ch.4 bontrager's: forearm
3-4
Fiberglass casts: increase kV by ______
proximal
For PA, oblique and lateral projections of the 2nd through 5th digits the central ray is directed perpendicular to the (distal, middle, or proximal) [__________] interphalangeal joints.
parallel
For a Fan lateral projection of the hand the fingers are spread apart and positioned [__________] to the image receptor to open the interphalangeal joint spaces.
up
For a Fan lateral projection of the hand the hand is placed in a lateral position with the thumb side (down or up) [_____].
third, MCP
For a PA and oblique projections of the hand the central ray is directed perpendicular to the (first, second, third, fourth or fifth) [________] (DIP, MCP, PIP, CMC) [_____] joint.
45
For the AP oblique bilateral projection (Norgaard method) of the hands rotate both hand internally [____] degrees.
MCP (metacarpophalangeal)
For the PA stress "Skier's Thumb" projection the central ray is directed perpendicular to the image receptor midway between the level of the ______ joints.
Bennett's fracture
Fracture that involves the base of the first metacarpal
Proximal radius crossed over ulna
How does the forearm appear radiographically if pronated for AP projection?
14
How many bones make up the phalanges ?
5
How many metacarpals are in each hand?
Distal aspects of metacarpals
How much of the metacarpals should be included for PA projection of the digits?
45 degrees
How much rotation is required for an oblique projection of the wrist?
Perform a thumb down lateral (mediolateral projection) to decrease OID
In a lateral position of the second digit what can be used to reduce distortion?
Perform medial oblique rather than lateral to decrease OID
In the PA oblique projection of the second digit, what should be used to reduce distortion ?
short exposure
Is a long or short exposure time needed for upper limb radiography ?
8-10
Large plaster casts: increase kV by _________
capitulum
Lateral aspect of the distal humerus
In the anatomic position, which of the bones of the forearm is located on the lateral thumb side?
Radius
PA
The [____] projection of the first digit is not recommended because of the loss of recorded detail caused by the increased OID.
Trochlea
The articular portion of the medial aspect of the distal humerus is called:
Rheumatoid arthritis
The ball catcher's position is commonly used to evaluate for early signs of __________
proximal
The first digit has two phalanges, which are called the distal and [_______] phalanges
40, 102
The miminum SID that is used for projections of the fingers and hand is [____] inches ([____] cm).
Scaphoid
The most fractured carpal bone
Humerus
The olecranon fossa is part of the:
Ulna
The olecranon process is part of the:
14
The phalanges of the hand are comprised of [___] bones.
Pivot
The proximal radiolunar joint is considered a __________ joint
Ulna
The radial notch is part of the:
Ellipsoidal
The radiocarpal joint is considered a _________ joint
Humerus
The trochlea is part of the:
Ulna
The trochlear notch is part of the:
Detail screens
Type of intensification screens most commonly used for Analog imaging
8x10
What IR size should be used for thumb projection?
40-44 SID, minimal OID, correct central day placement and angulation, use of small focal spot
What all can reduce image distortion during upper limb radiography?
Scaphoid fat stripe, pronator fat stripe
What are the two important fat stripes or bands around the wrist joint?
Symmetrical appearance of both sides of shafts of phalanges and distal metacarpals Equal amounts of tissue on each side of phalanges
What can be used to determine whether rotation is present on the PA projection of the digits?
15° proximal
What degree of central ray angulation is required for a modified Roberts projection?
60-80 (digital and 60-70 for analog; low to medium range)
What is the kV range for upper limb radiography?
hamulus (hamular process)
What is the name of the hook like process extending anteriorly from the hamate?
ulnar deviation, radial deviation
What is the name of the two special turning or bending positions of the hand and wrist that demonstrate medial and lateral aspect of the carpal region?
PA, PA oblique and lateral
What is the positioning routine for the second through fifth digits of the hand?
Norgaard Method
What is the proper name for the position referred to as the ball catchers position?
proximal radiolunar joint
What joint permits the forearm to rotate during probation ?
Ulnar deviation
What position is most commonly performed to detect a fracture of the scaphoid bone?
Excessive lateral rotation from PA
What positioning error is involved if a majority of the carpal bones are superimposed in a pA oblique wrist projection?
pronated
When obtaining a PA projection of the 2nd - 5th digits, the hand should be (pronated or supinated) [_________].
90
When obtaining radiographs of the fingers and hand, the patient's elbow is flexed [_____] degrees in order to place the upper limb on the same horizontal plane.
8
How many carpal bones are there?
True
True or false ? The entire metacarpal and trapezium must be demonstrated in all projections of the thumb
15, CMC (carpometacarpal joint)
1 points For the AP projection (modified Robert's method) of the thumb the central ray is angled [___________] degrees proximally (toward the wrist) at the level of the first [________] joint.
metacarpals
A 45 degree lateral oblique of the hand may be obtained with the thumb and finger tips touching the image receptor if the [________] are the area of interest.
