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Radt 1502 A&P > Exam 3 - Hand, Finger, Wrist, Forearm, Elbow, Humerus > Flashcards

Exam 3 - Hand, Finger, Wrist, Forearm, Elbow, Humerus Flashcards

1
Q

how many bones are in the hand?

A

27

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2
Q

how many phalange bones are there?

A

14

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3
Q

how many metacarpal bones are there?

A

5

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4
Q

how many carpal bones are there?

A

8

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5
Q

what type of joints are interphalangeal joints?

A

synovial ellipsoidal joints (flexion & extension)

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6
Q

what type of joints are metacarpophalangeal joints?

A

synovial ellipsoidal joints (Flexion, Extension, Abduction, Adduction, Circumduction)

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7
Q

what type of bone is a sesamoid bone?

A

floating bone

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8
Q

which metacarpal has 2 sesamoid bones?

A

1st metacarpal

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9
Q

what type of joints are carpometacarpal joints between 2nd-5th metacarpals & the trapezoid, capitate, and hamate, and intercarpal articulation?

A

synovial gliding joints

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10
Q

what type of joint is the carpometacarpal joint between the 1st metacarpal & trapezium?

A

synovial saddle joint (thumb oppose fingers)

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11
Q

what type of joints are part of the radiocarpal articulation?

A

synovial ellipsoidal joints

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12
Q

radioulnar articulations

A

synovial pivot joints

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13
Q

what carpal bones are in the proximal row?

A

scaphoid (navicular), lunate (semiulnar), triquetrum (cuneiform), pisiform

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14
Q

what carpal bones are in the distal row?

A

trapezium (greater multangular), trapezoid (lesser multangular), capitate (os magnum), hamate (unciform)

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15
Q

what order are the carpal bones in starting proximally under the thumb?

A

scaphoid
lunate
triquetrum
pisiform
hamate
capitate
trapezoid
trapezium
(so long to pinky, here comes the thumb)

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16
Q

what is the most commonly fractured carpal bone?

A

scaphoid

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17
Q

what is formed by tendons of 2 major muscles of the thumbs?

A

anatomic snuffbox

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18
Q

what is tenderness in the snuffbox area a clinical sign of?

A

suggests fracture of the scaphoid

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19
Q

passageway created between the carpal sulcus and flexor retinaculum

A

carpal tunnel

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20
Q

what runs through the carpal tunnel?

A

median nerve

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21
Q

eval criteria for PA of digits 2-5

A

entire digit from distal portion to the adjoining metacarpal
no soft tissue overlap from other digits
open IP and MCP spaces without bone overlap

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22
Q

what surface do you lay the hand on for a lateral projection of digits 2 & 3?

A

lateral

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23
Q

what surface do you lay the hand on for a lateral projection of digits 4 & 5?

A

medial

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24
Q

where do you put the central ray for a lateral projection of the digits?

A

proximal interphalangeal (PIP) joint

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25
Q

eval criteria for lateral projection of digits 2-5

A

no obstruction of prox phalanx or MCP joint
open IP joint spaces

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26
Q

how to take PA OBL projection for digits 2-5

A

45 degree external obl, central ray at PIP joint

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27
Q

eval criteria for PA oblique projection of digits 2-5

A

45 degree external obl, no superimposition, open IP and MCP joint spaces

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28
Q

how to take AP projection of 1st digit

A

flip hand so dorsal side of thumb is touching the IR
central ray at the MCP joint
distal tip to trapezium

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29
Q

how to take lateral projection of 1st digit

A

place hand palmar side down on IR, abduct thumb, curl digits 2-5 to move thumb into lateral position
central ray at MCP joint

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30
Q

how to take PA OBL projection of 1st digit

A

palmar side down to IR, thumb abducted, CR to MCP joint, all fingers and palm flat touching IR

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31
Q

what carpal bone needs to be included on all 1st digit x-rays?

A

trapezium

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32
Q

how to take PA projection of hand

A

hand flat to IR, spread fingers, CR at 3rd MCP joint, open MCP and IP joints, include all carpals & radius and ulna

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33
Q

how to take PA OBL projection of hand

A

rotate hand 45 degrees externally, good OBL hand shows space between metacarpals, space gets smaller as you go 1-5

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34
Q

how to take lateral projection of hand

A

hand on medial surface, thumb free of super imposition, digits 2-5 superimposed

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35
Q

what is a lateral projection of the hand used for?

