QUIZ 3 1031

what type of bone is Phalanges

Long Bones

what type of bone is Metacarpals

Long Bones

what type of bone is Carpal Bones

Short Bones

what type of bone is Radius / Ulna

Long Bones

what are the centers of ossification? (2)

primary

secondary

Primary Ossification Center

location?

when does it occur?

Forms the shaft (Diaphysis) of long bones

Occurs before birth

Secondary Ossification Center

location?

when does it occur?

Found in the epiphyses (ends) of long bones

Occurs after birth

what are the layers of a bone? (5)

Compact / Cortical Bone

Periosteum

Cancellous Bone

Medullary Cavity

Endosteum

Periosteum

what is it?

what is it used for?

Tough fibrous connective tissue covering bone

bone growth, repair, & nutrition.

Compact / Cortical Bone

what is it?

what is it used for?

Dense outer layer of bone

provides strength.

Cancellous Bone

what is it?

what is it used for?

Spongy inner bone

contains trabeculae and red marrow.

Medullary Cavity

what is it?

what is it used for?

Hollow shaft of long bones

contains red marrow (children) or yellow marrow (adults).

Endosteum

what is it?

Membrane lining the medullary cavity.

what joint is Intercarpal Joints

Gliding

what joint is Interphalangeal Joints

Hinge

what joint is Metacarpophalangeal Joints (2–5)

Condyloid

what joint is Carpometacarpal Joints (2–5)

Gliding

what joint is 1st Carpometacarpal (Thumb)

Saddle

what joint is Distal Radioulnar Joint

pivot

what joint is Wrist Joint Proper (Radiocarpal)

condyloid

what does a gliding joint do?

Sliding / gliding movement.

what does a Hinge joint do?

Flexion & Extension only.

what does a Condyloid joint do?

Flexion/extension + abduction/adduction.

what does a Saddle joint do?

Flexion, extension, abduction, adduction, circumduction.

what does a Pivot joint do?

one bone rotates around another

Avulsion Fracture

Fragment pulled away by tendon/ligament force.

Colles Fracture

Distal radius fracture with fragment displaced posteriorly; often from fall on outstretched hand.

Boxer’s Fracture

Transverse fracture of neck of 5th metacarpal (from punching).

Bennett Fracture

fracture at base of 1st metacarpal bone

Monteggia Fracture

Fracture of the proximal ulna with dislocation of the radial head.

Subluxation

Partial loss of continuity between joint surfaces (not a full dislocation).

Callus Bone

New bone that forms around fracture during healing.

Reduction

Restoring fragments to normal alignment (closed = manual; open = surgical).

Fixation

Holding fragments in place after reduction (internal, external, or intramedullary devices).

LECTURE 7

how many bones are in the hand?

27

in regards to the 2nd-5th digits, what are the 3 Phalanges (3)? (name them and picture where they go)

Distal, Middle, Proximal

in regards to the 2nd-5th digits, what are their Joints(2)? (name them and picture where they go)

Distal Interphalangeal Joint, Proximal Interphalangeal Joint

in regards to the 1st digits, what are their Phalanges (2)? (name them and picture where they go)

Distal, Proximal

Largest Carpal Bone is what bone?

Capitate

Smallest Carpal Bone is what bone?

Pisiform

“Helps form the Saddle Joint” refers to what bone?

Trapezium

“Largest bone in Proximal Row” refers to what bone?

Scaphoid

“Has hook-like process” refers to what bone?

Hamate

“Half-moon shaped” refers to what bone?

Lunate

“Superimposed on Triquetrum” refers to what bone?

pisiform rests on top of it

“Most commonly fractured” refers to what bone?

Scaphoid

what is the proximal row?

what carpal bones are in the proximal row(4)?

hand bones closets to the forearm

Scaphoid, Lunate, Triquetrum, Pisiform

what is the distal row?

what carpal bones are in the distal row(4)?

closest to the metacarpals / palm

Trapezium, Trapezoid, Capitate, Hamate

posterior surfaces of the carpal bones:

Carpal Bridge

Anterior surface (palmar) of carpal bones (3 names)

Carpal Tunnel, Carpal Sulcus, Carpal Canal

Nerve that passes through the anterior Carpal Region

Median Nerve

Carpal Tunnel Syndrome

what is it?

what are the symptoms?

Compression of the Median Nerve

Causing pain/tingling from repetitive use.

1st Carpometacarpal joints: bones that form it (2), type of joint, movements allowed:

1st Metacarpal + Trapezium

saddle

Flex, Extend, Abd, Add, Circumduction

Interphalangeal Joint of 1st Digit: bones that form it (2), type of joint, movements allowed:

Prox + Distal phalanx (Thumb)

Hinge

flex/extend

Distal Interphalangeal Joints of 2-5 Digits: bones that form this joint(2), type of joint, movements allowed:

Between middle phalanx and distal phalanx

hinge

flex/extend

Proximal Interphalangeal Joints of 2-5 Digits: bones that form this joint(2), type of joint, movements allowed:

Between proximal phalanx and middle phalanx

Hinge

flex/extend

routine projections for the fingers 2-5

PA, 45° Oblique, Lateral

routine projections for the thumb

AP (preferred) or PA, 45° Oblique, Lateral

routine projections for the hand

PA, 45° Semi-Pronated Oblique, Lateral (Fingers Fanned)

Central Ray location for PA Finger

Metacarpophalangeal (MP) Joint of affected digit

Central Ray location for Lateral Finger

Proximal interphalangeal (PIP) Joint

Central Ray location for AP Thumb

1st metacarpophalangeal (MP) Joint

Central Ray location for PA Hand

3rd metacarpophalangeal (MP) Joint

Position that best demonstrates an avulsion fracture of the finger

45° Oblique Finger

what bone of the finger is an avulsion fracture most common?

