Chest:

1. What are the 3 divisions of the chest?

o Respiratory
o Bony thorax
o Mediastinum
2. What is the pharynx? What are the 3 subdivisons?
Pharynx- passageway for food and air
o 3 subdivisions
Naso
Oro
Laryngopharynx
Uvula- separates oro and laryngopharynx
3. What is the larynx and where is it located?
Larynx- C3 to C6
o Thyroid cartilage
4. What is the Trachea? Where is it located?
C6 to T4/T5
o Windpipe
o Rigid rings
5. What is different about the Rt./ Lt. bronchi? What is aspiration?
o Carina- T5
o Right bronchi- short, wider, more vertical
o Aspiration- when food or water goes into lungs
More apt to go to right bc it is shorter and more
vertical
6. How many portions do the left and right Lungs have?
o 2 portions on left
o 3 portions on right
7. What is the Apex? What are the apices?
top of lungs
Apices- both top of lungs
8. What is the Parietal pleura? What is the pleural cavity?
outside lining of lungs
o Pleural cavity- releases serous fluid to reduce friction
Pleurisy- inflammation in pleural cavity
9. What is Parenchyma?
general lung tissue
10.
What are the steps of Respiration?
o Starts at larynx then trachea then right and left bronchi,
secondary bronchi, then bronchial lobes, then alveoli
11.
Landmarks for positioning?
o Jugular notch T2- T3
Center 3 to 4 inches inferior to notch is central ray
Want to put central ray at T6- T7 for AP

o Sternal angle/ Carina T4/T5

Hard to find
o Xiphoid process- T9/T10
o Inferior scapula borders- T6/T7
On back of shoulder blade
Brings you to exact level of central ray
12.
o
o
o
o
o
o

What are the Clinical indications for a chest x-ray?

Pre op screening
Chest pain
Physical exam
Numerous pathologies
Post trauma
F/U follow-up to phenomena

13.
14.

What are the Pathologies for a chest x-ray?

What is dyspnea?
Dyspnea- difficulty breathing
15.
What does COPD stand for?
chronic obstruction pulmonary disease
hard to breathe
emphazema can come from this
16.
What is atelectasis?
collapse of lungs with scaring from the collapse
i. Looks black
ii. Have to go up in technique
17.
What is pnemothorax?
accumulation of air in pleural space
go down in technique
18.
What is bronchiectasis?
irreversible inflammation
19.
What is the difference between benine and malignant?
Benine- non-cancerous
1. More smooth
Malignant- cancerous
2. No definite rounded shape, hazy around the
edges or spiculated
20.
What kind of technique do you use? What kind of contrast
is it? What is the kVp range?
a. Long scale contrast
b. 100 kVp or higher is required
21.

What is hypersthenic vs hypostenic and asthenic?

o hypersthenic male patients require 14*17 crosswise

hyposthenic- very small patient

sthenic- average patient
asthenic- tall narrow patient
Women always safe doing 14*17 lengthwise
22.
How do you reduce heart magnification?
PA- reduce heart magnification
o 72 SID for reduction of magnification
o Left lateral- bring heart closest to image receptor
23.
What is an Apical axial?
o Requires a 25-30 degree cephalic angle to bring clavicles
away from lung apices
o CR 2 inches inferior to jugular notch
o Radiologist sees an artifact in chest only in superior aspect
of chest
o Same SID and technique as PA chest but increased
collimation
24.
What is an Apical lordotic?
o Patient leaning back
o Angle patient instead of tube
25.
What is a Decubitus and why do you do it? How must the
CR be?
o See air fluid levels
o Pneumo- side up/ effusion- side down
o Patient should be in the side position for 10 minutes to
allow for delineation of air/fluid levels
o Book/boards= 20 mins
o Patient will need to be propped up to include all anatomy
o CR must be horizontal
o If right numothorax you want to do a left decubitis
Whatever side the air is in you want that side up
If fluid in right lung you want right side down
If you dont know then side of interest is that side
down
26.
What is an Oblique and why would you do it?
o If potential super imposition
o 10-15 degrees for superimposition
o 45 degrees RAO/LAO preferred for pathology in lung field,
reduces magnification
o 60 degree LAO oblique for heart studies
o CR level @ T7
o 110=125 kVp, on 2nd inspiration
27.
What does AEC do?
automatic exposure control keeps technique consistent
o You have to set mA but it controls the time, sets total mAs
o
o
o
o

