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Upper Xtremities
Upper Extremities
| Question | Answer |
|---|---|
| kV for AP or AP Axial Clavicle | 65-75kV |
| Centering for Clavicle | perpendicular to mid clavicle |
| kV for AP or Lateral Scapula | 70-80kV |
| AP Axial of Clavicle, the CR is angled _____? | 15-30 degrees cephalad |
| Bilateral AC joints require what two positions? | with and without 5-8lbs of weights |
| Name the three angles of the Scapula | Superior, Inferior, and Lateral angles |
| Name the two fossa on the Dorsal Scapula | Supraspinous and Infraspinous Fossa |
| The two views of the Scapula | AP and Lateral |
| Criteria for good Scapula image | entire scapula, lateral border free of ribs and lungs, optimal exposure factors |
| SID for Scapula and Clavicle | 40 inches |
| SID for AC Joints | 72 inches |
| Centering for AC Joints | 1 inch above Jugular Notch |
| True/False: Bilat. AC joints require markers- R, L, with, without | TRUE |
| True/False: Bilat. AC Joints can be done WITHOUT a grid | TRUE |
| Name the 3 arm positions that can be used for a lateral scapula | behind back, across chest, over head. |
| True/False: Humerus should be superimposed over the scapula | FALSE |
| Name Criteria for lateral Scapula | entire scapula,in profile,separated from ribs, humerous not superimposed over area of interest. |
| True/False: Respiration is not important for a AP Scapula | False - Should be slow respiration |
| True/False: Respiration is not important for a Lateral Scapula | False - Should be suspended respiration |
| Name the Trauma Shoulder positions | AP neutral rotation, Transthoracic lateral or the Scapular Y view |
| Name the Routine Shoulder positions | AP with external and internal rotation |
| Another name for Inferosuperior axial (Shoulder) | Lawrence method |
| Another name for Superoinferior axial (Shoulder) | Hobbs modification |
| Another name for Posterior Oblique- glenoid cavity (Shoulder) | Grashey method |
| Another name for Tangential projection - intertubercal groove(Shoulder) | Fisk modification |
| Another name for Transthoracic lateral (Shoulder) | Lawrence method |
| Routine positions for the Humerus are: | AP and Lateral |
| Trauma positions for the Humerus are: | Lateral for distal Humerus, Transthoracic lateral for proximal Humerus, Y-view for proximal Humerus |
| Criteria for good AP Humerus | entire Humerus, Greater tubercle in profile, epicondyles in profile, exposure factors. |
| Criteria for good Lateral Humerus | entire Humerus, Lesser tubercle in profile, epicondyles are superimposed, exp. factors. |
| Type of joint: Scapulohumeral | Spheroidal (ball and socket) |
| Type of joint: Sternoclavicular | Plane (gliding) |
| Type of joint: Acromioclavicular | Plane (gliding) |
| Describe epicondyles and tubercles with Shoulder AP External rotation | Epicondyles are parallel to IR, Greater tub in profile laterally, Lesser tub anterior |
| Describe epicondyles and tubercles with Shoulder AP Internal rotation | Epicondyles are perpendicular to IR, Greater tub anterior, Lesser tub in profile medially |
| Centering point for AP shoulder? | 1" inferior of Coracoid process (Scapulohumeral joint) |
| Where is the Coranoid Process? | The proximal end of the Ulna, articulates with the Trochlea of the Humerus |
| Where is the Coracoid Process? | Superior border of Scapula and inferior to the Distal end of the Clavicle |
| What carpal bone articulates with the radius? | Scaphoid |
| What carpal bone articulates with the radius and the capitate? | Lunate |
| Which carpal bone is proximal to the first metacarpal (thumb)? | Trapezium |
| Which carpal bone is proximal to the 2nd metacarpal? | Trapezoid |
| Which carpal bone is proximal to the 3rd metacarpal? | Capitate |
| Which carpal bone is proximal to the 4th and 5th metacarpal? | Hamate |
| The metacarpals are concave on the anterior and convex on the posterior. | True |
| The wrist joint is an ellipsoidal joint which is the most freely moveable of synovial joints. | True |
| What is the joint called where the radius articulates with the scaphoid and the lunate? | radiocarpal joint |
| What is the average range of kV for the fingers hand and wrist? | 50-65 kV |
| Where do you center for a PA hand and an oblique hand? | 3rd MCP |
| Where do you center for a lateral of the hand? | 2nd MCP |
