Module 5 Upper EXTREMITY Flashcards
8 CARPAL BONES
- Scaphiod
- Lunate
- Triquetrum
- Pisiform
- Trapezium
- Trapezoid
- Capitate
- Hamate
ELBOW
A joint between forearm and arm and has three articulations =
- Humeroradial joint
- Humeroulna joint
- Proximal radioulnar joint
HUMERUS
Proximal bone of the upper arm
PROXIMAL END OF THE HUMERUS ANATOMY
Head Anatomical neck Greater tubercle Lesser tubercle Bicipital groove Surgical neck
DISTAL END OF THE HUMERUS ANATOMY
Lateral epicondyles Medial epicondyles Troclea Capitulum Coronoid fossa Radial fossa Olecranon fossa
SCAPHOID ULNA DEVIATION VIEW PROJECTION STRUCTURES DEMONSTRATED
- Corrected foreshortening of the scaphoid
- Opens the spaces between the scaphoid and adjacent carpals
SCAPHOID (Stecher Method) VIEW PROJECTION STRUCTURES DEMONSTRATED ( 20deg cep)
Demonstrates the scaphoid without superimposition
RADIAL HEAD LATERALS PROJECTIONS
Their are four in total and they demonstrate the occult fractures of the radial head and neck
Done with the lateral elbow with 4 movements of the hand.
SUPERNATED
LATERAL
PRONATED
INTERNALLY ROTATED
ELBOW COYLE PROJECTION-METHOD
Elbow in lateral position with the hand pronated
CR 45 deg towards shoulder entering mid elbow
Demonstrates radial head free from superimposition
PA WRIST RADIOGRAPHIC CRITERIA
- Carpal bones at the centre of the IR
- Distal radial margined are almost superimposed
- 2nd to 5th carpometacarpal joints are open
- Carpalbones, distal radius and ulna and proximal metacarpals are included
- 3rd metacarpal and midforearm are aligned
RADIOGRAPHIC CRITERIA FOR PA OBLIQUE WRIST
- Demonstrate the carpals on the lateral side of the wrist ( trapezium and scaphoid)
- Separation between the trapezium and scaphoid
- 3rd metacarpal and the mid forearm are aligned
RADIOGRAPHIC CRITERIA FOR LATEROMEDIAL WRIST
- Anterior aspect of the distal scaphoid and pisiform are aligned
- Distal aspects of distal scaphoid and pisiform are aligned
- Distal radius and ulna are superimposed
- Carpal bones at the centre
RADIOGRAPHIC CRITERIA FOR ULNA DEVIATION SCAPHOID VIEW
- Scaphotrapezium and scaphotrazoidal, scaphocapitate and scaphoidlunate and radioscaphoid joint space are open
- 1st metacarpal and radius are aligned
- Scaphoid is at the centre
RADIOGRAPHIC CRITERIA FOR FOREARM
- Wrist and elbow joint included
- Radioscaphoid and radiolunate joint space are open
- Radial head, neck and tuberosity are superimposed over the proximal ulna
- Olecranon process is with in the Olecranon fossa
- Radius and ulna are parallel
RADIOGRAPHIC CRITERIA FOR LATEROMEDIAL FOREARM
- Distal radius and ulna are superimposed
- Elbow flexed 90degrees
- Radial head superimposed over the coronoidprocess
RADIOGRAPHIC CRITERIA FOR AP ELBOW
- Humeral epicondyles are in profile
- Radial head is superimposed over the proximal ulna
- Radial tuberosity is in profile medially
- Open radiocapitulum joint
- Olecranon process is within the Olecranon fossa
- Elbow joint at centre
RADIOGRAPHIC CRITERIA LATERAL ROTATION ELBOW
- Radiocapitulum joint is open
- Ulna is demonstrated without radial head, neck, and tuberosity superimposition
- Elbow joint is at the centre
RADIOGRAPHIC CRITERIA FOR AP OBLIQUE MEDIAL ROTATION ELBOW PROJECTION
- Coronoid process, trochlea, trochlear notch, Olecranon are in profile
- Trochlear coronoid process is open
- Radial head and neck are superimposed over the ulna
- Elbow joint is at the centre
RADIOGRAPHIC CRITERIA FOR LATERAL ELBOW
- Elbow is flexed 90 degrees
- Elbow joint is open
- Radial head and Coronoid process are aligned
- Capitulum and trochlea are superimposed
- Elbow joint is at the centre
RADIOGRAPHIC CRITERIA OF AP HUMERUS
- Humeral condyles are in profile
- The greater tubercle is demonstrated in profile laterally
- Humeral head is demonstrated medially in profile
- Humeral midpoint is at the centre of exposure
RADIOGRAPHIC CRITERIA FOR LATERAL HUMERUS
- Lesser tuberosity is in profile medially
- Humeral head and greater tubercle are superimposed
- Radial head and Coronoid process are superimposed
- Capitulum is distal to the trochlea, due to superior central ray replacement
DELAYED BONE AGE
A developmental condition, skeletal development is determined by the presence of primary ossification centres and the development of the epiphysis
Carpal ossification and knee ossification epiphysis are looked at to determine skeletal maturation. Under 1 year
Only PA left hand over 1 year
COLLES FRACTURE
- Involves the distal radius with posterior displacement of distal fragment
- Posterior angulation
- New with no callus formation
SMITHS FRACTURE
- Involves the distal radius
- Anterior and lateral displacement of distal fragment with Volar angulation
- New fracture with no callus formation
GREENSTICK FRACTURE
- Break of bone with no break in cortex
- A childhood fracture
- Often seen in the forearm
- Bone bend appearance
- Fracture on one side of the bone and bent on the other
MONTEGGIA FRACTURE
Fracture of the shaft of the ulna with dislocation of the radial head caused by blow to the ulna or fallen outstretched hand
GALEAZZI FRACTURE
Fracture of the shaft of the radius with dislocation of the ulnar head. May be caused by an outstretched arm.
RADIAL HEAD FRACTURE
- Intra- articulate radial head fracture
- Vertical
- Lateral displacement
- New soft tissue swelling with no callus formation