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What position is the thumb in when hand is pronated? (palm down)
oblique
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Position of the hand for the AP forearm
supinated (palm up)
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Hand is pronated, fingers extended and separated, central ray is directly perpendicular to 3rd MCP_ what projection is this?
PA hand
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PA wrist - are the fingers flexed or extended? Why?
flexed, to bring the carpal bones closer to image receptor (IR)
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Lateral 4th finger - is the hand on the radial or ulnar surface?
Ulnar surface
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What happens if hand is pronated for an AP forearm
radius crosses over ulna
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what surface is the forearm on for lateral?
medial/ulnar
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Centering point of finger
proximal interphalangeal joint
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oblique thumb centering point
1st metacarpophalangeal joint
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PA wrist centering point
mid carpal area
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Lateral forearm centering point
mid shaft
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PA hand centering point
3rd metacarpophalangeal joint
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Recommended source-to-image-receptor-distance (SID) for extremity images
48 inches
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Norgaard or ball catcher's projection is used to demonostrate
rheumatoid arthritis
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Carpal bone best demonstrated on AP oblique projection of the wrist
pisiform
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how is the central ray directed for the Gaynor Hart method/carpal tunnel? Where does it enter?
25-30 degrees to the long axis of the hand, entering 1 inch distal to base of 3rd metacarpal base
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Scaphoid is best demonstrated in which projection
ulnar deviation/ Stetcher
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which lateral of the hand will demonstrate foreign bodies?
lateral in extension
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what must be included on all hand radiographs?
14 phalanges, 5 metacarpals, 8 carpal bones, distal end of radius and ulna
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PA oblique of the hand MCP joint form a __________ angle with the IR
45 Degree angle
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what structures must be included on all of the wrist radiographs
8 carpals, proximal ends/bases/ of metacarpals and distal end of the radius and ulna
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Wrist PA or IR, finger end of IR elevated 20 degrees, this describes which projection? What is demonstrated?
Stecher/PA axial demonstrates navicular
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When performing a lateral forearm, what structures must all lie in the same plane
shoulder, humerus, forearm, and hand
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what must be included on all finger radiographs
proximal, middle, and distal phalanges and head of the metacarpal
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hand rests on which surface for a lateral 2nd digit
radial/lateral
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What is the difference between AP and PA thumb when looking at the radiograph
PA thumb is magnified
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Where does the central ray enter for lateral projections of the hand
2nd metacapophalangeal joints
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where does the central ray enter for the PA projection of the wrist
mid carpal area
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where does the central ray for a lateral projection of the forearm
mid shaft/body
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what is the recommended kVp range for finger, hand, wrist, and forearm radiographs
54-65 kVp
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an AP projection of the thumb requires that the patient's hand be rotated into extreme:
internal rotation
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for a lateral projection of the wrist which surface of the wrist should be in contact with image receptor (IR)
Medial/Ulnar
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a lateral wrist should demonstrate superimposed what?
metacarpals, carpals, and distal ends of the radius and ulna
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for the lateral projection of the forearm, how should the elbow be position
flexed 90 degrees in the lateral position
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how is the hand placed for a lateral forearm projection
lateral position resting on ulnar side
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what projections of the upper limb require the hand to be supinated
AP forearm
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what projection requires the shoulder, forearm, wrist, and hand to be in the same plane
AP forearm
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What view of the thumb is demonstrated with fingers completely flexed?
lateral thumb
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what is referred to as a boxer's fracture
fractures of the 4th and 5th metacarpals
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what bone is of primary interest when performing ulnar deviation
scaphoid (navicular)
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If no angle sponge is used to support the cassette during the Stecher method, how is the central ray directed
20 degrees toward the elbow
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when performing Gaynor Hart, how is the wrist position?
hyperextended
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How should the long axis of the hand be placed for carpal tunnel view
vertical
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how is the central ray directed for the carpal canal view
25-30 degrees
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PA digits projection where do you center the (IR)
(PIP) proximal inter phalangeal joint
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Second and fifth digits directly in contact with IR and 3rd and 4th placed parallel with IR
Lateral fingers
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What is the 3rd metacarpophalangeal (MCP) joint
3rd knuckle
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how many bone are found in your hand
27 bones
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the hand bones can be subdivided into 3 groups what are they?
- 1) phalanges- bones of digits (finger and thumb)
- 2) metacarpals- slightly concave anteriorly (form palm of hand) they are numbered from 1-5 beginning from lateral side of the hand (metacarpal heads are commonly called knuckles) 1st metacarpal (thumb) has 2 small sesamoids bones below neck (head- distally, base - proximal)
- 3) carpals- bones of the wrist there are 8
- they are in 2 horizontal rows (Short bones)
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carpal bone closest to 1st metacarpal at base of (thumb)
trapezium also known as (greater multangular)
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carpal bone directly beneath 2nd metacarpal
trapezoid (lesser multangular)
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carpal bone beneath trapezoid and directly on head of radius
scaphoid (navicular)
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carpal bone directly below 3rd and 4th metacarpal
capitate (os magnum)
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carpal bone directly below 4th and 5th metacarpal
hamate (unciform)
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carpal bone touching the hamate located below 5 digit
pisiform
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directly below the pisiform
triquetrum (cuneiform or triangular)
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located beneath capitate next to scaphoid
lunate (semilunar)
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what two bones are in the forearm
- 1) radius - located on lateral side of forearm(closest to the thumb)
- 2) ulna- located on the medial side of forearm (closest to pinky)
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Body long and slender, tapers inferiorly upper portion is large contains has 2 processes: proximal process is (olecranon) forms proximal portion of trochlear notch, distal process (coronoid) triangular in shape forms lower portion of trochlear notch, has a depression (radial notch) distal end contains round process on lateral side (head) and a conic projection called (ulnar styloid process)
ulna
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proximal end small presents a flat disklike head above a constricted neck just inferiorly (below) neck on medial side of body roughened process called radial tuberosity, distal end is broad and flattened
radius
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