Upper extremity FINGERS AND THUMB test 2 part 1 Flashcards

1
Q

how many phalanges

A

14 phalanges

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2
Q

how many metacarpals

A

5 metacarpals

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3
Q

how many carpals

A

8 carpals

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4
Q

how many bones in total in the hand and wrist?

A

27 total

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5
Q

Digit 1

A

thumb
has only 1 interphalangeal joint
has proximal and distal phalanges

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6
Q

digits 2-5

A

pointer finger to pinkie
has proximal, middle, and distal phalanx
has 2 interphalangeal joints

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7
Q

PIP

A

proximal interphalangeal joint

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8
Q

DIP

A

distal interphalangeal joint

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9
Q

phalanx

A

head (distal)
body (shaft)
base (proximal)

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10
Q

metacarpals

A

consists of head, body and shaft
head articulates with base of phalanges
base articulates with carpals

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11
Q

anterior part of the metacarpal

A

concave in shape

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12
Q

dorsal part of metacarpal

A

convex in shape

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13
Q

metacarpal heads are referred to as

A

knuckles

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14
Q

interphalangeal joints

A

located between the phalanges
named by their location
PIP and DIP

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15
Q

metacarpophalangeal joint (MCP)

A

articulation between metacarpal and proximal phalanges

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16
Q

Carpometacarpal joints

A

articulation between carpals and base of the metacarpals

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17
Q

sesamoid bones

A

small and oval
protect tendon from wear and tear
largest is the patella

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18
Q

carpals

A

proximal row: scaphoid lunate triquetrum pisiform

Distal row: trapezium trapezoid capitate hamate

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19
Q

scaphoid

A

AKA navicular
articulates with the radius
most frequently fractured carpal

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20
Q

Lunate

A

crescent shape

articulates with radius

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21
Q

pisiform

A

pea shaped

anterior to triquetrum

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22
Q

trapezium

A

proximal to 1st metacarpal

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23
Q

trapezoid

A

smallest bone in distal row

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24
Q

capitate

A

large bone

articulates with base of 3rd metacarpal

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25
Q

hamate

A

hook on anterior surface called the hamulus

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26
Q

anatomic snuffbox

A

triangular depression on posterior wrist

overlies the scaphoid

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27
Q

carpal sulcus

A

formed by concave anterior surface of the wrist

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28
Q

flexor retinaculum

A

fibrous band that attaches to the hook of hamate and trapezium and scaphoid

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29
Q

carpal tunnel

A

passageway created between the carpal sulcus and flexor retinaculum

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30
Q

median nerve

A

passes through the carpal canal

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31
Q

carpal tunnel syndrome

A

compression of median nerve inside carpal tunnel

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32
Q

proximal/distal radioulnar joint

A

were the ulna and radius meet.

allow for rotational movement of hand and wrist.

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33
Q

styloid process of the radius

A

projection on lateral distal surface

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34
Q

ulnar notch

A

depression on medial aspect of distal radius that receives the head of the ulna to form the distal radioulnar joint

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35
Q

radial head

A

flattened rounded disk like structure

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36
Q

radial neck

A

inferior to head of radius

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37
Q

radial tuberosity

A

rough process on medial and anterior side of radius, distal to the neck

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38
Q

Olecrananon process

A

beak like process of proximal ulna

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39
Q

troclear notch

A

concave depression that makes the U on the ulna

40
Q

coronoid process

A

beak shaped process on the lower portion of the troclear notch

41
Q

coronoid tubercle

A

located on medial margin of coronoid process

42
Q

radial notch

A

depression located on lateral margin of coronoid process

head of the radius fits in depression to form proximal radioulnar joint

43
Q

head of the ulna

A

on the lateral aspect of the distal ulna

44
Q

styloid process of ulna

A

small projection at distal end of ulna

45
Q

during pronation, the radius crosses the ulna…….

A

near the upper 1/3 of the forearm

46
Q

body of the humerus

A

long center section

47
Q

humeral condyle

A

the whole bottom end of the humerus

48
Q

trochlea

A

articulates with the trochlear notch

shaped like a spool

49
Q

trochlear sulcus

A

indentation in the trochlea

50
Q

capitulum

A

articulates with the radial head

“cap over the head”

51
Q

coronoid fossa

A

depression on anterior medial surface

receives coronoid process when elbow is bent

52
Q

radial fossa

A

depression on the anterior lateral surface

receives radial head when elbow is bent

53
Q

olecranon fossa

A

posterior depression

receives the olecranon process when elbow is fully extended

54
Q

you know you have accurate 90 degree flexion when :

A

there’s the appearance of 3 concentric arches

1) troclear sulcs
2) capitulum and trochlea
3) troclear notch

55
Q

ulnar deviation

A

turn or bend the hand and wrist toward the ulnar side
opens up carpals on lateral side of wrist
scaphoid/navicular projection

56
Q

radial deviation

A

turn or bend the hand and wrist toward the radial side

opens carpals on the ulnar side of wrist

57
Q

pronation of the hand:

A

crosses the radius over the ulna at its proximal third and rotates the humerus medially

58
Q

fat pads

A

fatty structure within certain joints which may act as a cushion to absorb forces generated across joint

