Fingers, Hand, and Wrist Flashcards by Jennifer Gonzalez

How many phalanges are in each hand?

14 phalanges

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How many metacarpals are in each hand?

5 metacarpals

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How many carpals bones are in each wrist?

8 carpal bones

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How many phalanges are in the first digit (thumb)?

two phalanges

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phalanges of hand:

-distal
-middle
-proximal

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where do the head of the metacarpals (distal end articulate?

phalanges

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where do the bases of the metacarpals(proximal) articulate with?

carpals

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what does the proximal row (lateral to medial) of carpal bones consist of?

-scaphoid
-lunate
-triquetrum
-pisiform

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what does the distal row (lateral to medial) of carpal bones consist of?

-trapezium
-trapezoid
-capitate
-hamate

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Mnemonic aids to remember the carpal bones

steve left the party to take carol home
- scaphoid
-lunate
-triquetrum
-pisiform
-trapezium
-trapezoid
-capitate
-hamate

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articulation between phalanges
-classified as synovial, diarthrotic, or freely movable joint

Interphalangeal (IP) Joints

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articulations between the heads of the metacarpals and the proximal phalanges
- classified as synovial, diarthrotic, ellipsoidal type

Metacarpophalangeal (MCP) joints

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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

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articulations between the carpal bones
-classified as synovial, diarthrotic, gliding type

intercarpal joints

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articulation between the carpals and the distal radius
-classfied a synovial, diarthrotic, ellipsoidal type

radiocarpal joint

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Essential projections: digits 2 to 5

-PA
-Lateral
-PA oblique

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Where do you center for a PA finger?

-Perpendicular to IR
-Enters patient at PIP joint

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Where do you center for a Lateral finger?

-Perpendicular to the IR
-Enters patient at PIP joint

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How many degrees do we rotate the finger for an PA oblique digit?

45 degrees

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Where do you center for the PA oblique digit?

-Perpendicular to PIP joint of affected digit

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Essential Projections: Thumb

-AP
-Lateral
-PA oblique

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Where do we center for an AP thumb?

-Perpendicular to the 1st MCP joint

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To put the thumb in a lateral position what do you do?

Curl your fingers up to make the thumb true lateral

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Where do we center for the lateral thumb?

-Perpendicular to the 1st MCP joint

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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