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IMAG 301- Positioning Princ. I > Ch. 4 Upper Limb > Flashcards

Ch. 4 Upper Limb Flashcards

1
Q

How many phalanges are in each hand?

A

14

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2
Q

How many metacarpals are in each hand?

A

5

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3
Q

How many carpal bones are in the wrist?

A

8

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4
Q

How many phalanges re contained in the thumb?

A

Only 2

*digits 2-5 have 3 digits

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5
Q

Which digit is most lateral?

A

The thumb

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6
Q

What are the two names of the phanlanges in the thumb?

A

Proximal phalanx and distal phalanx

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7
Q

What are the metacarpals?

A

The bones that compose the palm of the hand

-identified by numbers

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8
Q

Are the heads of the metacarpals distal or proximal to the point of attachment?

A

Distal

-Base of metacarpals are proximal (articulate with carpals)

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9
Q

What are the four wrist bones that are proximal?

A

Scaphoid, lunate, triquetrum, pisiform

lateral-medial

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10
Q

What are the four wrist bones that are distal?

A

trapzium, trapezoid, capitate, hamate

Lateral-medial

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11
Q

What does IP stand for?

A

Interphalangeal (IP) joints

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12
Q

Where are IP joints located?

A

between phalanges

DIP, PIP, IP

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13
Q

What is MCP?

A

Metacarpophalangeal joints

-Articulations between the head of the metacarpals and the proximal phalanges

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14
Q

What are MCP joints classified as?

A

Synovial, diarthrotic, or ellipsoidal joints

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15
Q

What are IP joints classified as?

A

Synovial, diarthrotic, (freely movable joint), and hinge joint

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16
Q

Where are the Carpometacarpal joints (CMC) located?

A

Articulations between the bases of the metacarpals and the carpal bones

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17
Q

Intercarpal joints?

A

Between carpal bones

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18
Q

Radiocarpal joint

A

Between carpals and distal radius

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19
Q

If a patient can not remove their ring, what do you do?

A

Make a note saying that the patient has a ring on their finger

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20
Q

What size IR is used for hand, wrist, and finger xrays?

A

10x12

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21
Q

What is critical when imaging the hand, wrist, and fingers?

A

Collimation!

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22
Q

What is the SID for imaging of the hands, fingers, and wrists?

A

40 in SID, to the IR (which is placed on top of the table)

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23
Q

What are the essential projections for Digits 2-5?

A

PA, Lateral, and PA Oblique

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24
Q

What is the collimation field size for hand, wrist, and finger images?

