Fingers, Hand, and Wrist Flashcards
How many phalanges are in each hand?
14 phalanges
How many metacarpals are in each hand?
5 metacarpals
How many carpals bones are in each wrist?
8 carpal bones
How many phalanges are in the first digit (thumb)?
two phalanges
phalanges of hand:
-distal
-middle
-proximal
where do the head of the metacarpals (distal end articulate?
phalanges
where do the bases of the metacarpals(proximal) articulate with?
carpals
what does the proximal row (lateral to medial) of carpal bones consist of?
-scaphoid
-lunate
-triquetrum
-pisiform
what does the distal row (lateral to medial) of carpal bones consist of?
-trapezium
-trapezoid
-capitate
-hamate
Mnemonic aids to remember the carpal bones
steve left the party to take carol home
- scaphoid
-lunate
-triquetrum
-pisiform
-trapezium
-trapezoid
-capitate
-hamate
articulation between phalanges
-classified as synovial, diarthrotic, or freely movable joint
Interphalangeal (IP) Joints
articulations between the heads of the metacarpals and the proximal phalanges
- classified as synovial, diarthrotic, ellipsoidal type
Metacarpophalangeal (MCP) joints
articulates between the bases of the metacarpals and the carpal bones
-first CMC classified as synovial, diarthrotic, saddle type
-second to fourth CMC joint are gliding types
Carpometacarpal (CMC) joint
articulations between the carpal bones
-classified as synovial, diarthrotic, gliding type
intercarpal joints
articulation between the carpals and the distal radius
-classfied a synovial, diarthrotic, ellipsoidal type
radiocarpal joint
Essential projections: digits 2 to 5
-PA
-Lateral
-PA oblique
Where do you center for a PA finger?
-Perpendicular to IR
-Enters patient at PIP joint
Where do you center for a Lateral finger?
-Perpendicular to the IR
-Enters patient at PIP joint
How many degrees do we rotate the finger for an PA oblique digit?
45 degrees
Where do you center for the PA oblique digit?
-Perpendicular to PIP joint of affected digit
Essential Projections: Thumb
-AP
-Lateral
-PA oblique
Where do we center for an AP thumb?
-Perpendicular to the 1st MCP joint
To put the thumb in a lateral position what do you do?
Curl your fingers up to make the thumb true lateral
Where do we center for the lateral thumb?
-Perpendicular to the 1st MCP joint
To put the thumb in a oblique position what do you do?
just put your hand out, since the thumb is already in a oblique position
how many degrees is the PA oblique thumb?
45 degrees
If you can’t turn the thumb over on its side for the AP projection what do you do?
Do the thumb in a PA position but make sure the thumb is at the same level of the 2nd finger
Where do you center for an PA oblique thumb?
perpendicular to 1st MCP joint
What is the distance for hand, fingers, wrist?
40 inches (100 cm)
Essential projections: hand
-PA
-Lateral
- Fan lateral
- lateral full extension
-PA oblique
Where do we center for the PA hand?
perpendicular to 3rd MCP joint
What’s the collimation for PA hand?
1 inch on all sides of the hand, including 1 inch proximal to the ulnar styloid
How many degrees in an PA Oblique hand?
45 degrees
Where do we center for the PA Oblique hand?
perpendicular to 3rd MCP joint
joint spaces will be opened in a?
PA Oblique Hand
In a true lateral hand
-elbow is flexed 90 degrees
-radial and ulnar styloids superimposed and peripendicular
-digits aligned parallel to IR
-hand on medial surface
-bring thumb down
where do we center for a lateral hand?
perpendicular to 2nd MCP joint
in a lateral fan hand
-fan the hand
-separate fingers
-elbow flexed 90 degrees
-medial aspect in contact with IR
demonstrates anterior and posterior metacarpal fractures
Lateral hand in flexion
Why do we do the Norgaard Method-Ball-catcher’s position?
Early detection of rheumatoid arthritis
The Norgaard method is known as?
ball catcher position
How is the Norgaard method done?
-Hands oblique at 45 degrees
-AP
-Pisiform is best demonstrated
What is the central ray for the Norgaard method?
Mid way between both hands at the level of the MCP joint
Essential Projections: Wrist
-PA
-Lateral
-PA oblique
-PA projection (ulnar deviation position)
-PA axial (stecher method) to see scaphoid
-Tangenital (Gaynor-Hart Method) for carpal canal
What is the collimation for wrist?
2 1/2 inches proximal and distal to the wrist joint and 1 inch on the sides
Where do we center for the PA wrist?
perpendicular to midcarpal area
What happens to the elbow on a PA wrist?
Elbow flexed at 90 degrees
Why do we curl our fingers up for the PA wrist?
To put the carpal bones closer to the IR
You see the carpal interspaces in?
An AP wrist
Why do we do a lateral wrist?
To better demonstrate the ulna styloid process
Where do we center for a lateral wrist?
Perpendicular to the midcarpal area
Why does the thumb come down for the lateral wrist?
You can better see the trapezium
For the wrist how should everything be?
-be in the same plane
-elbow at 90 degrees
fracture of distal radius with posterior displacement?
Colles fracture
Where do we center for the PA Oblique wrist?
Perpendicular to midcarpal area
How many degrees for the PA oblique wrist?
45 degrees (lateral rotation)
Known as the largest carpal bone?
Capitate
The bone that has the most fractures in the wrist?
Scaphoid
In an AP Oblique Wrist?
The triquetrum, hook of hamate, and pisiform free of superimposition
In the PA projection (Ulnar Deviation Position)
turning hand outwards towards the ulna into extreme ulnar deviation
What do you see in the ulnar deviation?
The 1st metacarpal is aligned with the radius
What happens in the PA axial Scaphoid (Stecher Method)?
Angle cassette 20 degrees or angle tube 20 degrees
What happens to the scaphoid in the ulnar deviation?
Scaphoid gets elongated (longer) and more posteriorly
Where do we center for the Stecher Method?
Perpendicular to table and enters at scaphoid
Why do we do the Gaynor-hart method (tangential view)?
For carpal tunnel syndrome
How many degrees do you angle the tube for the Gaynor-hart? What should you do with your hands
-25 to 30 degrees toward the palm of the hand (base of 3rd)
-tilt hand up to the sky
If the patient can’t bend their hands up for the Gaynor hart what do you do instead?
make them turn around and do a superoinferior carpal canal
What is the collimation for the Gaynor hart?
Enters at a point approximately 1 inch (2.5 cm) distal to the base of the 3rd metacarpal
