Where is the centering point for the central ray for the AP projection of the thumb?
First MCP
Which projection of the thumb requires the patient to rotate the hand into extreme internal rotation?
AP
Where is the centering point for the central ray for the PA projection of the third digit of the hand?
PIP
Explain why the hand should be rotated into extreme internal rotation until the lateral surface of the index finger is in contact with the IR, rather than positioning that finger with its medial (ulnar) surface toward the IR, for the lateral projection of
To minimize OID
Name the four bones that should be completely seen in the image of the AP projection of the thumb
Distal and proximal phalanges of the thumb, 1st metacarpal, trapezium
Excluding the thumb, name the two digits of the hand that should rest directly on the IR for the lateral projection of individual digits
2nd and 5th digit
Describe how and where the central ray should be directed for the PA projection of the hand
Perpendicular to the 3rd MCP
What surface of the hand should be in contact with the IR for the PA projection of the hand?
Anterior
From the prone position, how many degrees should the hand be rotated for the PA oblique projection? For the lateral projection?
45 degrees, and 90 degrees
To best demonstrate all digits, how should the thumb and index finger be positioned with respect to the IR for the PA oblique projection of the hand?
Elevated from the IR and parallel with the plane of the IR
Which bones of the hand are of primary interest if the fingertips are allowed to rest on the IR for the PA oblique projection of the hand?
Metacarpals
What group of bones of the hand is best demonstrated with the fan lateral projection of the hand?
Phalanges
For the PA projection of the wrist, why should the hand be slightly arched by flexing the fingers?
To place the anterior surface of the wrist in contact with the IR
Describe how and where the central ray should be directed for the PA projection of the wrist
Perpendicular to the midcarpal area
In addition to the eight carpal bones, what other bones should be seen in the image of the PA projection of the wrist?
Distal radius and ulna proximal metacarpals
How many degrees from the prone position should the wrist be rotated for the PA oblique projection of the wrist?
45 degrees
Which projection of the wrist requires the superimposition of the radial and ulnar styloid processes?
Lateral
Which surface of the wrist should be in contact with the IR for the lateral projection of the wrist?
Ulnar (medial)
In which projection of the wrist should the metacarpals appear superimposed in the image?
Lateral
For the PA oblique projection of the wrist, which side of the wrist should be elevated from the IR?
Lateral (radial)
What two carpal bones on the lateral side of the wrist should be clearly demonstrated in the image of the PA oblique projection of the wrist?
Scaphoid & trapezium
What carpal bone is best demonstrated with the ulnar deviation position of the wrist?
Scaphoid
How does the placement of the IR for the PA axial projection of the scaphoid (Stecher method) differ from IR placement for PA projections of the wrist?
The IR is inclined toward the elbow at an angle of 20 degrees
How does the forearm appear if the hand is pronated when performing the AP projection of the forearm?
The radius crosses over the ulna, which results in an oblique image of the forearm
To prevent radial crossover, how should the hand be positioned for the AP projection of the forearm?
Supinated
What structure on the distal end of the ulna should be seen in the image of the AP projection of the forearm?
Styloid process
How should the humeral epicondyles appear in the image of the lateral projection of the forearm?
Superimposed over each other
How should the hand be positioned for the lateral projection of the forearm?
True lateral, thumb side up
What would most likely cause the bones of the forearm to appear rotated in the image of the AP projection of the elbow?
The hand was not supinated
Why should the patient lean laterally for the AP projection of the elbow?
To help adjust the humeral epicondyles and the anterior surface of the forearm parallel with the plane of the IR
What structures of the proximal radius are seen slightly superimposed over the proximal ulna in the AP projection of the elbow?
Head, neck, tuberosity
How should the hand be positioned for the lateral projection of the elbow? Explain why.
True lateral with thumb side up
What projection and position of the elbow best demonstrates the coronoid process in profile?
AP oblique projection in medial rotation position
How should the forearm and elbow be rotated to best demonstrate the radial head free of superimposition from the ulna?
Laterally (externally)
How many AP projections are necessary to best demonstrate the elbow without distortion when an injury prevents full extension of the elbow?
Two
Explain how the humerus and the forearm are positioned differently for each AP projection of the elbow when the elbow is in partial flexion
For one exposure the humerus is parallel and in contact with the IR; for the other exposure the forearm is parallel and in contact with the IR
What is the CR orientation for the axiolateral projection of the elbow (Coyle method) to demonstrate the coronoid process?
Angled 45 degrees away from the shoulder
What humeral process should be palpated to ensure proper alignment when the humerus is being positioned?
Epicondyles
Which projection for the humerus requires the patient;s hand to be supinated?
AP
Describe how to best position the IR for the lateral projection of the humerus if the AP projection radiograph clearly shows a fracture 2 inches superior to the elbow
Place the IR between the humerus and the thorax