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Clinicals ll Summer

Finger Image Analysis

QuestionAnswer
What classification of bones are the metacarpals and phalanges? long bones
A long bone consists of? Head, neck, shaft, and base
how many phalanges form the fingers? 14
what classification of bones are carpal bones? short bones
name the fingers from the lateral side beginning with the Thumb? thumb, index finger, middle finger, ring finger, little finger
a broken bone can either be classified as a complete or incomplete fracture and can occur as a result of? physical forces, pathological fractures (weakened by diseases), or stress fractures (repetitive overuse)
clinical indications of a fracture? limited movement, loss of movement, bruised or deformed, pain at injury site, loss of feeling
new bone is called? callus bone
fracture healing depends on? regional blood supply
fracture healing process: hematoma formation → fibrocartilaginous callus formation (osteoblasts (bone cells) form a spongy bone) → bony callus formation (mineralized by calcium deposits) → bone remodeling (callus bone expands to fracture site until absorbed by bone)
both cortices of bone have been broken complete fracture
only one cortice of bone has been broken incomplete fracture
the bone retains its normal alignment nondisplaced fracture
bones are not in anatomical alignment displaced fracture
fracture has more than two fragments, usually from a crush comminuted fracture
what is a baseball fracture? fracture of distal phalanx, ball striking end of extended finger, usually accompanied by an avulsion fracture at the base of phalanx
what is a tuft fracture? comminuted fracture of the distal phalanx of the finger or thumb, caused by a crushing blow
what is a boxers fracture? a transverse fracture of the neck of the 5th metacarpal, caused by punching someone or something
what is an avulsion fracture? occurs at attachment sites for muscles, tendons, and ligaments - the force of violent contraction of muscles pulls a fragment of bone away from the rest of the bone
the process of restoring fracture fragments that are displaced to their normal anatomical position reduction
fractures which do not require a surgical incision to be made - restored with manual manipulation or traction or a combination of both closed reduction
performed in surgery - fracture site is reduced by placement of screws, plates, or rods to maintain alignment of the bony fragments until new bone growth can take place open reduction
holding fracture fragments in position following reduction fixation
what are examples of external fixation devices? casts, slings or metal devices
what are examples of internal fixation devices? during open reduction - plates, screws, pins, nails and wires applied to reduce or realign a fracture
what is an intramedullary fixation device? intramedullary rod within the medullary cavity of the shaft of long bones
the complete disruption of a joint with a loss of contact between articulating surfaces of adjacent bones dislocation
a partial loss of continuity between two articular surfaces with some part remaining intact subluxation
results from twisting or overstretching a joint causes ligament to tear or separate from bony attachment sprain
a result of too great a demand placed on a muscle, overstretching, or tearing muscle strain
a bruise with a possible avulsion fracture contusion
results from injury, heavy exercises or infection inflammation
inflammation of a bursae surrounding a joint bursitis
inflammation of the tendon sheath around a joint from trauma or excess use tendonitis
inflammation of a joint osteoarthritis
an immune response to inflammation - attacks joints or organs rheumatoid arthritis
routine projections of the 2-5th digits pa, 45 degree oblique, lateral
SID for a finger projection 40 inches
IR orientation for a finger projection 10x12 lengthwise
disadvantage of performing the alternative pa projection of the thumb? increased OID and reduces detail
when is the pa projection of the thumb performed instead of the ap? when the patient is unable to perform the positioning for the ap
what is the ap axial projection of the 1st digit modified roberts method and what does it demonstrate? special projection of the 1st cm joint that demonstrates the 1st cm joint free of superimposition of the hand or other bony elements - a bennett fracture
the ap axial projection of the 1st digit - modified roberts method is performed to? demonstrate arthritic changes, displacement of the 1st cm joint and a bennetts fracture fracture of the base of the 1st metacarpal
how is the CR placed for the modified roberts method - ap axial of the 1st digit? 15 degrees proximally, toward the wrist to enter the 1st cm joint
CR direction for the pa projection of the thumb? perpendicular to the 1st mp joint
collimation for the pa thumb distal phalanx through trapezium
collimation for the modified roberts method, ap axial of the 1st digit? distal phalanx through the 1st cm joint
exposure factors evident for all finger images soft tissue margins and bony trabeculae should be evident
