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