Self-Test for Upper Limb
A. Head of ulna
In an erect anatomic position, which one of the following structures is considered to be most inferior or distal? A. Head of ulna C. Radial tuberosity B. Olecranon process D. Head of radius
A. Supinated
In what position should the hand be for an AP medial rotation oblique elbow position? A. Supinated B. Pronated D. True lateral C. Rotated 20 degree from supinated position
False
True/False: The hand(s) is (are) placed in true PA position when using the Norgaard method.
True
True/False: To visualize fat pads surrounding the elbow, exposure factors must be adjusted to see both bony & soft tissue structures.
A. Increased OID
What is a major disadvantage of performing a PA projection of the thumb rather than an AP? A. Increased OID C. More painful to patient B. Increased in pt dose D. Awkward position for pt
C. Bennett's fracture
What type of fracture is best demonstrated with a modified Robert's method? A. Barton fracture C. Bennett's fracture B. Colles' fracture D. Smith facture
Hamate
Which carpal contains a "hooklike" process?
Scaphoid
Which carpal is most commonly fractured?
68 to 70 kV
A patient had a Colles' fracture reduced, & a large plaster cast is placed on the upper limb. The orthopedic surgeon orders a postreduction study. The original technique, used before the cast placement, involved 60 kV & 5 mAs (analog system). How should the exposure factors be altered with a large plaster cast?
Wrist
A patient with a possible Barton fracture enters the ER. Which positioning routine should be performed to confirm a diagnosis
Wrist/forearm
A patient with a possible Smith fracture enters the ER. Which positioning routine should be performed to confirm a diagnosis.
A. Rotate upper limb medially
A radiograph of a AP elbow projection demonstrates total separation between the proximal radius & ulna. What must be done to correct this positioning error on the repeat exposure?
D. decrease obliquity of the hand
A radiograph of a PA oblique of the hand reveals that the third, fourth, & fifth metacarpals are superimposed. What must be done to correct this positioning problem on the repeat exposure? A. increase obliquity of the hand B. spread fingers out further C. decrease obliquity of the hand D. form a tight fist with the fingers
Place humerus/forearm in same horizontal plane
A radiography of a lateral projection of the elbow reveals that the epicondyles are not superimposed & the trochlear notch is not clearly seen. What must be done to correct the positioning during repeat exposure?
Insufficient medial rotation
A radiography of an AP oblique-medial rotation reveals that the coronoid process is not in profile and the radial head is not superimposed over the ulna. What specific positioning error was involved
Rotate wrist laterally 5 to 10 degrees
A radiography of the carpal canal (inferosuperior) projection reveals that the pisiform & hamulus are superimposed. What can be done to correct the problem on the repeat exposure?
D. Soft tissues structures within certain synovial joints
Arthrography is a radiographic study of: A. Fat pads C. Epiphyses of long bones B. Medullary aspect of long bones D. Soft tissues structures within certain synovial joints
First Carpometacarpal (CMC) Joint
Between the carpals & the first metacarpal
Distal radioulnar
Between the distal radius & ulna
First Metacarpophalangeal (MCP) Joint
Between the first metacarpal & the proximal phalanx of the thumb
Radiocarpal
Between the forearm & the carpals
Fourth Distal Interphalangeal (DIP) Joint
Between the middle & distal phalanges of the fourth digit
Interphalangeal (IP) Joint
Between the two phalanges of the first digit (thumb)
AP, Medial Rotation Oblique
Coronoid process in profile
AP elbow
Coronoid tubercle Olecranon process seated in olecranon fossa
Lateral elbow
Olecranon process in profile Trochlear notch in profile
AP, Lateral Rotation Oblique
Radial head & tuberosity without superimposition Capitulum & lateral epicondyle in profile
64 kV, 200 mA, 1/20 second, small focal spot, 40-inch (102-cm) SID, detail-speed screens
The best set of exposure factors for upper limb radiography using analog (film-based) system.
B. parallel to the long axis of the IR
The long axis of the anatomic part being imaged should be placed: A. perpendicular to the long axis of the IR B. parallel to the long axis of the IR C. 30 degree angle to the long axis D. Any way that will accommodate multiple images on a single IR
False
True/False: Anterior & posterior fat pads of the elbow are best seen on correctly positioned & correctly exposed anteroposterior (AP) elbow projections.
True
True/False: Both hands are examined with one single exposure when using the Norgaard method
False
True/False: Placing multiple images on the same digital IP is recommended as long as close collimation is applied for each projection
A. Anterior aspect of distal humerus
Where are the coronoid & radial fossae located? A. Anterior aspect of distal humerus B. Posterior aspect of the distal humerus C. Proximal radius & ulna D. Distal end of radius
Affected PIP joint
Where is the CR centered for a PA projection of the second digit?
Third MCP
Where is the CR placed for a PA projection of the hand?
A. Medial aspect of coronoid process
Where is the coronoid tubercle located? A. Medial aspect of coronoid process B. Anterior aspect of distal humerus C. Lateral aspect of proximal radius D. Posterior aspect of distal humerus
D. Ulna
Which bone of the upper limb contains the coronoid process? A. Humerus C. Radius B. First metacarpal D. Ulna
D. Trapezium
Which carpal articulates with the base of thumb? A. Scaphoid C. Trapezoid B. Lunate D. Trapezium
C. Advanced osteoporosis
Which one of the following clinical indications requires a decrease in manual exposure factors? A. Paget's disease C. Advanced osteoporosis B. Advanced osteopetrosis D. Joint effusion
C. Lateral & medial epicondyles
Which two bony landmarks are palpated to assist with positioning of the upper limb? A. Coronoid & olecranon process B. Pisiform & hamate C. Lateral & medial epicondyles D. Radial & ulnar styloid processes
D. Scaphoid & trapezium
Which two carpal bones are located most anteriorly as seen on a lateral wrist radiography? (They are on the radial side of wrist) A. Hamate & pisiform C. Capitate & lunate B. Trapezium & trapezoid D. Scaphoid & trapezium
To reduce distortion of phalanges To properly visualize joints To demonstrate small fractures
Why is it important to keep the long axis of the digit parallel to the IR?
Causes the proximal radius to cross over the ulna
Why should a forearm never be taken as a PA projection?