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Radiographic Procedures 1 > Fingers, Wrist and Hand > Flashcards

Fingers, Wrist and Hand Flashcards

1
Q

How many bones are in the hand?

A

27
- 14 phalanges
- 5 metacarpals
- 8 carpals

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2
Q

What makes up the finger?

A

5 sets of phalanges (3 for each finger - distal, middle and proximal) and (2 for each thumb - distal and proximal)

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3
Q

How are the digits numbered?

A

1-5 from lateral to medial

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4
Q

What are the interphalangeal joints?

A

connect phalanges, proximal interphalangeal joint (PIP) connects middle and proximal phalanx, distal interphalangeal joint (DIP) connects middle and distal phalanx

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5
Q

What are the metacarpals?

A

5 per hand, numbered in the same manor as the phalanges, usually 2 sesamoid bees at the distal end of the 1st metacarpal

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6
Q

What are the carpals?

A

8 short bones, roughly laid out into 2 horizontal rows, develop at different ages

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7
Q

What are all 8 metacarpals and the pneumonic to remember them?

A

Some Lovers Try Positions That They Can’t Handle
Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate and Hamate

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8
Q

What are the fat pads of the wrist and why are they important?

A

Scaphoid fat pad and pronator quadrates fat pad
Sometimes you find fractures from fat pad being abnormal

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9
Q

What is the Bennett’s fracture?

A

fracture of the proximal end/base of the first metacarpal

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10
Q

What is the Boxer’s fracture?

A

fracture of the head of the 5th metacarpal

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11
Q

What are FOOSH injuries?

A

injuries obtained from falling on an out stretched hand

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12
Q

What are the Colles’ and Smith’s fractures? and which is more common?

A

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

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13
Q

How many projections would be required of the fingers, hand and wrist?

A

3 because there are joints

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14
Q

Finger - PA Projection

A
  • hand prone, extend digit parallel in the centre of the IR
  • Separate digits
  • CR - perpendicular to IR
  • CP - PIP
    Include the distal metacarpal
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15
Q

Finger - PA Evaluation Criteria

A
  • 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
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16
Q

Finger- Lateral Projection

A
  • 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
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17
Q

Finger - Lateral Evaluation Criteria

A
  • entire digit and distal metacarpal on image
  • true lateral: concave anterior aspect, fingernail in profile
  • no superimposition of other digits
  • open joint spaces
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18
Q

Finger - PA Oblique Projection

A
  • 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
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19
Q

Finger - PA Oblique Evaluation Criteria

A
  • entire digit and distal metacarpal
  • rotated 45 degrees: concave lateral aspect
  • no superimposition of other digits
  • open joint spaces
20
Q

Thumb - AP projection

A
  • Extreme internal/medial rotation: may extend entire arm to help, keep parallel
  • CR - perpendicular to IR
  • CP - MCP
    Include entire digit and metacarpal
    Marker face down
21
Q

Thumb - AP Evaluation Criteria

A
  • Tip of thumb to trapezium
  • No rotation: Concavity on both sides, equal soft tissue bilaterally, thumbnail in centre on distal phalanx
  • Open joints: IP, MCP and CMC
22
Q

Thumb - PA Projection

A
  • Hold hand lateral, elevate and abduct thumb: may need support, ensure thumb is not rotated
  • CR - perpendicular to IR
  • CP - MCP joint
  • Include entire digit and metacarpal
23
Q

Thumb - PA Evaluation Criteria

A
  • Tip of thumb to trapezium
  • No rotation: Concavity on both sides, equal soft tissue bilaterally, thumbnail in centre on distal phalanx
  • Open joints: IP, MCP and CMC
    More magnified than AP view
    Better visualization of trapezium
24
Q

Thumb - Lateral Projection

A
  • Pronate hand, then curve fingers or raise with sponge to rotate thumb to lateral
  • CR - perpendicular to IR
  • CP - MCP joint
  • Include entire digit and metacarpal
25
Q

Thumb - Lateral Evaluation Criteria

A
  • Tip of thumb to trapezium
  • True lateral: fingernail in profile, concave anterior aspect
  • Open joint spaces: IP and MCP
26
Q

Thumb - PA Oblique Projection

A
  • pronate hand, thumb normally sits around 45 degrees: ulnar deviation
  • CR - perpendicular to IR
  • CP - MCP joint
  • Include entire digit and metacarpal
27
Q

