Chapter 4 Flashcards by Rachel Brenner

How many finger bones are in the hand and wrist?

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Finger bones are also known as:

Digits

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How many bones in the fingers?

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What are the most distal bones of the hand?

Phalanges/phalanx

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How are phalanx named?

By location to the midline - distal, middle, and proximal

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How many bones in the thumb? How many in the rest of the fingers?

2, 3

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How are the fingers numbered?

Thumb = 1
Index finger = 2.. etc

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What does each phalanx consist of?

Head, body, and base

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What are metacarpals?

Bones of the palm

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How many bones are in the palm?

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What part of the metacarpal is always on a radiograph?

Thumb

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Carpal bones in the 1st proximal row - starting from radial side

Scaphoid (navicular)
Lunate
Triquetrum
Pisiform

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Carpal bones in the 2nd distal row - starting from radial side

Trapezium
Trapezoid
Capitate
Hamate

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What are interphalangeal joints?

Spaces between two phalanx

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What are distal interphalangeal joints?

Space between distal phalanx and middle phalanx

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What are proximal interphalangeal joints?

Space between proximal and middle phalanx

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What are the metacarpalphalangeal joints?

Space between the distal metacarpals and the proximal phalanx

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What are the carpometacarpal joints?

Joints that join the carpals to the proximal metacarpals

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Where is the styloid process located?

On the extreme distal ends of the radius and the ulna

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Where/what is the ulnar notch?

Medial side of the radius. Head of the ulna fits into this notch

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Where is included on the proxminal end of the radius?

Head and neck, and radial tuberosity

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Is the radius or ulna shorter?

Radius

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How does the radius articulate with the wrist?

Directly turns the wrist, primary bone

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What does the ulna form?

Elbow

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What are the two pointy processes of the proximal ulna?

Olecranon process Coronoid process

Where is the coronoid tubercle located?

Medial side of ulna

What does the trochlear notch articulate with?

Distal end of the humerus

What is the radial notch?

Depression on the lateral aspect of the proximal ulna

What does the radial notch do?

Allows for rotation (pronation) of the forearm. Radius crosses over the ulna

What is the humeral condyle?

Whole distal end of the humerus; made up of 2 parts

What are the 2 parts of the humeral condyle?

Trochlea - articulates with the ulna and is shaped like a pulley Capitulum - means little head; lateral aspect of humerus, articulates with the head of the radius

Where is the lateral epicondyle?

Small projection on the lateral aspect of the humerus above the capitulum

Where is the medial epicondyle?

More prominent condyle located on the medial edge of the distal humerus

Function of the coronoid and radial fossa's?

The coronoid process and the radial head fit into these fossa's when the arm is flexed completely

Location of the olecranon fossa?

Posterior side of the end of the distal humerus. This sits the olecranon process when the arm is extended

What are the 3 concentric circles of the lateral elbow?

Trochlear sulcus Outer ridges of capitulum and trochlea Trochlear notch

What bones open in ulnar deviation?

Wrist bones on the radial side - scaphoid, trapezium, trapezoid

What bones open in radial deviation?

Wrist bones on ulnar side - hamate, pisiform, triquetrum, and lunate

What do fat pads indicate?

Disease Injury Fracture

Where are fat pads located?

Extrasynovial (outside the synovial sac) but inside the capsule joint

How many fat pads does the wrist have?

2 - scaphoid and pronator fat stripe

How many fat pads does the elbow have? And what are they?

3 - anterior, posterior, and supinator fat stripe

What do you need to see the anterior and posterior fat pads of the elbow?

90 degree flexion True lateral Optimum exposure (long scale)

Technique for fingers

55-60 @ 1.6-2

Technique for wrist

58-60 @ 2 - 2.5

Technique for Humerus

70-75@ 6-10

Technique for casts

Med plaster - 50%-60% mAs increase or 5-7 kVp Large plaster - 100% mAs increase or 8-10 kVp Fiberglass - 25%-30% mAs increase or 3-4 kVp

What hand/wrist/elbow joints are ginglymus?

Interphalangeal joints Elbow joint

What hand/wrist/elbow joints are ellipsoidal?

Metocarpophalangeal joints Wrist (radiocapral)

What hand/wrist/elbow joints are Saddle?

Thumb

What hand/wrist/elbow joints are Plane?

Carpometocarpal - 2nd through 5th digits Intercapral joints

What hand/wrist/elbow joints are pivot?

Proximal radioulnar

Technique for Hand

60 @ 2-2.5

Technique for Forearm

65 @ 2.5-4

Technique for Elbow

65-70 @ 3-5

How to adjust SID for tube angle

For every 5 degree angle, drop SID by 1"

Name of hooklike process extending anteriorly from hamate?

Hamulus (hamular process)

What are the ligaments used to stabilize the wrist?

Ulnar/Radial collateral ligaments Dorsal radiocarpal Palmar radiocarpal TFCC Scapholunate Lunotriquetral

What wrist ligament extends frm the styloid process of the radius to the lateral aspect of the scaphoid and trapezium?

Radial collateral ligament

What routine projections best shows scaphoid fat pat?

PA and Oblique wrist

What routine projections best shows pronator fat pad?

Lateral

Radiographic procedure that used contrast to visualize soft tissue pathology of wrist/shoulder/elbow joints?

Arthrography

What special positioning method is used for Bennett fracture?

Modified Robert's w/ 15 degree angle proximally

What is the Brewerton method?

CR angled 15 degrees towards ulna, hand is cupped 65 degrees

What is Brewerton's method used for?

Rheumatoid arthritis

What fracture is not demonstrated in a wrist routine?

Pott

What special projection of the wrist helps to rule out abnormal calcifications in the capral sulcus?

Tangential Inferiosuperior

What wrist bones articulate with the radius?

Scaphoid and Lunate (radiocarpal joint)

What wrist ligament is attached to the styloid process of the ulna and the triquetrum/pisiform

Ulnar Collateral Ligament

What projection is used for foreign bodies of the hand/fingers

Lateral in extension

What projection is used for skier's thumb?

Folio method

What is the angle difference for carpel tunnel projection vs carpal bridge projection

Carpal tunnel - 25-30 degree angle proximally Capral bridge - 45 degree angle distally

What projections should be used if elbow cannot fully extend?

Humerus parallel to IR Forearm parallel to IR

What elbow projection is best to see the radial head/neck and capitulum?

Lateral oblique

What elbow projection is best to see the coronoid process and trochlea

Medial oblique

What is the Coyle method?

Radial head -angle 45 degrees toward shoulder Coronoid process -angle 45 degress from shoulder