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Upper Extremity Flashcards

1
Q
  1. HAND CONSIST OF __(#)___ BONES
    - GROUPS & # IN EACH:
  2. DISTAL LOCATED:
    - PROXIMAL LOCATED:
A
  1. 27
    - PHALANGES (14)
    - METACARPAL (5)
    - CARPAL (8)
  2. DISTAL = TIP OF FINGER / FURTHER FROM POINT OF ORIGIN (THINK DISTANCE AWAY)
    - PROXIMAL = LOWER PART OF FINGER / CLOSER POINT OF ORIGIN (THINK IN MY PROXIMITY)
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2
Q
  1. WHERE IS DIP JOINT?
    - PIP?
    - MCP?
  2. JOINTS OF THUMB:
  3. HOW DO YOU KNOW ENTIER THUMB WAS RADIOGRAPHED / WHAT IS NEEDED?
A
  1. DISTAL INTERPHALANGEAL IS LOCATED ON 2-5TH DIGIT BETWEEN DISTAL & MIDDLE PHALANGE (TOP MOST JOINT_
    - PROXIMAL INTERPHALANGEAL IS LOCATED BETWEEN MIDDLE AND PROXIMAL PHALANGES (IN MIDDLE OF FINGER / THINK KNUCKLE)
    - METACARPOPHALANGEAL BETWEEN PROXIMAL PHALANGE & METACARPAL (LOWER JOINT)
  2. INTERPHALANGEAL (IP) BETWEEN TDISTAL AND PROXIMAL PHALANX
    - METACARPOPHALANGEAL (MCP) BETWEEN PROXIMAL PHALANX AND 1ST METACARPAL
  3. 1ST MCP IS APART OF THUMB, SO INCLUDE TRAPEZIUM TO ENSURE
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3
Q
  1. HOW MANY CARPALS ARE THERE?
  2. PROXIMAL CARPALS:
  3. DISTAL CARPALS:
  4. SMALLEST CARPAL:
  5. LARGEST CARPAL:
  6. MOST FRACTURES CARPAL:
A
  1. 8
  2. SCAPHOID, LUNATE, TRIQUETRUM, PISIFORM
  3. TRAPEZIUM, TRAPEZOID, CAPITATE & HAMATE
  4. PISIFORM
  5. CAPITATE
  6. SCAPHOID
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4
Q
  1. WRIST JOINT IS CALLED ____________
    - TYPE: ______________
    - MOVEMENT: ____________
  2. WHAT CONSIST OF WRIST JOINT?
  3. WHICH BONE OF FOREARM ARTICUALTES DIRECTLY WITH CARPALS?
A
  1. RADIOCARPAL JOINT
    - CONDYLOID JOINT / DIATHRODIAL
    - FREELY MOVING
  2. RADIUS, SCAPHOID & LUNATE
    • ALSO DISTAL RADIOULNAR JOINT
  3. RADIUS
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5
Q
  1. IN ANATOMICAL POSITION OF FOREARM:
    _________ IS MEDIAL & _________ LATERAL SIDE
  2. WHICH CONTAIN OLECRANON & CORONOID PROCESS?
  3. WHERE IS TROCHLEA NOTCH LOCATED?
    - FUNCTION?
  4. WHERE IS RADIAL NOTCH LOCATED?
    - FUNCTION?
A
  1. ULNA MEDIAL, RADIUS LATERAL
  2. PROXIMAL ULNA
  3. DEPRESSION ON PROXIMAL ULNA, ACCEPTS PART OF HUMERUS
  4. DEPRESSION PROXIMAL ULNA, RECEIVES RADIAL HEAD THIS FORMS PROXIMAL RADIOULNAR JOINT
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6
Q
  1. DURING PRONATION, ________ CROSSES OVER ______.
  2. WHAT IS ON THE PROXIMAL RADIUS? (3 KEY THINGS)
  3. WHERE IS STYLOID PROCESS LOCATED?
  4. WHERE IS ULNAR NOTCH LOCATED?
    - FUNCTION
A
  1. RADIUS OVER ULNA
  2. RADIAL HEAD, NECK & TUBEROSITY
  3. STYLOID ON DISTAL END OF RADIUS AND ULNA
  4. ON RADIUS, ACCEPTS ULNAR HEAD
    - CREATES DISTAL RADIOULNAR JOINT
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7
Q
  1. PROXIMAL VS DISTAL RADIOULNAR JOINTS:
  2. TROCHLEA ARTICULATES WITH ________
    - CAPITULUM ARTICULATES WITH __________
  3. RADIAL FOSSA LOCATED:
    - FUNCTION
  4. CORONOID FOSSA LOCATED:
    - FUNCTION
A
  1. PROXIMAL = RADIAL NOTCH ON ULNA & RADIAL HEAD ON RADIUS
    - DISTAL = ULNAR NOTCH ON RADIUS, ULNA HEAD ON DISTAL ULNA
  2. TROCHLEA - ULNA
    - CAPITULUM - RADIUS
  3. RADIAL FOSSA ON HUMERUS, ABOVE CAPITULUM
    - ACCEPT RADIUS IN FLEXION
  4. CORONOID FOSSA ON HUMERUS ABOVE TROCHLEA
    - ACCEPTS CORONOID PROCESS IN FLEXION
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8
Q
  1. ELBOW IS WHAT TYPE OF JOINT?
  2. WHERE ARE MEDIAL & LATERAL EPICONDYLES LOCATED IN UPPER EXTREMITY?
    - FUNCTION
  3. WHICH OF ABOVE IS LARGER?
A
  1. HINGE TYPE / DIATHROTIAL