45, parallel
A PA oblique projection of a finger is obtained with the affected finger obliqued [_____] degrees and placed (parallel or perpendicular) [________] to the image receptor.
medial
A PA oblique projection of the second digit is obtain with the finger in a (lateral or medial) [_______] oblique position to improve recorded detail.
One
A minimum of ______ inch(es) of the forearm should be included radiographically for a PA projection of the hand
over
A radiograph of a PA oblique of the hand reveals that the third, fourth, and fifth metacarpals are superimposed is (over or under) [_____] rotated.
anthrography
A radiographic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist, elbow, and shoulder joints
MCP
A sesamoid bone is frequently found adjacent to the ______ joint of the thumb
true PA
Both of the patent's thumbs should be in a _________ projection for the PA stress "Skier's Thumb projection.
soft tissue, trabecular
Correctly exposed upper limb radiographs visualize ___________ margins and ___________ markings of all bones
head, shaft, base
Each phalanx consists of a distal rounded [____], a body or [_____] the long curved portion, and the expanded proximal end called the [____].
5-7
Small to medium dry plaster casts: increase kV by _______
proximal
The (distal or proximal) [_________] end of the metacarpals articulate with the carpal bones to form the carpometacarpal, or CMC joints.
base
The AP projection (modified Robert's method) of the thumb is used to demonstrate the __________ of the first metacarpal to rule out a Bennett's fracture
Saddle
The CMC joint of the first digit is considered a ___________ joint
Hinge (ginglymus)
The IP joint is considered a ____________ joint
Ellipsoidal
The MCP joints of the 2nd to 5th digits are considered _____________ joints
phalanges
The bones of the digits are called [_______].
MCP (metacarpophalangeal)
The central ray is directed perpendicular to the second_______ joint for the lateral projection of the hand.
Humerus
The coronoid fossa is part of the:
Ulna
The coronoid process is part of the
Ulna
The coronoid tubercular is part of the:
Olecranon fossa
The deep depression located on the posterior aspect of the distal humerus:
metacarpals
The five bones that make up the palm of the hand are called [________].
Plane
The intercarpal joint is considered a __________ joint
DIP (distal interphalangeal joint)
The joints between the distal and middle phalanges of the second through fifth digits are called the __________ joints.
PIP (Proximal Interphalangeal Joint)
The joints between the middle and proximal phalanges of the second through fifth digits are called the __________ joints.
Head, body, base
Three parts of each phalanx starting distally:
Base, body, head
Three parts of metacarpal starting proximally
parallel
To prevent foreshortening of the phalanges and closing the interphalangeal joints on a 45 degree lateral oblique projection of the hand, the fingers should be placed [___________] to the image receptor.
true
True or false? Joint effusion refers to an accumulation of fluid in the joint cavity.
True
True or false? Slight super imposition of the distal third, fourth, and fifth metacarpal's maker with a well-positioned PA oblique projection of the hand
PIP joint
Where is the central ray centered for a PA oblique projection of the second digit?
Third MCP joint
Where is the central ray centered for a PA projection of the hand?
first MCP joint
Where is the central ray centered for an AP projection of the thumb?
AP projection with hand slightly arched
Which alternative projection to the routine PA rest best demonstrates the intercarpal joint spaces and wrist joint?
trapezium
Which carpal bones must be included on AP/PA projections of the first digit?
Ulna
Which forearm bone is located on the medial side in anatomic position?
Lateral in extension
Which lateral projection of a hand best demonstrates a possible foreign body in the palm of the hand?
Radial collateral ligament
Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid and trapezium bones?
Fan lateral
Which preferred lateral position of the hand best demonstrates the phalanges without excessive superimposition?
Lateral wrist
Which routine projection best demonstrates the pronator fat stripe?
PA and oblique wrist
Which routine projections best demonstrate the scaphoid fat pad?
To prevent distortion of the phalanx To prevent distortion of the joints To demonstrate small, nondisplaced fractures near the joint
Why is it important to keep the affected digit parallel to the IR for the PA oblique and lateral projections?
AP position produces a decrease in OID and increased resolution
Why is the AP projection of the thumb recommended instead of PA?
false
true or false? A correctly positioned 45 degree lateral oblique of the hand is evidenced by a slight overlap of the heads of the first and second metapals
false
true or false? A sandbag should be placed over the distal forearm to prevent motion when obtaining radiographs of the hand.
true
true or false? Lead masks should be used when more than two projections are taken on one image receptor to prevent scattered radiation from degrading the image quality.
false
true or false? Radiographs of the fingers and hands require the use of a grid.
true
true or false? Sesamoid bones are commonly found at the first metacarpophalangeal joint.
false
true or false? When obtaining radiographs of an ambulatory patient, the patient should be seated in a chair at the end of the x-ray table with his/her lap under the x-ray table.
PA oblique
which projection of the thumb is achieved naturally by placing the palmar surface of the hand in contact with the cassette?
Modified Robert's Method
which special positioning method can be performed to demonstrate a Bennett's fracture?