Thumb - PA Oblique Evaluation Criteria

A
  • Tip of thumb to trapezium
  • Proper rotation: concave medial aspect
  • Open joint spaces
28
Q

Hand - PA Projection

A
  • Hand Pronated, digits separated: keep forearm on table
  • CR - perpendicular to IR
  • CP - 3rd MCP
  • Include tips of fingers to distal forearm
29
Q

Hand - PA Evaluation Criteria

A
  • Tips of finger to distal forearm
  • No overlap of fingers
  • No rotation
  • Open joint spaces
30
Q

Hand - PA Oblique Projection

A
  • pronate hand, rotate externally/laterally to 45 degrees: may use sponge to stabilize and separate fingers
  • CR - perpendicular to IR
  • CP - 3rd MCP
  • Include tips of fingers to distal forearm
31
Q

Hand - PA Oblique Evaluation Criteria

A
  • tips of finger to distal forearm
  • separation of digits: metacarpals will have separation between 2nd and 3rd, less between others
  • open joints
32
Q

Hand - AP Oblique Projection

A
  • supinated, then rotate internally/medially until 45 degrees: can use sponge to support
  • CR - perpendicular to IR
  • CP - 3rd MCP joint
    Include tips of fingers to distal forearm
33
Q

Hand - AP Oblique Evaluation Criteria

A
  • minimal overlap of metacarpals
  • demonstrate medial hand and carpals, note the pisiform
  • open joints
34
Q

Hand - Fan Lateral Projection

A
  • medial surface of hand in contact with IR
  • 1st and 2nd digits almost (but not) touching, others spread out
  • CR - perpendicular to IR
  • CP - anterior to the MCPs
  • tips of fingers to distal forearm
35
Q

Hand - Fan Lateral Evaluation Criteria

A
  • Tips of fingers to distal forearm
  • Superimposition of metacarpals and radius/ulna
  • Fingers superimposed only at proximal bases
36
Q

Hand - Lateral Extension Projection

A
  • Medial surface in contact with the IR, fingers extended
  • thumb abducted from hand
  • CR - perpendicular to IR
  • CP - 3rd MCP joint
  • include tips of fingers to distal forearm
37
Q

Hand - Lateral Extension Projection

A
  • similar to fan projection, but fingers are superimposed as well
  • thumb demonstrated with PA projection
38
Q

Hand - Norgaard Method/ “Ballcatchers” Projection

A
  • Bilateral AP oblique
  • Both hands supinated at 45 degrees
  • CR - perpendicular to IR
  • CP - between hands at the level of MCPs
  • include tips of fingers to distal forearm
39
Q

Hand - Norgaard Method/ “Ballcatchers” Evaluation Criteria

A
  • both hands fro tip of fingers to distal forearm
  • metacarpal heads free of superimposition
  • pisiform seen free of superimposition
40
Q

Wrist - PA Projection

A
  • Hand pronated, slightly curl fingers to bring wrist into contact with IR
  • CR - perpendicular to IR
  • CP - through the middle of carpals
  • Include distal forearm and half of metacarpals
41
Q

Wrist - PA Evaluation Criteria

A
  • proximal half of metacarpals to distal forearm
  • no rotation
  • open radioulnar joint space
  • good visualization of the styloid processes
  • can do AP for better visualization of the spaces between carpals
42
Q

Wrist - Lateral Projection

A
  • Same position as lateral hand: but no abduction of thumb
  • CR - perpendicular to IR
  • CP - through the middle of the carpals
  • include distal forearm and half of metacarpals
43
Q

Wrist - Lateral Projection Evaluation Criteria

A
  • proximal half of metacarpals to distal forearm
  • superimposed radius and ulna
  • superimposed carpal bones
  • lunate in profile
44
Q

Wrist - PA and AP Oblique Projections

A
  • Hand semi-pronated 45 degrees or semi-supinated 45 degrees
  • CR - perpendicular to IR
  • CP - through the middle of the carpals
  • Include distal forearm and half of metacarpals
45
Q

Wrist - PA Oblique Evaluation Criteria

A
  • lateral and carpal bones: scafoid and trapezium
  • STT complex
46
Q

Wrist - AP Oblique Evaluation Criteria

A
  • medial carpal bones
  • Hamate, triquetrum and pisiformW
47
Q

What is the PACEMAN approach?

A

Positioning
Area/Anatomy
Collimation/CR/CP
Exposure criteria
Markers
Aesthetics
Name

Radiographic Procedures 1 (10 decks)

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