Humerus & Shoulder Girdle & hands exam 3 positioning

Base of the first metacarpal

A Bennett's fracture involves:

1 inch (2.5 cm)

A minimum of ___ inch(es) (___ cm) of the forearm should be included radiographically for a PA projection of the hand.

superior

A posterior dislocation of the humerus projects the humeral head __ to the glenoid cavity with the special projection described in the previous question

metacarpophalangeal

A sesamoid bone is frequently found adjacent to the ___ joint of the thumb.

Synovial

All the joints of the shoulder girdle are classified as being ________.

more

An asthenic patient requires __ CR angle for an AP axial clavicle projection than a hypersthenic patient

osteoporosis

Atrophy of skeletal tissue

40 to 44 inches (102 to 113 cm) SID Minimal object image receptor distance (OID) Correct central ray placement and angulation Use of small focal spot

Circle all pertinent factors that help reduce image distortion during upper limb radiography.

impingement syndrome

Compression between the greater tuberosity and soft tissues on the coracoacromial ligamentous and osseous arch

Hills-Sachs defect

Compression fracture of the articular surface of the humeral head

10 to 15, proximally

During the PA axial scaphoid projection with central ray angle and ulnar flexion, the central ray must be angled ___ degrees ___ (distally or proximally)

The proximal radius crosses over the ulna

How does the forearm appear radiographically if pronated for a posteroanterior (PA) projection?

20 degrees

How much are the hand and wrist elevated from the IR for the modified Stecher method?

45 dgrees

How much central ray angulation from the long axis of the forearm is required for the carpal bridge (tangential) projection?

25-30 degrees

How much central ray angulation to the long axis of the hand is required for the carpal canal (tunnel) projection?

Distal aspect 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?

8

Identify the number of bones in the carpals

5

Identify the number of bones in the metacarpals

14

Identify the number of bones in the phalanges

27

Identify the number of bones in the total hand

PA oblique projection: Perform the medial oblique rather than lateral oblique to decrease OID. Lateral position: Perform a thumb-down lateral (mediolateral projection) to decrease OID.

Identify which positioning modification(s) should be used for study of the second digit to reduce distortion for each of the following

Parent or guardian

If physical immobilization is required, which individual should be asked to restrain a child for a shoulder series?

parent or guardian

If physical immobilization is required, which individual should be asked to restrain a child for a shoulder series?

humerus

Indicate whether the part is on the radius, ulna, or distal humerus: coronoid fossa

ulna

Indicate whether the part is on the radius, ulna, or distal humerus:coronoid process

ulna

Indicate whether the part is on the radius, ulna, or distal humerus:coronoid tubercle

humerus

Indicate whether the part is on the radius, ulna, or distal humerus:olecranon fossa

ulna

Indicate whether the part is on the radius, ulna, or distal humerus:olecranon process

ulna

Indicate whether the part is on the radius, ulna, or distal humerus:radial notch

humerus

Indicate whether the part is on the radius, ulna, or distal humerus:trochlea

tendonitis

Inflammatory condition of the tendon

Bankart lesion

Injury of the anteroinferior glenoid labrum

Steve Left The Party To Take Carol Home

List one of the mnemonics for remembering the eight carpal bones

Symmetric appearance of both sides of the shafts of phalanges and distal metacarpals.Equal amounts of tissue on each side of the phalanges

List the two radiographic criteria used to determine whether rotation is present on the PA projection of the digits.

Clavicle

Location: Acromial extremity

Not part of the shoulder girdle

Location: Condylar process

Scapula

Location: Coracoid process

Not part of the shoulder girdle

Location: Coronoid process

Scapula

Location: Crest of spine

Proximal humerus

Location: Greater tubercle

Proximal humerus

Location: Intertubercular groove

Proximal humerus

Location: Surgical neck

Plane

Movement type: Acromioclavicular

Spheroidal

Movement type: Scapulohumeral

Plane

Movement type: Sternoclavicular

Interphalangeal Joint (IP)

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

distal phalanx, proximal phalanx, middle phalanx

Name the three portions of the second through fifth fingers

proximal phalanx, distal phalanx

Name the two portions of the thumb

ulnar deviation

Of the two positions listed in the previous question, which is most commonly performed to detect a fracture of the scaphoid bone?

