Deck 4: Upper Limb

Question 1

Which of the following carpals articulates with the radius?

A)Trapezium
B)Scaphoid
C)Pisiform
D)Hamate

Answer 1

Scaphoid

Question 2

The joint found between the base of the third metacarpal and carpal bone is the:

A)intercarpal.
B)interphalangeal.
C)carpometacarpal.
D)proximal metacarpophalangeal.

Answer 2

carpometacarpal.

Question 3

Which of the following structures is considered to be most posterior?

A)Coronoid process
B)Radial tuberosity
C)Trochlea
D)Olecranon process

Answer 3

Olecranon process

Question 4

Which of the following structures is considered to be most lateral?

A)Capitulum
B)Head of ulna
C)Trochlea
D)Coronoid tubercle

Question 5

Which carpal bone is 5?

A)Trapezium
B)Trapezoid
C)Hamate
D)Scaphoid

Question 6

Which carpal articulates with both the fourth and fifth metacarpals?

A)Triquetrum
B)Capitate
C)Hamate
D)Trapezoid

Question 7

Which one of the following structures is NOT part of the ulna?

A)Styloid process
B)Radial notch
C)Ulnar notch
D)Coronoid tubercle

Question 8

Which of the following bony structures is found on the distal aspect of the ulna?

A)Coronoid process
B)Head
C)Olecranon process
D)All of the above

Question 9

What is the name of the joint found between the proximal and distal phalanges of the first digit?

A)Proximal interphalangeal
B)Distal interphalangeal
C)Metacarpophalangeal
D)Interphalangeal

Question 10

Which carpal bone is the smallest?

A)Scaphoid
B)Pisiform
C)Hamate
D)Capitate

Question 11

Which of the carpal bones is considered to be the largest?

A)Hamate
B)Triquetrum
C)Trapezium
D)Capitate

Question 12

Which of the following structures is considered to be most distal?

A)Radial head
B)Styloid processes
C)Radial tuberosity
D)Capitulum

Question 13

How many carpal bones are found in the wrist?

A)14
B)8
C)5
D)7

Question 14

Which two structures primarily form the hinge-like structure and movement of the elbow joint?

A)Trochlea and olecranon process
B)Capitulum and trochlea
C)Coronoid process and coronoid fossa
D)Coronoid fossa and trochlea

Question 15

Which carpal bone is 1?

A)Scaphoid
B)Trapezium
C)Hamate
D)Pisiform

Question 16

Which carpal bone is 4?

A)Scaphoid
B)Trapezoid
C)Hamate
D)Lunate

Question 17

This projection is performed to rule out:

A)median nerve impingement.
B)calcification in carpal sulcus.
C)carpal tunnel syndrome.
D)all of the above.

Question 18

Which of the following structures is considered to be most proximal?

A)Head of ulna
B)Radial styloid process
C)Olecranon process
D)Radial tuberosity

Question 19

Which is the most commonly fractured carpal bone?

A)Lunate
B)Trapezium
C)Scaphoid
D)Hamate

Question 20

This projection is correctly referred to as:

A)carpal canal, inferosuperior projection.
B)carpal tunnel, inferosuperior projection.
C)Gaynor-Hart method.
D)all of the above.

Question 21

The two fat stripes of the wrist demonstrated radiographically are known as the scaphoid fat stripe and the _____ fat stripe.

A)pronator
B)pisiform
C)abductor
D)anterior

Question 22

Where is the central ray (CR) placed for a PA projection of the third digit?

A)At the distal interphalangeal joint
B)At the metacarpophalangeal joint
C)At the head of the third metacarpal
D)At the proximal interphalangeal joint

Question 23

A ginglymus joint can also be referred to as a _____ joint.

A)trochoid
B)saddle
C)hinge
D)pivot

Question 24

A general positioning rule is to place the long axis of the part ____ to the long axis of the image receptor.

A)perpendicular
B)adjacent
C)axial
D)parallel

Question 25

The radiocarpal (wrist) joint possesses a(n) ____ type of joint movement.

A)ellipsoidal
B)ginglymus
C)plane
D)pivot

Question 26

The first metacarpophalangeal joint has a(n) ____ type of joint movement.