2, ON HUMERUS, SUPERIOR TO HUMERAL CONDYLES (CAPITULUM & TROCHLEA)
- MEDIAL CONDYLE = ABOVE TROCHLEA, LATERAL = ABOVE CAPITULUM
PALPABLE BONE FOR IMAGING

  1. MEDIAL LARGER
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9
Q
  1. WHERE IS OLECRANON FOSSA LOCATED?
    - FUNCTION?
  2. WHERE IS TROCHLEA SULCUS LOCATED?
  3. WHICH STRUCTURES ARE INDICATIONS OF TRUE LATERAL ELBOW?
A
  1. POSTERIOR DEPRESSION BEHIND CORONOID FOSSA / LOCATED ON HUMERUS
    - ACCEPTS OLECRANON PROCESS WHEN ELBOW EXTENDED
  2. ON TOP OF ULA / UNDER TROCHLEA
  3. THREE CONCENTRIC ARCS & THREE FAT PADS
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10
Q
  1. THREE CONCENTRIC ARCS NAMES:
    - SEEN ON WHAT PROJECTION?
  2. THREE FAT PADS ASSOCIATED WITH ELBOW JOINT:
    - SEEN ON WHICH PROJECTION?
  3. WHAT IS INDICATED IF POSTERIOR FAT PAD IS VISUALIZED ON IMAGE?
A
  1. TROCHLEAR SULCUS, RIDGES OF CAPITULUM & TROCHLEA & TROCHLEA NOTCH
    - LATERAL ELBOW
  2. ANTERIOR FAT PAD (FRONT OF HUMERUS)
    - SUPINATOR FAT PAD (ABOVE RADIUS)
    - POSTERIOR FAT PAD (IN OLECRANON FOSSA)
  3. POSTERIOR PUSHES OUT OF OLECRANON FOSSA ON LATERAL INDICATES INJURY
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11
Q
  1. ON HUMERUS, WHICH NECK IS MORE DISTAL- ANATOMICAL OR SURGICAL
  2. GREATER TUBERCLE LOCATED _________ & LESSER TUBERCLE LOCATED ___________.
  3. WHAT IS TERM FOR DEPRESSION BETWEEN GREATER & LESSER TUBERCLE?
  4. WHERE ON HUMERUS ARE THESE ALL LOCATED?
A
  1. SURGICAL (THINK A BEFORE S)
  2. GREATER = LATERAL
    - LESSER = ANTERIOR / MORE MEDIAL
  3. INTERTUBERCULAR GROOVE
  4. PROXIMAL HUMERUS (CLOSER TO SHOULDER)
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12
Q
  1. WHAT DOES SHOULDER GIRDLE CONSIST OF?
  2. JOINTS OF SHOULDER GIRDLE & TYPE:
    A.
    B.
    C.
  3. SHOULDER GIRDLE ITSELF CLASSIFIED AS _____ JOINT & MOVEMENT IS ______
A
  1. CLAVICLE & SCAPULA
  2. A. Scapulohumeral joint – ball and socket
    - B. Acromioclavicular (AC) joint – gliding (or plane)
    - C. Sternoclavicular (SC) joint – gliding (or plane)
  3. SHOULDER GIRDLE = SYNOVIAL & DIATHROTAL (FREE MOVE)
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13
Q
  1. IS HUMERUS APART OF SHOULDER GIRDLE?
  2. CLAVICLE IS A ____ BONE
  3. TWO ENDS OF CLAVICLE NAMES & ARTICULATIONS:
    A.
    B.
A
  1. NO!! ONLY CLAVICLE & SCAPULA
  2. LONG BONE
  3. A. ACROMIAL EXTREMITY - ART. ACROMION PROCESS OF SCAPULA
    - B. STERNAL EXTREMITY - ART. MANUBRIUM OF STERNUM & 1ST COSTAL CARTILAGE
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14
Q
  1. SCAPULA IS A ______ BONE
  2. SCAPULA SURFACES: _________ & ___________
  3. BORDERS: _________, ___________& _____________
  4. ANGLES: _________, ___________& _____________
  5. WHERE IS SUBSCAPULAR FOSSA?
A
  1. FLAT BONE
  2. COSTAL (ANTERIOR) & DORSAL (POSTERIOR)
  3. LATERAL (AXILLA), MEDIAL (VERTEBRA) & SUPERIOR
  4. SUPERIOR, INFERIOR & LATERAL ANGLES
  5. SUBSCAPULAR FOSSA ON ANTERIOR ASPECT
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15
Q
  1. WHERE IS CORACOID PROCESS LOCATED?
  2. WHERE IS THE SPINE CREST LOCATED ON SCAPULA?
    - A. AREA ABOVE SPINE = __________
    - B. AREA BELOW SPINE = __________
  3. WHERE IS ACROMION LOCATED?
A
  1. ON SCAPULA / ANTERIOR SIDE
  2. POSTERIOR ASPECT SCAPULA
    - ABOVE = SUPRASPINOUS FOSSA
    - BELOW = INFRASPINOUS FOSSA
  3. OVERHANGS SHOULDER JOINT
    - POSTERIOR ASPECT OF SCAPULA
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16
Q
  1. ROUTINE DIGIT PROJECTIONS:
  2. DIGITS CR:
  3. WHAT IS IMPORTANT ABOUT OBLIQUE DIGITS?
  4. WHAT IS IMPORTANT ABOUT LATERAL DIGITS?
A
  1. PA, PA OBLIQUE & LATERAL
  2. DIRECTED AT PIP
  3. OBLIQUE = 45* OBLIQUE
    - DIGIT CLOSER TO IR / SO CHANGE WAY HAND ROTATES TO REDUCE OID
  4. LATERALS BASED ON WHICH DIGIT OF INTEREST
    - DIGIT CLOSER TO IR / SO CHANGE WAY HAND ROTATES TO REDUCE OID
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17
Q
  1. WHAT IS POSITION OF EACH IMAGE:
    (IS IT MEDIOLATERAL OR LATEROMEDIAL)
    A.
    B.
    C.
    D.
A
  1. A. LATEROMEDIAL
    B. MEDIOLATERAL
    C. LATEROMEDIAL
    D. LATEROMEDIAL