| What is another name for the Norgaard Method and what is it used to diagnose? | Ball Catcher's Position - diagnoses rheumatoid arthritis |
| Where do you center for a PA and oblique wrist? | mid carpal area |
| WHere do you center for a lateral wrist? | Perpendicular to wrist joint |
| How much of a CR angle is used for the Stecher Method (Scaphoid)? | 20 degrees up hand centered over the scaphoid |
| Where do you ceneter on the thumb? | At 1st MCP joint |
| What position is used for an oblique of the thumb? | PA hand |
| WHat needs to be demonstrated on an exam of the thumb? | Entire thumb including the 1st MCP |
| Where do you center for the 2nd-5th digits? | PIP joint |
| The radial head is proximal/near the elbow on the lateral or thumb side. | True |
| The ulnar head is distal/near the wrist on the medial side. | True |
| When does the radius cross over the ulna? | during pronation |
| When do the radius and ulna show no superimposition? | external rotation (oblique with lateral rotation) |
| What does a true lateral show? | THe proximal head and neck of the radius, the radial tuberosity, and the trochlear notch. |
| Does the forearm need to show both joints? | YES |
| What exam shows the coronoid process free of superimposition? | AP oblique (medial rotation) |
| Acute flexion is also called? | Jones method |
| Technical factors for the Shoulder? (kV/mAs) | Medium kV (70-80) High mA/low exposure time |
| The lesser tuberosity of the humerus is seen in profile with the arm in ________ . | Internal rotation |
| Which part of the scapula does the humerus articulate with? | glenoid fossa |
| To demonstrate the shoulder and upper humerus in anatomical position, the arm should be rotated __________ | Externally |
| The AP internal rotation of the shoulder places the humerus _______ in the position | Lateral |
| What is the centering point for AP shoulder WITH external rotation? | 1" inferior of the coraCoid process |
| Which shoulder position shows the lesser tubercle in profile? | AP with internal rotation |
| Another name for inferosuperior, axial projection of the shoulder is? | Lawrence method |
| In the inferiosuperior, axial projection of the shoulder, the ______ tubercle is in profile | Lesser |
| The AP shoulder with neutral rotation is done for? | Trauma |
| When doing the humerus how many, and which joints are demonstrated? | 2, Scapulohumeral and elbow joint (includes humeralulna, humeralradial, and proximal radioulnar joints.) |
| When doing a dislocated shoulder exam, what positions would be performed? | AP shoulder with neutral rotation and the Y view |
| What is the centering point for a transthoracic lateral of the humerus? | surgical neck |
| What is the Grashey method and how much is the patient rotated? | AP oblique of the shoulder, 35degrees toward the affected side |
| What is the position of the scapula when doing a Y view? | Lateral |
| The Grashey method is used to demonstrate? | profile of the glenoid cavity |
| For the oblique of the Hand, what do you use to measure your rotation and what is the degree? | The styloid processes should be at a 45degree angle |
| Why are the fingers parallel to the IR and not bent in a hand exam? | to show joint spaces |
| What should you do with the fingers in a wrist projection? | curl them, to move the carpals closer to the IR |
| What is the name of the furthest lateral carpal on the proximal row? | Schapoid |
| Name the carpals in order, proximal row first. | Schaphoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapazoid, Capitate, Hamate |
| Ok Hotshot, what are the OLD names the carpals in order ? | Navicular, Semilunar, Triangular, Pisiform, Greater Multiangular, Lesser Multiangular, Os magnum, Unciform |
| WOW, you are good! | Yeah, I know you know. |
| In the anatomical position, what is it called when the hand is moved medially, but the arm is kept straight? | Ulnar deviation |
| R______ A_______ is a common pathology that hand and wrist exams are ordered for. | Rhumatoid Artharitis |
| How many bones are in the hand? | 27 |
| How many bones in the Phalanges? | 14 |
| How many carpals? | 8 |
| What kind of joint is the 1st MCP? | Sellar (saddle) |
| What kind of joint is the DIP? | Ginglymus (hinge) |
| What kind of joint are the intercarpals? | Plane (Gliding) |
| What kind of joint is the Wrist (carpal to ulna and radius)? | Ellipsoid (condyloid) |