A

finding forgein bodies and metacarpal fracture displacement

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36
Q

how to take fanned lateral projection of hand

A

hand on medial surface, fan out fingers to see each individually, CR to 2nd MCP, used to see phalangeal joints, superimposed metacarpals and radius & ulna

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37
Q

how to take AP OBL projection “ball-catchers” Norgaard method

A

hands dorsal surface to IR, rotated medially 45 degrees, hands relaxed in position like they are holding a ball

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38
Q

what is the “ball-catchers” Norgaard method used for?

A

to diagnose rheumatoid arthritis, demonstrates fractures at the base of the 5th metacarpal

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39
Q

how to take PA projection of wrist

A

CR perpendicular to midcarpals, flexed digits to decrease wrist OID, includes MCP joints and part of the radius & ulna

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40
Q

how to take lateral projection of wrist

A

hand on medial surface, elbow at 90 degrees, CR to carpals, metacarpals and radius & ulna are superimposed

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41
Q

what does a lateral projection of the wrist demonstrate?

A

anterior/posterior displacement fractures

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42
Q

what is a posterior displacement fracture of the wrist called?

A

colle’s fracture

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43
Q

what is an anterior displacement fracture of the wrist called?

A

smith’s fracture

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44
Q

how to take PA OBL projection of wrist

A

lateral (external) rotation 45 degrees, CR to carpals, slight space between metacarpals, slight overlap of radius and ulna

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45
Q

what does a PA OBL projection of the wrist demonstrate?

A

trapezium and scaphoid

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46
Q

what does a PA projection of the wrist with ulnar deviation show?

A

scaphoid (aka navicular view)

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47
Q

what does a PA projection of the wrist with radial deviation show?

A

open interspaces between carpals on medial side

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48
Q

how to take PA Axial projection - Scaphoid Stecher Method

A

20 degree angulation to project scaphoid free of superimposition

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49
Q

why is the PA Axial projection - Scaphoid Stecher Method used?

A

used when ulnar deviation is not possible

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50
Q

how to image the carpal canal

A

tangential projections
25-30 degree angle

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51
Q

an infection of bone and bone marrow, usually caused by pyogenic bacteria or mycobacteria, bone death appears as radiolucencies, if not treated affected area needs to be amputated

A

osteomyelitis

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52
Q

fracture that occurs when normal stress is placed on diseased areas of bone, the disease must be treated for the healing of the fracture to take place

A

pathologic fracture

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53
Q

when a small chip of bone breaks away when a joint is dislocated

A

avulsion fracture

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54
Q

occurs when the distal radius fractures with the fragment being displaced posteriorly

A

colles’ fracture

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55
Q

bone broken in 3 or more places, “shattered”

A

comminuted fracture

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56
Q

ends are driven into each other; commonly seen in arm fractures in children

A

buckled or impacted fracture

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57
Q

an incomplete fracture in which the bone is bent; occurs most often in children

A

greenstick fracture

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58
Q

the break has a curved or sloped pattern

A

oblique fracture

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59
Q

one part of the bone has been twisted at the break point

A

spiral fracture

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60
Q

a hairline crack

A

stress fracture

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61
Q

the broken piece of bone is at a right angle to the bone’s axis

A

transverse fracture

62
Q

a fracture in which the bone breaks through the skin and can be seen outside the leg or there is a deep wound that exposes the bone through the skin

A

open or compound fracture

62
Q

fracture where the bone doesn’t separate and does not break the skin

A

closed or simple fracture

63
Q

distal clavicle is displaced superiorly
appearance: widening of AC space

A

AC dislocation

64
Q

partial or complete tear of AC or CC ligaments
appearance: asymmetric
widening of AC compared to
opposite side (>3mm)

A

AC joint separation

65
Q

fracture of anteroinferior genoid rim
appearance: disruption of glenoid rim

A

bankart lesion

66
Q

fluid filled cyst within the wall of bone’s fibrous tissue
appearance: radiolucency

A

bone cyst

67
Q

inflammation of the bursa
appearance: fluid filled joint space, possible calcification

A

bursitis

68
Q

compression of the median nerve causing pain and paresthesia
appearance: possible calcification of the carpal sulcus

A

carpal tunnel syndrome

69
Q

displacement of the bone from the joint space
appearance: bone displaced from the joint space

A

dislocation

70
Q

fractures of the ribs causing irregular rise and fall of the chest during inspiration and expiration; underlying pulmonary injury
appearance: disruption of bony cortex of rib with linear lucency through the rib

A

flail chest

71
Q

disruption of continuity of bone caused by a force (direct or indirect)

A

fracture

72
Q

break and
dislocation of the
posterior lip of the
distal radius

A

barton’s fracture

73
Q

break at the base
of the 1st
metacarpal

A

bennett fracture

74
Q

transverse fracture of the 5th metacarpal neck

A

boxer’s fracture

75
Q

fracture of distal radius with
posterior displacement of
the distal fragment. 50-60% have
associated ulnar styloid fracture

