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From Flashcardlet > Eval-upper extremity > Flashcards

Eval-upper extremity Flashcards

0
Q

True AP projection of proximal humerus

Where should lesser tubercle be visualized?

A

Greater tubercle in lateral profile
Humeral head in medial profile

Lesser-btwn the humeral head and greater tubercle

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1
Q

True AP projection of Humerus … distal end (2)

Relationship of coronal plane to IR? CR?

A

Full visibility of epicondyles
Olecranon fossa in middle btwn epicondyles see all of fossa

Parallel
Perpendicular

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2
Q

Which lateral projection is used for humerus

A

Lateromedial lateral

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3
Q

Erect vs. supine positioning for lateral humerus

A

Erect -arm flexed and posterior hand on hip

Supine - same as erect OR rotate hand so thumb touches table and arm is extended

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4
Q

True lateral projection of distal humerus?

MCP relationship to IR? CR?

A

Superimposed condyles and epicondyles
Distal joint is open

Perpendicular
Parallel

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5
Q

True lateral proximal humerus

A

Lesser tubercle in medial profile

Greater tubercle superimposed with humeral head

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6
Q

What part of the humerus is demonstrated on transthoracic lateral projection? Method name?

A

Lawrence method

Proximal humerus, relationship to scapula and clavicle

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7
Q

When do you perform transthoracic lateral?

A

When arm can’t be abducted or rotated for a lateral and need to visualize proximal end

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8
Q

Position, central ray and breathing tech for transthoracic lateral

A

Seated, erect, semi upright, dorsal decubitus
Place affected arm against IR, try to supinate hand
Raise unaffected arm above head to prevent superimposing of affected arm

CR is MCP at surgical neck

Suspend on full inspiration to fill lungs to improve contrast and easier to penetrate
Or use breathing technique to blur out ribs and markings

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9
Q

Where is humerus visualized in transthoracic

A

Through ribs and lung fields and anterior to vertebral column

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10
Q

Lateral Distal humerus for trauma…. Projection? Position? IR? CR?

A

Lateromedial lateral projection
Dorsal decubitus or lay on unaffected side
Place IR btwn body and affected arm, supinate hand
CR at mid humerus

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11
Q

Elbow joint … Structural tissue type and mvmt? Functional class?

A

Synovial, hinge and diarthrosis

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12
Q

How to obtain a full extension AP elbow? MCP to IR and CR

A

Hand supinated, extend arm, make sure shoulder, humerus, elbow, forearm are all in same horizontal plane allows to open joint
IR parallel
CR perpendicular

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13
Q

True AP proximal elbow

A

Full visualization of epicondyles

Olecranon fossa in center of epicondyles

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14
Q

True AP do distal elbow

A

Radial head, neck and tuberosity slightly superimposed with proximal ulna

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15
Q

Why supinate hand for elbow

A

To prevent rotation of forearm at proximal end

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16
Q

When to do an AP with Partial Flexion

A

In cases of trauma, can’t extend elbow and get in same horizontal plane

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17
Q

How many images and positions for partial Flexion elbow

A

Two images
One with forearm on IR for distal
One with humerus on IR for proximal

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18
Q

How will AP partial Flexion look different than AP elbow?

A

No open joint space

Elongated or foreshortened humeral condyles

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19
Q

Which lateral projection is used for elbow

A

Lateromedial lateral projection, less awkward

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20
Q

Why flex elbow 90 degrees for lateral elbow

A

Olecranon - full process in profile

Fat pads - relaxed and not compressed, if compressed they can mimic pathology esp posterior

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21
Q

How should the hand be positioned for lateral elbow and why

A

Lateral, thumb up to keep radius and ulna superimposed

Determines location of radial tuberosity which should face anteriorly

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22
Q

True lateral of elbow is evident by…

A

Elbow flexed 90 degrees
Olecranon process in profile wo superimposition of humerus
Radial head partially superimposed with coronoid process
Humeral epicondyles are superimposed
Open elbow joint
Radial tuberosity is anteriorly

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23
Q

Which oblique demonstrates radial head and capitulum free of super

A

Lateral rotation ap oblique

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24
Q

Which position shows the proximal radius and ulna superimposed. Also trochlea is free of super

A

Medial rotation ap oblique

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25
Q

What is relationship of MCP passing through epicondyles of elbow to IR? CR?