o Has 3 chambers
Right and left= PA, decubitis and oblique
Lateral and apical would use center chamber
Abdomen:
28.
o
o
o
o

29.
30.
31.
32.
33.
34.
35.
36.
o

37.

o
o
o
a.
b.

38.
a.
b.
c.
d.
e.
f.

What are Clinical indications for the abdomen?

Rupture/perforation of abdominal viscera
Obstruction
Infection
Pathologies
Pneumoperitoneum (free of intraperitoneal air)
Air/fluid levels
Cholelithiasis and urolithiasis
(biliary and renal calculi)
Ascites (build up of fluid in abdomen)
Usually caused by fluid in liver
Volvulus (twist of bowel upon itself)
Intuessusception
What is pnemoperitoneum?
What is cholelithiasis?
What is urolithiasis?
What is ascites?
What does volvulus mean?
What is intuessusception?
What are the 9 regions of the abdomen?
What are the Clinical landmarks?
Xiphiod- T9-T10 for locating MSP, superior
abdomen/diaphragm
Inferior costal margin- L2-L3, lower part of ribs
Iliac crest- L4-L5
Greater trochanter at level of symphysis pubis
What does Supine mean? Why is it performed?
Most frequently performed for initial and f/u evaluation of
most pathologies
Also performed as the scout image for upper and lower
G.I. series; excretory urography; biliary procedures
What are the Positioning criteria for supine?
Patient placed in supine position with MSP centered to mid
table
Central ray directed perpendicular to iliac crest (must
include symphasis pubis)
kVp range 80 for digital
Gonadal shield for a male
Apply breast shield for a female
Correct respiratory phase on exhalation

39.
a.
b.
c.
d.

e.
40.
a.
b.
c.
d.
e.
41.
AP?
a.
b.
42.
a.

i. Pushes the diagram up

ii. Decrease peristaltic activity (gets rid of motion)
Why do you perform an Erect/upright position?
Done for air/fluid levels
Rule out atopic organs
i. Situs Inversus is when intestines are reversed
ii. Dextrocardia- just the heart on the reversed side
Must include diaphragms
Patient should be positioned PA if kidneys not of primary
interest to reduce breast/godnal dose
i. This needs to be done first when this is ordered
ii. Unless the renal system is involved then it is always
PA because it reduces significant gonad and breast
radiation
Allow 10 min for air/fluid levels to develop
What is the Positioning criteria for an erect PA?
Patient positioned PA on vertical table or upright unit with
MSP centered to film
Central ray directed perpendicular and 2 inches superior to
iliac crest
Respiratory phase on full exhalation
Increase kVp 6-10
Shield gonadal region
Why do you do a x-ray PA and not AP? When do you do an

You significantly decrease patient dose

Do it AP only when looking at kidneys
What kind of Lateral decubitis is preferred and why?
Left lateral preferred
i. Immediately turn on left side if in a stretcher
ii. Do left lateral so you get rid of gastric bubble only
goes as far as stomach and if there is free air then it
goes into diaphram
43.
Where do you put the central ray for a decubitis? What
marker do you put?
a. Alternate for erect or if required by protocol
b. Allow 10 mins for air/fluid separation
c. Central ray directed to MSP and 2 inches superior to iliac
crest
d. Full exhalation
e. Same exposure as erect
f. Side marker on down side
g. Put marker near pelvic
44.
Intestinal obstruction? What can common mechanical
causes include?
o Can be mechanical or malfunction

o Common mechanical causes include:

Surgical adhesions
Diverticulitis - when diverticulum (balloon shaped
coming out from wall of lower intestine) bursts
Foreign body
Volvulus
Tumors
Hand:

45.

