T RRE EXTREMETIES complete
wheres the coracoid
(scapula) its the little macaroni peice that sticks out just below the acromion process that attaches to clavicle
wheres the glenoid
(scapula) where humerus attaches
the major muscles of the rotator cuff
supraspinatus, infraspinatus, subscapularis, and teres minor
lateral knee? 1.fibular head should be somewhat superimposed on the proximal tibia. 2.patellofemoral joint should be visualized. 3.femoral condyles should be superimposed.
12&3
medial oblique foot demonstrates the articulation between the 1.talus and the calcaneus 2.calcaneus and the cuboid 3.talus and the navicular
2-3
In the 45-degree medial oblique projection of the ankle, the 1.talotibial joint is visualized 2.tibiofibular joint is visualized 3.plantar surface should be vertical
2-3 The 45-degree oblique opens the distal tibiofibular joint (dorsiflex for all ankle views so plantar always vertical
Valid evaluation criteria for a lateral projection of the forearm requires that 1.the epicondyles be parallel to the IR. 2.radius and ulna be superimposed distally. 3.the radial tuberosity should face anteriorly.
2-3 The radius and ulna are superimposed distally---coronoid process and radial head are superimposed Proximally---radial head faces anteriorly
A lateral projection of the hand in extension is often recommended to evaluate 1.a fracture 2.a foreign body 3.soft tissue
2-3 extension not a fan, fingers are extended--flexion is also used, the hand forms a cup, sometimes less painful
Skeletal conditions characterized by faulty bone calcification include 1. osteoarthritis. 2. osteomalacia. 3. rickets.
2-3 osteomalacia, bones become soft and are easily misshapen. Rickets affects the growing bones of children and is also characterized by soft, misshapened bones
Ulnar flexion/deviation will best demonstrate which carpal(s)? 1.Medial carpals 2.Lateral carpals 3.Scaphoid
2-3 scaphoid is a lateral carpal
whats an alternative to the settagast method 90 degree knee flexion
hughston method 55 deg knee flexion
All elbow fat pads are best demonstrated in which position? (A.) AP (B). Lateral (C). Acute flexion (D) AP partial flexion
lateral
best position to demonstrate olecranon process
lateral
Which of the following projection(s) require(s) that the shoulder be placed in internal rotation? 1. AP humerus 2. Lateral forearm 3. Lateral humerus
lateral humerus
which oblique demonstrates the interspaces between the first and second metatarsals and between the first and second cuneiforms
lateral oblique
which projection of the feet is used to demonstrate the longitudinal arches
lateral weight bearing
The femoral shaft presents a long, narrow ridge posteriorly called the
linea aspera.
linea aspera
long, narrow ridge posteriorly on femur
which projection shows 1st and 2nd metatarsals slightly superimposed and 3rd to 5th metatarsals not superimposed
medial oblique foot
which oblique demonstrates most of the tarsals and intertarsal spaces (including the cuboid, sinus tarsi, and tuberosity of the fifth metatarsal),
medial oblique(remember thats why we really only do medial oblique protocal)
anterior or posterior scaupula demonstrates the sternal articular surface
neither!! the scapula has no sternal articulation
opposite of the vertebral border of the scapula is the
axillary border
which projection best visualizes the ulnar side carpals
pa wrist (radial deviation)
which projections will best demonstrate the carpal scaphoid?
pa wrist (ulnar deviation) scaphoid is somewhat curved and consequently foreshortened radiographically in the PA position. To better separate it from the adjacent carpals, the ulnar flexion (ulnar deviation) maneuver is frequently employed
An AP projection of the elbow would demonstrate
partial overlap of the proximal radius and ulna
Amphiarthrotic joints -
partially movabe-articular surfaces are connected by cartilage, such as intervertebral joints
on the distal anterior femur is the --------—which is a smooth surface for patellar motion during flexion and extension of the knee
patellar surface
the greater and lesser trochanters are on posterior or anterior femur?
proximal posterior femur
The greater trochanter is a prominent positioning landmark that lies in the same transverse plane as the ----- and ------
pubis and coccyx
(carpals starting proximal on radius(thumb) side) Some Lovers Try Positions That They Can't Handle
scaphoid-lunate-triquetrum-pisiform trapezium(thumb)-trapezoid-capitate-hamate(4/5)
patient prone, knee flexed 90 degrees (settagast method) what are we veiwing?
tangential projection of the patella and an unobstructed view of the patellofemoral articulation(aiming straight between patella and femur, not femur and tibfib joint)
The lateral aspect of the distal humerus presents a raised, smooth, rounded surface that articulates with the superior surface of the radial head(whats it called)
the capitulum
The bases of the metacarpals articulate with each other and the
the distal row of carpals at the carpometacarpal joints
In the AP projection of the ankle, the 1.plantar surface of the foot is vertical. 2.fibula projects more distally than tibia. 3.calcaneus is well visualized.