A

45 degrees

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26
Q

Method name for axiolateral projection of elbow

A

Coyle method

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27
Q

When to do an axiolateral elbow

A

Pts who can’t fully extend or rotate the elbow for oblique projections
Important when wanting to look at radial head, capitulum, trochlea or coronoid process w/o superimposition

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28
Q

Axiolateral positioning seated? Supine? For radial head and capitulum free of super?

A

Seated - elbow flexed 90, pronate hand, angle tube 45 degrees toward the shoulder… replaces lateral oblique

Supine - elbow flexed, IR under humerus and elbow, angle CR 45 towards the shoulder, condyles look elongated

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29
Q

Axiolateral positioning to demonstrate trochlea and coronoid process free of super? Seated? Supine?

A

Replaces medial rotation

Seated - Flex elbow 80 degrees, pronate hand, angle CR 45 away from shoulder

Supine - flex elbow 80, IR under humerus and elbow, Cr 45 away from shoulder

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30
Q

Which forearm bone articulates with carpal bones

A

Radius

31
Q

Radiocarpal joint type

A

Synovial and ellipsoidal

32
Q

Intercarpal joint type

A

Synovial and gliding

33
Q

4 PA wrist free rotation

A

Equal concavity of metacarpals, thumb slightly obliqued
Slight superimposition of carpal bones and also base of metacarpals
Distal radio ulnar joint

34
Q

How should hand be placed for PA wrist

A

Fingers curled under or place15-20 degree sponge under hand

This allows carpal bones to be closer IR

35
Q

When do an AP wrist -2

A

When carpal interspaces and ulna is of interest

36
Q

True PA oblique with LATERAL rotation of wrist

A

Open trapeziotrapezoid
Slight interosseus space btwn 3-4 and 4-5 metacarpal shafts … Look at bases
Superimposition of carpal bones, slight to a lot
Slight super of radioulnar joint

37
Q

What is effect on carpal bones of over rotation of wrist pa oblique

A

Too much superimposition

38
Q

Carpal bones best demonstrated on lateral PA oblique

A

Trapezium and scaphoid

39
Q

Which lateral projection is used for lateral wrist?

True lateral is evident by..(3)

A

Lateromedial lateral projection

Superimposed carpal bones
Superimposed radius and ulna
1st metacarpal free of super an in PA

40
Q

2 primary reason for lateral wrist

A

Anterior posterior displacement and fractures

Looking for foreign object

41
Q

Tangential projection of wrist commonly called? Method name? 3 bones of interest?

A

Carpal tunnel view
Gaynor-hart method
Trapezium, hamate and pisiform
Pisiform is free of superimposition

42
Q

Two projections of tangential projection? CR?

A

Inferiosuperior tangential - hyper extend fingers back, hand verticals
CR is 25-30 and 1” distal to base 3rd metacarpal

Superioinferior tangential - dorsiflex wrist
CR 20-30 degrees to long axis of forearm, angle arm or tube

43
Q

How is patient positioned for AP oblique wrist with medial rotation? Carpal bone best demonstrated

A

Supinate forearm and hand then rotate hand 45 degrees Medially, think ball catchers view

Pisiform

44
Q

Position and carpal bone of interest for PA Ulnar deviation

A

Pronate hand, elbow 90, forearm flat on table, move hand in extreme ulnar deviation
Scaphoid

45
Q

PA Axial wrist… Method name, bone best demonstrated, 2 ways to position?

A

Strecher method
Scaphoid

Center wrist to IR, elevate fingers up 20 degrees, CR perpendicular towards scaphoid
Hand pronate on IR, CR angled 20 degrees towards elbow entering scaphoid

46
Q

PA wrist with Radial deviation…carpals best demonstrated?

A

Pronate and deviate hand inward

Hamate, triquetrum and capitate

47
Q

Which 2 wrist projections best demonstrate the pisiform without superimposition

A

AP oblique medial rotation

Tangential projection

48
Q

What type of joints are the radioulnar joints?

