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What should be seen in a Lat Elbow
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Upper Limb Bontrager
Upper Limb exam: digits, hand, wrist, forearm, elbow
| Question | Answer |
|---|---|
| Name 3 elbow special projections | Acute Flexion (Jones), Trauma Axial (Coyle), Radial Head |
| What should be seen in a Lat Elbow | olecranon in profile and superimposition of condyles, open joint spaces |
| What does the posterior fat pad demonstrate? | elbow joint pathology |
| What does the supinator fat stripe demonstrate? | radial head fx |
| What should be seen in a lat forearm? | ulnar head superimposed over radius |
| What should be seen in an AP forearm? | humeral epicondyles in profile |
| 3 common Fxs of the forearm | Monteggia (fx prox 1/3 ulna), Parry/nightstick, Galeazzi (fx distal 1/3 radius) |
| How would you fx the scaphoid? | fall on outstretched hand |
| What is the joint classification for the radiocarpal joint? | ellipsoidal |
| What is shown in an internal/medial oblique elbow? | ICU-Internal shows coronoid and ulna |
| Where is the CR for Acute Flexion (Jones) of elbow? | perp to forearm 2" proximal to olecranon process |
| What is a Mason fx? | radial head Fx |
| What are the 3 types of bone in the hand? | Phalanges, Metacarpals and Carpals |
| What are the 3 types of phalanges | Proximal, Middle, Distal |
| What is the joint in the thumb? | Interphalangeeal (IP Joint) |
| What is the joint between the base of the proximal phalanx and the metacarpal? | Metacarpophlangeal Joint (MCP) |
| What is the joint in between the carpals? | Carpmetacarpal (CMC) |
| What bone does the scaphoid articulate with? | Radius |
| What bone does the lunate articulate with? | Radius |
| What are the two joints between the radius and ulna? | Proximal radioulnar and distal radioulnar |
| Where is the head of the ulna located? | Near the wrist |
| What is the kvp for upper limb? | 50-70 |
| What size focal spot should be used? | small |
| What is a Barton's Fx? | dislocation of the posterior lip of the distal radius |
| What is a Bennett's Fx? | @ base of 1st metacarpal |
| What is a Boxer's Fx? | @ fifth metacarpal |
| What is a Colles' Fx? | Fx in distal radius when the fragment is displaced posteriorly |
| What is a Smith's Fx? | Fx of distal radius where fragment is displaced anteriorly |
| For the fingers, where is the PA, PA oblique and Lateral centered? | PIP |
| For the thumb, where should the CR be centered for the AP, PA Oblique and Lateral Projections | 1st MCP |
| Which projection should be used for a Bennett's Fx? | AP Modified Robert's |
| How and where is the CR placed for a Modified Robert's | 15degrees towards the wrist at the 1st CMC |
| Where is the CR for a PA Hand? | 3rd MCP joint |
| Where is the CR for a "fan" hand? | 2nd MCP joint |
| What is the kVp for a lateral hand? | 55-65 |
| Where is the CR for a Lateral Extension/Flexion? | 2nd to 5th MCP |
| What is the kVp for Wrist projections? | 60+/-6 |
| Where is the CR for a PA/AP wrist? | Midcarpal area |
| What wrist projection is best to show a Barton's, Colles' or Smith's Fx? | Lateral-Lateromedial Projection |
| Where is the CR for a PA and PA Axial Scaphoid | At scaphoid and at 10 degree proximal angle towards elbow |
| What type of joint is the IP joint? | Hinge |
| What type of joint is the MCP joint? | Ellipsoidal |
| What type of joint is the CMC1 joint? | Saddle |
| What type of joint is the CMC2-5 joint? | Gliding |
| What is the cast conversion for fiberglass? | Increase mAs 25-30 and kVp 3-4 |
| What is the cast conversion for dry plaster? | Increase mAs 50-60 and kVp 5-7 |
| What is the cast conversion for wet plaster? | Increase mAs 100 and kvp 8-10 |
| What is a subluxation? | partial dislocation |
| What is the most common fx of the distal radius and ulna? | Torus or Buckle |
| What type of joint is the "radiocarpal joint"? | ellipsodal, diarthrotic |
| What two bones does the radius articulate with? | scaphoid and lunate |
| What is the other name for the scaphoid? | navicular |
| Which deviation is best to view the scaphoid? | ulnar deviation |
| What carpals are best seen in a PA with radial deviation? | hamate, pisiform, triquetrum and lunate |
| What are the exposure factors for upper limb? i.e. exposure time, focal spot and kVp | short time, 50-70 kVp, small focal spot |
| How can you tell if film is oblique? | ulnar head partially superimposed by distal radius, 3-5th metacarpals are superimposed |
| Which projection demonstrates Barton's, Colles' and Smith's fractures? | Lateral-lateromedial wrist |
| Which projection is best used to view the scaphoid? | PA Axial Scaphoid (ulnar deviation) |
| Which projection is best used to view the ulnar-side carpals? | PA Projection (radial deviation) |
| What is the most fractured carpal? | Scaphoid |
| What is the most common wrist fracture for young children? | Torus or Buckle Fx |
| How should the CR be angled for the PA Axial Scaphoid? | 10-15° proximal |
| 2 structures in lateral elbow | olecranon process and trochlear notch |
| Projection instead of AP elbow when elbow is flexed | Trauma lateral |
| IR angle of modified Stetcher | 20 degrees |
| Which position shows a Bennet's Fx and what is the CR angle? | Modified Robert's and 15 proximal |
| What are 2 criteria that indicate rotation on PA digits? | phalanx shift concavity, soft tissue on sides of phalanges |
| Elbow fat pads indicate what 3 aspects of lateral? | true lateral, elbow 90, optimum exposure |
| Why does the Stetcher Method use a 20 degree sponge? | To elongate scaphoid and make it less painful than deviation |
| What part of the humeral anatomy separates the tubercles? | Intertrabecular Groove |
| What is the most common elbow fracture in children? | Supracondylar Fx (distal humerus above condyles) |
| What is a Nursemaid Fx? | Partial dislocation of radial head cause by pulling |
| In an AP humerus, what structures are in profile? | Greater Tubercle and epicondyles |
| What is the position for a Lateromedial Humerus Projection? | Elbow partially bent, body rotated toward effected part to bring shoulder and elbow in contact with IR. |
| Are the epicondyles perp or parallel in a Lateromedial Humerus? | They are Perpendicular to the IR |
| What are the 3 joints that makes the elbow? | Proximal radioulnar, humeroulnar, and humeroradial joints |
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