Upper extremity FINGERS AND THUMB test 2 part 1 Flashcards
(97 cards)
1
Q
how many phalanges
A
14 phalanges
2
Q
how many metacarpals
A
5 metacarpals
3
Q
how many carpals
A
8 carpals
4
Q
how many bones in total in the hand and wrist?
A
27 total
5
Q
Digit 1
A
thumb
has only 1 interphalangeal joint
has proximal and distal phalanges
6
Q
digits 2-5
A
pointer finger to pinkie
has proximal, middle, and distal phalanx
has 2 interphalangeal joints
7
Q
PIP
A
proximal interphalangeal joint
8
Q
DIP
A
distal interphalangeal joint
9
Q
phalanx
A
head (distal)
body (shaft)
base (proximal)
10
Q
metacarpals
A
consists of head, body and shaft
head articulates with base of phalanges
base articulates with carpals
11
Q
anterior part of the metacarpal
A
concave in shape
12
Q
dorsal part of metacarpal
A
convex in shape
13
Q
metacarpal heads are referred to as
A
knuckles
14
Q
interphalangeal joints
A
located between the phalanges
named by their location
PIP and DIP
15
Q
metacarpophalangeal joint (MCP)
A
articulation between metacarpal and proximal phalanges
16
Q
Carpometacarpal joints
A
articulation between carpals and base of the metacarpals
17
Q
sesamoid bones
A
small and oval
protect tendon from wear and tear
largest is the patella
18
Q
carpals
A
proximal row: scaphoid lunate triquetrum pisiform
Distal row: trapezium trapezoid capitate hamate
19
Q
scaphoid
A
AKA navicular
articulates with the radius
most frequently fractured carpal
20
Q
Lunate
A
crescent shape
articulates with radius
21
Q
pisiform
A
pea shaped
anterior to triquetrum
22
Q
trapezium
A
proximal to 1st metacarpal
23
Q
trapezoid
A
smallest bone in distal row
24
Q
capitate
A
large bone
articulates with base of 3rd metacarpal
25
hamate
hook on anterior surface called the hamulus
26
anatomic snuffbox
triangular depression on posterior wrist
| overlies the scaphoid
27
carpal sulcus
formed by concave anterior surface of the wrist
28
flexor retinaculum
fibrous band that attaches to the hook of hamate and trapezium and scaphoid
29
carpal tunnel
passageway created between the carpal sulcus and flexor retinaculum
30
median nerve
passes through the carpal canal
31
carpal tunnel syndrome
compression of median nerve inside carpal tunnel
32
proximal/distal radioulnar joint
were the ulna and radius meet.
| allow for rotational movement of hand and wrist.
33
styloid process of the radius
projection on lateral distal surface
34
ulnar notch
depression on medial aspect of distal radius that receives the head of the ulna to form the distal radioulnar joint
35
radial head
flattened rounded disk like structure
36
radial neck
inferior to head of radius
37
radial tuberosity
rough process on medial and anterior side of radius, distal to the neck
38
Olecrananon process
beak like process of proximal ulna
39
troclear notch
concave depression that makes the U on the ulna
40
coronoid process
beak shaped process on the lower portion of the troclear notch
41
coronoid tubercle
located on medial margin of coronoid process
42
radial notch
depression located on lateral margin of coronoid process
| head of the radius fits in depression to form proximal radioulnar joint
43
head of the ulna
on the lateral aspect of the distal ulna
44
styloid process of ulna
small projection at distal end of ulna
45
during pronation, the radius crosses the ulna.......