WHICH WAY BEAM ENTERS DIGIT

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18
Q
  1. LABEL WHAT VIEW IS EACH IMAGE & MAIN ANATOMY
    A.
    B.
    C.
A

A. PA DIGIT
- SOFT TISSUE & MIDSHAFT CONCAVITY EQUAL BOTH SIDES
- IP & MCP JOINTS OPEN

B. PA OBLIQUE DIGITS (45*)
- MORE CONCAVITY ON ONE ASPECT PHALANX THAN OTHER
- IP & MCP JOINT SPACES OPEN

C. LATERAL DIGIT
- ANTERIOR SURFACE HAS MIDSHALF CONCAVITY
- IP & MCP JOINT OPEN

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19
Q
  1. PROJECTIONS OF THUMB:
  2. THUMB CR:
  3. ANATOMY FOR TUMB VIEWS:
A
  1. AP, OBLIQUE & LATERAL
  2. 1ST MCP JOINT
  3. IP & MCP JOINTS OPEN,
    - AP FOR REDUCED OID
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20
Q
  1. ROUTINE PROJECTIONS OF HAND:
  2. CR FOR HAND
  3. WHICH PROJECTION BEST FOR LOCALIZING FOREIGN BODIES?
  4. WHICH IS BEST FOR DISPLACEMENT OF FRACTURES?
A
  1. PA, PA OBLIQUE (45*) & LATERAL (FAN & TRUE LATERAL)
  2. PA & OBLIQUE = 3RD MCP
    LATERAL = 2ND MCP
  3. TRUE LATERAL / LATERAL HAND IN EXTENSION
  4. TRUE LATERAL / LATERAL HAND IN EXTENSION
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21
Q

MAJOR ANATOMY FOR EACH HAND PROJECTION:
A. PA:
B. PA OBLIQUE:
C. LATERAL:

A

A. PA: IP & MCP JOINTS OPEN
- UNIFORM CONCAVITIES OF 2-5TH PHALANGES
B. PA OBLIQUE: 1-2 MC HEADS NOT SUPERMIP.
- 3-5TH ARE SLIGHTLY SUPERIMP.
- IP & MCP JOINTS OPEN
C. LATERAL: 2-5 MC SUPERIMP.

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22
Q
  1. ROUTINE PROJECTIONS OF WRIST:
  2. ADVANCED PROJECTIONS OF WRIST (5):
  3. CR FOR ROUTINE WRIST PROJECTIONS:
  4. ALTERNATIVE TO PA WRIST:
A
  1. PA, PA OBLIQUE & LATERAL
  2. PA ULNAR DEVIATION
    - PA AXIAL SCAPHOID (ULNAR DEVIATION)
    - STECHER METHOD (PA AXIAL)
    - RADIAL DEVIATION
    - GAYNOR - HART (TANGENTIAL CARPAL CANAL)
  3. PERP. MID-CARPAL AREA
  4. AP
23
Q

MAJOR ANATOMY FOR EACH WRIST PROJECTION:
A. PA:
B. PA OBLIQUE:
C. LATERAL:

A

A. PA: NOT ALL INTERCARPALS OPEN B/C IRREGULAR SHAPES
B. PA OBLIQUE: CARPALS ON LATERAL SIDE OF WRIST (TRAPEZIUM & SCAPHOID)
C. LATERAL: ULNA HEAD OVER RADIUS
- 2-5TH MC NEARLY SUPERIMP.
- SHOWS ANTERIOR / POSTERIOR DISLOCATION