A)plane
B)pivot
C)saddle
D)ellipsoidal

Question 27

Which two structures form the distal radioulnar joint?

A)Radial notch and radial head
B)Ulnar notch and head of ulna
C)Radial tuberosity and ulnar notch
D)Coronoid tubercle and radial notch

Question 28

The interphalangeal joints have a(n) ____ type of joint movement.

A)plane
B)saddle
C)ellipsoidal
D)ginglymus

Question 29

What are the names of the two small depressions found on the anterior aspect of the distal humerus?

A)Trochlea and capitulum
B)Olecranon and coronoid fossa
C)Radial and coronoid fossa
D)Olecranon and radial fossa

Question 30

Which wrist ligament is attached to the styloid process of the ulna and continues to the triquetrum and pisiform?

A)Radial collateral ligament
B)Dorsal radiocarpal ligament
C)Palmar radiocarpal ligament
D)Ulnar collateral ligament

Question 31

What is the approximate distance between the tabletop and Bucky tray on most floating tabletop types of tables?

A)1/2 to 1 inch (1.3 to 2.5 cm)
B)1 to 2 inches (2.5 to 5.1 cm)
C)2 to 3 inches (5 to 7.6 cm)
D)3 to 4 inches (8 to 10 cm)

Question 32

Which of the following sets of exposure factors would be best for an adult hand study using a digital imaging system?

A)80 kV, 600 mA, 1/60 seconds, large focal spot
B)64 kV, 200 mA, 1/20 seconds, large focal spot
C)78 kV, 600 mA, 1/60 seconds, large focal spot
D)70 kV, 300 mA, 1/30 seconds, small focal spot

Question 33

The first carpometacarpal joint is classified as a ____ joint.

A)saddle
B)ginglymus
C)plane
D)trochoidal

Question 34

Grids are generally not required unless the anatomy measures greater than _____ cm in thickness.

A)8
B)10
C)14
D)5

Question 35

How should the original analog kV range be changed with a fiberglass cast applied for a wrist or forearm radiographic procedure?

A)No change
B)Increase 3 to 4 kV
C)Increase 5 to 7 kV
D)Increase 8 to 10 kV

Question 36

A nonvisible posterior fat pad on a well-exposed, correctly positioned lateral elbow radiograph generally suggests:

A)negative study for injury.
B)fracture of one of the bones of the elbow.
C)injury to the synovial joint.
D)a congenital defect.

Question 37

What two bony landmarks are palpated for positioning of the AP elbow?

A)Ulnar and radial heads
B)Humeral epicondyles
C)Humeral condyles
D)Trochlea and capitulum

Question 38

The bending or forcing of the hand outward with the hand pronated in a posteroanterior (PA) projection is known as:

A)radial deviation.
B)ulnar deviation.
C)radial abduction.
D)ulnar extension.

Question 39

An ellipsoidal joint allows movement in ____ directions.

A)two
B)all
C)four
D)six

Question 40

The smooth, depressed, center portion of the trochlea used for evaluating rotation on a lateral elbow is termed the trochlear:

A)process.
B)fossa.
C)depression.
D)sulcus.

Question 41

Which special projection of the wrist will open up the interspaces on the ulnar side of the wrist?

A)Radial deviation
B)Ulnar deviation
C)Carpal canal
D)Carpal bridge

Question 42

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

A)At the third proximal interphalangeal joint
B)At the third metacarpophalangeal joint
C)At the base of the third metacarpal
D)At the third distal interphalangeal joint

Question 43

Which projection best demonstrates pathology involving the first carpometacarpal joint and trapezium?

A)AP axial (modified Robert's method)
B)PA oblique thumb
C)Norgaard method
D)PA scaphoid, ulnar deviation wrist projection

Question 44

Local or generalized infection of bone or bone marrow caused by bacteria introduced by trauma or surgery is a condition termed:

A)osteomyelitis.
B)Paget's disease.
C)osteoarthritis.
D)cellulitis.

Question 45

The second most common type of primary cancerous bone tumor is:

A)multiple myeloma.
B)chondrosarcoma.
C)Ewing's sarcoma.
D)osteogenic sarcoma.