near the upper 1/3 of the forearm
46
body of the humerus
long center section
47
humeral condyle
the whole bottom end of the humerus
48
trochlea
articulates with the trochlear notch
| shaped like a spool
49
trochlear sulcus
indentation in the trochlea
50
capitulum
articulates with the radial head
| "cap over the head"
51
coronoid fossa
depression on anterior medial surface
| receives coronoid process when elbow is bent
52
radial fossa
depression on the anterior lateral surface
| receives radial head when elbow is bent
53
olecranon fossa
posterior depression
| receives the olecranon process when elbow is fully extended
54
you know you have accurate 90 degree flexion when :
there's the appearance of 3 concentric arches
1) troclear sulcs
2) capitulum and trochlea
3) troclear notch
55
ulnar deviation
turn or bend the hand and wrist toward the ulnar side
opens up carpals on lateral side of wrist
scaphoid/navicular projection
56
radial deviation
turn or bend the hand and wrist toward the radial side
| opens carpals on the ulnar side of wrist
57
pronation of the hand:
crosses the radius over the ulna at its proximal third and rotates the humerus medially
58
fat pads
fatty structure within certain joints which may act as a cushion to absorb forces generated across joint
59
fat pads are:
radiolucent/dark
| difficult to visualize radiographically
60
wrist fat pads
1) scaphoid fat pad
| 2) pronator fat pad
61
scaphoid fat pad
visualized on PA and oblique projections
| absence or displacement may indicate scaphoid fracture
62
pronator fat pad
located on anterior surface of radius
| displacement may indicate distal radius fracture
63
elbow joint fat pads
1) anterior fat pad
2) supinator fat pad
3) posterior fat pad
64
anterior fat pad
teardrop shape anterior to the distal humerus
65
supinator fat pad
anterior and parallel to the anterior aspect of the proximal radius
displacement may diagnose fracture of radial head or neck
66
posterior fat pad
lies in olecranon fossa
| visualization on a lateral elbow indicates change in a joint
67
upper extremity exposure factors
lower to medium kvp
short exposure time
small focal spot
high contrast
68
cast conversions
casts usually require an increase in exposure factors depending on the thickness or type of cast
69
why must the part and the IR be parallel to one another?
to eliminate distortion of the part
70
FINGERS:
| routine projections
PA
PA oblique
Lateral
71
FINGER:
| PA projection clinical indications
fractures and/or dislocations of distal middle and proximal phalanges.
osteoporosis and osteoarthritis
72
FINGER:
| PA projection technical factors
minimum SID 40 inces
IR size 8x10
nongrid
55-60 kvp range
73
FINGER:
| PA projection patient position
seated at end of table
| elbow flexed 90 degrees
74
FINGER:
| PA projection part position
hand pronated with fingers extended
long axis of affected finger centered to IR
other fingers separated from the affected finger
75
FINGER:
| PA projection central ray
perpendicular to the IR and centered to the PIP joint
76
FINGER:
| PA projection collimation
collimate on all 4 sides to area of affected digit and distal aspect of metacarpal
77
FINGER:
| PA projection anatomy demonstrated
distal, middle, and proximal phalanges
distal metacarpal
associated joints (MCP, PIP ,DIP)
78
FINGER:
| PA projection NO ROTATION
symmetric concavities of shafts of phalanges and distal metacarpals
equal amount of soft tissue on each side of phalanges
interphalangeal joints OPEN
79
FINGER
PA oblique projection medial or lateral
patient position
seated at end of table
elbow flexed 90 degrees
fingers extended
80
FINGER:
| PA oblique projection lateral rotation part position
fingers extended and placed in a 45 degree lateral oblique
81
FINGER
PA oblique projection medial rotation part position
(SECOND DIGIT)
fingers extended placed in a 45 degree medial oblique
| reduces the OID
82
FINGER
| PA oblique projection medial or lateral Central ray
perpendicular to the IR and centered at the PIP joint
83
FINGER:
| PA oblique projection medial or lateral evaluation criteria
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
FINGER:
| Lateral projection lateromedial or mediolateral Part position
hand in lateral position thumb side up
align and center finger to long axis of IR
use support device to support finger
85
FINGER:
| lateral projection MEDIOLATERAL for 2nd digit
thumb side down
reduces the OID
improves definition
86
FINGER:
| lateral projection lateromedial or mediolateral evaluation criteria
concave appearance of anterior shafts of phalanges
| IP and MCP joints open
87
THUMB basic projections
AP
PA oblique
Lateral
88
THUMB special projections
```
AP modified Robert's
PA stress (Folio method)
```
89
THUMB basic:
| AP projection clinical indications
fractures and dislocations of the distal and proximal phalanges and entire 1st metacarpal
osteoporosis
osteoarthritis
90
THUMB basic:
| AP projection technical factors
minimum SID 40 inches
8x10 IR
nongrid
55-60 kvp
91
THUMB basic:
| AP projection patient position
seated facing the table
| arms extended in front and hand rotated internally to supinate the thumb
92
THUMB basic:
| AP projection part position
hand in extreme internal rotation
align thumb with long axis of IR
center to 1st MCP joint
93
If you can't do an AP projection of the thumb what can you do instead?
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
When I xray the thumb i must remember to include the .....
TRAPEZIUM!
95
THUMB basic:
| AP projection no rotation
concave sides of shafts of phalanges
equal soft tissue on each side of phalange
IP joint open
96
THUMB basic:
| PA oblique projection patient position
patient seated at end of table
elbow flexed 90 degrees
thumb slightly abducted and palmar surface in contact with IR
97
THUMB basic:
| PA oblique projection central ray
perpendicular to IR
| centered to the 1st MCP joint