24
Q
  1. PA ULNAR DEVIATION:
    A. CR:
    B. KEY REASON FOR PROJECTION:
    C. ANATOMY:
  2. PA AXIAL SCAPHOID (ULNAR DEVIATION)
    A. CR:
    B. KEY REASON FOR PROJECTION:
    C. ANATOMY:
  3. PA AXIAL - STECHER METHOD
    A. CR:
    B. KEY REASON FOR PROJECTION:
    C. ANATOMY:
A
  1. PA ULNAR DEVIATION:
    A. CR: PERP. ENTERING SCAPHOID
    B. KEY REASON FOR PROJECTION: INJURY TO SCAPHOID
    C. ANATOMY: SCAPHOID W/O SUPERIMPOSITION OR FORESHORTENING
  2. PA AXIAL - SCAPHOID:
    A. CR: 10-15* TOWARD ELBOW
    - ENTERING SCAPHOID
    B. KEY REASON FOR PROJECTION: INJURY TO SCAPHOID
    C. ANATOMY: SCAPHOID W/O SUPERIMPOSITION OR FORESHORTENING
  3. PA AXIAL SCAPHOID
    A. CR: PERP. MID SCAPHOID
    - ANGLE IR 20* ON DIGIT SIDE
    B. KEY REASON FOR PROJECTION: INJURY TO SCAPHOID
    C. ANATOMY: SCAPHOID W/O SUPERIMPOSITION OR FORESHORTENING
25
Q
  1. PA WRIST - RADIAL DEVIATION
    A. CR:
    B. KEY REASON FOR PROJECTION:
    C. ANATOMY:
  2. TANGENTIAL CARPAL CANAL - GAYNOR-HART METHOD
    A. CR:
    B. KEY REASON FOR PROJECTION:
    C. ANATOMY:
A
  1. PA WRIST - RADIAL DEVIATION
    A. CR: MIDCARPAL AREA
    B. KEY REASON FOR PROJECTION: MEDIAL CARPALS
    C. ANATOMY: OPEN INTERSPACES ON MEDIAL SIDE OF WRISTS
  2. TANGENTIAL CARPAL CANAL - GAYNOR-HART METHOD
    A. CR: 1 IN DISTAL BASE OF 3 MC
    • 25-30* TOWARD HEAD
      - HAND SLIGHTLY ROTATED INTERNALLY
      B. KEY REASON FOR PROJECTION: CARPAL TUNNEL / CARPAL CANAL
      C. ANATOMY: PISIFORM & HAMULUS PROCESS WITHOUT SUPERIMP.
      - CARPAL CANAL
26
Q
  1. HOW IS HAND PLACED IN GAYNOR-HART?
  2. WHAT IS CARPAL TUNNEL SYNDROME?
  3. WHAT VIEW SHOWS ANTERIOR OR POSTERIOR DISPLACEMENT IN WRIST?
A
  1. SLIGHTLY INTERNALLY ROTATED
    - FINGERS PULLED BACK
  2. IMPINGEMENT ON MEDIAN NERVE
    - CARPAL CANAL SYNDROME
  3. LATERAL WRIST
27
Q
  1. PROJECTIONS OF FOREARM:
  2. CR FOR FOREARM:
  3. KEY ANATOMY OF FOREARM PROJECTIONS:
  4. EPICONDYLES POSITION IN EACH:
A
  1. AP & LATERAL
  2. MID-FOREARM
  3. AP: HUMERAL EPICONDYLES PROFILE
    - RADIAL READ, NECK & TUBEROSITY SLIGHTLY SUPIMP. BY ULUNA

LAT: HUMERAL EPICONDYLES SUPERIMP.
- DISTAL RADIUS & ULNA SUPERIMP
- RADIAL HEAD SUPERIMP. CORONOID

  1. AP = EPICODYLES PARALLEL
    - LATERAL: EPICONDYLES PERP.
28
Q
  1. ROUTINE PROJECTIONS OF ELBOW:
  2. ADVANCED PROJECTIONS OF ELBOW: (3)
  3. CR FOR ROUTINE ELBOW PROJECTIONS:
A
  1. AP, LATERAL, AP OBLIQUE (MEDIAL OR LATERAL ROTATION)
  2. A. AP PARTIAL FLEXION
    - COYLE METHOD - TRAUMA AXIAL (LATEROMEDIAL OR MEDIOLATERAL)
  3. PERP. ELBOW JOINT
29
Q
  1. OBLIQUITY OF OBLIQUE ELBOW:

2 EPICONDYLES IN AP & LATERAL ELBOW PROJECTIONS

  1. ANATOMY FOR ELBOW PROJECTIONS
    A. AP:
    B. LATERAL:
    C. LATERAL OBLQIUE:
    D. MEDIAL OBLIQUE:
A
  1. 45* MEDIAL & 45* LATERAL OBLIQUES
  2. AP = PARALLEL
    - LATERAL = PERP.
  3. A. AP: MEDIAL & LATERAL EPICONDYL. IN PROFILE
    - RADIAL HEAD, NECK & TUBEROSITY SLIGHT SUPERIMP. BY ULNA
    - RADIAL TUBEROSITY IN PROFILE MEDIALLY
    B. LATERAL: OLECRANON PROCESS IS IN PROFILE
    - RADIAL HEAD SUPERIMP. BY CORONOID
    - EPICONDYLES SUPRIMP.
    - 3 CONCENTRIC ARCS & 3 FAT PADS
    C. LATERAL OBLIQUE: RADIAL HEAD, NECK & TUB FREE SUPERIMP.
    D. MEDIAL OBLIQUE: CORONOID PROCESS OF ULNA PROFILE
    - RADIAL HEAD, NECK SUPERIMP.
30
Q
  1. AP ELBOW - PARTIAL FLEXION
    - A. CR:
    - B. REASON FOR PROJECTION:
    - C. ANATOMY:
  2. ELBOW COYLE METHOD - AXIAL LATEROMEDIAL
    - A. CR:
    - B. REASON FOR PROJECTION:
    - C. ANATOMY:
  3. ELBOW COYLE METHOD - MEDIOLATERAL
    - A. CR:
    - B. REASON FOR PROJECTION:
    - C. ANATOMY:
A
  1. AP ELBOW - PARTIAL FLEXION
    - A. CR: ELBOW JOINT
    - B. REASON FOR PROJECTION: WHEN ELBOW CANNOT BE FULLY EXTENDED FOR AP
    - C. ANATOMY: DISTAL HUMERUS ON FIRST IMAGE
    * PROXIMAL HUMERUS ON FOREARM IMAGE
    TWO PROJECTIONS, ONE WITH HUMERUS PARALLEL & ONE WITH FOREARM PARALLEL
  2. ELBOW COYLE METHOD - AXIAL LATEROMEDIAL
    - A. CR: 45* TOWARD SHOULDER
    • ELBOW FLEXED 90*
      - B. REASON FOR PROJECTION: TRAUMA / REPLACES LATERAL OBLIQUE
      - C. ANATOMY: OPEN JOINT BTWN RADIAL HEAD & CAPITULUM
    • RADIAL HEAD, NECK & TUBEROSITY FREE SUPERIMP.
  3. ELBOW COYLE METHOD - MEDIOLATERAL
    - A. CR: 45* AWAY FROM SHOULDER
    - B. REASON FOR PROJECTION: TRAUMA / REPLACES MEDIAL OBLIQUE
    - C. ANATOMY: OPEN JOINT BTWN CORONOID & TROCHLEA
    • CORONOID PROCESS IN PROFILE
    • RADIAL HEAD & NECK SUPERIMP. BY ULNA
31
Q
  1. ROUTINE PROJECTIONS OF HUMERUS:
  2. ADVANCED PROJECTION OF HUMERUS:
  3. WHAT IS IMPORTANT TO INCLUDE IN HUMERUS PROJECTIONS?
  4. CR FOR ROUTINE HUMERUS
A
  1. AP & LATERAL
  2. TRANSTHORACIC LATERAL - LAWRENCE METHOD
  3. AC / SHOULDER JOINT PROXIMALLY & ELBOW JOINT LATERALLY
  4. PERP. MID-POINT HUMERUS
32
Q
  1. ANATOMY FOR HUMERUS PROJECTIONS:
    - A. AP:
    - B. LATERAL:
  2. HOW IS LATERAL HUMERUS PREFORMED?
  3. HOW ARE EPICONDYLES IN AP HUMERUS?
    - LATERAL?
A
  1. AP: GREATER TUBERCLE LATERALLY
    - EPICONDYLES IN PROFILE
    - B. LATERAL: LESSER TUBERCLE MEDIALLY
    • EPICONDYLES SUPERIMPOSED
  2. LATEROMEDIAL OR MEDIOLATERAL
  3. AP = PARALLEL TO IR
    - LATERAL = PERPENDICULAR TO IR
33
Q
  1. TRANSTHORACIC LATERAL HUMERUS - PROXIMAL
    - A. METHOD NAME:
    - B. CLINICAL INDICATION:
    - C. RESPIRATION
    - D. CR:
    - E. ANATOMY:
  2. TRANSTHORACIC LATERAL HUMERUS - DISTAL
    - A. METHOD NAME:
    - B. CLINICAL INDICATION:
    - C. RESPIRATION
    - D. CR:
    - E. ANATOMY:
A
  1. TRANSTHORACIC LATERAL HUMERUS - PROXIMAL
    - A. LAWRENCE METHOD
    - B. WHEN ARM CANT BE ROTATED
    - C. ORTHOSTATIC
    - D. CR: THROUGH THORAX AT SURGICAL NECK
    - E. ANATOMY: LATERAL PROXIMAL HUMERUS
    • HUMERUS THROUGH LUNG FIELD
  2. TRANSTHORACIC LATERAL HUMERUS - DISTAL
    - A. LAWRENCE METHOD
    - B. TRAUMA, DISTAL PART OF HUMERUS
    - C. SUSPENDED
    - D. MIDPOINT OF DISTAL HUMERUS
    - E. ANATOMY: DISTAL HUMERUS
    • EPICONDYLES SUPERIMP.
34
Q
  1. WHAT IS NEEDED BEFORE TRANSTHORACIC LATERAL PROJECTION OF HUMERUS?
  2. ROUTINE PROJECTIONS OF SHOULDER:
  3. ADVANCED PROJECTIONS OF SHOULDER:
  4. CR FOR AP SHOULDER PROJECTIONS:
A
  1. NEUTRAL HUMERUS PROJECTION FIRST
  2. AP INTERNAL, EXTERNAL & PA OBLIQUE - SCAPULAR Y
  3. INFEROSUPERIOR AXIAL - LAWRENCE METHOD,
    - AP OBLIQUE - GRASHEY METHOD,
    - SUPRASPINATUS OUTLET - NEER METHOD
  4. CR: 1 IN INFERIOR TO CORACOID PROCESS
35
Q
  1. HOW ARE EPICONDYLES IN AP SHOULDER WITH:
    - A. EXTERNAL ROTATION
    - B. INTERNAL ROTATION
    - C. NEUTRAL ROTATION
  2. ANATOMY FOR AP SHOULDER:
    - A. EXTERNAL ROTATION
    - B. INTERNAL ROTATION
    - C. NEUTRAL ROTATION
A
    • A. EXTERNAL - PARALLEL
      - B. INTERNAL - PERP.
      - C. NEUTRAL - 45* ANGLE
    • A. EXTERNAL: GREATER TUBERCLE LATERALLY
      * LESSER SUPERIMP. BY HUMERAL HEAD
      - B. INTERNAL - LESSER IN PROFILE LATERALLY, GREATER SUPERIMP. BY HUMERAL HEAD
      - C. NEUTRAL - GREATER AND LESSER PARTIALLY SEEN
36
Q
  1. WHAT POSITIONAL ERRORS ARE SEEN IN IMAGES?
    IMAGE A:
    IMAGE B:
A
  1. IMAGE A: ROTATION
    - TORSO ROTATED TOWARD AFFECTED SIDE
    - MEDIAL CLAVICLE END ROTATED AWAY FROM SPINE
    - THORAX & SCAPULA INCREASED SUPERIMPOSITION

