Chapter 4 Flashcards
(172 cards)
1
Q
The bones of the upper limb can be divided into four main groups:
A
(1) hand and wrist, (2) forearm, (3) arm (humerus), and (4) shoulder girdle
2
Q
__ bones in each hand and wrist
A
The 27
3
Q
How many bones are in the Phalanges (fingers and thumb)
A
14
4
Q
How many bones in the Metacarpals (palm)
A
5
5
Q
How many bones are Carpals (wrist)
A
8
6
Q
The most distal bones of the hand are the,
A
phalanges (fa-lan-jez)
7
Q
The second group of bones is the metacarpals (met*-ah-kar-palz); these bones make up the __ of each hand.
A
palm
8
Q
The third group of bones, the carpals (kar-palz), consists of the bones of the
A
wrist
9
Q
Each finger and thumb is called a digit, and each digit consists of two or three separate small bones called
A
phalanges
10
Q
The digits are numbered, starting with the thumb as __ and ending with the little finger as __
A
Thumb as 1
Little finer as 5
11
Q
Each of the four fingers (digits 2, 3, 4, and 5) is composed of three phalanges
A
proximal, middle, and distal.
12
Q
The thumb, or first digit, has two phalanges
A
proximal and distal.
13
Q
Each phalanx consists of three parts:
A
distal rounded head, a body (shaft), and an expanded base,
14
Q
The second group of bones of the hand, which make up the palm, consists of the five
A
metacarpals.
15
Q
metacarpal bones are numbered the same way as the digits are, with the first metacarpal being on the
A
thumb, or latera, side when the hand is in the anatomic position.
16
Q
Each metacarpal is composed of three parts, similar to the pha-langes. Distally, the __.
A
rounded portion is the head
17
Q
Each metacarpal is composed of three parts, similar to the pha-langes. The body (shaft) is the long, curved portion; the anterior part
A
is concave in shape, and the posion or dorsal, portion is convex.
18
Q
Each of the second through fifth digits has three phalanges, and they have three joints each. Starting from the most distal portion of each digit, the joints are the ___ followed by the __, and, most proximally, the
A
distal interphalangeal (DIP) joint,
proximal interphalangeal (PIP) joint
MCP joint.
19
Q
The metacarpals articulate with the phalanges at their distal ends and are called __ joints.
A
metacarpophalangeal (MCP)
20
Q
At the proximal end, the metacarpals articulate with the respective carpals and are called __ joints.
A
carpometacarpal (CMC)
21
Q
The five metacarpals articulate with specific carpals as follows:
• First metacarpal with __
• Second metacarpal with __
• Third metacarpal with __
• Fourth and fifth metacarpal with __
A
trapezium
trapezoid
capitate
hamate
22
Q
For carpals beginning on the lateral, or thumb, side is the
A
scaphoid (skaf-oyd, sometimes referred to as the navicular.
23
Q
The scaphoid, a boat-shaped bone, is the largest bone in the proximal row and articulates with the
A
radius proximally
24
Q
Its location and articulation with the forearm make it important radiographi-cally because it is the most frequently fractured carpal bone.
A
The scaphoid
25
is the second carpal in the proximal row; it articulates with the radius.
The lunate (moon shaped)
26
The lunate (moon shaped) is the second carpal in the proximal row; it articulates with the
radius
27
The third carpal is the __, which has three articular surfaces and is distinguished by its pyramidal shape and anterior articulation with the small pisiform.
triquetrum (tri-kwe-trum)
28
The third carpal is the triquetrum (tri-kwe-trum), which has three articular surfaces and is distinguished by its __ and anterior articulation with the small pisiform.
pyramidal shape
29
The third carpal is the triquetrum (tri-kwe-trum), which has three articular surfaces and is distinguished by its pyramidal shape and anterior articulation with the
small pisiform.