What are the types of Fracture?

Longitudinal
Spiral
Simple
Compound
i. Very serious
ii. Parts of fracture have gone through the skin
e. Oblique
f. Comminuted
i. Multiple fragments
g. Impacted
i. Common in elderly
ii. Pushing the bone back against itself
iii. A lot in humerus and femur
h. Compression
i. In thoracic or lumbar spine
ii. Kyphosis- hunch back
46.
What is the most common fractured site in the hand?
a. Distal phalanx most commonly fractured site in hand of
adults and children
i. of all hand related FX
ii. tuft- bony part at the very end of the finger
b. Metacarpals are 2nd-1st digit (thumb) 3rd
47.
How many phalanges are there? How many IP? How many
metacarpals? How many MCP joints?
a.
b.
c.
d.

a.
b.
c.
d.

14 phalanges
9 interphalangeal joints (IP joints)
5 metacarpals
5 metacarphalangeal (MCP) joints
48.
What side is the thumb always on?
a. Thumb is always lateral side
49.
What are the bones of the hand? What is the acronim for
them?
a. Phalanges labeled medial to lateral
b. Proximal then lateral to medial then go to distal row by
lateral to medial
c. S.C.T.P.T.C.H
50.
What is a diarthrodial joint?
a. Diarthrodial joint because they are freely moveable
51.
How do you position a PA Hand? What kind of receptor
plate do you use? What is the kVp? Where is the CR?
a. Affected side closet to table with arm flexed 90 degrees
with elbow bent
i. Helps minimize angulation and rotation at the hand
and wrist
b. 100 ss (extremity) receptor or CR plate
c. Usually 60-65 kVp
d. Shield shield appropriate for adults
i. Full apron for children
e. Hand fully pronanted with digits extended
f. CR perpendicular to 3rd MCP joint
g. Collimation from tufts to proximal carpal row
i. Include part of radius and ulna (1 inch)
52.
What anatomy is demonstrated on a PA hand?
i. Interphalangeal and MCP joints
ii. Base of 3-5 metacarpals best seen free of
superimposition
iii. All soft tissue
iv. Include carpals and 1 of distal radius/ulna
v. 1st digit seen in PA oblique position
53.
What is the position for a PA Oblique? Why do you increase
kVp and by how much?
a. Hand rotated 45 degree laterally
b. Fingers in extension or slightly flexed per protocols
c. CR perpendicular at 3rd MCP joint
i. Near knuckle
d. +3 kVp because you need to penetrate because you start
to superimpose
e. You want to see carpal and metacarpal of thumb and 1st
phalange
54.
What do you want to see in a PA oblique hand?

a. Base of 1st and 2nd metacarpals seen free of

superimposition, as well as 1st carpometacarpal joint
b. Base of 3-5 metacarpals seen with slight superimposition
c. Sesamoid frequently seen medial to 1st metacarpal head
55.
What is the positioning for a Fan lateral hand? Where is the
CR? What do you increase the kVp by? Why would you do a fan
lateral?
a. Most commonly performed lateral
b. Medial aspect closest to receptor
c. Digits separated as much as possible
d. CR is perpendicular to 2nd MCP joint
e. Get individual laterals of 4 digits
f. Increase kVp by 10
g. Provides whether the fraction is in the anterior or posterior
part of the anatomy
56.
What is a Lateral with flexion relaxed? Why would you do
this? Where is the CR? What do you do to the kVp?
a. Evaluate anterior vs posterior metacarpals FXs
b. Truest lateral of metacarpals
c. Less painful for painful
d. Always perform for post reduction radiographs
e. CR is perpendicular to 2nd MCP joint
f. Fan and relaxed lateral= +6 kVp
57.
Why do you perform a Full extension lateral? Where is the
CR?
a. Used to demonstrate suspected soft tissue foreign bodies
b. Provides optimal superimposition of phalanges
c. CR is perpendicular to MCP joint
d. Usually recommend with soft tissue exposure (1/2 mAs)
for analog imaging only
58.
What is an AP oblique also called?
a. ball-catchers/norgaard
59.
Why do you do an AP oblique? Where is the CR?
a. Performed bilaterally so you can compare right and left
b. Use 100 ss analong receptor
c. R/O early arthritic changes and base of proximal phalanges
d. Rheumatoid arthritic- joints are deteriorated and very
painful
i. Decrease kVp 6-10 depending on severity
e. CR is right between two hands
60.
What do you do for a Traumatic hand protocol?
a. 2 AP approach
b. Do AP of phalanges parallel
c. Do AP of metacarpals parallel
61.
In an AP thumb where is the thumb placed? What is the
kVp?

