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nenyabrooke
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How many total bones are in the hand? Phalanges? Metacarpals? Carpals?
- 27 total
- 14 phalanges
- 5 metacarpals
- 8 carpals
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Label the joints.
- A. distal interphalangeal joint
- B. proximal interphalangeal joint
- C. Metacarpophalangeal joint
- D. Interphalangeal joint
- E. Metacarpophalangeal joint
- F. carpometacarpal joint
- G. radiocarpal joint
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What are the secondary names for the Scaphoid, Lunate, Triquetrum, and Pisiform?
- Navicular
- Semilunar
- Triangular or cuneiform
- (no secondary name)
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What are the secondary names for the Trapezium, Trapezoid, Capitate, and Hamate?
- Greater Multangular
- Lesser Multangular
- Os Magnum
- Unciform
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Label the carpal bones.
- A. Scaphoid
- B. Lunate
- C. Triquetrum
- D. Pisiform
- E. Trapezium
- F. Trapezoid
- G. Capitate
- H. Hamate
- (Remember: Steve Left The Party To Take Carol Home!)
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What are the largest and smallest carpal bones?
- largest: Capitate
- smallest: Pisiform
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What is the most commonly fractured carpal bone?
Scaphoid
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Which carpal bone forms the saddle joint?
Trapezium
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Which forearm bone is directly involved with the wrist joint?
Radius
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Which forearm bone is directly involved with the elbow joint?
Ulna
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The styloid process of which bone of the forearm is more palpatable?
Ulna
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What are the two beak-like processes of the ulna?
- Olecranon process
- Coronoid process
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In a true lateral position, the epicondyles of the radius and ulna are:
directly superimposed
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What are the two anterior depressions of the distal humerus?
- coronoid fossa
- radial fossa
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What is the name of the posterior depression of the distal humerus?
olecranon fossa
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What classification and movement type do the joints of the hand, wrist, forearm, and elbow have?
- synovial
- diarthrodial (freely moveable)
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When the patient has a large, wet plaster cast, you should increase the kVp by:
10 kv or double the mAs
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When the patient has a synthetic or fiberglass cast, you should up the kVp by:
3-4 kv
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When x-raying an upper extremity, when is a grid needed?
When part thickness is 10 cm or greater
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In the PA, oblique, and lateral projections of a digit, where should the CR be centered?
to the PIP joint
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What are two other names for the pinky side of the arm?
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What are two other names for the thumb side of the arm?
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Will the lateral projection of the 2nd digit be a lateromedial or mediolateral projection?
mediolateral
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Will the lateral projections of the 3rd-5th digits be lateromedial or mediolateral projections?
lateromedial
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In the AP, PA oblique, and Lateral projections of the thumb, where is the CR centered?
1st MCP joint
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What is a fracture at the bast of the first metacarpal?
Bennet's fracture (most common thumb fracture)
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Why is the Robert's Method (modified AP thumb) generally used?
to demonstrate a Bennett's fracture or a dislocation of the thumb
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For the Robert's Method of the thumb, where is the CR centered?
1st CMC joint
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What are three modifications of the AP thumb projection?
- Robert Method
- Lewis modification
- Long and Rafert modification
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For the PA, and oblique projections of the hand, where should the CR be centered?
3rd MCP joint
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For the fan lateral projection of the hand, where should the CR be centered?
2nd MCP joint
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What is a Boxer's fracture?
Fracture of a metacarpal neck (usually 4th and 5th metacarpals, common with punching)
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When would you use the lateral projection of the hand in extension?
to localize foreign bodies or demonstrate a Boxer's fracture.
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Describe the AP oblique bilateral projection of the hands. (Norgaard Method)
- both hands on one cassette
- supinate hands and place in the ball catcher's position
- internally rotate hands 45 degrees
- CR directed at mipoint between hands at the level of 5th MCP joints
- mark both left and right hands
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For PA, oblique, and lateral projections of the wrist, where should the CR be centered?
midcarpal area
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For the PA oblique projection of the wrist, which carpal bones are best demonstrated?
the lateral carpals (mainly trapezium and scaphoid)
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Which carpal bones are in profile and free of superimposition in a AP oblique projection of the wrist?
triquetrum, hamate, and pisiform
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Label the carpal bones.
- A. Capitate
- B. Lunate
- C. Trapezium
- D. Scaphoid
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Which carpal bones are projected most anteriorly on the lateral projection of the wrist?
trapezium and scaphoid
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In an ulnar deviation of the wrist, where should the CR be centered?
to the scaphoid
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What important factor are you looking for on a radiograph of an ulnar deviation?
open articulation all the way around the scaphoid
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Which projection is used to best demonstrate the medial carpal bones?
radial deviation (stress movement toward the thumb)
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How should the CR be angled and centered for the Stecher Method?
- degrees proximally
- center to the scaphoid
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What geometric property will be demonstrated on a Stecher Method of the wrist?
elongation of the carpal bones
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What method for the wrist is used to demonstrate the carpal canal?
Gaynor-Hart Method
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How should the CR be angled and centered for the Gaynor-Hart method?
- 25-30 degrees to the long axis of the hand
- 1 1/2 inches distal to the base of the 3rd MC
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What size cassette should you use for the forearm?
10x12 diagonally or 11x14 lengthwise
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Where should the CR be centered for AP and lateral projections of the forearm?
midforearm and halfway between skin margins
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How should the hand be positioned for an AP projection of the forearm?
supinated (palm up)
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Where should the CR be centered for AP, oblique, and lateral projections of the elbow?
midelbow joint between epicondyles of the humerus
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Label the AP elbow
- A. medial epicondyle
- B. olecranon fossa
- C. lateral epicondyle
- D. slight superimposition of the radius and ulna
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When is the posterior fat pad visible on a lateral projection of the elbow?
when pathology is present
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What is the name of the fat pad that can be seen on the lateral projection of the elbow, anterior to the radius?
Supinator fat stripe
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For an AP oblique projection of the elbow with medial rotation, is the hand pronated or supinated?
pronated (palm down)
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What process of the elbow is best demonstrated with an AP oblique with internal rotation?
coronoid process
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Label the oblique elbow with medial rotation.
- A. olecranon process
- B. olecranon fossa
- C. medial epicondyle
- D. coronoid process
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Which two projections should be done on a trauma elbow with acute flexion?
- AP of the distal humerus
- AP of the proximal forearm
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Describe the axiolateral projection of the elbow which demonstrates the radial head. (Coil Method)
- pronate the hand
- flex elbow 90 degrees
- direct CR proximally and angle 45 degrees
- center midelbow joint
- (to demonstrate the coronoid: direct CR distally)
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For the AP and rotational lateral projections of the humerus, where should the CR be centered?
to the midpoint of the humerus
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What size cassette should be used for the humerus?
11x14 or 14x17 lengthwise (long enough to include the entire arm)
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What breathing technique is used for projections of the humerus?
suspend respiration
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With a rotational lateral projection of the humerus, is the arm rotated internally or externally?
internally
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What method is used for a transthoracic lateral projection of the humerus?
the Lawrence Method
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Which side should be closer to the IR when performing a transthoracic lateral of the humerus?
the injured side.
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During a transthoracic lateral of the humerus, should the mid coronal plane of the body be parallel or perpendicular to the IR?
perpendicular
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Where should the CR be centered for a transthroacic lateral of the proximal humerus?
the region of the surgical neck
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What breathing technique should be used during a transthoracic lateral projection of the proximal humerus?
have the patient take short panting breaths
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To utilize motion during a transthoracic lateral projection, what two things should you do?
- have the patient take short panting breaths
- use a long exposure time
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