(1&2) dorsiflex To demonstrate the ankle joint space to best advantage, the plantar surface of the foot should be vertical in the AP projection of the ankle
Which of the following articulations participate(s) in formation of the ankle mortise? 1.Talotibial 2.Talocalcaneal 3.Talofibular
(1&3) The ankle mortise, or ankle joint, is formed by the articulation of the tibia, fibula, and talus---The calcaneus is not associated with formation of the ankle mortise
What process is best seen using a perpendicular CR with the elbow in acute flexion and with the posterior aspect of the humerus adjacent to the image receptor? A. CoracoidB. CoronoidC. OlecranonD. Glenoid
(lateral elbow) the olecranon process of the ulna is seen in profile.
internal shoulder shows
(lesser tubercle) in profille on medial apsect of humeral head
Which is important to avoid excessive MCP joint overlap in the oblique hand? (A). Oblique the hand no more than 45 degrees.(B). Use a support sponge for the phalanges.(C). Clench the fist to bring the carpals closer to the IR.(D). Use ulnar flexion.
Oblique the hand no more than 45 degrees.
Which (are) valid criteria for a lateral projection of the forearm? 1. The radius and ulna should be superimposed proximally and distally. 2. The coronoid process and radial head should be superimposed. 3. The radial tuberosity should face anteriorly.
(2&3)To accurately position a lateral forearm, the elbow must form a 90° angle with the humeral epicondyles superimposed. The radius and ulna are superimposed only distally. Proximally, the coronoid process and radial head are superimposed, and the radial head faces anteriorly
Which of the following articulates with the base of the first metatarsal? (A). First cuneiform(B). Third cuneiform(C). Navicular(D). Cuboid
(A)First cuneiform
Which of the following projections will best demonstrate the tarsal navicular free of superimposition? (A). AP obl, med rotation(B). AP obl, lat rotation(C). Mediolateral(D). Lateral weight-bearing
(AP oblique, medial rotation)--The lateral oblique projection of the foot superimposes much of the navicular on the cuboid
projection of os calsis with leg extended, plantar surface vertical and perp to the IR, and CR directed 40 degrees cephalad? (A) Axial plantodorsal projection(B) Axial dorsoplantar projection(C) Lateral projection(D) Weight-bearing lateral projection
(Axial plantodorsal projection) The CR enters the plantar surface and exits the dorsal surface.
All the following are posterior structures except (A). the linea aspera.(B). the intertrochanteric line.(C). the popliteal surface.(D). the intercondyloid fossa.
(B) intertrochanteric line on anterior femur-- intertrochanteric crest on posterior femur---
To evaluate the interphalangeal joints in the obl and lat positions, the fingers (A). rest on the cassette for immobilization(B). must be supported parallel to the IR(C). are radiographed in natural flexion(D). are radiographed in palmar flexion
(B)The fingers must be supported parallel to the IR (e.g., on a finger sponge) in order that the joint spaces parallel the x-ray beam
inferosuperior axial (nontrauma, Lawrence method) projection of the shoulder (ALL) true, except (A). the coracoid process and lesser tubercle are seen in profile.(B). the arm is abducted about 90° from the body.(C). the arm should be in internal rotation.(D). the CR is directed medially 25° to 30° through the axilla.
