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X-Ray positioning
chapter 13- upper extremity
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Professional
02/25/2007

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Term
what is another word for fingers?
Definition
digits
Term
What are digits 2-5?
Definition
phalanges
Term
What are the proximal carpel bones in order from lateral to medial?
Definition
scaphoid, lunate, triquetrum, pisiform
Term
What are the distal carpel bones from lateral to medial?
Definition
trapezium, Trapezoid, Capitate, Hamate
Term
where is the greatest movement of anterior and posterior flexion of the wrist?
Definition
scaphoid and lunate as they articulate with the radius
Term
what bone is larger in the forearm?
Definition
radius
Term
when is the ulnar styloid most prominate?
Definition
when the arm is in pronation
Term
Why do we always radiograph the forearm in supination?
Definition
to avoid superimposition of the bones
Term
what is anterior to the olecranon process on the ulna?
Definition
semilunar notch, the inferior lip of semilunar notch is coronoid process
Term
Where is the trochlea compaired to the capitulum?
Definition
trochlea is more medial and capitiulum is more lateral. Capitiulum is associates with radius head, and trochlea with the ulnar semilunar notch
Term
What are the bones of the shoulder often refered to as?
Definition
shoulder girdle
Term
What bones are included in the shoulder girlde?
Definition
scapula, clavicle, humerus
Term
Would you take upper extremity x-rays on the table or with the bucky?
Definition
on the table (nongrid0
Term
When doing the upper extremity can you use more than one exposure per Image Receptor?
Definition
yes
Term
When do pt. need to get rid of all jewelery vs. getting the gown on too
Definition
gown on for shoulders and AC jewelery for the rest of the extremity
Term
What is the most significant pathology affecting the upper extremity?
Definition
trauma
Term
What is the common fracture of the 5 metacarpel?
Definition
boxers (striking with a closed fist)
Term
What is the common fracture of the carpel bones?
Definition
scaphoid from a fall on outstretched arm
Term
What is it called when fractures are new and hard or impossible to see?
Definition
occult
Term
what do you recommend if you suspect a fracture but the first early radiograph dosen't prove it?
Definition
take another x-ray in 10 days
Term
What is the common complication of scaphoid fracture?
Definition
ischemia leading to necrosis of the bone, wrist function decreases
Term
what is a colle's fracture?
Definition
fracture of distal radius with posterior and medial displacement
Term
What is Monteggia's fracture?
Definition
fracture of ulna and dislocation of the radial head
Term
What is the most common elbow fracture?
Definition
of the radial head
Term
What do you look for to show elbow fracture?
Definition
joint effusion (increased fluid in the joint) shown on x-ray as a anterior fat pad.
Term
What is a very common non fracture of the upper extremty?
Definition
dislocation of the glenohumeral head anteriorly or posteriorly
Term
Can foreign bodies be seen in the soft tissue on x-ray?
Definition
yes
Term
What is bursitis? What do you look for on the x-ray?
Definition
chronic irritation to bursa (inflammation) Will cause calcium deposits in soft tissie
Term
tendonitis/tendinitis
Definition
inflammation of a tendon
Term
most common type of arthritis?
Definition
osteoarthritis
Term
What is osteoarthritis?
Definition
chronic contiditon that causes hypertrophy of the bone
Term
Osteophytes
Definition
enlarged deformed protion of bone in osteoarthritis
Term
osteomyelitis
Definition
inflammation of the bone (esp. marrow) by pathogenic organism (staph. and tuberculsis)
Term
when are fluid filled cysts normally found in the bone?
Definition
asymptomatic so nomrally only by x-ray
Term
pathologic fractures
Definition
ones caused by disease
Term
osteoblastic neoplasm
Definition
increased bone growth tumor
Term
osteoclastic neoplasm
Definition
decrease in bone size tumor
Term
P to A Hand
IR: speed
central ray
position
pt. instruction
structures seen
Definition
IR speed: 100-200
Central Ray: third (MCP) joint
Position: palmer surface contact fingers out(if too injured do AP)
Pt. Instruct: don't move
Sruructrues seen: entire hand no overlap of metacarpals or digits
Term
PA OBLIQUE hand patient postion
Definition
PA rotated laterally to make the 5th metacarpal area touch the IR. C shape (modified tea-cup) with 1st and 2nd digits. Or stair step to hold up
Term
What is the key to the image of the oblique structures seen in the hand?
Definition
no minimal overaly of metalcarpal shafts w/ slight overlap of metacarpal heads and bases
Term
Lateral hand patient position
Definition
5th metacarpal is touching IR only. (lateral portion) can spread fingers to not superimpose them
Term
structures seen in the lateral Hand
Definition
superimposition of 2nd though 5th metacarpals thumb seen in PA projection
Term
Central ray in PA, Oblique and Lateral hand
Definition
PA, and Oblique; 3rd (MCP)
Lateral: 2nd (MCP)
Term
Should you used hand projections for finger readings?
Definition
usually there are seperate x-rays taken of the fingers because there is usually one area of interest and there is not a need to expose the whole hand for one finger
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