger

1. proximal phalanx 2. middle phalanx 3. distal phalanx

two important fat stripes or bands around the wrist joint are:

1. scaphoid of the fat stripe 2. pronator fat stripe

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 phalanges

why is it important to keep the affected digit parallel to the image receptor (IR) for the PA oblique and lateral projects?

1. to prevent distortion of the phalanx 2. to prevent distortion of the joints 3. to demonstrate small, nondisplaced fractures near the joint

criteria for evaluating a true lateral position of the elbow are the appearance of three concentric arcs

1. trochlear sulcus (groove) 2. intermediate double arc, consisting of the outer ridges of: capitulum (smaller) trochlea (larger) 3. trochlear arch (part of the ulna)

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. ulnar deviation 2. radial deviation

are grids used if upper limb body part measures greater than?

10cm

# of phalanges

14

which IR size should be used for a thumb projection?

18 x 24

upper limb most common SID?

40 in

how much rotation is required for an oblique projection of the wrist?

45 degree

# of metacarpals

5 in each hand

for upper limb small to medium plaster casts increase kV how much?

5-7kV

upper limb kV range

60-70 kVp

for upper limb large plaster cast increase kV how much?

8-10 kV

the elbow generally should be flexed _____ degrees for the routine positions of the wrist

90

the fat pads around the elbow joint are valuable diagnostic indicators if they following three technical/positioning requirement are met with the lateral positions.

A. elbow flexed at 90 degrees B. optical exposure factors used C. in a true lateral position

which routine projections are required for a study of the forearm

AP and Lateral

which routine projection of the elbow best demonstrates the radial head, neck, and tuberosity with slight (if any) superimposition of the ulna?

AP oblique w 45 degree lateral rotation

which projection of the elbow best demonstrates the coronoid process in profile

AP oblique w 45 degree medial rotation

which alternative projection to the routine PA wrist best demonstrates the inter carpal joint spaces and wrist joints?

AP projection

joints between the metacarpals and the phalanges are the..

Metacarpophalangeal (MCP) joint

which routine projections best demonstrate the scaphoid fat pad?

PA and oblique wrist

which projection of the thumb is achieved naturally by placing the palmar surface of the hand in contact with the cassette?

PA oblique

what is the positioning routine for the second through fifth digits of the hand?

PA, PA oblique, and Lateral

where is the central ray centered for a PA oblique projection of the second digit?

PIP joint

what is the most commonly fractured carpal bone?

Scaphoid

an abnormality of the cartilage affecting long bones

achondroplasia

__________ is a radiographic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist, elbow, and shoulder joints.

arthography

fracture and dislocation of the posterior lip of the distal radius

barton's fracture

a Bennett's fracture involves:

base of first metacarpal

transverse fracture extending through the distal aspect of the metacarpal neck, most often the fifth metacarpal

boxer's fracture

what is the largest carpal bone

capitate

the similar structure found on the lateral aspect of the distal humerus is called

capitulum

possible calcification in the carpal sulcus

carpal tunnel syndrome

transverse fracture of the distal radius with posterior displacement of the distal fragment

colle's fracture

should exposure factors increase, decrease or remain the same? advanced rheumatoid arthritis

decreased

should exposure factors increase, decrease or remain the same? osteoporosis

decreased

why is the AP projection of the thumb recommended instead of a PA?

decreases OID and increases resolution

upper limb: type of intensification screens most commonly used for analog imaging

detail screen

ellipsoidal joints are classified as freely movable, or ________, and allow movement in _______ directions.

diarthrodial, 4

how much of the metacarpals should be included for PA projection of the digits?

distal aspect of the metacarpals

True/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: nonvisable fat pad suggest negative exam

true/false: lead (gonadal) shielding is not required for upper limb radiographs if the patient can sit upright for these exams

false; bc scatter, divergent rays, or both reaching the gonads

which preferred lateral position of the hand best demonstrates the phalanges without excessive superimpostion?

fan lateral

what is the name of the hooklike process extending anteriorly from the hamate?

humulus or hauler process

should exposure factors increase, decrease or remain the same? advanced paget's disease

increased

should exposure factors increase, decrease or remain the same? osteopetrosis

increased

name of the joint between the proximal and distal phalanges of the first digit

interphalangeal joint

a sesamoid is frequently found adjacent to the _______ joint of the thumb?

metacarpopharengeal

what special positioning method can be performed to demonstrate a Bennett's fracture?

modified Roberts method

most common type of primary malignant tumor occurring in bone

multiple myeloma

what is the proper name for the position referred to as the "ball-catcher's position"?

norgaard method

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

olecranon fossa

narrowing of joint space with periosteal growth on the joint margins

osteoarthritis

soft tissue swelling and loss of fat pa detail visibility

osteomyelitis

hereditary condition marked by abnormally dense bone

osteopetrosis

mixed areas of sclerotic and cortical thickening along with radiolucent lesions

osteopetrosis

reduction in the quantity of bone or atrophy of skeletal tissue

osteoporosis

to position the patient properly for an AP projection of the elbow, the epicondyles must be _______ tp the IR.

parallel

how does the forearm appear radiographically if pronated for a psoteroanterior (PA) projection?

the proximal radius crosses over the ulna

where is the central ray for a PA projection of the hand?

third MCP joint

the articular portion of the medial aspect of the distal humerus is called

trochlea

True/false: excessive kV (analog imaging) may obscure the visibility of a fat pad.

true

true/ false: slight superimposition of the distal third, fourth, and fifth metacarpals may occur with a well positioned PA oblique projection of the hand.

true

anatomic position which bones of the forearm is located on the medial side?

ulna

what is most commonly performed to detect a fracture of the scaphoid bone?

ulnar deviation