(C is false) pt supine with arm stretched out, CR goes through axilla and exits top of shoulder 25 degree angle towards head. (just picture xraying a black garbed arabian w/ sword)
Which of the following is most likely to be the correct routine for a radiographic examination of the forearm? (A). PA and medial oblique(B). AP and lateral oblique(C). PA and lateral(D). AP and lateral
(D) Two views, at right angles to each other, are generally required for each examination. Therefore, AP and lateral is the usual routine for an examination of the forearm
portion of the humerus articulates with the ulna to help form the elbow joint? A. Semilunar/trochlear notchB. Radial headC. CapitulumD. Trochlea
(D) the semilunar/trochlear notch of ulna articulates with trochlea of medial humerus (The capitulum articulates with the radial head )
Which of the following projections will best demonstrate acromioclavicular separation? (A). AP recumbent, affected shoulder(B). AP recumbent, both shoulders(C). AP erect, affected shoulder(D). AP erect, both shoulders
(D). AP erect, both shoulders--you do both for comparison--not recumbant because that may reduce seperation
Which of the following positions will separate the radial head, neck, and tuberosity from superimposition on the ulna? (A). AP(B). Lateral(C). Medial oblique(D). Lateral oblique
(D). Lateral oblique
The coronoid process should be visualized in profile in which of the following positions? A. Scapular Y B. AP scapula C. Medial oblique elbow D. Lateral oblique elbow
(Medial oblique elbow) ap scapula is coroCoid!!
To demonstrate the entire circumference of the radial head, exposure(s) must be made with the 1.epicondyles perpendicular to the cassette 2.hand pronated and supinated as much as possible 3.hand lateral and in internal rotation
(all are done) Elbow projections -ap/obliques/lateral To demonstrate the entire circumference of the radial head, four exposures are made
Which of the following may be used to evaluate the glenohumeral joint? 1.Scapular Y projection 2.Inferosuperior axial 3.Transthoracic lateral
(all) 1Y-demonstrate ant or post shoulder dislocation (2inferosuperior, if pt can abdunt arm) (3transthoracic, if pt cant abduct arm)
Which projection is most likely to demonstrate the carpal pisiform free of superimposition? (A). Radial flexion/deviation(B). Ulnar flexion/deviation(C). AP (medial) oblique(D). AP (lateral) oblique
(c)The AP oblique projection (medial surface adjacent to the IR) separates the pisiform and triquetrum and projects the pisiform as a separate structure
internal (medial) oblique elbow best visualizes
(coronoid process) is seen in profile. nearly everything else is superimposed. "radius and ulna look like twisty tie"
Which of the following bones participate(s) in the formation of the knee joint? 1.Femur 2.Tibia 3.Patella
(femur and tibia) The knee (tibiofemoral joint) is the largest joint of the body, formed by the articulation of the femur and tibia
which is the more distal of the two long bones of the lower leg
(fibula) the fibula is the more distal of the two long bones of the lower leg and forms the lateral malleolus
external shoulder shows
(greater tubercle) in profile on lateral aspect of proximal humerus. lesser superimposed in middle of proximal humerus
external (lateral) oblique elbow best visualizes
(radial head and neck) without superimposition. "radius and unla sit side by side"
To demonstrate glenoid fossa in profile, patient is AP recumbent and obliqued 45 degrees (A). toward the affected side(B). away from the affected side(C). with the arm at the side in the anatomic position(D). with the arm in external rotation
(toward the affected side) in AP shoulder, there is superimposition of the humeral head and glenoid fossa. but when patient obliqued 45 degrees toward the affected side, the glenohumeral joint is open
wheres the olecranon
(ulna), looking at lat elbow its the back part of elbow. ( if proximal ulna was an ice cream scoop, olecranon would be the outside, and coronoid process the inside, humerus would be the ice cream lol
wheres the head of ulna? head of radius?
(ulnar head)- distal end by carpals, just above ulnar styloid process (radial head) proximal end next to elbow
In the lateral projection of the foot, the 1.plantar surface should be perpendicular to the IR. 2.metatarsals are superimposed. 3.talofibular joint should be visualized.
1&2 When the foot is positioned for a lateral projection, the plantar surface should be perpendicular to the IR so as to superimpose the metatarsals.
In the lateral projection of the ankle, the 1.talotibial joint is visualized. 2.talofibular joint is visualized. 3.tibia and fibula are superimposed.