A

1 in. on all sides of hand, wrist, or finger

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25
What should you also included in the collimation field in finger images?
Include 1 in. proximal to the MCP (half way down metacarpals)
26
Where is the centering for a finger image?
PIP joint for whatever finger you are imaging (middle knuckle)
27
Lateral Digit 2-5 projection conditions
Separate digit of interest using a cotton swab or tape, and fold other digits into fist
28
What digits for the lateral projections are positioned on their lateral surface? (mediolateral)
digits 2 and 3 | this is done to demonstrate fractions and dislocations
29
What digits for the lateral projection should be positioned on their medial surface? (lateromedial)
digits 4 and 5
30
PA Oblique digits 2-5 conditions
- Extend w. palm surface resting at 45 degrees on a sponge (if necessary) - centering at PIP for particular digit
31
What is the more comfortable position for PA oblique of the fingers?
PA External Oblique where patient moves hands to 45 degrees towards the outside
32
Essential projections of the Thumb?
AP, Lateral, and PA Oblique
33
Centering point for Thumb projections?
MCP and include entire metacarpal of thumb
34
AP thumb projection conditions
- Rotate hand exteriorly | - Centering point, MCP
35
Oblique Thumb
Hand is flat on IR, centering at MCP
36
Lateral Thumb
- Have patient curl fingers (makes it comfortable for them) - thumb nail perpendicular to IR - center line in the center of the thumb, center at MCP
37
PA hand
- Center at 3rd MCP | - light field 1 in above hand and below wrist
38
Centering Point for all Hand projections
3rd MCP for PA and PA oblique, 2nd MCP for both Lateral projections (fan and extended)
39
Essential Projections for the Hand?
PA, Lateral (2 - extended and fan), PA Oblique
40
Where does the central ray enter the 3rd digit for the PA projection ?
3rd PIP (PA of 3rd digit)
41
PA External Obliqye of Hand
-Can support digits w. sponge, digits are extended so we can see joint spaces better
42
What should be flexed 90 degrees during the Lateral Hand projection?
Elbow should be flexed 90 degrees
43
Why is a PA lateral done for a hand?
To look for foreign bodies (needle, or a wood chip stuck in the hand)
44
Essential projections for the Wrist
PA, Lateral, PA oblique, AP oblique, and Ulnar deviation
45
What position is most comfortable regarding an oblique projection of the hand? A. AP Oblique B. PA Oblique
A. AP Oblique
46
What projection of the wrist is done to see fractures of the scaphoid of the wrist?
PA Oblique
47
Essential Projection to view Scaphoid
PA axial (Stecher method)
48
The PA axial projection is also known as what?
The Stecher method
49
Essential Projection to view the carpal canal
Tangential (Gaynor-Hart method)
50
The Tangential projection is also known as what?
The Gaynor-Hart method
51
Collimated field size for Wrist projections
2.5 in. proximal and distal to the wrist joint | Including all metacarpals and centering at wrist joint
52
What should the patient do with their wrist in order to get it closer to the IR for a PA wrist projection?
Flex digits
53
What part of the body needs to be flexed 90 degrees for a Lateral Wrist projection?
Elbow must be flexed 90 degrees
54
PA Oblique Wrist
Rotate palmar surface toward IR until wrist forms 45 degrees | -can use sponge to support wrist
55
AP Oblique
Where wrist is rotated medially at 45 degrees to the IR (wrist should be in a semisupinated position)
56
PA Projection of Ulnar Deviation
- Upper limb rests on table - Elbow flexed 90 degrees - CR is perpendicular to the scaphoid - CR angulation of 10-15 degrees proximally or distally
57
PA Axial Scaphiod (Stecher Method)
- Upper limb resting on table - finger end of IR is supported to elevate it 20 degrees - CR perpendicular to table and enters at scaphoid
58
Tangential Carpal Tunnel (Gaynor-Hart Method)
- Hyperextended wrist - Center IR to joint at level of radial styloid - Have patient grasp digits with other hand in order to maintain extended position - CR is angled 25-30 degrees toward the palm of the hand and centered about 1 in. distal to the base of the 3rd metacarpal
59
Which essential projections requires the CR to be centered to the 3rd MCP joint
PA Hand, PA Oblique Hand,
60
Collimated field for PA projection of the hand extends 1 in. on all sides of the hand, including 1 in. proximal to the what?
Radial Styloid
61
How far proximal and distal to the wrist joint should the collimated field extend for the PA projection of the wrist?
2.5 in.
62
What tells you that a digit is parallel to the IR?
When you see the joint spaces are the same all the way up the finger
63
When is a PA thumb done?
When a patient can't put their thumb in the AP projection
64
AP Forearm positioning
- Elbow is extended w. hand supinated - Upper limb in same plane - CR centered at midpoint of forearm
65
Lateral Forearm positioning
- Entire upper limb is in the same plane w. forearm - elbow flexed 90 degrees - CR enters at midpoint of forearm
66
What position is done if patient can't extend their arm fully?
AP Partial Flexion
67
AP Elbow
- Upper limb in same plane - Elbow extended and hand supinated - Humeral epicondyles parallel to IR - CR centered to elbow joint
68
Collimation for Elbow projections?
3 in. proximal and distal to the elbow joint and 1 in. on all sides
69
Collimation for Forearm projections?
2 i n. distal to the wrist joint and proximal to the elbow joint
70
Lateral Forearm positioning?
Flex elbow 90 degrees, place medial aspect of forearm against IR -Centering at midpoint of forearm
71
What does the Capitulum articulate with?
Radius
72
What does the Trochlea articulate with?
Ulna

IMAG 301- Positioning Princ. I (8 decks)

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