62.

63.
64.

65.

66.

67.
it?

a. Affected hand is hyper pronanted to place the dorsal

aspect of thumb in contact with receptor
b. CR is parallel to MCP joint
i. Make sure you get to bottom on hand to make sure
you include scaphoid
c. 60 kVp
d. Attempt to free the base of the carpometacarpal region of
soft tissue superimposition
e. Must include carpometacarpal articulation
f. Hyperpronante until thumb is in superimposition
g. Have them take their other hand and pull the hand being xrayed back
h. Make sure they dont over rotate the thumb
PA Oblique thumb placement? Where is the CR?
a. Place hand in true PA position with 1st digit separated from
other digits
b. Thumb is naturally obliqued 45 degree when hand is
pronanted
c. CR is perpendicular to MCP Joint
What do you do for a Lateral thumb?
a. Rotate digit into lateral position by arching fingers
b. CR is perpendicular to MCP Joint
What is a Bennetts FX? Where is it?
a. Primary intrarticular type associated with the 1st digit
b. A fracture dislocation- base of 1st MC- 1st CM joint
c. Make sure it is healed so they dont get severe arthritis
d. Fracture of the proximal end of the 1st metacarpal with
dorsal and lateral dislocation of the distal segment
When can an Avulsion fracture happen? What is it?
a. Bone fracture, which occurs when a fragment of bone tears
away from the main mass of bone as a result of physical
trauma.
b. Occur at the ligament due to the application forces
external to the body (such as a fall or pull) or at the tendon
due to a muscular contraction that is stronger than the
forces holding the bone together
What is a Rolando FX?
a. A comminuted (has multiple fragments) Bennetts
b. Intra-articular type with many fragments
c. Much more difficult to treat then regular Bennetts because
of multiple fragments
Why would you do a Roberts projection? How would you do
a. Useful in assessment of Bennetts vs Rolando FX
b. 1st digit is positioned same as routine AP thumb
c. Incorporates a 15 degree angle proximally/to the elbow

d. Uses distortion to help differentiate possible fragments

68.
What position would you do if you wanted to see digits 2-5?
a. PA- PA oblique and lateral positions are performed
b. Positioning criteria is same as PA, PA oblique hand and
lateral thumb
c. For all digits (2-5) CR is perpendicular proximal
interphalangeal joint (PIP)
i. Has to be here so there is no beam divergence/ no
distortion
ii. As beam emerges from tube and spreads out
laterally it starts to come out an angle so when you
center at a certain joint then there is less distortion
69.
Where is a Boxers FX? In what metacarpal is it the most
common FX?
a. Metacarpals are 2nd most frequently fractured area of the
hand
b. Boxers is the most common FX of the 5th metacarpal
c. It is a transverse FX through the neck of the metacarpal,
with volar (anterior) displacement
70.
What do you do for a plaster cast? What if the cast is still
wet?
a. Plaster= 2x > mAs
i. If it still has moisture in it then you must 2x the mass
plus 10% more kVp
71.
What do you do for a waterproof cast?
a. Waterproof= +3 kVp
72.