1,3 The talofibular joint is not visualized because of superimposition with other bony structures. its visualized in the medial oblique projection of the ankle
Which of the following is (are) located on the anterior aspect of the femur? 1.Patellar surface 2.Intertrochanteric crest 3.Linea aspera
1.Patellar surface--
demonstrate the intercondyloid fossa? 1.Prone, knee flexed 40 deg, CR caudad 40 deg to the popliteal fossa 2.Supine, IR under flexed knee, CR cephalad to knee, perp to tibia 3.Prone, patella parallel to IR, heel rotated 5 to 10 deg lateral, CR perp to knee joint
1-2 (1 is Camp-Coventry method) (2 is Béclère method) they are a reverse of eachother
Radial flexion/deviation is used to better demonstrate 1.medial carpals 2.pisiform 3.lateral carpals
1-2 pisiform is a medial carpal
When examining a patient whose elbow is in partial flexion, how should an AP projection be obtained? 1.With humerus parallel to IR, CR perp 2.With forearm parallel to IR, CR perp 3.Through the partially flexed elbow, resting on the olecranon process, CR perp
1-2 take two films
Which of the following articulations may be described as diarthrotic? 1.Knee 2.Intervertebral joints 3.Temporomandibular joint (TMJ)
1-3 Diarthrotic, or synovial, joints, such as the knee and the TMJ, are freely movable. Most diarthrotic joints are associated with a joint capsule containing synovial fluid
AP ankle mortise projection-whats the rotation?
15-20 degree medial rotation
Which statements regarding the scapular Y projection of the shoulder is (are) true? 1.The midsagittal plane should be about 60 degrees to the IR. 2.The scapular borders should be superimposed on the humeral shaft. 3.An oblique projection of the shoulder is obtained.
2-3
In the lateral projection of the knee, the joint space is obscured by the magnified medial femoral condyle unless the CR is angled hoew much?
5-7 degrees cephalad
Which projection is most useful for bone age evaluation?
A PA projection of the left hand and wrist is obtained most often to evaluate skeletal maturation
whats the apophysis
Apophysis refers to vertebral joints formed by articulation of superjacent articular facets
In which position of the shoulder is the greater tubercle seen in profile? (A). AP(B). External rotation(C). Internal rotation(D). Neutral position
B). External rotation--is the true AP position and places the greater tubercle in profile laterally and places the lesser tubercle anteriorly
In which positions can the sesamoid bones of foot be free of superimposition with the metatarsals or phalanges? (A). Dorsoplantar metatarsals/toes(B). Tangential metatarsals/toes(C). 30-degree medial oblique foot(D). 30-degree lateral oblique foot
B). Tangential metatarsals/toes--patient is best examined in the prone position because this places the parts of interest closest to the IR. The affected foot is dorsiflexed
In which position of the shoulder is the greater tubercle seen superimposed on the humeral head? (A). AP(B). External rotation(C). Internal rotation(D). Neutral position
C). Internal rotation--demonstrates the lesser tubercle in profile medially and the greater tubercle is seen superimposed on the humeral head
what type of joints are carpometacarpal joints A. Gliding joint B. Pivot joint C. Diarthrotic joint D. Amphiarthrotic joint
C. saddle-type diarthrotic joint-they are freely movable joints and the most plentiful type of joint in the human body
All the following can be associated with the elbow joint except A. the capitulum. B. the trochlea. C. the tubercles. D. the epicondyles.
C. the tubercles. (lesser and greater at proximal hunerus)
patient seated at the end of table, elbow flexed 80 degrees, and CR directed 45 degrees laterally from shoulder to the elbow joint, which structures demonstrated best? A. Radial headB. Ulnar headC. Coronoid processD. Olecranon process
Coronoid process---The axial trauma lateral (Coyle) position is described
Which of the following positions would be the best choice for a right shoulder examination to rule out fracture? (A). Internal and external rotation(B). AP and tangential(C). AP and AP axial(D). AP and scapular Y
D). AP and scapular Y ---Rotational views must be avoided in cases of suspected fracture
Which of the following articulates with the base of the fifth metatarsal? (A). First cuneiform(B). Third cuneiform(C). Navicular(D). Cuboid
D). Cuboid
Which of the following is proximal to the carpal bones? (A). Distal interphalangeal joints(B). Proximal interphalangeal joints(C). Metacarpals(D). Radial styloid process
D). Radial styloid process--The term proximal refers to structures closer to the point of attachment. For example, the elbow is described as being proximal to the wrist; that is, the elbow is closer to the point of attachment (the shoulder) than is the wrist
Which of the following is used to obtain a lateral projection of the upper humerus on patients who are unable to abduct their arm? (A). Bicipital groove projection(B). Superoinferior lateral(C). Inferosuperior axial(D). Transthoracic lateral
D). Transthoracic lateral
drag the following structures into order from medial to lateral. A. Coracoid process B. Scapular notch C. Acromion process D. Vertebral border
DBAC--The scapula has superior border, a medial (or vertebral) border, a lateral (or axillary) border, and an inferior angle, or apex. Its superior border presents a scapular notch projecting anteriorly just medial to coracoid process
T/F In the lateral projection of the scapula, the acromion and coracoid processes are superimposed
FALSE The coracoid and acromion processes should be readily identified separately (not superimposed) in the lateral projection
T/F In the lateral projection of the scapula, the inferior angle is superimposed on the ribs
FALSE The entire scapula should be free of superimposition with the ribs
T/F In the lateral projection of the scapula, the vertebral and axillary borders are superimposed.