Distal Phalanx

Disadvantage of performing a PA projection of the Thumb instead of the AP

Increased OID = reduced detail.

What structures must be included on all thumb projections?

say the distance it needs to include from top bone to bottom

then if you want list all the bones from distal to proximal

nail to the wrist thus including

Distal phalanx, Interphalangeal (IP) joint, Proximal phalanx, First metacarpophalangeal (MP) joint, First metacarpal, First carpometacarpal joint, Trapezium

Describe the positioning for a Modified Robert’s Method of the Thumb to include:

o Type of Fracture best demonstrated

o Patient position

o CR angle, centered where, and in what direction

Bennett’s fracture

Arm internally rotated, thumb flat on IR

15° proximal (toward wrist) to 1st CMC joint

specifically regarding the oblique that is performed of the Hand / degree of obliquity / Purpose of using the step wedge sponge

Semi-Pronated

45° 

keeps fingers parallel to IR + keeps joint spaces open.

Purpose of the Lateral Hand positioning (2)

Evaluate foreign bodies & metacarpal fracture displacement.

in regards to Bone Age Hand for Pediatric Patients:

what image image to take?

what is the image supposed to show?

PA Left Hand 

lets you compare ossification centers to growth charts in pediatrics

LECTURE 8

Routine Projections of the Wrist (4)

Lateral

Posteroanterior (PA)

45° Semi-pronated Oblique

45° Semi-supinated Oblique

Why are the fingers flexed when performing the PA projection of the Wrist?

brings carpal bones closer to the image receptor =reduces OID = improves detail.

Alternative AP Wrist:

what structures will be best demonstrated?

why?

carpal interspaces

bc in the AP position they align more closely with the divergent x-ray beam, making the joint spaces more open.

Carpal best demonstrated on a 45 Semi-pronated Oblique

Trapezium

Structure best demonstrated on a 45 Semi-supinated Oblique

Pisiform

Structure best demonstrated on a Lateral

Lunate

positioning for “Stetcher Method”s for Scaphoid aka Navicular (say 2 different IR positioning and 1 hand positioning)

Place the image receptor on a 20° angle sponge, wrist in PA with ulnar deviation.

Wrist flat on IR in PA with ulnar deviation.

(notice only the IR positioning changes)

Gaynor Hart position of the Carpal Tunnel

positioning?

CR ? degree and where is it centered?

Forearm resting on table, Wrist hyperextended (fingers pulled back), Hand slightly rotated toward the radius to avoid superimposition

25–30° toward the palm (toward the elbow).

CR enters 1 inch distal to the base of the 3rd metacarpal.

What projection was performed to produce this image?  What is the structure best demonstrated?

45° Semi-pronated Oblique

Radial side of carpal bones aka trapezium, scaphoid, lunar NOTCH

What projection was performed to produce this image?  What is the structure best demonstrated?

Lateral Wrist

Lunate

What projection was performed to produce this image?  What is the structure best demonstrated?

Gaynor-Hart (Tangential Carpal Tunnel)

carpal bridge

LECTURE 9

ulna is located in what part of the body and where?

forearm

medially

radius is located in what part of the body and where?

forearm

laterally

What are the pointed processes on the distal radius and ulna called?

styloid process

Distal Radioulnar Joint:

what bones form it?

what type of joint is it?

what movements r allowed?

Ulnar Head + Ulnar Notch of Radius

Pivot

Supination / Pronation

Wrist Joint Proper

what bones form it?

what type of joint is it?

what movements r allowed?

Distal Radius + Scaphoid + Lunate

Condyloid

Flex, Extend, Abduct, Adduct

Proximal Radioulnar Joint

what bones form it?

what type of joint is it?

what movements r allowed?

Radial Head + Radial Notch of Ulna

Pivot

Supination / Pronation

Humeroulnar Joint

what bones form it?

what type of joint is it?

what movements r allowed?

Trochlea + Semilunar (Trochlear) Notch of Ulna

Hinge

Flex / Extend

Humeroradial Joint

what bones form it?

what type of joint is it?

what movements r allowed?

Capitellum + Radial Head

Hinge

Flex / Extend

Where are the heads of the bones of the forearm located? (2)

radius is proximal (like elbow)

ulna is distal (like wrist)

When the hand is pronated, which bone of the forearm crosses over medially?

radius crosses over the ulna

What structure on the Radius is the attachment site for the Biceps Tendon?

Radial Tuberosity

The Head of the Radius articulates with what structure in:

o Extension

o Flexion

Capitellum

Radial Fossa

What structures form the Semilunar Notch of the Proximal Ulna? (2)

Olecranon Process

Coronoid Process

The Coronoid Process of the Ulna articulates with what structure in:

o Extension

o Flexion

Trochlea of Humerus

Coronoid Fossa of Humerus