IMAGE B:

37
Q
  1. SHOULDER PA OBLIQUE - SCAPULAR Y
    - A. PATIENT ROTATION:
    - B. SCAPULA POSITION TO IR:
    - C. CR:
    - D. ANATOMY:
A
  1. SHOULDER PA OBLIQUE - SCAPULAR Y
    - A. 45-60* , ARM SLIGHTLY POSTERIOR
    - B. PERP. IR
    - C. CR: PERP. SCAPULOHUMERAL JOINT
    - D. ANATOMY: LATERAL SCAPULA & HUMERUS
    ARMS OF Y = ACROMION & CORACOID
    SCAPULAR BODY = LEG OF Y
    - HUMERUS, SCAP BODY SUPERIMP. W/O RIB SUPERIMP.
38
Q
  1. HOW IS SCAPULA BODY IS POSITIONED TO IR IN OBLIQUE SHOULDER - SCAPULAR Y?
  2. HOW IS IT APPEAR ON IMAGE?
  3. WHERE IS HUMERAL HEAD IN SCAPULAR Y WITH
    - A. NO DISLOCATION:
    - B. POSTERIOR DISLOCATION:
    - C. ANTERIOR DISLOCATION:
  4. WHICH DISLOCATION MOST COMMON?
A
  1. SCAPULA PERP. TO IR
  2. SCAPULA IN LATERAL
  3. A. NO DISLOCATION: HUMERAL HEAD, SCAPULAR BODY & HUMERAL SHAFT SUPERIMP.
    B. POSTERIOR - HUMERAL HEAD POSTERIORLY, BELOW ACROMION
    C. ANTERIOR - HUMERAL HEAD ANTERIORLY, BELOW CORACOID PROCESS
  4. ANTERIOR
39
Q
  1. WHAT MUST BE SEEN ON SCAPULAR Y IMAGE TO ENSURE IT ISN’T ROTATION AND IS ACTUALLY DISLOCATION: (3 THINGS):
  2. IDENTIFY EACH DISLOCATION IN IMAGES (IF ANY)
A
    • Y FORMATION SEEN
      - MEDIAL AND LATERAL SCAPULAR BORDERS SUMPERIMP.
      - HUMERUS NOT SUPERIMP. OVER SCAP. BODY
  2. IMAGE A: NO DISLOCATION
    - IMAGE B: POSTERIOR ( HUMER. HEAD UNDER ACROMION)
    - IMAGE C: ANTERIOR ( HUM. HEAD UNDER CORACOID)
40
Q
  1. WHAT ARE POSITIONING ERRORS IMAGED IN THE OBLIQUE SHOULDER - SCAPULAR Y IMAGES:
  2. HOW CAN YOU IDENTIFY LATERAL BORDER VS. MEDIAL BORDER OF SCAPULA?
A
  1. IMAGE 1: EXCESSIVE OBLIQUITY
    - LATERAL BORDER SUPERIMP. THORAX OR CLOSER TO THORAX THAN MEDIAL

