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?