Question 46

The CR placement for an AP axial projection (modified Robert's method) of the thumb is at the:

A)first carpometacarpal joint.
B)first proximal interphalangeal joint.
C)first distal interphalangeal joint.
D)midproximal phalanx of the first digit.

Question 47

Which of the following actions will lead to the proximal radius crossing over the ulna?

A)Supination of the hand
B)Placing epicondyles parallel to the image receptor
C)Pronation of the hand
D)External rotation of the elbow

Question 48

A "skier's thumb" is an injury of the:

A)scaphoid.
B)pronator fat stripe.
C)ulnar collateral ligament.
D)median nerve

Question 49

Why is it recommended that the PA oblique (with medial rotation) projection be performed rather than the PA oblique (with lateral rotation) for the second digit of the hand?

A)Minimizes optimal immunomodulating dose (OID).
B)Is more comfortable for the patient.
C)Opens up joints better.
D)Minimizes object image-receptor distance (OID).

Question 50

How much CR angulation to the long axis of the hand is required for the tangential, inferosuperior projection to demonstrate the carpal sulcus (canal)?

A)10° to 15°
B)25° to 30°
C)35° to 45°
D)5° to 10°

Question 51

Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?

A)Sesamoid bones
B)Carpals
C)Phalanges
D)Carpometacarpal joints

Question 52

From a pronated position, which of the following is required for a PA oblique projection of the fourth digit of the hand?

A)45° medial rotation
B)30° to 35° lateral rotation
C)30° to 35° medial rotation
D)45° lateral rotation

Question 53

Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?

A)Prevents foreshortening of phalanges and obscuring of interphalangeal joints.
B)Prevents foreshortening of radiocarpal joint.
C)Opens up the carpometacarpal joints.
D)Demonstrates the sesamoid bones near the first interphalangeal joint.

Question 54

Which one of the following is the most common primary cancerous bone tumor?

A)Multiple myeloma
B)Osteochondroma
C)Osteosarcoma
D)Osteocarcinoma

Question 55

What CR angle is required with the modified Robert's method?

A)5° proximally (toward the wrist)
B)10° distally (away from the wrist)
C)15° proximally (toward the wrist)
D)20° distally (away from the wrist)

Question 56

How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the elbow?

A)30°
B)90°
C)45°
D)20°

Question 57

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces?

A)AP
B)PA
C)Gaynor-Hart
D)30° PA oblique

Question 58

What is the purpose of performing the AP partially flexed projections of the elbow?

A)To provide a view of the radial head and capitulum
B)To separate the radial head from the ulna
C)To provide an AP perspective if the patient cannot fully extend the elbow
D)To demonstrate any possible elevated fat pads

Question 59

What type of rotation of the hands is required for the AP oblique-bilateral (Norgaard method) hand projection?

A)45° internally
B)30° to 35° externally
C)5° to 10° internally
D)None

Question 60

Which special projection of the wrist is ideal for demonstrating possible calcification in the dorsal aspect of the carpals?

A)Carpal bridge
B)Carpal canal
C)Ulnar deviation
D)Lateral wrist

Question 61

A patient enters the emergency department (ED) with a Smith fracture.Which region of the upper limb must be radiographed to demonstrate this injury?

A)Trapezium
B)Elbow
C)Wrist and forearm
D)Hand

Question 62

A patient with a fractured forearm had the fracture reduced and a fiberglass cast placed on the extremity.The orthopedic surgeon orders a postreduction study.The original (analog) kV was 60 kV.Which one of the following kV factors should be selected for the postreduction study?

A)63 kV
B)67 kV
C)70 kV
D)75 kV

Question 63

A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamular process is superimposed over the pisiform.Which of the following measures will correct this problem?

A)Rotate the wrist and hand 10° internally.
B)Increase the CR angle.
C)Decrease the CR angle.
D)Increase the extension of the hand and/or wrist.

Question 64

A patient enters the ED with a possible scaphoid fracture.The patient is unable to assume the ulnar deviation position.Which of the following positions should be performed to confirm the diagnosis?

A)Gaynor-Hart
B)Jones
C)Modified Stecher
D)Coyle

Question 65

How should the humeral epicondyles be aligned for a lateral projection of the elbow?