IMAGE 2: INSUFFICIENT OBLIQUITY:
- VERTEBRAL BORDER SUPERIMP. THORAX, OR CLOSER TO THORAX THAN LATERAL

  1. LATERAL BORDER: THICKER WITH 2 CORTICAL OUTLINES
    - VERTEBRAL BORDER: SINGLE THIN LINE
41
Q
  1. INFEROSUPERIOR AXIAL SHOULDER - LAWRENCE METHOD
    - A. BODY/ARM POSITION:
    - B. CR:
    - C. ANATOMY SEEN:
  2. AP OBLIQUE SHOULDER - GRASHEY METHOD
    - A. BODY/ARM POSITION:
    - B. CR:
    - C. ANATOMY SEEN:
  3. TANGENTIAL SUPRASPINATUS OUTLET - NEER METHOD:
    - A. BODY/ARM POSITION:
    - B. CR:
    - C. ANATOMY SEEN:
A
  1. INFEROSUPERIOR AXIAL SHOULDER - LAWRENCE METHOD
    - A. ABDUCT ARM 90, EXTERNAL ROTATION
    - B. CR: MEDIALLY 25-30     @ AXILLA & HUMERAL HEAD
    - C. ANATOMY SEEN: OPEN GLENOHERMERAL JOINT
    * GLENOID CAVITY IN PROFILE
    * CORACOID * LESSER IN PROFILE
  2. AP OBLIQUE SHOULDER - GRASHEY METHOD
    - A. 35-45* TOWARD AFFECTED SIDE, SCAPULAR PARALLEL IR
    - B. CR: SCAPULOHUMERAL JOINT
    - C. ANATOMY SEEN: SCAPULOHUMERAL JOINT OPEN
    *GLENOID CAVITY PROFILE W/O SUPERIMP.
  3. TANGENTIAL SUPRASPINATUS OUTLET - NEER METHOD:
    - A. 45-60* FROM MCP, POSITION FOR Y VIEW
    - B. CR: 10-15 CAUDAD THROUGH HUMERAL HEAD
    - C. ANATOMY SEEN: CORACROMIAL ARCH
    *SUPRASPINATOUS OUTLET OPEN
    * SCAPULA LATERAL Y VIEW
42
Q
  1. WITH INFEROSUPERIOR AXIAL SHOULDER (LAWRENCE METHOD), WHAT IS DONE IF ARM ABDUCTION IS LESS THAN 90?
    - WHAT IS RULE OF THUMB FOR THIS?
  2. HOW IS SCAPULAR BODY POSITIONED TO IR IN GRASHEY METHOD?
  3. WHAT IS HILL-SACH DEFECT?
    - WHAT PROJECTION IS IT SEEN?
A
  1. LESS 90 = DECREASE CR 15-20*
    - GREATER ARM ABDUCTION = GREATER CR ANGLE
  2. SCAPULAR BODY IS PARALLEL IR
  3. COMPRESSION FRACTURE OF HUMERAL HEAD
    - EXAGGERATED EXTERNAL ROTATION ON INFEROSUPERIOR AXIAL LAWRENCE METHOD OF SHOULDER
43
Q
  1. WHICH ADVANCED SHOULDER PROJECTIONS DEMONSTRATE OPEN GLENOID CAVITY?
    - WHAT OTHER SIMILAR ANATOMY DO THESE PROJECTIONS SHOW
  2. WHICH PROJECTION SHOWS SHOULDER IMPINGEMENT?
  3. IN AP OBLIQUE SHOULDER - GRASHEY METHOD, WHICH DIRECTION IS PATIENT ROTATED?
A
  1. INFERO LAWRENCE & GRASHEY
    • BOTH SHOW SCAPHUMERAL JOINT
  2. TANGENTIAL SUPRASPINATUS OUTLET - NEER METHOD
  3. 35-45* TOWARD AFFECTED SIDE
44
Q
  1. ROUTINE PROJECTIONS OF SCAPULA:
  2. ROUTINE PROJECTIONS OF CLAVICLE:
  3. PROJECTIONS OF AC JOINTS:
  4. PROJECTIONS OF SC JOINTS:
A
  1. AP & LATERAL
  2. AP & AP AXIAL
  3. AP PEARSON METHOD
  4. PA & PA OBLIQUE
45
Q
  1. AP SCAPULA:
    - A. ARM PLACEMENT:
    - B. CR:
    - C. RESPIRATION:
    - D. ANATOMY:
  2. LATERAL SCAPULA:
    - A. ARM PLACEMENT:
    - B. CR:
    - C. RESPIRATION:
    - D. ANATOMY:
A
  1. AP SCAPULA:
    - A. ABDUCT AFFECTED ARM 90*
    * AFFECTED ARM RAISED (LIKE A SALUTE)
    - B. CR: 2 IN INFERIOR TO CORACOID (LEVEL OF AXILLA) & 2 IN MEDIAL FROM LATERAL BORDER
    - C. ORTHOSTATIC BREATHING (IF NOT - SUSPENDED)
    - D. ANATOMY: LATERAL SCAPULA BORDER W/O SUPERIMP.
    * MEDIAL BORDER SEEN THROUGH THORAX
    * HUMERAL SHAFT SEEN 90* ABDUCTION
  2. LATERAL SCAPULA:
    - A. ARM PLACEMENT: BASED ON AREA OF INTEREST:
    * ACROMION/CORACOID = AFFECT ARM SLIGHT POSTERIOR & BEHIND BACK
    * SCAPULAR BODY = ARM ACROSS CHEST
    - B. CR: MIDVERTEBRAL BORDER
    - C. SUSPENDED RESP.
    - D. ANATOMY: SCAPULA IN LATERAL
    * SUPERIMP. BORDERS
    * SCAPULA BODY FREE OF SUPERIMP. BY RIBS
46
Q
  1. AP CLAVICLE
    - A. CR:
    - B. ANATOMY:
  2. AP AXIAL CLAVICLE
    - A. CR:
    - B. ANATOMY:
    - C. RESPIRATION:
    - D. WHY CR & RESPIRATION?
A
  1. AP CLAVICLE
    - A. CR: PERP. MIDCLAVICLE
    - B. ANATOMY: ENTIRE CLAVICLE SEEN
    * AC & SC JOINT INCLUDED
    * MIDCLAVICLE SUPERIMP BY SUPERIOR SCAPULAR ANGLE
  2. AP AXIAL CLAVICLE
    - A. CR: 15-30* CEPHALIC TO MIDCLAVICLE
    - B. ANATOMY: MEDIAL CLAVICLE SUPERIMP. OVER RIB
    * REST CLAVICLE FREE SUPERIMP.
    - C. SUSPEND END OF INSPIRATION
    - D. CR & RESPIRATION ELEVATES CLAVICLES
47
Q
  1. AP AC JOINTS - PEARSON METHOD
    - A. CR:
    - B. ANATOMY:
    - C. KEY PARTS OF EXAM (4 THINGS)
    - D. CLINICAL INDICATION:
  2. WHAT IS WIDENING OF JOINT SPACE INDICATE?
  3. ALTERNATIVE POSITION
A
  1. A. 1 IN ABOVE JUGULAR NOTCH (MIDPOINT BTWN AC JOINTS )
    - B. ANATOMY: SYMMETRICAL SC & AC JOINTS
    - C. 2 PROJECTIONS (WITH & WITHOUT PROJECTIONS)
    - 72 SID
    - CLAVICLE OR SHOULDER XRAY DONE FIRST R/O FX
    - WEIGHTS AROUND WRIST
    D. RULE OUT AC JOINT SEPARATION
  2. SEPARATION AC JOINT
  3. SUPINE
48
Q
  1. PA SC JOINT
    - CR:
    - ANATOMY:
  2. PA OBLIQUE SC JOINT
    - CR:
    - OBLIQUITY:
    - ANATOMY:
A
  1. PA SC JOINT
    - CR: PERP. MSP @ T2-T3 (APPROX. 3in DISTAL TO C7)
    - ANATOMY: BILATERAL SC JOINTS
  2. PA OBLIQUE SC JOINT
    - CR: T2-T3 (3IN DISTAL C7) & 1-2 IN LATERAL MSP (TO UPSIDE)
    - OBLIQUITY: 10-15*
    - ANATOMY: DOWNSIDE MANUBRIUM & SC JOINT FREE SUPERIMP.
    * RAO - RIGHT SC JOINT, LAO = LEFT
49
Q
  1. IN PA OBLIQUE SC JOINT:
    - A. PATIENT IN RAO - SHOWS ______ SIDE.
    - B. PATIENT IN LAO - SHOWS _______ SIDE.
  2. HOW DOES CR ENTER BODY ON PA OBLIQUE SC JOINT?
  3. WHAT TERMS DESCRIBE DISPLACEMENT OF BONE FROM JOINT?
A
  1. RAO = RIGHT SC
    - LAO = LEFT
  2. ENTERS UPSIDE / IMAGES DOWNSIDE
  3. DISLOCATION & SUBLUXATION
50
Q
  1. DISLOCATION IS:
  2. SUBLUXATION IS:
  3. SPRAIN IS:
  4. FRACTURE IS:
  5. NO FRACTURE / NO BREAKING OF SKIN:
A
  1. DISPLACEMENT OF BONE
  2. PARTIAL DISLOCATION
  3. SPRAIN: LIGAMENT TEARING
  4. DISRUPTED BONE DUE TO FORCE
  5. CONTUSION (BRUISE)
51
Q
  1. SIMPLE VS COMPOUND FRACTURE:
  2. COMPLETE VS INCOMPLETE FRACTURE:
  3. WHAT IS COMMINUTED FRACTURE?
  4. WHAT IS AVULSION FRACTURE?
    - COMMON SITE:
A
  1. SIMPLE = CLOSED FX, DOESNT BREAK SKIN
  2. COMPOUND = OPEN FX, THROUGH SKIN
  3. COMMINUTED = BONE CRUSHED AT SITE OF IMPACT, RESULT IN 2+ FRAGMENTS
  4. SEPARATION OF SMALL BONE AWAY BY STRESS
    - JONES FX IN FOOT (5TH METATARSAL TUBEROSITY)
52
Q
  1. WHAT IS GREENSTICK FRACTURE?
    - COMMON IN:

