Fingers, Wrist and Hand Flashcards
How many bones are in the hand?
27
- 14 phalanges
- 5 metacarpals
- 8 carpals
What makes up the finger?
5 sets of phalanges (3 for each finger - distal, middle and proximal) and (2 for each thumb - distal and proximal)
How are the digits numbered?
1-5 from lateral to medial
What are the interphalangeal joints?
connect phalanges, proximal interphalangeal joint (PIP) connects middle and proximal phalanx, distal interphalangeal joint (DIP) connects middle and distal phalanx
What are the metacarpals?
5 per hand, numbered in the same manor as the phalanges, usually 2 sesamoid bees at the distal end of the 1st metacarpal
What are the carpals?
8 short bones, roughly laid out into 2 horizontal rows, develop at different ages
What are all 8 metacarpals and the pneumonic to remember them?
Some Lovers Try Positions That They Can’t Handle
Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate and Hamate
What are the fat pads of the wrist and why are they important?
Scaphoid fat pad and pronator quadrates fat pad
Sometimes you find fractures from fat pad being abnormal
What is the Bennett’s fracture?
fracture of the proximal end/base of the first metacarpal
What is the Boxer’s fracture?
fracture of the head of the 5th metacarpal
What are FOOSH injuries?
injuries obtained from falling on an out stretched hand
What are the Colles’ and Smith’s fractures? and which is more common?
fractures of the distal radius
Colles’ more common due to FOOSH, posterior displacement
Smith’s less common would be obtained by being smacked on the back of the wrist, anterior displacement
How many projections would be required of the fingers, hand and wrist?
3 because there are joints
Finger - PA Projection
- hand prone, extend digit parallel in the centre of the IR
- Separate digits
- CR - perpendicular to IR
- CP - PIP
Include the distal metacarpal
Finger - PA Evaluation Criteria
- Entire digit on image, including distal metacarpal
- No overlap of digits
- No rotation: equal soft tissue and concavity bilaterally, an d fingernail centered on distal phalanx
- Open joint spaces: IP and MCP
- See boney trabeculae and soft tissue
Finger- Lateral Projection
- Hand in fist, only digit of interest extended
- lateral surface in contact for 2nd, medial for 3rd-5th
- CR - perpendicular to IR
- CP - PIP
Include 1/3 to 1/2 distal metacarpal
Marker face down for 2nd digit
Finger - Lateral Evaluation Criteria
- entire digit and distal metacarpal on image
- true lateral: concave anterior aspect, fingernail in profile
- no superimposition of other digits
- open joint spaces
Finger - PA Oblique Projection
- hand pronated, rotate externally/laterally until at 45 degree angle: Keep parallel to IR, can use sponge as support, keep fingers separate
- CR - perpendicular to IR
- CP - PIP
Include distal metacarpal