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Week 11: Upper Extremities Flashcards

(57 cards)

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1
Q

What are the 5 exams included in Upper Extremities of MRI?

A
  1. TMJs
  2. Shoulder
  3. Elbow
  4. Wrist
  5. Hand
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2
Q

MRI TMJ and Shoulder require the patient to be in what position?

A

Supine, head-first

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3
Q

An MRI TMJ requires the body to be off-set and perpendicular to the alignment light. True or False?

A

False; Mid-sagittal plane of the body should be perpendicular to the alignment light.

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4
Q

What is the landmark used during an MRI of the TMJs?

A

Maxilla

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5
Q

What coil should be selected by the tech during an MRI TMJs?

A

8 channel brain (or TMJ coil, though rarely available)

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6
Q

Which of the 5 exams of the Upper Extremities require the body to be relaxed, with the legs uncrossed?

A

All of them

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7
Q

All 5 exams of the Upper Extremities require the same sequence options; what are they?

A
  1. Flow compensation ON
  2. No Phase Wrap ON
  3. Saturation bands used, depending on the phase direction
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8
Q

Of the 5 exams of the Upper Extremities, which has the unique set of protocols and what are they?

A

MRI TMJs
1. 3 plane localizer
2. Sagittal-Oblique Open
3. Sagittal-Oblique Closed
4. Coronal-Oblique Open
5. Coronal-Oblique Closed

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9
Q

What does TMJs stand for, what is it, and where?

A

Tempo-mandibular Joints; The articulations of the jaw; Just anterior to the ears.

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10
Q

TMJs protocols are performed with the jaws opened and closed, why?

A

The mandibular condyles move backwards while open, and forward while closed.

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11
Q

The 3 plane localizer performed during MRI TMJs views the bony skull layout to achieve what?

A

The localization of the TMJs’ obliqued positioning, both sagitally and coronally.

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12
Q

Which protocol of MRI TMJs views the joints in profile, which the mandibular condyle pushed posteriorly into the mandibular fossa?

A

Sagittal-Oblique Open

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13
Q

Which MRI TMJs protocol views the joints in profile, with the mandibular condyle in anatomical position within the mandibular fossa?

A

Sagittal-Oblique Closed

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14
Q

The Coronal-Oblique Open and Closed of MRI TMJs is used to show what?

A

Any medial or lateral shifting/tilting of the joints during both positions of the jaw, revealing the presence of arthritis.

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15
Q

How would the FoV and slice thickness be described in all protocols of MRI TMJs?

A

Small and Thin

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16
Q

How is the body positioned during an MRI Shoulder?

A

Off-set, with the affected shoulder in external rotation and perpendicular to the alignment light

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17
Q

What is the importance of keeping the shoulder externally rotated during MRI Shoulder?

A

Internal rotation will close the glenoid labrum and shorten the rotator cuff, causing suboptimal imaging of shoulder joint.

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18
Q

What landmark is used for positioning during an MRI Shoulder?

A

Coracoid process

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19
Q

What coil should be selected by the tech during an MRI Shoulder?

A

3 or 8 channel shoulder coil

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20
Q

Besides MRI TMJs, what are the 5 basic protocols for the rest of the Upper Extremity exams?

A
  1. 3 plane localizer
  2. Coronal (IR, T2FS)
  3. Coronal (T1, T2, PD)
  4. Axial (T1, T2, PD)
  5. Sagittal (T1, T2, PD)
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21
Q

The coronal protocols of an MRI Shoulder are unique in that they are not true coronal; they are coronal oblique. Why?

A

In anatomical position, the shoulder joint is not on a straight plane; the joint lies on an oblique plane as the shoulder curves into the upper arm.

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22
Q

During both coronal-oblique protocols of an MRI Shoulder, what determines the degree of angulation when plotting from true coronal?

A

The plane is angled parallel to the supraspinatus tendon OR perpendicular to the glenohumeral joint

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23
Q

The MRI Shoulder coronal-oblique (IR, T2FT) protocol views fat-suppressed, long-axis cross sections of what?

Study These Flashcards
A
  1. Supraspinatus attachment
  2. Superior and inferior glenoid labrum
  3. Fluid within the glenohumeral joint (Synovitis)
24
Q

What is better viewed on the coronal-oblique (T1, T2, PD) protocol of an MRI Shoulder?