A

colles fracture

76
Q

fracture of the
distal radius with
anterior
displacement of
distal fragment

A

smith fracture

77
Q

impacted fracture
with bulging of the
periosteum

A

torus or buckle fracture

78
Q

impacted
compression
fracture of
posterolateral
aspect of the
humeral head with
anterior dislocation

A

hills-sachs defect fracture

79
Q

Hereditary form of arthritis in which uric acid is deposited in joints. Most common within the MTP joint of the foot
appearance: Uric acid
deposits in joint space. Destruction of the joint space

A

gout

80
Q

Disability caused by chronic inflammation in and around the joint
appearance: possible calcification and/or other joint space anomalies

A

Idiopathic Chronic
Adhesive Capulitis
(frozen shoulder)

81
Q

Impingement of the greater tuberosity and soft tissues on the coracoacromial ligamentous and osseous arch during arm abduction
appearance: Subacromial
spurs

A

impingement syndrome

82
Q

Accumulated fluid (synovial or hemorrhagic) within the joint space
appearance: Fluid filled Cavity

A

joint effusion

83
Q

Transfer of cancerous lesion from one area to another
appearance: Areas of
varying density

A

metastasis

84
Q

Arthritis with gradual
degeneration of the articular cartilage with hypertrophic bone formation.
apperance: Narrowing of joint space(s) with periosteal growths on the
joint margins

A

Osteoarthritis/Degenerative Joint Disease

85
Q

Inflammation of the bone as a result of pyogenic infection. Localized infection of bone or bone marrow.
appearance: Soft-tissue swelling and loss of the fat-pad detail visibility

A

Osteomyelitis

86
Q

Hereditary disease. Abnormally dense bone.
appearance: “Marble Bone”, Opaque appearance with lack of distinction between bony cortex and trabeculae

A

Osteopetrosis

87
Q

Loss of bone density appearance: Decreased density in distal extremities and joints. Long bones demonstrate thinned cortex

A

osteoporosis

88
Q

chronic bone disease that causes destruction of the bone followed by a reparative process of overproduction of very dense yet soft bones that tend to fracture easily.
appearance: Mixed areas of sclerotic and cortical thickening accompanied by radiolucent lesions. “Cotton wool” appearance

A

paget’s disease

89
Q

Congenital anomaly in which there is anterior protrusion of the lower sternum
appearance: Anterior protrusion of lower sternum

A

Pectus Carinatum
(Pigeon Chest)

90
Q

Congenital anomaly demonstrating a depressed sternum
appearance: Depressed Sternum

A

Pectus Excavatum
(Funnel Chest)

91
Q

Chronic, systemic, inflammatory collagen (connective tissue) disease
appearance: Closed joint
spaces with subluxation of the MCP joints

A

Rheumatoid Arthritis

92
Q

Injury to one or more of these: teres minor, supraspinatous, infraspinatous, and/or subscapularis
appearance: Limited range of motion, fluid collections and soft tissue swelling

A

Rotator Cuff Tear

93
Q

Transfer of lesions from one area to another
appearance: Osteolytic lesions are
destructive with irregular
margins

A

rib metastatic lesions

94
Q

Removal of humeral head from the glenoid cavity (most anterior dislocations)
appearance: Separation
between the humeral head and glenoid cavity

A

Shoulder Dislocation

95
Q

Sprain or tear of the ulnar
collateral ligament of the thumb caused by hyperextension of the MCP joint.
appearance: Widening of
the inner MCP
joint space of
thumb

A

“Skier’s Thumb”

96
Q

inflammation of the tendon and tendon muscle attachment
appearance: Calcification

A

Tendinitis

97
Q

New tissue growth where cell proliferation is uncontrolled

A

tumor malignant

98
Q

Arises from cartilage cells
appearance: Contains
calcifications
with cartilaginous mass

A

Chondrosarcoma

99
Q

Arises from
medullary tissue. Common in children and young adults
appearance: Has an “onion peel” appearance

A

Ewing’s Sarcoma

100
Q

Most common malignant. Arises from bone marrow or marrow plasma cells
appearance: appear as
“punched out” osteolytic lesions

A

Multiple Myeloma

101
Q

Primary tumor of the bone with bone and cartilage formation
appearance: Dependent on stage of tumor

A

Osteosarcoma Benign

102
Q

Slow growing
tumor consisting of
cartilage
appearance: radiolucent with thin cortex, often
associated with pathologic
fractures

A

Enchondroma

103
Q

Most common benign. Arise from outer cortex and grow parallel
to the bone
appearance: Growth of tumor is parallel and pointing away from the adjacent joint

A

Osteochondroma

104
Q

Where does the CR go for a single digit?

