Anatomy and positioning of the hand

3 structures best demonstrated on a AP axial projection

1. 1st CM joint free of superimposition of the hand 2. 1st metacarpal 3. trapezium

3 projections of the 1st digit

1. AP or PA 2. 45 degree oblique 3. lateral

3 projections of 2nd-5th digits

1. PA 2. 45 degree oblique 3. lateral

3 projections of the hand

1. PA 2. 45 degree semi-pronated oblique 3. lateral

What 4 carpal bones are in the proximal row?

1. Scaphoid/navicular 2. lunate/semilunar 3. triangular/triquetrium/ triquetral/ cuneiform 4. pisiform

5 saddle joint movements allowed

1. adduction 2. abduction 3. flexion 4. extension 5. circumduction

The 2nd-5th digits have 2 joints called

1. distal interphalangeal joint 2. proximal interphalangeal joint

7 anatomical structures for a thumb

1. distal phalanx 2. IP joint 3. proximal phalanx 4. 1st MP joint 5. metacarpal 6. 1st CM joint 7. trapezium/greater multangular

8 anatomical structures for a PA projection of a finger

1. distal phalanx 2. distal IP joint 3. middle phalanx 4. proximal IP joint 5. proximal phalanx 6. MP joint 7. metacarpal 8. carpometacarpal joint

4 anatomical structures for a lateral of a finger

1. distal phalanx 2. middle phalanx 3. proximal phalanx 4. superimposed metacarpals

5 anatomical structures for a oblique finger

1. distal phalanx/DIP joint 2. middle phalanx 3. PIP joint/proximal phalanx 4. MP joint/metacarpal 5. CM joint

9 anatomical structures for a 45 degree oblique of a hand

1. distal, middle and proximal phalanges 2. distal/proximal !P joints 3. metacarpals and MP joints 4. sesamoid bone 5. carpal bones and CM joints on ulna side overlapped 6. distal radius/ulna 7. wrist joint proper 8. distal radioulnar joint 9. scaphoid/navicular elongated

5 anatomical structures for a lateral projection of the hand

1. distal, middle and proximal phalanges 2. distal/proximal IP joints 3. metacarpals and MP joints - superimposed 4. carpal bones and CM joints superimposed 5. distal radius/ ulna superimposed

8 anatomical structures for a PA projection of a hand

1. distal, middle, and proximal phalanges 2. distal/proximal IP joints 3. metacarpals and MP joints 4. sesamoid bone 5. carpal bones and CM joints 6. distal radius/ulna 7. wrist joint proper 8. distal radioulnar joint

4 parts of a long bone

1. head 2. neck 3. shaft 4. base

2 purposes of performing a lateral hand in extension is to:

1. localize foreign body 2. demonstrate anterior or posterior fracture displacement

The CR angle for a AP axial projection serves 2 purposes

1. open joint space 2. helps projects the soft tissue of the hand away from the 1st CM joint

What 4 carpal bones are in the distal row?

1. trapezium/greater multangular 2. trapezoid/lesser multangular 3. capitate/os magnum 4. hamate/unciform

The hand and wrist is formed by:

14 phalanges 5 metacarpals - palm 8 carpals - wrist

Where is the CR directed for a AP axial projection?

15 degrees proximally (toward wrist)

For all projections of a thumb center the ______ ______ joint to the center of IR

1st MP

AP axial projection of the thumb (robert method) is a special projection of the _______ _______ joint

1st carpometacarpal

What joint is the true saddle joint?

1st carpometacarpal

The 1st digit has ______ phalanges: _______ and ________

2 distal proximal

Each hand and wrist contain _____ bones

27

The 2nd-5th digits have _____ phalanges: ________, ________, __________

3 distal middle proximal

For all projections of the hand the CR is directed to the

3rd MP joint

On the posterior lateral surface of the wrist, is a triangular depression seen when thumb is abducted and extended called the

Anatomical snuff box

A _______ fracture will be visualized as a fracture of the base of the 1st metacarpal that extends into the 1st CM joint

Bennett

What fracture will be best demonstrated on the AP axial projection of the thumb?

Bennett fracture

The joint between the distal and proximal phalanges on the thumb is called

IP joint of the thumb

For a PA projection of the finger center the _______ joint of the affected digit to the center of the IR

MP

What is the classification of phalanges, metacarpals, and carpals?

Phalanges - long bones metacarpals - long bones carpals - short bones

What do the metacarpals articulate with?

Proximally: the distal row of carpal Distally: the proximal phalanges

Tenderness at the anatomical snuffbox is indicative of a fracture of the

Scaphoid/navicular

How to tell if the fingers are not parallel to the IR?

The DIP and PIP joints are closed and the phalanges are foreshortened

An ______ study is performed to evaluate the extent of arthritis in the joints of the hand

arthritis

The wrist joint proper is formed by:

base of the radius, scaphoid/navicular, lunate/semilunar

An arthritis study of the hand is performed

bilaterally with the both hands in a PA projection

Carpal bones are composed of ______ bone

cancellous

Bone standards are determined by the presence of _____ bones and ________ _______ centers

carpal bones and epiphyseal ossification centers

The posterior surface of the carpal bones is convex and is called the

carpal bridge

The anterior or palmer surface of the carpal bones is concave and is called the

carpal tunnel or carpal sulcus or carpal canal

_______ ________ ________ is a condition in which the median nerve are compressed by ligaments and bones

carpal tunnel syndrome

The metacarpals articulate with distal row of carpal bones to form the __________ joints

carpometacarpal

The wrist joint proper is classified as a _______ joint

condyloid

MP joints are classified as ______ joints

condyloid flexion, extension, adduction, abduction

Collimation for all projections performed of the hand is from the

distal phalanges through the distal radius and ulna

Collimation for all projections of the thumb is from the

distal phalanx through the trapezium

Collimation for a PA and oblique finger is from the

distal phalanx to the carpometacarpal joint

Collimation for a lateral finger is from the

distal phalanx to the head of the affected metacarpal

For a lateral hand spread the fingers and thumb into a " ______ _______"

fan position

The intercarpal joints are classified as ______ joints

gliding

The 2nd-5th carpometacarpal joints are considered _______ joints formed by:

gliding 2nd metacarpal and trapezium 3rd metacarpal and capitate 4th-5th metacarpals and hamate

The distal radioulnar joint is formed by the:

head of ulna and ulnar notch of radius

Distal IP joint and proximal IP joint are classified as _______ joints

hinge -flexion -extension

Disadvantage of a PA projection of a thumb

increased OID

A bone age examination is a projection of the _____ hand and _____ performed to determine if bone growth corresponds to chronological age

left hand and wrist

What nerve passes through the carpal tunnel?

median nerve

The _____ are the bones of the palm of the hand

metacarpals

What position of the fingers will best demonstrate an Avulsion fracture of the distal phalanx?

oblique

When the hand is in a PA position, what position is the thumb?

oblique

IP and MP joints open without overlap indicating _______ to the IR

parallel

What are the most distal bones of the hand?

phalanges

The distal and proximal radioulnar joints are ______ joints

pivot -supination and pronation

A 45 degree oblique hand is semi ________

pronated

For a lateral finger center the _______ _______ joint to the center of the IR

proximal interphalangeal

The wrist proper joint is a _____ joint enveloped in an articular capsule

synovial

The 1st carpometacarpal joint is formed the base of the 1st metacarpal and the

trapezium

When is a PA thumb performed?

when the patient is unable to perform the position for the AP projection