Study These Flashcards
A

Cartilage within the glenohumeral joint

25
In what protocol/plane is insufficient external rotation most evident within an MRI Shoulder exam?
The axial (T1, T2, PD)
26
The MRI Shoulder Axial (T1, T2, PD) protocol is used to view short-axis cross sections of what?
1. Anterior and posterior glenoid labrum 2. Rotator cuff attachments 3. Position of the humeral head within the glenoid fossa
27
Similar to the coronal protocols of an MRI Shoulder, the sagittal (T1, T2, PD) is also slightly angled from true sagittal. What determines the angulation?
Plane is angled perpendicular to the supraspinatus tendon OR parallel to the glenohumeral joint
28
The MRI Shoulder sagittal (T1, T2, PD) protocol views long-axis, in-profile cross sections of what?
1. Supraspinatus tendon 2. Infraspinatus tendon 3. Subscapularis muscle 4. Teres minor muscle 5. Possible dislocations
29
What are some common clinical concerns for an MRI Shoulder?
1. Rotator cuff tear (most common) 2. Labral tear 3. Adhesive capsulitis/Frozen shoulder 4. Dislocations
30
What 4 muscles make up the "Rotator cuff"?
1. Supraspinatus 2. Infraspinatus 3. Subscapularis 4. Teres minor
31
Where do tendons most often tear?
At insertion or attachment, not origin.
32
What are the 2 ways to position a patient for Upper Extremity MRI exams (excluding Shoulder and TMJs)?
1. Supine, feet first 2. Prone, head first ("Superman" position)
33
How should the body be positioned during an MRI Elbow for both patient orientations?
1. off-set, with the affected elbow in external rotation and perpendicular to alignment light 2. off-set, with affected arm above head
34
What landmark is during MRI Elbow exams?
Olecranon process
35
The coil used during MRI Elbow exams depends on the patient position - which coil would you use for each?
1. Supine: 32 channel elbow coil 2. Superman: 8 channel knee coil
36
Which protocol of an MRI Elbow identifies fractures and edema patterns, views ulnar and radial collateral ligaments, and evaluates articulations of radio-humeral and ulno-humeral joints?
Coronal (IR, T2FT)
37
The axial (T1, T2, PD) protocol of an MRI Elbow exam views short-axis cross sections of what?
1. Bicep 2. Triceps 3. Ulnar nerve 4. Medial and lateral collateral ligament attachments
38
What anatomy in viewed in profile during a Sagittal (T1, T2, PD) protocol of an MRI Elbow?
1. Olecranon 2. Bicep and Triceps attachments 3. Bursa 4. Fat pads
39
What are some of the most common clinical concerns for an MRI Elbow?
1. Ulnar Collateral ligament tear (most common) 2. Lateral epicondylitis (tennis elbow) 3. Pigmented villonodular synovitis (PVNS) 4. Radial head fractures
40
Ulnar Collateral Ligament tears are common in which sport player?
Baseball pitchers
41
"Tommy John Surgery" is performed to reconstruct what anatomical structure?
The medial collateral ligament
42
Bicep tears usually occur at the muscle's insertion point at what bone marking?
the radial tuberosity
43
What type of motion frequently results in bicep tears?
pulling
44
What are the 2 acceptable body positions during an MRI Wrist, depending on the patient's orientation?
1. Supine: off-set, with the affected wrist supinated and perpendicular to the alignment light 2. Superman: off-set, with affected arm above head
45
What landmark is used during an MRI Wrist exam?
Mid-carpal region
46
The coil used during MRI Wrist exams depends on the patient position - which coil would you use for each?
1. Supine: 8 channel wrist coil 2. Superman: 8 channel knee coil
47
As with most of the exams of Upper Extremities, MRI Wrist includes a coronal (IR, T2FS) and coronal (T1, T2, PD). What do they view?
1. fractures and edema patterns 2. Triangular Fibrocartilage Complex (TFCC) 3. Ulnar and Radial Collateral ligaments 4. Carpal bones
48
Which protocol of an MRI Wrist exam views short-axis cross sectionals of the Median nerve, Flexor/extensor tendons, retinaculum, and Ulnar nerve?
Axial (T1, T2, PD)
49
The Sagittal (T1, T2, PD) protocol of an MRI Wrist exam view in-profile, long-axis cross sectionals of what?
1. Carpal bone articulations 2. flexor tendons
50
What are the 2 most common clinical concerns for an MRI Wrist?
1. Triangular Fibrocartilage Complex (TFCC) 2. Carpal Tunnel Syndrome
51
How do patient's with suspected TFCC tears normally present?
With distal ulnar pain after a fall on out-stretched hand
52
What condition of the wrist is characterized by finger numbness, caused by compression of the retinaculum and impingement of median nerves?
Carpal tunnel syndrome
53
What are the 2 acceptable body positions during an MRI Hand, depending on the patient's orientation?
1. Supine: off-set, with affected hand perpendicular to alignment light 2. Superman: off-set, with arm and hand above head
54
The MCP joints are used as a landmark for which exam of MRIs of Upper Extremities?
MRI Hand
55
What kind of coil is used for MRI Hand?
a small, general purpose hand coil
56
The Coronal (IR, T2FS) protocol of an MRI Hand uses fat-suppression to better identify fractures and edema patterns. True or False?
True
57
What anatomical structures are evaluated during an MRI Hand?
1. Metacarpals 2. Flexor digitorum tendons 3. Interosseous muscles 4. Collateral ligaments 5. Interphalangeal joints

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