Positions and Procedures Quiz 3
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- What three projections do you do for a hand?
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PA
PA Oblique
Lateral - What size film do you use?
- 8*10
- Position of patient for PA and PA Oblique.
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Seat pt at end of table.
Adjust seat and rest forearm on table. - Position of part for PA.
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Forearm on table with PALMAR surface down.
Spread fingers slightly. - What do you center the IR to on a PA?
- The Metacarpophalangeal(MCP) joints
- Where should the CR be on a PA?
- Perpendicular to the third MCP joint.
- What should a PA show/include?
-
All anatomy distal to the radius and ulna.
1)carpals, metacarpals, phalanges
2)distal radius and ulna
3)an oblique projection of the first digit - What should the obliquity of the hand be for a PA Oblique?
- The MCP joints should form an angle of approximately 45 degrees with the IR plane.
- How do you obtain a PA oblique projection of the hand?
- By rotating the patient's hand laterally (externally) from the pronated position until the fingertips touch the IR.
- Where should the CR be on a PA Oblique?
- Perpendicular to the third MCP joint.
- What should be demonstrated on a PA Oblique?
-
Minimal overlap of the third-fourth and fourth-fifth metacarpal shifts.
All anatomy distal to the distal radius and ulna. - What is the position of the pt for a lateral?
- Pt up to table with hand in the lateral position with the ulnar aspect down.
- What is the position of the part for a lateral?
-
Extend the pt's digits and adjust the first digit at a right angle to the palm.
Center the IR to the MCP joints. - A position of part which eliminates superimposition of all but the proximal phalanges.
- fan lateral position
- What does a true lateral position cause?
- Superimposition of the phalanges.
- Where should the CR be in a lateral?
- Perpendicular to the second digit MCP joint.
- What is a lateral projection of the hand good for?
- Localizing of foreign bodies and metacarpal fracture displacement.
- What is the criteria for a hand to be in a true lateral position?
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1)superimposed phalanges
2)superimposed metacarpals
3)superimposed distal radius and ulna - What should the CR be for any projection with second through fifth digits?
- Perpendicular to the PIP joint of the affected digit.
- For a lateral projection what surface should the hand rest on for the second or third digit?
- lateral/radial
- For a lateral projection what surface should the hand rest on for the fourth or fifth digit?
- medial/ulnar
- For a PA oblique of a finger, how should you position the part?
- Rotate the hand externally until the digits are separated and at 45 degrees.
- What should be demonstrated on a PA Oblique of a finger?
- The entire digit at a 45 degree angle, including the distal portion of the adjoining metacarpal.
- What is the preferred projection for a thumb and why?
- AP because the thumb is closer to the IR and the magnification is decreased.
- How do you position the part for a AP projection of the thumb?
- Put the pt's hand in a position of extreme internal rotation.
- How do you position the part for a lateral projection of the thumb?
- Adjust the arching of the hand until a true lateral position of the thumb is obtained.
- How do you position the part for a PA Oblique projection of the thumb?
- Same as a PA hand.
- Where should the CR be for any projection of the thumb?
- Perpendicular to the MCP joint.
- What is the routine for a wrist?
-
PA
PA Oblique
AP Oblique
Lateral - For a lateral wrist, what is the position of the patient?
- Place the shoulder, elbow, and wrist joint in the same plane to permit right angle rotation of the ulna and radius.
- What is the center for a wrist?
- The joint or the flexion point.
- Position of part for a PA wrist.
- Align parallel with long axis of IR and slightly flex the digits to press wrist down.
- What should you be able to see on a PA wrist?
- Distal radius and ulna, carpals, and proximal half of metacarpals.
- Position of part for the lateral wrist.
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Have the pt flex the elbow 90 degrees to rotate the ulna to the lateral position.
Center the IR to the carpals. - What are the structures shown in a PA Oblique of the wrist?
- Demonstrates the carpals on the lateral side of the wrist, particularly the trapezium and the scaphoid.
- Position of part for a PA Oblique of the wrist.
- Rotate the wrist laterally(externally) until it forms an angle of approximately 45 degrees.
- Position of part for an AP Oblique of the wrist.
- Rotate the wrist medially(internally) until it forms a semisupinated position of approximately 45 degrees.
- What are the structures shown in an AP Oblique of the wrist?
- It separates the pisiform from the adjacent carpal bones.