What is the difference between a closed reduction?

a. Post reduction protocols
b. Closed reduction-simple realignment w/o SX, apply
pressure
c. Internal fixation- put screws, etc or need SX

Wrist:
1. What do you do for a PA wrist?
a. Patient is positioned with affected side closest to table with
arm flexed 90 degrees
b. Mid carpus centered to mid receptor
c. Fingers are then flexed or elevated to bring carpals in
contact with receptor or make a fist
d. CR is perp to midcarpus
2. Why do you have the patient make a fist?
i. This minimizes OID (object image distance) and
increases resolution and minimizes magnification
distortion

3. What is the PA critique? What do you want to see?

a. Collimation should include from mid metacarpals to 2 of
the distal radius/ulna
b. Proximal scaphoid, capitate and hamate are the only
carpals seen free of superimposition
c. Radiolunar joint is well demonstrated
4. How do you do a PA Oblique wrist? What is the kVp?
a. Wrist is rotated 45 degrees to receptor plane
b. CR perp to midcarpus
c. Best demonstrates the trapezium, trapezoid free of
superimposition and the distal scaphoid and lunate are well
seen
d. 3 kVp is good
5. How do you do an AP Oblique wrist? What does this projection
show free of superimposition?
a. Wrist semisupinated and adjusted at 45 degrees obliquity
to receptor place
b. CR directed perp to midcarpus
c. Best demonstrates the pisiform and triquetral free of
superimposition
d. Only routine projection that shows pisiform free of
superimposition
e. Can either supinate or pronante
6. How do you do a Lateral wrist? What does this best demonstrate?
Where do you put the marker?
a. Rotate hand and wrist to a true lateral position with ulnar
aspect in contact with receptor
b. CR perp to midcarpus
c. Best demonstrates anterior vs posterior displacement of
structures
d. Put marker on anterior side
7. What is the difference between a Colles vs Smiths FX? What are
they both associated with?
a. Both associated with the distal radius and ulna
b. Colles most common in females > 50 because of
osteoporosis
c. Colles- FX distal radius with posterior (dorsal)
displacement
i. Happens when they fall forward on the outstretched
arm
ii. Posterior displacement with ulna styloid FX
d. Smiths- FX distal radius with anterior (volar) displacement
i. Fall backwards
ii. Anterior displacement
8. How would you see if there is a fracture?

a. To see if there is a fracture RA look for cortex of bone

(outer lining of bone)
b. Suppose to be smooth
c. And look for bone trabeculae pattern should be smooth
endless fractured
i. Pathology more interrupts boney trabeculae
9. What is the most commonly fractured carpal? Why is it important
to visualize early?
a. Scaphoid injuries
b. Most commonly fractured carpal (80% of all carpals FX)
c. Important to properly visualize early due to vascular supply
and decrease ANV (avascular necrosis) bone begins to die
10.
What Projections do you do for a scaphoid injury?
a. PA- ulnar deviation
b. Stetchers
c. Multi-angle series
11.
What are the common sites of scaphoid FX?
a. 70% happen at waist
b. 20% proximal
c. 10% distal
12.
Why do you do Ulnar vs radial deviation?
a. Do them for ligament stability
b. Radial- medial carpal bones
c. Ulnar-scaphoid
13.
What is the Stetchers projection?
a. Performed to better demonstrate the scaphoid
b. Scaphoid seen w/o anatomical foreshortening or bony
superimposition
c. 2 methods- both required hand in maximum ulnar
deviation
i. Both open and elongate the scaphoid
14.
What is a True Stetchers? Where is the CR? What does this
do?
a. Wrist is pronanted in max. ulnar deviation
b. Hand is then elevated 20 degrees
c. CR is perpendicular snuffbox
d. 20 degree angle brings scaphoid parallel to IR
e. Deviation decreases palmar tilt of distal pole
f. Open and elongate scaphoid
15.
What is a Modified stetchers? what do you angle? What
does this show?
a. Hand and wrist are pronanted in maximum ulnar deviation
b. CR @ 20 degrees proximal angle
c. Fingers in flexed position
d. Angle tube not anatomy
e. Open and elongate scaphoid

16.

