Upper limb study

Question 1

Which two bony landmarks are palpated to assist with positioning of the upper limb?

Answer 1

lateral and medial epicondyles

Question 2

In an erect anatomic position, which of the following structures is considered most inferior or distal?

head of ulna
olecranon process
radial tuberosity
head of radius

Answer 2

head of ulna

Question 3

Why should a forearm never be taken as a PA projection?

A. too painful for patient
B. causes the proximal radius to cross over the ulna
C. causes the distal radius to cross over ulna
D. increases the OID of the distal radius

Answer 3

causes the proximal radius to cross over the ulna

Question 4

In what position should the hand be for an AP elbow projection?

Answer 4

supinated

Question 5

In what position should the hand be in for an AP medial rotation oblique elbow position?

Answer 5

pronated

Question 6

What projection best demonstrates the coronoid process in profile?

Answer 6

AP medial rotation oblique elbow

Question 7

What projection best demonstrates the radial head and tuberosity without superimposition?

Answer 7

AP lateral rotation oblique elbow

Question 8

What projection best demonstrates the olecranon process in profile?

Answer 8

lateral elbow

Question 9

What projection best demonstrates the coronoid tubercle?

Answer 9

AP elbow

Question 10

What projection best demonstrates the trochlear notch in profile?

Answer 10

lateral elbow

Question 11

What projection best demonstrates the capitulum and lateral epicondyle in profile?

Answer 11

AP lateral rotation oblique

Question 12

What projection best demonstrates the olecranon process seated in olecranon fossa?

Answer 12

AP elbow

Question 13

The long axis of the anatomic part being imaged should be placed:

Answer 13

parallel to the long axis of the IR

Question 14

Where is the CR centered for a PA projection of the second digit?

Answer 14

affected PIP joint

Question 15

Why is it important to keep the long axis of the digit parallel to the IR?

to reduce distortion of phalanges
to visualize joints properly
to demonstrate small fractures
all of the above

Answer 15

all of the above

Question 16

Where is the CR placed for a PA projection of the hand?

Answer 16

third MCP joint

Question 17

What is the major disadvantage of performing a PA projection of the thumb rather than an AP?

Answer 17

increased OID (you lose spatial resolution)

Question 18

What type of fracture is best demonstrated with a modified Robert method (AP axial) ?

Barton
Colles
Bennett
Smith

Answer 18

Bennett fracture

Question 19

What type of CR angle is required for the AP axial projection? (modified Robert’s method)?

A. 5° proximal
B. 10° distal
C. 15° proximal
D. 20° to 25° distal

Answer 19

15° proximal

Question 20

The Brewerton method requires a CR angle of 15° proximal.

Answer 20

true

Question 21

To visualize fat pads surrounding the elbow, exposure factors must be adjusted to see both bony and soft tissue structures.

Answer 21

true

Question 22

Placing multiple images on the same digital IP is recommended as long as close collimation is applied for each projection.

Answer 22

false

Question 23

Choose the best set of exposure factors for upper limb radiography.

A. 64 kVp, 200 mA, 1/20 second, small focal spot, and 40-inch SID
B. 64 kVp, 100 mA, 1/10 second, small focal spot, and 40-inch SID
C. 75 kVp, 600 mA, 1/60 second, large focal spot, and 40-inch SID
D.75 kVp, 200 mA, 1/20 seond, small focal spot, and 40-inch SID

Answer 23

64 kVp, 200 mA, 1/20 second, small focal spot, and 40-inch SID

Question 24

A radiograph of a PA oblique of the hand shows that the third, fourth, and fifth metacarpals are superimposed. What must be done to correct this positioning problem on the repeat exposure?

A. increase obliquity of hand
B. spread fingers out farther
C. decrease obliquity of the hand
D. form a tight fist with the fingers

Answer 24

decrease obliquity of the hand

Question 25

A radiograph of an AP elbow projection demonstrates total separation between the proximal radius and ulna. What must be done to correct this positioning error on the repeat exposure? A. rotate upper limb medially B. rotate upper limb laterally C. angle CR 5-10° caudad D. fully extend elbow

Answer 25

rotate upper limb medially

Question 26

A radiograph of the carpal canal projection shows that the pisiform and hamulus are superimposed. What can be done to correct this problem on the repeat exposure? A. flex wrist slightly B. extend wrist slightly C. rotate wrist laterally 5-10° D. rotate wrist medially 5-10°

Answer 26

rotate wrist laterally 5-10°

Question 27

A radiograph of an AP oblique-medial rotation shows that the coronoid process is not in profile and the radial head is not superimposed over the ulna. What specific positioning error was involved? A. insufficient medial rotation B. excessive medial rotation C. excessive extension of elbow D. excessive flexion of elbow

Answer 27

insufficient medial rotation

Question 28

A radiograph of a lateral projection of the elbow shows that the epicondyles are not superimposed and the trochlear notch is not clearly seen. What must be done to correct this positioning error? A. angle CR 45° toward shoulder B. place humerus/forearm in same horizontal plane C. angle CR 45° away from shoulder D. extend elbow to form an 80° horizontal plane angle

Answer 28

place humerus/forearm in same horizontal plane

Question 29

A patient with a possible Barton fracture enters the ER. Which positioning routine should be performed to confirm the diagnosis?

Answer 29

wrist

Question 30

A patient with a possible Smith fracture enters the ER. Which positioning routine should be performed to confirm the diagnosis?

Answer 30

wrist/forearm

Question 31

A patient has a Colles fracture reduced, and a large plaster cast is placed on the upper limb. The original technique, used before the cast placement, involved 60 kVp and 5 mAs. How should the exposure factors be altered with a large plaster cast?

Answer 31

68 to 70 kVp

Question 32

A pediatric patient with a possible radial head fracture is brought to the ER. It is too painful for the patient to extend the elbow beyond 90° or to rotate the hand. What type of special projection could be performed on this patient to confirm the diagnosis without causing further discomfort?

Answer 32

Coyle method

Question 33

The fat pads around the elbow joint are valuable diagnostic indicators if the following 3 technical/positioning requirements are met with the lateral position:

Answer 33

flexed 90° in a true lateral position optimum exposure techniques used

Question 34

Excessive kVp may obscure the visibility of a fat pad.

Answer 34

true

Question 35

Which routine projections best demonstrates the scaphoid fat pad?

Answer 35

PA + PA oblique wrist

Question 36

Which routine projection best demonstrates the pronator fat stripe?

Answer 36

lateral wrist

Question 37

Which of the following projections would best demonstrate a possible elevated fat pad near the elbow joint? A. lateral B. AP C. AP partially flexed D. acute flexion

Answer 37

lateral

Question 38

Guardians of young pediatric patients who are undergoing upper limb studies can be asked to hold their child during the radiographic study.

Answer 38

true

Question 39

a radiographic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist, elbow, and shoulder joints:

Answer 39

arthrography

Question 40

A Bennett fracture involves:

Answer 40

base of first metacarpal

Question 41

Which of the following fractures is not demonstrated in a wrist routine? A. Barton B. Pott C. Smith D. Colles

Answer 41

Pott