| What ind of joint is the proximal and distal radioulnar joints? | Trochoid (pivot) |
| What kinda of joint is the elbow? | Ginglymus (hinge) |
| kV AP hand? | 50-60 |
| kV Lateral hand? | 55 |
| kV Oblique hand | 55-65 |
| kV wrist and trauma wrist? | 55-65 and 50-70 |
| Define Subluxion | partial dislocation |
| Define Sprain | rupture or tearing of ligaments |
| Define Contusion | bruise without fracture |
| Define Greenstick | incomplete fracture |
| fx means? | fracture |
| Baseball mallet fx is? | fx of distal phalynx |
| Boxer's fx is? | broken knuckle |
| Name the fat pads of the elbow | anterior fat pad, posterior fat pad, supinator fat stripe. |
| To obtain a lateral forearm: | Thumb side must be up & forearm & humerus must be in the same plane |
| To clearly see the olecranon process in profile, which position should be used? | AP Oblique w/medial rotation |
| For some soft tissue injuries the lateral elbow is only flexed: | 30-35 degrees |
| The proximal radioulnar joint is considered a: | pivot joint and is diarthrodial |
| For a lateral view of the elbow to be accurate, what should be superimposed? | epicondyles of the humerus |
| For a trauma elbow, how many AP projections should be taken | 2 |
| Which projection of the elbow superimposes the forearm and the humerus? | AP projection;acute flexion |
| Are both joints usually visualized when taking a forearm on an 11 x 14? | YES |
| Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid & trapezium bones? | radial collateral ligament |
| The two important fat stripes around the wrist joint are: | scaphoid fat stripe & pronator fat stripe |
| Pathology revealed in a AP forearm? | Fractures, dislocations,and pathologic processes such as osteomyelitis or arthritis. |
| Describe Positioning for an AP forearm | Entire limb in the same planeShoulder at table levelAlign and centre forearm to long axis of IRSupinate hand (2nd to 5th metacarpal heads against IR)Elbow fully extendedCheck the humeral epicondyles are equidistant from the IR |
| A forearm film is hung from which end? | from the fingers...or wrist end. |
| A shoulder is hung from which end? | from the shoulder. |
| You are _______ | Amazing! |
| Rotation of the forearm is shown by ? | separation of ulna and radius(lat. rot.) or MORE THAN SLIGHT superimposition (med. rot.) or pronation- if radius is rotated across ulna (hand not supinated) |
| Name wrist fat pads? | scaphoid fat stripe and pronator fat stripe |
| Name Elbow fat pads? | Anterior fat pad, posterior fat pad, supinator fat stripe. |
| Define Bursitis | Inflammation of the bursae (fluid filled sacs that enclose joints) |
| Define Osteroarthritis | degenerative joint disease |
| Define Osteoporosis | reduction in quantity of bone or atrophy of skeletal tissue |
| Define Rheumatoid Arthritis | systemic chronic inflammation of connective tissue. |
| Detect rotation on AP thumb or fingers by? | should be symmetric concave sides of phalanges and equal soft tissue. |
| Detect rotation of AP hand. | should be symmetric concavity of sides of metacarpals and phalanges 2 thru 5. |
| Detect rotation of Oblique hand | true 45degree oblique will have some overlap of 3rd, 4th, and 5th metacarpal head only. |
| Detect rotation for lateral hand | radius and ulna should be superimposed. metacarpals should also be superimposed. |
| Detect rotation AP wrist | should be equal concavity of proximal metacarpals and near equal distance between proximal carpals. |
| Detect rotation of Lateral wrist | true lateral ulnar head will be superimposed over distal radius 2-5 metacarpals aligned and superimposed. |
| Detect rotation for AP Forearm | should be humeral epicondyles in profile. radial head, neck, and tuberosity slightly superimposed by ulna. |
| Detect rotation for Lateral Forearm | head of ulna and radius SHOULD be superimposed and humeral epicondyles should be superimposed. |
| the wrist joint is also called the | radiocarpal joint |
| ellipsoidal joints move in how many directions | 4 |
| cast conversions | fiberglass-^25-30%ma or kV^3-4, sm to dry- ^mas 50-60% or kV^5-7, heavy or wet- ^mas 100% or kV ^8-10 |
| CR for carpal canal-tangential inferiorsuperior projection for carpal tunnel syndrome | 25-30deg 1 inch distal to base of third metacarpal |
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