Upper limb anatomy (hand, wrist, forearm)

Question 1

Projection recap of the hand, wrist, forearm, elbow, humerus and shoulder.

Answer 1

Hand – Dorsi-Palmer & Oblique (Lateral if required)
Wrist- Posterio-Anterior & Lateral
Forearm- Anterio-Posterior & Lateral
Elbow- Anterio-Posterior and Lateral
Humerus- Anterio-Posterior and Lateral
Shoulder- Anterio-Poster & appropriate projection (Lateral, Yscap, Modified, Axial)

Question 2

What groups of bones does the hand and wrist consist of?

Answer 2

Carpal
Metacarpals
Phalanges

Question 3

what are the metacarpal bones bone classification and its divisions?

Answer 3

Long bone.

Head
shaft
base

Question 4

what are the carpal bones bone classification and its divisions?

Answer 4

Short bone.

Proximal row
distal row

Question 5

what are the Phalanges bones bone classification and its divisions?

Answer 5

Long bone.

shaft
2 extremities
Distal extremity head
Proximal extremity base

Question 6

Anatomical appearances and landmarks

Answer 6

S-
L-
T-
P-
T-
T-
C-
H-

Question 6

Paediatric anatomy and characteristics

Answer 6

1-2 years:
Capitate
Hamate

2 – 4 Years:
Triquetrum

3- 5 Years:
Lunate

4 – 6 Years:
Trapezium
Trapezoid
Scaphoid
Pisiform

Early Childhood:
Metacarpals
Phalanges

Question 7

Paediatric anatomy and characteristics

Answer 7

Ossification ages are rough guides and can vary depending on the individual
The sequence generally remains the same
Complete fusion can take until adolescent years
Congenital abnormalities or conditions can affect both growth

Question 8

The following conditions can affect bone development:-

Answer 8

• Genetic disorders
• Nutritional deficiencies
• Hormone imbalances
• Chronic Illnesses
• Malabsorption disorders
• Connective tissue disorders
• Medications

Question 9

How do we detect slow development radiographically?

Answer 9

• There are two widely regarded gold standards methods for determining bone age and both methods require a radiograph as part of the diagnostic method
• The standard radiograph is a single DP hand to include the wrist joint
• Some trust protocols vary (please ask your local placement provider)

Question 10

Common abnormalities and pattern recognition

Answer 10

Fracture of the 4th and/or 5th metacarpal
Commonly known as boxers # or punch injury
Mechanism punching with closed fist

Fracture of distal radius with dorsal displacement
Often called a Colles fracture
Named after the doctor that identified the pattern of fracture
Colloquial term which we are trying to move away from
Mechanism usually FOOSH injury
Prevalent in populations with reduced bone strength/density

Question 11

Radius and ulna classification and bone division:

Answer 11

Bone classification
Long bone

Bone division
Proximal (upper) end

Shaft
 
Distal (lower) end

Question 12

Proximal ends of radius and ulna features:

Answer 12

Radius
Head of radius
Neck
Radial tuberosity

Ulna
Olecronon process
Coronoid process
Trochlear notch
Radial notch

Question 13

Shaft of radius and ulna features:

Answer 13

Radius
Borders
Medial (interosseous) border
Posterior border
Anterior border

Ulna
Borders
Anterior border
Posterior border
Lateral (Interosseous) border

Question 14

Distal ends of radius and ulna features:

Answer 14

Radius
Consists of 5 surfaces
Styloid process
Ulnar notch

Ulna
Head
Styloid process

Question 15

Radius and Ulna-Ossification Centres

Answer 15

Primary ossification centre Radius and Ulna:
Shaft

Secondary ossification centres:

Radius:

Head 
Lower end of radius

Ulna

Olecranon process 
Lower end of ulna

Question 16

Paediatric: Common abnormalities and pattern recognition

Answer 16

Fracture of the proximal ulna
Associated dislocation of the radial head
Usually occur aged 4-10 and can lead to serious complications if not treated
Referred to as the Monteggia fracture
Usually FOOSH mechanism

Fracture to middle>distal 1/3 of the radius
Associated dislocation of the distal radioulnar joint
Usually occur aged 9-13 and can lead to serious complications if not treated
Referred to as the Galleazzi fracture
Usually FOOSH mechanism