30
The __, the smallest of the carpal bones, is located anterior to the triquetrum and is most evident in the carpal canal or tangential projection (Fig. 4.7).
pisiform (pi-si-form) (pea shaped)
31
The pisiform (pi-si-form) (pea shaped), the smallest of the carpal bones, is located anterior to the __and is most evident in the carpal canal or tangential projection (Fig. 4.7).
triquetrum
32
For the distal row in carpals on the lateral, or thumb, side is the
trapezium
33
the trapezium (trah-pe-ze-um), a four-sided, irregularly shaped bone that is located medial and distal to the __ and proximal to the first __.
scaphoid
metacarpal
34
wedge-shaped __, also four sided, is the smallest bone in the distal row.
trapezoid (trap'-e-zoyd)
35
This bone is followed by the largest of the carpal bones, the
capitate
36
the capitate is identified by its large rounded head that fits proximally into a concavity formed by the __ bones.
scaphoid and lunate
37
The last carpal in the distal row on the medial aspect is the __, which is easily distinguished by the hooklike process called the __, which projects from its palmar surface (see Fig. 4.7).
hamate (ham'-ate
hamulus (ham-u-lus), or hamular process
38
This concave area or groove is called the carpal sulcus (carpal tunnel or canal), through which __pass.
major nerves and tendons
39
The term __ means hooked, which describes the shape of the bone
hamate
40
The anteriorly located pisiform and the hamulus process of the hamate are visualized best on this view.
Tangential view
41
In the lateral position , the __ are located more anteriorly.
trapezium and scaphoid
42
In a lateral position the ulnar deviation projection best demonstrates the __ without the foreshortening and overlapping seen on the posteroanterior (PA)
scaphoid
43
The second group of upper limb bones consists of the bones of the forearm-the
radius on the lateral or thumb side and the ulna on the medial side
44
The radius and ulna articulate with each other at the __ and __ joints,
proximal radioulnar joint and at the distal radio-ulnar
45
proximal radioulnar joint and at the distal radio-ulnar joint, These two joints allow for the rotational movement of the
wrist and hand,
46
Small conical projections, called styloid processes, are located at the
extreme distal ends of both the radius and the ulna
47
is a small depression on the medial aspect of the distal radius.
ulnar notch
48
fits into the ulnar notch to form the distal radioulnar joint.
The head of the ulna
49
The head of the ulna is located
near the wrist at the distal end of the ulna.
50
The head of the radius is located at the
proximal end of the radius near the elbow joint.
51
The long midportion of both the radius and the ulna is called the
body (shaft).
52
___, the shorter of the two bones of the forearm, is the only one of the two that is directly involved in the wrist joint.
The radius
53
The rough oval process on the medial and anterior side of the radius, just distal to the neck, is the
radial tuberosity.
54
__, the longer of the two bones of the fore-arm, is primarily involved in the formation of the elbow joint.
The ulna
55
The two beaklike processes of the proximal ulna are called the
olecra-non and the coronoid processes
56
The olecranon process can be palpated easily on the
posterior aspect of the elbow joint.
57
The large concave depression, or notch, that articulates with the distal humerus is the
trochlear (trok-le-ar) notch (semilunar notch).
58
The small, shallow depression located on the lateral aspect of the proximal ulna is the
radial (ra-de-al) notch.
59
The head of the radius articulates with the ulna at the radial notch, forming the
proximal radioulnar joint.
60
the proximal radioulnar joint that combines with the distal radioulnar joint to allow rotation of the
forearm during pronation.
61
During the act of pronation, the radius crosses over the ulna near the
upper third of the forearm (see Fig. 4.25).
62
The body (shaft) of the humerus is the long center section, and the expanded distal end of the humerus is the
humeral condyle.
63
The articular portion of the humeral condyle is divided into two parts:
the trochlea (medial condyle) and the capitu-lum
64
The trochlea (meaning "pulley") is shaped like a pulley or spool; it has two rimlike outer margins and a smooth depressed center portion called the
trochlear sulcus, or groove.
65
This depression of the trochlea, which begins anteriorly and continues inferiorly and posteriorly, appears __ on a lateral end-on view; on a lateral elbow radiograph, it appears as a __
circular
less dense
66
The trochlea is located more medially and articulates with the.
ulna
67
The capitulum, meaning "ittle head," is located on the lateral aspect and articulates with the head of the
radius.