What does ulnar deviation do?

a. Ulnar deviated pulls the prox pole of the scaphoid out from
underneath the lunante
17.
What does the angle do to the scaphoid?
a. Angle reduced superimposition of scaphoid up on itself and
opens and elongates scaphoid
18.
What does the multi-angle series for scaphoid?
a. 4 exposure series
b. Demonstrates occult scaphoid FX
c. Same as PA with ulnar deviation
d. 0-10-20-30 degrees proximally
19.
What is the Carpal canal/tangential/gaynor-hart? Why do
you do it?
a. Used to visualize the carpal tunnel
b. R/o carpal tunnel syndrome
i. Usually damage or narrowing of a canal (stenosis)
ii. Any type of narrowing puts pressure on the nerve
iii. Repetitive motion over a long period of time
20.
What is an EMG?
a. electromylo cardiogram- test for carpal tunnel
1. Nerve conduction study
21.
What does the carpal canal show?
a. Visualize pisiform and hamulus free of superimposition
b. Perfect for hamulus and pisiform and AB oblique
22.
How do you do a Carpal canal/tangential?
a. Affected arm extended and parallel to table
b. Hyperextend hand and wrist (attempt to place fingers 90
degrees to receptor)
c. CR directed 25-30 degrees angled to base of 3rd metacarpal
d. Less hyperextension=more tube <
e. Slight 5 degree rotated toward thumb to help elevate
hamulus
23.
Why do you perform a AP wrist? What does it demonstrate?
a. Used to better demonstrate intercarpal spaces and r/o
ligamentous disruption or carpal instability DO NOT TO PA
WRIST
b. Fingers clenched to increase stress on ligaments
c. Have patient clench wrist
d. Do AP to demonstrate spaces in between carpals better
because their more parallel to beam and IR
i. PA closes a lot of these carpal spaces
24.
What is a Terry Thomas?
a. Terry Thomas sign (scapholunar disruption) big space
between scaphoid and lunate
25.
What does show Lunate dislocation?

26.
27.
28.

a. lateral (if you see moon of lunate sitting over the radius
then its a typical sign of lunar dislocation)
What is Kienbocks disease?
a. avascular necrosis of the lunate
b. It can re-vascularize quickly with immobilization
Lateral wrist in flexion
a. Extension and flexion for carpal instability along with AP
wrist
What is a carpal boss? Where does it occur?
a. Carpal boss- bony lump on the back of the hand. The
carpal boss occurs at the junction of the long hand bones
and the small wrist bones

Elbow and forearm

29.
allow
a.
b.
c.
d.
30.
a.
b.
c.
31.
a.
b.

c.

d.
32.
a.
b.

What side is the ulna on? What does the trochela notch
for? Anatomy of the elbow?
Ulna side is medial
Trochela notch allows for extension and flexion
i. Associated with distal head of the humerus
Radial head, neck, and tuberosity
Radial head associates with capitulum
What is the Arthrology of the elbow?
Diarthrodial hinge articulation
Humeroradial (capitulum and radial head)
Humeroulnar (trochlea and trochlea notch)
Fractures associated with the forearm (Pediatric)
Look for growth plates on child forearm
Torus (buckle fracture)
i. Not an impaction fracture
ii. Prolapse and pops back out but leaves a fracture line
iii. From falling
Greenstick
i. Occurs with complete fracture on cortex side
ii. Bone doesnt brake completely through
iii. Usually caused by bending of the arm
iv. Also an early sign of child abuse
Salter- harris
i. Lots of classifications
ii. Fracture that involves the apophysis
Fractures associated with the forearm (adult)
Parry (nightstick)- an isolated fracture of the unla
i. Mid shaft of the ulna
ii. Goes completely through bone
Monteggia- FX of the proximal 1/3 of the ulna with
dislocation of the proximal radius