1" inferior to coracoid process

Specifically, where is the CR placed for an AP projection of the shoulder?

acromioclavicular joint dislocation

Superior displacement of the distal clavicle

Rheumatoid arthritis

The "ball-catcher's position" is commonly used to evaluate for early signs of:

Lateral angle, superior angle, inferior angle

The 3 angles of the scapula include the

Sternal extremity, body, acromial extremity

The 3 aspects of the clavicle are the

male

The ____ clavicle tends to be thicker and more curved in shape.

Anterior oblique/Grashey method

The _______ ______ projection of the shoulder produces an image of the glenoid process in profile. This projection is referred to as the ______ method.

Tangential projection/ Neer method

The __________ projection is the special projection of the shoulder that best demonstrates the acromiohumeral space for possible subacromial spurs, which create shoulder impingement symptoms

costal

The anterior surface of the scapula is referred to as the ______ surface.

90

The elbow generally should be flexed ___ degrees for the routine positions of the wrist.

Collimation borders should be visible on all four sides without cutting off essential anatomy.

The general rule for collimation for upper limb radiography states

90 degrees

The hand and wrist form a ___ degree angle to the forearm with the carpal bridge (tangential) projection.

the metacarpophalangeal joints (MCP)

The joints between the metacarpals and the phalanges are

Proximal humerus, scapula, clavicle

The shoulder girdle consists of

15° - 20°

The supine version of the tangential projection for the intertubercular groove requires that the CR be angled __ to __ posteriorly from the horizontal plane.

head, body (shaft), base

The three parts of each phalanx starting distally are:

Scaphoid fat stripe and Pronator fat stripe.

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

rotator cuff tear

Traumatic injury to one or more of the supportive muscles of the shoulder girdle

Infraspinous fossa, Supraspinous fossa

What are the names of the 2 fossae located on the posterior scapula?

Osteoporosis

What clinical indication requires a decrease in manual exposure factors?

Axilla

What is the anatomic name for armpit?

Capitate

What is the largest carpal bone?

Hamulus or hamular process

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

Ulnar deviation and radial deviation

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 regions?

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 a position referred to as the "ball-catcher's position"?

80-90 kVp

What kV range (digital) should be used for a shoulder series on an average adult?

Fracture of clavicle

What must be ruled out before performing the weight-bearing study for acromioclavicular joints?

25°-30° medially

What type of CR angulation is required for the inferosuperior axial projection for the shoulder?

Proximal interphalangeal (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 metacarpophalangeal (MCP) joint

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

Superior angle of the scapula and the AC joint articulation

Which 2 landmarks are placed perpendicular to the IR for the scapular Y lateral projection?

AP external rotation, AP internal rotation

Which 2 routine shoulder projections are routinely taken for a shoulder (no trauma) and proximal humerus?

18 x 24 cm (8 x 10 inch)

Which IR size should be used for a thumb projection?

Anteroposterior (AP) projection (with the hand slightly arched)

Which alternative projection to the routine PA wrist best demonstrates the intercarpal joint spaces and wrist joint?

scaphoid

Which is the most commonly fractured carpal bone?

Transthoracic lateral projection for humerus

Which lateral projection can be performed to demonstrate the entire humerus for a patient with midhumeral fracture?

Lateral in extension

Which lateral projection of the 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?

pott's

Which of the following fractures is not demonstrated in a wrist routine?

PA transaxillary projection (Hobbs modification)

Which of the following non trauma projections can be performed erect to provide a lateral view of the proximal humerus in relationship to the scapulohumeral joint?

Excessive lateral rotation from PA

Which positioning error is involved if a majority of the carpal bones are superimposed in a PA oblique wrist projection?