TRUE
(femur) whats the linea aspera?
The (posterior) femoral shaft presents a long, narrow ridge posteriorly called the linea aspera
a deep notch, is found on the distal posterior femur between the large femoral condyles
The intercondyloid fossa
(femur) whats the Intertrochanteric crest?
The intertrochanteric crest runs obliquely between the trochanters; the intertrochanteric line runs anteriorly parallel to the crest
That ossified portion of a long bone where cartilage has been replaced by bone is known as the A. diaphysis B. epiphysis C. metaphysis D. apophysis
The ossified growth area of long bones is the metaphysis
What should be done to better demonstrate the coracoid process on an AP projection of the shoulder
To project the coracoid process with less self-superimposition, the CR must be angled cephalad 15 degrees (your only seeing top of macaroni head otherwise cause its pointing toward u.)
Tangential axial projections of the patella can be obtained in which of the following positions? 1. supine flexion 45° (Merchant) 2. prone flexion 90° (Settegast) 3. prone flexion 55° (Hughston)
all basically the same sunrise or skyline patella--The supine flexion 45° (Merchant) position requires a special apparatus, and the patellae can be examined bilaterally
The 15- to 20-degree oblique projection of ankle demonstrates ----?
ankle mortise (articulations between the talus, tibia, and fibula)
which projection shows 3rd to 5th metatarsals slightly superimposed
ap foot
synarthrotic joints
are immovable-such as the cranial sutures
Synovial fluid is associated with the (A). brain.(B). spinal canal.(C). peritoneal cavity.(D). bony articulations.
bony articulations.
A medial oblique would demonstrate
complete overlap of the proximal radius and ulna; this position is used to demonstrate the (coronoid process only thing not superimposed in profile) and the olecranon process within the olecranon fossa
The scapula's anterior, or ----------surface is that which is adjacent to the ribs
costal
patellar surface--anterior or posterior femur
distal anterior-a triangular depression over which the patella glides during flexion
popliteal surface--anterior or posterior femur
distal posterior-a depression that houses the popliteal artery
lateral scapula, best to do erect or supine
erect is more comfortable for patient with scapular pain
The talofibular articulation is best demonstrated in what position?
in the medial oblique projection of the ankle
if patient is able to move (abduct arm) what projection would we do to view glenohumeral joint
inferosuperior axial (up through the arm pit)
Bankart lesion
is a FRACTURE of the anteroinferior portion of the rim of the GLENOID FOSSA
Hill-Sachs defect
is a compression FRACTUREof the posterolateral HUMERAL HEAD usually associated with anterior DISLOCATION of the SHOULDER JOINT
whats the diaphysis
shaft of the long bone
The bases of the proximal row of phalanges articulate with
the heads of the metacarpals to form the (condyloid) metacarpophalangeal joints
3 aticulations of the knee
the patellofemoral joint, the lateral tibiofemoral joint (lateral femoral condyle with tibial plateau), and the medial tibiofemoral joint (medial femoral condyle with tibial plateau)
smooth surface just superior to the intercondyloid fossa
the popliteal surface
whats the epiphysis
the two extremities on the end of long bone, just above epiphiseal plates (think epicondyles)
where is the coronoid process
theres 2--(mandible first process) and ulna fits right in between humeral epicondyles, if veiwing lat elbow, it would be in front of humerus. what process is behind humerus?
The first carpometacarpal joint is formed by the articulation of the base of the first metacarpal and the
trapezium
put bony structures into order from lateral to medial trapezoid hamate trapezium capitate
trapezium trapezoid capitate hamate
All the following can be associated with the distal ulna except (A). head.(B). radioulnar joint.(C). styloid process.(D). trochlear notch.
trochlear notch is proximal-(theres both a proximal and distal radioulnar joint)
The ulna is the principal bone of the ------ joint, and the radius is the principal bone of the ------- joint
ulna-elbow radius -wrist
lateral oblique elbow (describe ulnar radius)
ulnar and radius stand side by side, no superimposition
whats varus and valgus
varus means inward valgus means outward