WHERE IS:
2. BARTON FRACTURE:
3. BENNETT FRACTURE:
4. BOXER FRACTURE:
5. BASEBALL FRACTURE:

A
  1. BENDING OF BONE
    - COMMON IN CHILDREN
  2. BARTON FRACTURE: FX DISTAL RADIUS
  3. BENNETT FRACTURE: FX BASE 1ST MC
  4. BOXER FRACTURE: FX OF 5TH MC
  5. BASEBALL FRACTURE: FX DISTAL PHALANX
53
Q

WHERE IS
1. COLLES FRACTURE
2. SMITH FRACTURES:
3. HANGMAN FRACTURE
4. HUTCHINSON FRACTURE:
5. JONES FRACTURE:
6. MONTEGGIA FRACTURE:
7. POTT FRACTURE:

A
  1. COLLES FRACTURE: WRIST FX W. POSTERIOR DISPLACEMENT
  2. SMITH FRACTURES: WRIST FX W. ANTERIOR DISPLACEMENT (REVERSE COLLES)
  3. HANGMAN FRACTURE: FX PEDICLE C2
  4. HUTCHINSON FRACTURE: FX RADIAL STYLOID
  5. JONES FRACTURE: FX 5TH MT TUBEROSITY
  6. MONTEGGIA FRACTURE: FX PROXIMAL HALF ULNA
  7. POTT FRACTURE: FX DISTAL FIBULA
54
Q
  1. WRIST FRACTURE WITH DISTAL RADIUS DISPLACED POSTERIORLY:
  2. WRIST FRACTURE WITH DISTAL RADIUS DISPLACED ANTERIORLY:
  3. WHAT IMAGE SHOWS MONTEGGIA FRACTURE?
  4. WHAT IS A STELLATE FRACTURE?
  5. WHAT IMAGE SHOWS POTTS FRACTURE?
A
  1. COLLES
  2. SMITHS (REVERSE COLLES)
  3. LATERAL FOREARM OR ELBOW
  4. FX FROM CENTRAL POINT IN STARLIKE PATTERN

Ketering (13 decks)

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