pa projection of the finger best demonstrates all anatomical structures from distal phalanx to the cm joint
no rotation for the pa finger evident by symmetrical appearance of both sides or concavities of the shafts of phalanges and metacarpals
45 degree oblique position of the finger BD? an avulsion fracture of the distal phalanx
the 45 degree oblique position of the finger should include? IP and MP joints open indicating phalanges are parallel to IR
Lateral projection of the finger BD? distal phalanx through the proximal phalanx/PIP joint and superimposed metacarpals with IP and MP joints open
no rotation on the lateral finger phalanges in lateral position as evident by concave anterior surfaces of the shafts and superimposed carpal bones
what is focal spot size responsible for? radiographic sharpness → good for looking for more detail in an image such as fractures and extremities
smaller focal spot size = _______ spatial resolution = ______ detail higher; more
what is kVp responsible for? penetrating power of the x-ray beam; quality; contrast
high contrast equals? less shades of gray, more contrast
low contrast equals? more shades of gray, less contrast
mAs is responsible for? number of xray photons produced times the time exposed; quantity of xrays; density on an image (darkness)
what is quantom mottle? low mAs; noise or grainy appearance, scatter on an image
how to fix quantom mottle? increase mAs
what is voluntary motion? can be controlled by the patient
voluntary motion can be fixed by? breathing techniques, clear communication with patient, restraints
what is involuntary motion cannot be controlled by the patient, heartbeat, shaking, etc
involuntary motion can be fixed by? shorter exposure time, timed images with motion of patient, restrains
two types of distortion size and shape
size distortion is? magnification
what is magnification? enlargement of a part
how to fix size distortion on an image? decreasing OID and increasing SID
what is shape distortion? elongation and foreshortening of a part
how to fix shape distortion? making sure part is centered and tube is aligned
secondary ossification center of a long bone? epiphysis, ends of long bones
a long bone consists of head, neck, shaft, base
tough fibrous connective tissue, covers bony surfaces, essential for growth/nutrition/repair? periosteum
inner lining of bone, membrane that lines the medullary cavity endosteum
hollow portion of the shaft of the long bone medullary cavity
the medullary cavity contains what kind of marrow? yellow bone marrow
forms a thin layer beneath the compact bone in the shafts of long bones, porous loosely knit spongy bone cancellous bone
cancellous bone contains what type of marrow red bone marrow
strong dense outer layer of bone also called cortical bone, gives bone strength for support compact bone
three parts of the phalanges 2-5th? distal, middle and proximal
what two parts are there of the phalanges of the thumb? proximal and distal phalanx
2 joints between the phalanges? distal IP joint and proximal IP joint
what type of joints are the distal and proximal IP joints and what are their movements? hinge joints - flexion and extension
bones of the palms of the hands metacarpals
what type of joints are the metacarpophalangeal (MP) joints of the 1st through the 5th digits and what movements do they allow? condyloid joints - flexion, extension, adduction, abduction
what type of joint is the 1st MP joint of the thumb? Gliding joint
what type of joint is the CM joint of the 1st digit and what movements does it allow? the only true saddle joint ion the bony (thumb) - flexion, extension, adduction, abduction, circumduction
what forms the only true saddle joint of the thumb? 1st metacarpal and trapezium (greater multangular)
position of thumb on the pa finger? oblique
position of thumb on the oblique finger? thumb up
position of the thumb on the lateral? thumb up
position of the thumb on the ap thumb? thumbnail down against IR
position of the thumb on the pa thumb? parallel to IR
position of the thumb on the ap axial? thumbnail down
position of the thumb on the pa hand? oblique
position of the thumb on the lateral hand - fingers fanned? fan position
position of the thumb on the lateral hand - in extension? pa, thumbnail up
distal row of carpal bones lateral to medial: trapezium (greater multangular), trapezoid (lesser multangular), capitate (os magnum), hamate (unciform)
forms saddle joint with first metacarpal? trapezium or greater multangular
largest carpal bone? os magnum or capitate
hook like process - hook of hamate? hamate or unciform
proximal row of carpal bones just in case! scaphoid (navicular), Lunate (semilunar), triangular (triquetral, triquetrum or cuneiform), pisiform (atop triangular)
carpal bone that fractures easily, difficult to heal? scaphoid navicular
carpal bones that are part of wrist joint proper? lunate or semilunar, scaphoid or navicular
smallest carpal bone that sits atop triangular? pisiform
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