59
Q

fat pads are:

A

radiolucent/dark

difficult to visualize radiographically

60
Q

wrist fat pads

A

1) scaphoid fat pad

2) pronator fat pad

61
Q

scaphoid fat pad

A

visualized on PA and oblique projections

absence or displacement may indicate scaphoid fracture

62
Q

pronator fat pad

A

located on anterior surface of radius

displacement may indicate distal radius fracture

63
Q

elbow joint fat pads

A

1) anterior fat pad
2) supinator fat pad
3) posterior fat pad

64
Q

anterior fat pad

A

teardrop shape anterior to the distal humerus

65
Q

supinator fat pad

A

anterior and parallel to the anterior aspect of the proximal radius
displacement may diagnose fracture of radial head or neck

66
Q

posterior fat pad

A

lies in olecranon fossa

visualization on a lateral elbow indicates change in a joint

67
Q

upper extremity exposure factors

A

lower to medium kvp
short exposure time
small focal spot
high contrast

68
Q

cast conversions

A

casts usually require an increase in exposure factors depending on the thickness or type of cast

69
Q

why must the part and the IR be parallel to one another?

A

to eliminate distortion of the part

70
Q

FINGERS:

routine projections

A

PA
PA oblique
Lateral

71
Q

FINGER:

PA projection clinical indications

A

fractures and/or dislocations of distal middle and proximal phalanges.
osteoporosis and osteoarthritis

72
Q

FINGER:

PA projection technical factors

A

minimum SID 40 inces
IR size 8x10
nongrid
55-60 kvp range

73
Q

FINGER:

PA projection patient position

A

seated at end of table

elbow flexed 90 degrees

74
Q

FINGER:

PA projection part position

A

hand pronated with fingers extended
long axis of affected finger centered to IR
other fingers separated from the affected finger

75
Q

FINGER:

PA projection central ray

A

perpendicular to the IR and centered to the PIP joint

76
Q

FINGER:

PA projection collimation

A

collimate on all 4 sides to area of affected digit and distal aspect of metacarpal

77
Q

FINGER:

PA projection anatomy demonstrated

A

distal, middle, and proximal phalanges
distal metacarpal
associated joints (MCP, PIP ,DIP)

78
Q

FINGER:

PA projection NO ROTATION

A

symmetric concavities of shafts of phalanges and distal metacarpals
equal amount of soft tissue on each side of phalanges
interphalangeal joints OPEN

79
Q

FINGER
PA oblique projection medial or lateral
patient position

A

seated at end of table
elbow flexed 90 degrees
fingers extended

80
Q

FINGER:

PA oblique projection lateral rotation part position

A

fingers extended and placed in a 45 degree lateral oblique

81
Q

FINGER
PA oblique projection medial rotation part position
(SECOND DIGIT)

A

fingers extended placed in a 45 degree medial oblique

reduces the OID

82
Q

FINGER

PA oblique projection medial or lateral Central ray

A

perpendicular to the IR and centered at the PIP joint

83
Q

FINGER:

PA oblique projection medial or lateral evaluation criteria

A

twice as much soft tissue width on one side of the digit

more concavity is demonstrated on one aspect of the phalangeal midshafts than the other

84
Q

FINGER:

Lateral projection lateromedial or mediolateral Part position

A

hand in lateral position thumb side up
align and center finger to long axis of IR
use support device to support finger

85
Q

FINGER:

lateral projection MEDIOLATERAL for 2nd digit

A

thumb side down
reduces the OID
improves definition

86
Q

FINGER:

lateral projection lateromedial or mediolateral evaluation criteria

A

concave appearance of anterior shafts of phalanges

IP and MCP joints open

87
Q

THUMB basic projections

A

AP
PA oblique
Lateral

88
Q

THUMB special projections

A
AP modified Robert's 
PA stress (Folio method)
89
Q

THUMB basic:

AP projection clinical indications

A

fractures and dislocations of the distal and proximal phalanges and entire 1st metacarpal
osteoporosis
osteoarthritis

90
Q

THUMB basic:

AP projection technical factors

A

minimum SID 40 inches
8x10 IR
nongrid
55-60 kvp

91
Q

THUMB basic:

AP projection patient position

A

seated facing the table

arms extended in front and hand rotated internally to supinate the thumb

92
Q

THUMB basic:

AP projection part position

A

hand in extreme internal rotation
align thumb with long axis of IR
center to 1st MCP joint

93
Q

If you can’t do an AP projection of the thumb what can you do instead?

A

A PA projection.
hand placed in near lateral position and thumb is adjusted to a true PA position
loss of definition due to increased OID

94
Q

When I xray the thumb i must remember to include the …..

A

TRAPEZIUM!

95
Q

THUMB basic:

AP projection no rotation

A

concave sides of shafts of phalanges
equal soft tissue on each side of phalange
IP joint open

96
Q

THUMB basic:

PA oblique projection patient position

A

patient seated at end of table
elbow flexed 90 degrees
thumb slightly abducted and palmar surface in contact with IR

97
Q

THUMB basic:

PA oblique projection central ray

A

perpendicular to IR

centered to the 1st MCP joint