A

Synovial
Pivot
Diarthrosis

49
Q

Hoe should the entire arm be positioned for AP forearm?

A

Shoulder, humerus and forearm all in same horizontal plane
Supinate hand to prevent crossing of proximal forearm
Elbow may look slightly closed due to beam divergence

50
Q

True AP forearm is evident by? Proximal? Distal?

A

Proximal - slight superimposition of radial tuberosity and head with ulna, full visualization of humeral epicondyles with olecranon fossa in btwn.

Joint - open radioulnar joint if all same plane

Distal - slight superimposition of distal radius and ulna, visualize stay loud process

Visualize interosseus space btwn the shafts of radius and ulna

51
Q

How should hand and elbow be positioned for lateral forearm

A

Elbow flexed 90

Hand lateral to prevent crossing

52
Q

True Lateral forearm

A

Radial tuberosity facing anteriorly
Olecranon process in profile
Superimposed humeral condyles and epicondyles
Super by radial head over coronoid process
Super of distal radius and ulna
Visualized interosseus space btwn radius and ulna

53
Q

What type of joints are 2-5 carpometacarpals

A

Synovial and gliding

54
Q

When looking at image, how to tell if fingers were extended and flat on IR

A

Open IP and MCP joints

55
Q

CR for hand

A

Perpendicular to third MCP joint

56
Q

True PA hand evident by?

A

Equal concavity of metacarpals and phalangeal shafts except digit 1
Equal distance of metacarpal heads
Equal amt of soft tissue btwn metacarpals and phalanges
Slight super of metacarpal bases and carpals
Open MCP and IP joints

57
Q

Which type of rotation is performed when doing a PA oblique hand

A

Lateral rotation

58
Q

How should phalanges appear on PA oblique hand

A

Separated, extended to show anterior concavity of shafts

Use 45 foam wedge to keep joint spaces parallel with IR

59
Q

True PA oblique hand

A

Slight overlap of metacarpal bases and heads 3-5
Increased super of carpals and distal radius and ulna
Separation of 2-3 metacarpal
Open joints

60
Q

When doing a lateral hand, which forearm bone is closest to IR and which lateral projection is this

A

Ulna

Lateromedial lateral

61
Q

True lateral hand

A

Superimposed carpals, radius and ulna and metacarpal bones

62
Q

Straight lateral — thumb projection? Phalanges position? Carpal bone demonstrated?

A

PA projection
Superimposed and lateral
Trapezium

63
Q

Fan lateral hand… Thumb projection?

A

PA obliqued

64
Q

Two reasons for lateral hands

A

Localizing foreign bodies

Metacarpal fracture displacement

65
Q

Bilateral AP Oblique—-common name? Method name? Type of rotation?

A

Ball catcher
Norgaard method
Medial

66
Q

Which carpal bone demonstrated on bilateral AP oblique medial hand?

A

Pisiform

67
Q

Why do a bilateral AP oblique medial hand

A

Rheumatoid arthritis

Fractures at bases of 5 metacarpal

68
Q

Type of joint is metacarpophalangeal? Interphalangeal joint 2-5?

A

Ellipsoidal

Hinge

69
Q

Finger and thumb projections? CR for 2-5? CR thumb?

A

PA, PA oblique and lateral
2-5 = PIP joint
Thumb = IP

70
Q

How to tell if fingers were flat on IR

A

Open joint spaces

71
Q

How to ensure digits remain parallel with IR for oblique projections?

A

Use 45 degree radiolucent sponge

72
Q

Which digit will demonstrate best recorded detail for lateral projections and why?

A

2nd and 5th bc they can be placed directly on IR (less OID)

Others elevated to give accurate image of b ones and spaces

73
Q

Advantage of doing an AP thumb vs PA? Disadvantage?

A

Reduce IOD

Awkward for pt to put in AP

74
Q

Include what carpal bone when looking at thumb?

A

Trapezium

75
Q

Thumb free of rotation by…

A

Equal concavity of phalangeal and metacarpal shafts
Equal amts soft tissue on both sides
Fingernail in center of phalanx

From Flashcardlet (23 decks)

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