Deck 4: Upper Limb

Question 1

How many carpal bones are found in the wrist?

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

Answer 1

8

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 is the most commonly fractured carpal bone?

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

Answer 3

Scaphoid

Question 4

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

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

Question 5

Which carpal bone is the smallest?

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

Question 6

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 7

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 8

Which carpal bone is 5?

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

Question 9

Which carpal bone is 4?

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

Question 10

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 11

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

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

Question 12

Which carpal articulates with both the fourth and fifth metacarpals?

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

Question 13

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

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

Question 14

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

A) Capitulum
B) Proximal radioulnar joint
C) Trochlea
D) Coronoid tubercle

Question 15

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 16

Which carpal bone is 1?

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

Question 17

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 18

Which of the following carpals articulates with the radius?

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

Question 19

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 20

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

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

Question 21

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 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

What is the name 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 24

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

A) plane
B) trochoidal
C) sellar
D) ellipsoidal

Question 25

An ellipsoidal joint allows movement in ____ directions.

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

Question 26

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

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

Question 27

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 28

The bending or forcing of the hand laterally 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 29

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 30

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 31

The first carpometacarpal joint is classified as a____ joint.

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

Question 32

Which of the following sets of exposure factors would be best for an adult upper limb study using an analog (film-screen)system?

A) 80 kV, 600 mA, 1/60 sec, large focal spot, high-speed screens
B) 64 kV, 200 mA, 1/20 sec, large focal spot, detail-speed screens
C) 78 kV, 600 mA, 1/60 sec, large focal spot, detail-speed screens
D) 64 kV, 300 mA, 1/30 sec, small focal spot, detail-speed screens

Question 33

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

A) Radial and ulnar styloid processes
B) Humeral epicondyles
C) Humeral condyles
D) Trochlea and capitulum

Question 34

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 35

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

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

Question 36

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

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

Question 37

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 38

How should the original 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 39

What is the distance between the tabletop and Bucky tray on most floating tabletop type 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 40

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

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

Question 41

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces if the patient can assume this position?

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

Question 42

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

A) To minimize optimal immunomodulating dose (OID)
B) To be more comfortable for the patient
C) To open up joints better
D) To improve radiographic contrast

Question 43

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 44

The radiographic criteria for a true lateral finger indicate equal concavity of the anterior and posterior aspects of the phalanges.

Question 45

Nuclear medicine is generally more sensitive than radiography for assessing bones of the upper limb for either metastatic bone lesions or stress fractures.

Question 46

Which projection best demonstrates pathology involving the first carpometacarpal joint?

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

Question 47

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 48

Carpal tunnel syndrome is more common in middle-aged women than in middle-aged men.

Question 49

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 50

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 51

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 52

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 53

The Folio method is performed to rule out a nondisplaced fracture of the thumb.

Question 54

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

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

Question 55

Rheumatoid arthritis is three times more common in men than women.

Question 56

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

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

Question 57

The Folio method requires a bilateral projection of the thumbs be taken with one single exposure.

Question 58

The CR placement for an AP 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 59

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

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

Question 60

One of the early signs of rheumatoid arthritis is soft tissue swelling near the ulnar styloid process.

Question 61

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 62

What is the proper name for the acute flexion elbow projection?

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

Question 63

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 64

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 65

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 66

With the radial head 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 67

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 68

How much rotation of the hands is required for the AP oblique bilateral (Norgaard method)hand projection?

A) 45°
B) 30° to 35°
C) 5° to 10°
D) 20°

Question 69

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 patient cannot fully extend elbow
D) To demonstrate any possible elevated fat pads

Question 70

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 71

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 image receptor
C) Pronation of the hand
D) External rotation of elbow

Question 72

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

A) AP
B) Lateral
C) AP oblique with medial rotation
D) AP oblique with lateral rotation

Question 73

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 74

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 rotation oblique
D) Medial rotation oblique

Question 75

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 76

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 77

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 78

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 79

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 80

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

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