A

PIP joint

105
Q

All of the following are projections of the thumb except?

A

PA

106
Q

Which is true concerning fat pads of elbow?

A

can only see in lateral positions

107
Q

Which joint CR for OBL thumb?

A

MCP

108
Q

How to reduce motion in picture?

A

immobilization, decrease exposure time

109
Q

Which bones articulate with lunate and scaphoid of wrist?

A

distal radius

110
Q

When doing wrist what angle for OBL?

A

45 degree

111
Q

Ulnar deviation, which bone?

A

scaphoid

112
Q

Anatomical position what side is 1st metacarpal on?

A

lateral

113
Q

Which carpal bone is most fractured?

A

scaphoid (navicular)

114
Q

Lateral hand with digits super imposed what are you looking for?

A

foreign bodies or displacement of broken bone

115
Q

What carpal bone has hook?

A

hamate

116
Q

Trochlear notch =

A

semilunar notch

117
Q

what is between the greater and lesser tuberosity of humerus?

A

bicipital groove

118
Q

Capitulum is on the

A

lateral anterior side

119
Q

Trochlea is on the

A

posterior side and medial anterior side

120
Q

where do the radial head and coronoid process rest?

A

anterior of humerus

121
Q

What is the shallow depression on the anterior distal humerus?

A

coronoid fossa

122
Q

What is the distal portion of the humerus that articulates with the ulna called?

A

trochlea

123
Q

What are the bony prominences on proximal humerus?

A

greater and lesser tubercles

124
Q

What kind of joint is your elbow?

A

synovial, hinge, diarthrotic

125
Q

can only see fat pads in a

A

lateral position

126
Q

If you can see posterior fat pad on x-ray that indicates a

A

radial head fracture

127
Q

Why is the hand supinated for AP projection of forearm?

A

so the radius & ulna don’t cross

128
Q

AP forearm should include _______ to _______

A

elbow joint to carpals

129
Q

Be sure the shoulder is in the _____ _____ as the elbow for AP projection of elbow so there’s ___ ______

A

same plane, no flexion

130
Q

For lateral elbow the wrist and hand should be ______ because it makes the epicondyles _______

A

lateral, superimposed

131
Q

Why would you pronate hand for AP oblique medial elbow?

A

To see the coronoid process free of superimposition

132
Q

For AP oblique lateral rotation elbow you rotate the elbow _______ to see the ______ _____ free of superimposition

A

laterally, radial head

132
Q

What happens when a patient cannot fully extend the elbow due to injury?

A

You use partial flexion with 2 AP projections of the distal humerus and proximal forearm. Humerus on table for one, forearm on table for other

133
Q

Distal Humerus Acute flexion (Jones Orthopedic Method) demonstrates

A

the olecranon process

134
Q

Why should you take humerus images upright when possible?

A

it’s easier for the pt, less painful

135
Q

AP Humerus joint should include ______ ______ to ______ ______, with ______ ________ in profile

A

shoulder joint to elbow joint, greater tubercle

136
Q

Lateral humerus should show ______ ______ superimposed and _____ _______ in profile

A

greater tubercle, lesser tubercle

137
Q

What do you do for technique for transthoracic lateral projection proximal humerus?

A

increase time, decrease mA

138
Q

What definition refers to an epiphysis?

A

ossification center

139
Q

Which definition refers to periosteum?

A

membranous sheath

140
Q

Distal ulna articulates
with _____ Notch of
_____

A

ulnar, radius

141
Q

Proximal head of radius
articulates with _____
notch of _____

A

radial, ulna

142
Q

what type of joint allows supination and pronation of the forearm and hand?

A

synovial pivot joint

143
Q

Humeroulnar and humeroradial articulations

A

Synovial Hinge Joints
Flexion / Extension

144
Q

What are the 3 areas of fat pads?

A

posterior, anterior, supinator

145
Q

What view are the fat pads visible in?

A

lateral

146
Q

How do you do the trauma patient view to see the radial head?

A

angle tube 45 degrees cephalic to the radial head

147
Q

How do you do the trauma patient view to see the coronoid process?

A

angle tube 45 degrees caudal to the coronoid process

148
Q

What is the PA Axial Projection Distal Humerus used for?

A

to image radiohumeral bursitis (tennis elbow); detects otherwise obscured calcifications located in the ulnar sulcus
CR: is perpendicular

Radt 1502 A&P (5 decks)

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