68
is the small projection on the lateral aspect of the distal humerus above the capitulum.
The lateral epicondyle
69
is larger and more prominent than the lateral epicon-dyle and is located on the medial edge of the distal humerus.
The medial epicondyle
70
The distal humerus has specific depressions on both anterior and posterior surfaces. The two shallow anterior depressions are the
coronoid fossa and the radial fossa
71
The deep posterior depression of the distal humerus is the
olecranon fossa
72
The olecranon process of the ulna fits into this depression when the arm is fully extended.
olecranon fossa
73
accurate lateral with 90° flexion, along with possible associated visualization of __, are essential for evaluation of joint pathology of the elbow.
fat pads
74
good criterion by which to evaluate a true lateral position of the elbow when it is flexed 90° is the appearance of the
three concentric arcs
75
For a true lateral elbow the first and smallest arc is the
trochlear sulcus
76
For a true lateral elbow, the second, intermediate arc appears double lined as the outer ridges or rounded edges of the
capitulum and trochlea.' (The smaller of the double-lined ridges is the capitulum; the larger is the medial ridge of the trochlea.)
77
of the ulna appears as a third arc of a true lateral elbow.
The trochlear notch
78
All joints of the upper limb as described in this chapter are classified as
synovial and are freely movable, or diarthrodial.
79
distally with the phalanges, all IP joints are ginglymus, or hinge-type, joints with movement in
two directions only-flexion and extension
80
IP joints are
ginglymus, or hinge-type, joints with movement in two directions only-flexion and extension
81
The second to fifth MCP joints are ellipsoidal (condyloid)-type joints that allow movement in
four directions-flexion, extension, abduction, and adduction.
82
The first MCP joint (thumb) also is generally classified as an ellipsoidal (condyloid) joint, although it has
limited abduction and adduction movements because of the wider and less-rounded head of the first metacarpal
83
The first CMC joint of the thumb is a saddle (sellar)-type joint, which allows a great range of movement, including
flexion, extension, abduction, adduction, cir-cumduction, opposition, and some degree of rotation.
84
first CMC joint of the thumb is a saddle (sellar)-type joint. This joint best demonstrates the shape and movement of a saddle joint, which allows a great range of movement, including
first CMC joint of the thumb is a saddle (sellar)-type joint. This joint best demonstrates the shape and movement of a saddle joint, which allows a great range of movement, including flexion, extension, abduction, adduction, cir-cumduction, opposition, and some degree of rotation.
85
The second through fifth CMC joints are __ joints, which allow the least amount of movement of the synovial class joints.
plane (gliding)-type
86
The intercarpal joints between the various carpals have only a __ movement.
plane (gliding)
87
The wrist joint is an __ joint and is the most freely movable, or diarthrodial, of the synovial classification.
ellipsoidal (condyloid)-type
88
Of the two bones of the forearm, only the radius articulates directly with two carpal bones-the
scaphoid and the lunate.
89
This wrist joint is called the
radiocarpal joint.
90
The articular disk is part of the total wrist articulation, including a joint between the distal radius and ulna of the forearm __joint.
the distal radioulnar
91
The total wrist joint is enclosed by ___ that is strengthened by ligaments that allow movement in four directions, plus circumduction.
an articular synovial capsule
92
ligament is attached to the styloid process of the ulna and fans out to attach to the triquetrum and the pisiform.
The ulnar collateral
93
extends from the styloid process of the radius primarily to the lateral side of the scaphoid (scaphoid tubercle), but it also has attachments to the trapezium.
The radial collateral ligament
94
stabilizes the union between the lunate and scaphoid, which is best demonstrated with the PA clenched wrist position.
The scapulolunate ligament
95
The elbow joint generally is considered a__ joint with flexion and extension movements between the humerus and the ulna and radius.
ginglymus (hinge)-type
96
In addition to the hinge joints between the humerus and ulna and the humerus and radius, the __ is considered part of the elbow joint
proximal radioulnar joint (pivot or trochoidal type)
97
The ulnar deviation movement of the wrist "opens up" and best demonstrates what carpals on the opposite side (
scaphoid, trapezium, and trapezoid.