i. On outstretched arm
c. Galeazzi- mid to distal 1/3 radius with dislocation distal
radiolunar joint
i. On outstretched arm
33.
How do you do an AP forearm? What do you do to the
hand?
a. Long bone- must include joints proximal and distal to injury
b. Anode heel effect
c. Arm extended and supinated- humeral epicondyles parallel
to receptor
i. Any pronation will cross over the radias and ulna
d. CR is perpendicular to midshaft
34.
How do you do a Lateral Forearm? Where is the CR?
a. Arm flexed 90 degrees with humerus and forearm in same
plane
i. If the table doesnt move then you can use a sponge
or ask patient to squat down
b. Hand and wrist rotated into lateral position
c. Humerus needs to be on the same plane
d. CR is perpendicular to midshaft
35.
What makes a perfect lateral?
i. You want elecronon process free of superimposition
ii. Want to see trochelar notch free of superimposition
iii. See coronoid
iv. Distal Radius and ulna is superimposed
Elbow
36.
What is the percent of injuries to the adult elbow involve
the radial head and neck (fall on outstretched arm with forearm
pronated)
a. 50%
37.
What is the kVp for the elbow?
a. around 65
38.
What are the different types of fractures that can happen
to the radial head?
a. Mason fractures 1-4:
i. Type 1: non-displaced fracture simple fracture of the
radial head
ii. Type 2: fracture with radial displacement
iii. Type 3: comminuted
iv. Type 4: fracture with dislocation of the proximal
radius
39.
What does type 3 and 4 have in common?
a. Type 3 and 4 usually with open reduction with internal
rotation

40.

AP Elbow? Where is the CR?

a. Elbow extended with hand supination
b. Epicondyles must be parallel with receptor plane
c. Wrist has to be fully supinated
d. CR is perpendicular to joint
i. Right at the level of epicondyles
41.
How can you tell it is an AP?
a. You can tell its AP:
i. Medial epicondyle free of superimposition
ii. Rest of it is a survey
iii. See elecronon fossa
iv. 1/3 to of the proximal radius will still be
superimposed by the ulna
42.
Medial (internal) oblique
a. Elbow is positioned similar to AP, then entire arm is rotated
medially to place epicondyles in a 45 degree plane
b. CR is perpendicular to joint
c. Common area for an avulsion fracture
43.
What does the internal oblique best demonstrate?
a. Position best demonstrates the coronoid process and
trochlea
44.
What is the difference between AP vs Lateral oblique?
a. Lateral- no superimposition of the proximal radius and ulna
b. AP- 1/3 superimposition of the proximal radius
45.
Lateral (external) oblique
a. Elbow positioned same as AP
b. Entire is rotated laterally to place epicondyles in a 45
degree plane
c. Lean patient laterally
d. CR is perpendicular to joint
46.
What does the lateral external oblique best demonstrate?
a. Best demonstrates the radial head, neck and tubercle and
capitulum
47.
Lateral elbow
a. Elbow is flexed 90 degrees with humerus and forearm in
same plane
b. Hand and wrist rotated into a lateral position
c. CR is perpendicular to joint
48.
What does the lateral elbow best demonstrate?
a. Best demonstrates olecranon process and trochlear notch
49.
When should you see fat pads? What are the posterior,
anterior, and supernator fat pads?
i. You should not see fat pads endless there is an injury
ii. You do not see the fat pads on any other position but
the lateral

iii. Posterior- elecronon fossa, distal humerus or

elecronon
iv. Supernator fat pad- lies in soft tissue anterior of the
proximal radius
1. 100% for radial head FX
v. Anterior- coronoid fossa, distal humerus FX
50.
What does a supernator fat pad mean in terms of the radial
head?
1. 100% for radial head FX
*PA away= that side is elongated
*AP towards= side gets elongated