Fan lateral

Which preferred lateral position of the hand best demonstrates the phalanges without excessive superimposition?

posterior oblique (Scapular Y) projection

Which projection best deomonstrates a possible dislocation of the proximal humerus?

PA oblique

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

Fisk modification

Which projection produces a tangential projection of the intertubercular sulcus (groove)?

lateral wrist

Which routine projection best demonstrates the pronator fat stripe?

Posteroanterior (PA) and oblique wrist

Which routine projections best demonstrate the scaphoid fat pad?

Modified Robert's method. 15 degrees proximal

Which special positioning method can be performed to demonstrate a Bennett's fracture?What degree of central ray angulation is required for this projection?

AP Apical Oblique Axial (Garth Method)

Which special projection of the shoulder requires that the affected side be rotated 45 degrees toward the cassette and uses a 45 degree caudad central ray angle?

PA projection with radial deviation

Which special projection of the wrist best demonstrates the interspaces on the ulnar side of the wrist between the lunate, triquetrum, pisiform, and hamate bones?

Tangential inferosuperior or Gaynor-Hart projection

Which special projection of the wrist helps rule out abnormal calcifications in the carpal sulcus?

To prevent distortion of the phalanx and joints and to demonstrate small, nondisplaced fractures near the joint.

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

The AP position produces a decrease in OID and increased resolution.

Why is the anteroposterior (AP) projection of the thumb recommended instead of the PA?

Arthrography

___ 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.

Boomerang compensating filter

device permits good visualization of soft-tissue and bony anatomy for adult shoulder radiography

diarthroidal, 4

ellipsoidal joints are classified as freely moveable, or _, and allow movement in _ directions

5-15 degrees

how much is the CR angled for the inferosuperior axial projection (clements) if the patient cannot fully abduct the arm 90 degrees

radius

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

ulna

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

ulna

indicate whether the part is on the radius, ulna, or distal humerus:trochlear notch

saddle

match the following articulations with the correct joint movement types: carpometacarpal of first digit

ginglymus

match the following articulations with the correct joint movement types: elbow joint

plane

match the following articulations with the correct joint movement types: intercarpal

ginglymus

match the following articulations with the correct joint movement types: interphalangeal

ellipsoidal

match the following articulations with the correct joint movement types: metacarpophalangeal of second to fifth digits

pivot

match the following articulations with the correct joint movement types: proximal radioulnar joint

ellipsoidal

match the following articulations with the correct joint movement types: radoiocarpal

Acromioclavicular joint seperation

match the following radiographic appearances to the correct pathology: abnormal widening of acromioclavicular joint space

Bankart lesion

match the following radiographic appearances to the correct pathology: avulsion fracture of the glenoid rim

tendonitis

match the following radiographic appearances to the correct pathology: clacified tendons

rheumatoid arthritis

match the following radiographic appearances to the correct pathology: closed joint space

Hill-Sachs defect

match the following radiographic appearances to the correct pathology: compression fracture of humeral head

Bursitis

match the following radiographic appearances to the correct pathology: fluid filled joint space

osteoarthritis

match the following radiographic appearances to the correct pathology: narrowing of joint space

impingement syndrome

match the following radiographic appearances to the correct pathology: subacromial spurs

osteoporosis

match the following radiographic appearances to the correct pathology: thin bony cortex

capitulum

the articular portion found on the lateral aspect of the distal humerus is called

trochlea

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

olecranon fossa

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

Elbow flexed 90 degrees, optimal exposure factors used, and in a true lateral position

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

supraspinatus

the most common injury in the rotator cuff is to the _ tendon

Base, body, head

the three parts of each metacarpal, starting proximally:

Rotate affected arm externally approximately 45 degrees

to best demonstrate a possible Hill-Sacks defect, which additional positioning technique can be added to the inferosuperior axial projection?

15 degrees cephalad

what CR angle is required for the AP axial projection (alexander) for AC joints

30° caudad

what type of CR angle is required for the Apical AP axial shoulder projection?

proximal radioulnar joints

which two joints of the forearm allow it to rotate during pronation