98
Because the scaphoid is the most frequently fractured carpal bone, this ulnar deviation projection is commonly known as a
special scaphoid projection
99
radial deviation movement that opens and best demonstrates the carpals on the opposite, or ulnar, side of the wrist-the
hamate, pisiform, trique-trum, and lunate.
100
Why must the forearm routinely be radiographed in an AP projection with the hand supinated, or palm up (anatomic position).
"cross-over" position of the radius and ulna when the hand is pronated
101
radius and ulna can be separated through
lateral rotation
(40-45°) of the elbow,
102
This relationship is crucial in evaluation of AP projections of the elbow; lateral rotation __ and medial rotation __ the proximal radius and ulna.
separates
superimposes
103
fat pads are__ but are located within the joint capsule.
extrasynovial (outside the synovial sac)
104
The wrist joint includes two important fat stripes. First, a scaphoid fat stripe (A) is visualized on the __ projections.
PA and oblique
105
The wrist joint includes two important fat stripes. First, a __ is visualized on the PA and oblique projections.
scaphoid fat stripe (A)
106
what fat stripe is elongated and slightly convex in shape and is located between the radial collateral ligament and adjoining muscle tendons immediately lateral to the scaphoid.
a scaphoid fat stripe
107
A second fat stripe is visualized on the lateral view of the wrist. is normally visualized approximately ¼ inch (1 cm) from the anterior surface of the radius
This pronator fat stripe (B)
108
The three significant fat pads or stripes of the elbow are visualized only on the __ projection
lateral projection.
109
the lateral projec-tion, the __ fat pad, which is formed by the superimposed coronoid and radial pads, is seen as a slightly radio-lucent teardrop shape located just anterior to the distal humerus.
anterior fat pad
110
three significant fat pads or stripes of the elbow
Anterior, posterior, supinator fat pad
111
The __ fat stripe (Fig. 4.32E) is a long, thin stripe just anterior to the proximal radius.
supinator fat stripe
112
__ fat stripe that may indicate the diagnosis of radial head or neck fractures that are not obviously apparent. 3
supinator fat stripe
113
CAST CONVERSIONS
•Small to medium dry plaster cast:
•Large or wet plaster cast:
•Fiberglass cast:
•Small to medium dry plaster cast: +5-7 kV
•Large or wet plaster cast: +8-10 kV
•Fiberglass cast: +3-4 kV
114
The articulation portion of the medial aspect of the distal humerus is called
Trochlea
115
The particular portion of the lateral aspect of the distal humerus is called
Capitulum
116
Joint types for interphalangeal
Ginglymus
117
Joint types for carpometacarpal of first digit
Ellipsoidal
118
Joint type for elbow joint (humeroulnar and humeroradial)
Ginglymus
119
Joint type of metacarpophalangeal of second to fifth digit
Ellipsodial
120
Joint type of radiocarpal
Ellipsoidal
121
Joint type for intercarpal
Plane
122
Joint movement for Elbow joint
Ginglymus
123
Joint movement for proximal radioulnar joint
Pivot
124
Ellipsoidal joints are classified as freely movable, or ____, and allows movement in ___ directions
Diarthrodial, 4
125
Which ligament of the wrist extends from the styloid process of the radius to the lateral aspect of the scaphoid and trapezium bones?
Radial collateral ligament
126
The two important fat stripes or bands around the wrist joint are
Scaphoid and pronator
127
Technical factors for upper limb
KVp
60-80
128
Technical factors for upper limb
Long or short exposure time
Short exposure
129
Technical factors for upper limb
Large or small focal spot
Small focal spot
130
Technical factors for upper limb
Sid
40
131
Technical factors for upper limb
Small to medium dry plaster cast kvp
5-7kvp
132
Technical factors for upper limb
Large plaster cast kvp
8-10
133
Technical factors for upper limb
Fiberglass kvp
3-4
134
A Bennett fracture involves: A. Base of first metacarpals B. trapezium bone C. Scaphoid bone D. Fracture extending through first IP Joint
A
135
Which special positioning method can be performed to better delineate a possible Bennett fracture?
