Chapter 4 Flashcards
How many finger bones are in the hand and wrist?
27
Finger bones are also known as:
Digits
How many bones in the fingers?
14
What are the most distal bones of the hand?
Phalanges/phalanx
How are phalanx named?
By location to the midline - distal, middle, and proximal
How many bones in the thumb? How many in the rest of the fingers?
2, 3
How are the fingers numbered?
Thumb = 1
Index finger = 2.. etc
What does each phalanx consist of?
Head, body, and base
What are metacarpals?
Bones of the palm
How many bones are in the palm?
5
What part of the metacarpal is always on a radiograph?
Thumb
Carpal bones in the 1st proximal row - starting from radial side
Scaphoid (navicular)
Lunate
Triquetrum
Pisiform
Carpal bones in the 2nd distal row - starting from radial side
Trapezium
Trapezoid
Capitate
Hamate
What are interphalangeal joints?
Spaces between two phalanx
What are distal interphalangeal joints?
Space between distal phalanx and middle phalanx
What are proximal interphalangeal joints?
Space between proximal and middle phalanx
What are the metacarpalphalangeal joints?
Space between the distal metacarpals and the proximal phalanx
What are the carpometacarpal joints?
Joints that join the carpals to the proximal metacarpals
Where is the styloid process located?
On the extreme distal ends of the radius and the ulna
Where/what is the ulnar notch?
Medial side of the radius. Head of the ulna fits into this notch
Where is included on the proxminal end of the radius?
Head and neck, and radial tuberosity
Is the radius or ulna shorter?
Radius
How does the radius articulate with the wrist?
Directly turns the wrist, primary bone
What does the ulna form?
Elbow
What are the two pointy processes of the proximal ulna?
Olecranon process
Coronoid process
Where is the coronoid tubercle located?
Medial side of ulna
What does the trochlear notch articulate with?
Distal end of the humerus
What is the radial notch?
Depression on the lateral aspect of the proximal ulna
What does the radial notch do?
Allows for rotation (pronation) of the forearm. Radius crosses over the ulna
What is the humeral condyle?
Whole distal end of the humerus; made up of 2 parts
What are the 2 parts of the humeral condyle?
Trochlea - articulates with the ulna and is shaped like a pulley
Capitulum - means little head; lateral aspect of humerus, articulates with the head of the radius
Where is the lateral epicondyle?
Small projection on the lateral aspect of the humerus above the capitulum
Where is the medial epicondyle?
More prominent condyle located on the medial edge of the distal humerus
Function of the coronoid and radial fossa’s?
The coronoid process and the radial head fit into these fossa’s when the arm is flexed completely
Location of the olecranon fossa?
Posterior side of the end of the distal humerus. This sits the olecranon process when the arm is extended
What are the 3 concentric circles of the lateral elbow?
Trochlear sulcus
Outer ridges of capitulum and trochlea
Trochlear notch
What bones open in ulnar deviation?
Wrist bones on the radial side - scaphoid, trapezium, trapezoid
What bones open in radial deviation?
Wrist bones on ulnar side - hamate, pisiform, triquetrum, and lunate
What do fat pads indicate?
Disease
Injury
Fracture
Where are fat pads located?
Extrasynovial (outside the synovial sac) but inside the capsule joint
How many fat pads does the wrist have?
2 - scaphoid and pronator fat stripe
How many fat pads does the elbow have? And what are they?
3 - anterior, posterior, and supinator fat stripe
What do you need to see the anterior and posterior fat pads of the elbow?
90 degree flexion
True lateral
Optimum exposure (long scale)
Technique for fingers
55-60 @ 1.6-2
Technique for wrist
58-60 @ 2 - 2.5
Technique for Humerus
70-75@ 6-10
Technique for casts
Med plaster - 50%-60% mAs increase or 5-7 kVp
Large plaster - 100% mAs increase or 8-10 kVp
Fiberglass - 25%-30% mAs increase or 3-4 kVp
What hand/wrist/elbow joints are ginglymus?
Interphalangeal joints
Elbow joint
What hand/wrist/elbow joints are ellipsoidal?
Metocarpophalangeal joints
Wrist (radiocapral)
What hand/wrist/elbow joints are Saddle?
Thumb
What hand/wrist/elbow joints are Plane?
Carpometocarpal - 2nd through 5th digits
Intercapral joints
What hand/wrist/elbow joints are pivot?
Proximal radioulnar
Technique for Hand
60 @ 2-2.5
Technique for Forearm
65 @ 2.5-4
Technique for Elbow
65-70 @ 3-5
How to adjust SID for tube angle
For every 5 degree angle, drop SID by 1”
Name of hooklike process extending anteriorly from hamate?
Hamulus (hamular process)
What are the ligaments used to stabilize the wrist?
Ulnar/Radial collateral ligaments
Dorsal radiocarpal
Palmar radiocarpal
TFCC
Scapholunate
Lunotriquetral
What wrist ligament extends frm the styloid process of the radius to the lateral aspect of the scaphoid and trapezium?
Radial collateral ligament
What routine projections best shows scaphoid fat pat?
PA and Oblique wrist
What routine projections best shows pronator fat pad?
Lateral
Radiographic procedure that used contrast to visualize soft tissue pathology of wrist/shoulder/elbow joints?
Arthrography
What special positioning method is used for Bennett fracture?
Modified Robert’s w/ 15 degree angle proximally
What is the Brewerton method?
CR angled 15 degrees towards ulna, hand is cupped 65 degrees
What is Brewerton’s method used for?
Rheumatoid arthritis
What fracture is not demonstrated in a wrist routine?
Pott
What special projection of the wrist helps to rule out abnormal calcifications in the capral sulcus?
Tangential Inferiosuperior
What wrist bones articulate with the radius?
Scaphoid and Lunate (radiocarpal joint)
What wrist ligament is attached to the styloid process of the ulna and the triquetrum/pisiform
Ulnar Collateral Ligament
What projection is used for foreign bodies of the hand/fingers
Lateral in extension
What projection is used for skier’s thumb?
Folio method
What is the angle difference for carpel tunnel projection vs carpal bridge projection
Carpal tunnel - 25-30 degree angle proximally
Capral bridge - 45 degree angle distally
What projections should be used if elbow cannot fully extend?
Humerus parallel to IR
Forearm parallel to IR
What elbow projection is best to see the radial head/neck and capitulum?
Lateral oblique
What elbow projection is best to see the coronoid process and trochlea
Medial oblique
What is the Coyle method?
Radial head
-angle 45 degrees toward shoulder
Coronoid process
-angle 45 degress from shoulder