A)Parallel to image receptor
B)Perpendicular to image receptor
C)45° to image receptor
D)30° to image receptor

Question 66

A radiograph of an AP projection of the elbow reveals that there is complete separation of the proximal radius and ulna.What positioning error has been committed?

A)Excessive medial rotation
B)Partial flexion of the joint
C)Excessive lateral rotation
D)Incorrect CR location and angle

Question 67

A patient enters the ED with an elbow injury.The partially flexed AP and lateral positions reveal a possible fracture of the coronoid process.The patient's elbow is partially flexed and he refuses to extend it farther.Which one of the following positions/projections should be performed to confirm the fracture of the coronoid process?

A)AP-acute flexion
B)Coyle method with 80° flexion, CR angled 45° away from shoulder
C)Coyle method with 90° flexion, CR angled 45° toward the shoulder
D)Gaynor-Hart method

Question 68

Which basic projection of the elbow best demonstrates the trochlear notch in profile?

A)AP
B)Lateral
C)Medial rotation oblique
D)Lateral rotation oblique

Question 69

Which routine projection of the elbow will best demonstrate an elevated or visible posterior fat pad?

A)True AP with no rotation
B)True lateral with 90° flexion
C)Lateral rotation oblique
D)Coyle method

Question 70

How many projections are required for the AP-acute flexion study of the elbow?

A)One
B)Two
C)Three
D)Four

Question 71

A radiograph of the elbow demonstrates the radius directly superimposed over the ulna and the coronoid process in profile.Which projection of the elbow has been performed?

A)AP
B)Lateral
C)Lateral (external) rotation oblique
D)Medial (internal) rotation oblique

Question 72

A radiograph of an AP oblique elbow with medial rotation reveals that the radial head is superimposed over part of the coronoid process.What positioning error has been committed?

A)Excessive medial rotation
B)Flexion of the elbow
C)Excessive lateral rotation
D)Incorrect CR angulation

Question 73

Which routine projection of the elbow best demonstrates the olecranon process in profile?

A)AP
B)Lateral
C)Medial rotation oblique
D)Lateral rotation oblique

Question 74

A radiograph of a PA projection of the hand reveals that the distal radius and ulna and the carpals were cut off.What should the technologist do to correct this problem?

A)Accept the radiograph.Carpals and distal radius and ulna are not part of a hand study.
B)Make sure the carpals, distal radius, and ulna are included on the lateral projection.
C)If the injury to the patient did not involve the carpal region and distal forearm, do not repeat it.
D)Repeat the PA projection to include all the carpals and about 1 inch (2.5 cm) of the distal radius and ulna.

Question 75

With the radial head-lateromedial projections, what is the only difference between the four projections?

A)The position of the hand and/or wrist
B)The CR angulation
C)The amount of flexion of the elbow
D)The SID used for each projection

Question 76

A radiograph of a PA oblique of the hand reveals that the midshaft of the fourth and fifth metacarpals is superimposed.What specific positioning error has been committed?

A)Excessive rotation of the hand and/or wrist laterally
B)Insufficient rotation of the hand and/or wrist laterally
C)Incorrect CR angulation
D)Fingers of the hand are not parallel to IR

Question 77

Which of the following best demonstrates the radial head using the trauma lateral Coyle method routine?

A)Elbow flexed 80°, CR angled 45° away from shoulder
B)Elbow flexed 90°, CR angled 30° toward shoulder
C)Elbow flexed 90°, CR angled 45° toward shoulder
D)Elbow flexed 90°, CR perpendicular to image receptor

Question 78

A patient enters the ED in severe pain with a possible dislocation of the elbow.The patient has the elbow flexed more than 90°.Which one of the following routines should be performed to confirm the diagnosis?

A)Partially flexed AP and limited lateral projections
B)Jones method and limited lateral projection
C)Coyle method and limited lateral projection
D)Lateral elbow only

Question 79

A patient enters the ED with a possible Bennett's fracture.Which of the following routines should be performed to confirm this diagnosis?

A)Finger
B)Wrist
C)Forearm
D)Thumb

Question 80

Which routine projection of the elbow best demonstrates the radial head and tuberosity free of superimposition?

A)AP
B)Lateral
C)AP oblique with internal rotation
D)AP oblique with external rotation