Mod Robert’s
136
What type of CR angle is required for the AP axial projection (Brewerton method)?
15 prox
137
The AP axial projection (Brewerton method) is commonly used to evaluate for early signs of: A. Osteoporosis B. Osteomyelitis C. Osteopetrosis D. Rheumatoid arthritis
D
138
Which of the following fractures is not demonstrated in a wrist routine? A. Barton B. Potts. C. Smith D. Colles
B
139
During the PAnaxial scaphoid projection with central ray angle and ulnar flextion, the central ray must be angled __ degrees __ (distally or proximally)
10-15 degrees prox
140
Which projection best demonstrates possible scapholunate ligament tears?
PA stress wrist
141
How much are the hand and wrist elevated from the IR for the modified Strecher method? A. None B. 10 degrees C. 20 degrees D. 15 degrees
C
142
How much central ray angulation to the long axis of the hand is required for the carpal canal (tunnel) projection
25-30
143
Which special projection of the wrist helps rule out abnormal calcifications in the carpal sulcus?
144
How much central ray angulation from the long axis of the forearm is required for the carpal bridge (tangential) projection
145
The hand and wrist form a __ degree angle to the forearm with the carpal bridge (tangential) projections
146
List the correct pathology term for each of the following definitions
147
Correct pathology term for
fracture and dislocation of the posterior articular surface of the distal radius
Barton fracture
148
Correct pathology term for
Most common type of primary malignant (cancerous) tumor occurring in bone
Multiple myeloma
149
Correct pathology term for
Reduction in the quantity of bone or atrophy of skeletal tissue
Osteoporosis
150
Correct pathology term for
Sprain or tear of the ulnar collateral ligament
Skiers thumb
151
Correct pathology term for
An abnormality of the cartilage affecting long bones
Achondroplasia
152
Correct pathology term for
Transverse fracture extending through the distal aspect of the metacarpals neck, most often the fifth metacarpal
Boxes fracture
153
Correct pathology term for
Hereditary condition marked by abnormally dense bone
Osteopetrosis
154
Correct pathology term for
Transverse fracture of the distal radius with posterior displacement of the distal fragment
Colles fracture
155
Narrowing of joint space with periosteal growths on the joint margin
Osteoarthritis
156
Possible calcification in carpal sulcus
Carpal tunnel syndrome
157
Soft tissue swelling and loss of fat pad detail visibility
osteomyelitis
158
Mixed areas of sclerotic and cortical thickening along with radiologist lesions
Osteopetrosis
159
Which routine projection of the elbow best demonstrates the radial head, neck, and tuberosity with slight superimposition of the ulna
Ap obl with 45 lateral rotation
160
Which position of the elbow best demonstrates the coronoid process
Ap obl w 45 medial rotation
161
How much and in which direction should the central ray be angles for the trauma axial lateral projection (Cole method) involving the radial head
45 toward shoulder
162
How much and in which direction should the central ray be angled for the trauma axial lateral projection (Coyle method) involving the Coronoid process
45 away from shoulder
163
What is the amount of elbow flection required for the trauma lateral projection (Coyle Method) to demonstrate a he coronoid process
80 degrees of flexing
164
What is the difference among the four radial head lateral projections of the elbow
The rotational position of the hand and wrist
165
Fluid filled joint space with possible calcification
Bursitis
166
Where is the coronoid tubercle located A. Medical aspect of coronoid process B. Anterior aspect of distal humerus C. Lateral aspect of proximal radius D. Posterior aspect of distal humerus
A. Medical aspect of coronoid process
167
Joint movement for intercarpal joints
Plane
168
Joint movement for radiocarpal joint
Ellipsoidal
169
Joint movement elbow joint
Ginglymus
170
Joint movement first carpometacarpal joint
Saddle
171
Joint movement for third carpometacarpal joint
Plane
172
What type of fracture is best demonstrated with a mod Robert’s method
A. Barton fracture B. Colles fracture C. Bennett fracture D. Smith fracture
C
