Skills Labs - Hands and Feet
What are the 3 areas of the hand?
Phalanges, metacarpals and carpals
What are the phalanxes of the hand?
Proximal, distal and middle
What are the areas of interest in a hand x-ray?
From the distal phalanges including the soft tissue fingertips to the distal ends of the radius and ulna
How many carpal bones are there?
8
What are the 3 joints in the fingers?
Distal interphalangeal joint, proximal interphalangeal joint & metacarpo-phalangeal joint
What is located between the 2 phalanx and the 3rd phalanx?
Carpometacarpal joint
What is the area of interest in a lateral hand x-ray?
From the fingertips including the soft tissue margins to the radial and ulnar styloid processes
Where should the ray be positioned during a DP hand x-ray?
Over the head of the 3rd metacarpal
How should the hand be rotated in an oblique hand x-ray?
Hand externally rotated through 45 degrees from DP position
How should the hand be positioned in a lateral hand x-ray?
Hand externally rotated through 90 degrees from the DP position
Where should the ray be positioned in a lateral hand x-ray?
The ray should be centred over the head of the 2nd metacarpal
Name the tarsal bones in the distal row
Cuneiform bones
How many tarsal bones do we have?
7
Where should the ray be centred on a DP fingers x-ray?
Centred over the proximal interphalangeal joint of the affected finger
Name the arches of the foot
Medial longitudal arch, lateral longitudal arch & anterior transverse arch
What are the medial and lateral sides of the wrist?
Medial: ulna. Lateral: radius
Where should the ray be centred on a lateral fingers x-ray?
Over the proximal interphalangeal joint of the affected finger
What type and class of joint are the interphalangeal joints?
Synovial hinge joints
What is an avulsion fracture?
Caused by pull on joint or ligament
What should be included in an AP thumb x-ray?
1st carpometacarpal joint and the soft tissue fingertip
Where should the ray be centred on an AP thumb x-ray?
Ray should be centred over the 1st metacarpo-phalangeal joint
What is ideal the exposure factor for a hand x-ray?
60kV, 1-2 mAs
What is the ideal exposure for a finger x-ray?
60kV, 0.5-1 mAs
What is the ideal exposure for a thumb x-ray?
60kV, 0.5-1 mAs
What is the ideal exposure for a foot x-ray?
60kV, 1 mAs
What is the ideal exposure for a toe x-ray?
60kV, 0.5 mAs
What is the ideal exposure for a calcaneum (axial) x-ray?
63kV, 3.2 mAs
Which ligament attaches to the base of the 5th metatarsal?
Peroneus brevis
Where should the ray be centred on a lateral thumb x-ray?
Centred over the 1st metacarpo-phalangeal joint
What are the four parts of the joints in the fingers referred to as?
Head, Neck, Shaft and Base
What is another name for the calcaneum?
Oscalcis
What is the effective dose for a hand or foot x-ray?
0.001 mSv
Why is the metacarpals named the metacarpals?
Meta is the prefix for beyond so it means beyond the wrist
What type of joint is the 1st metacarpo-phalangeal joint?
Ellipsoid joint
Why should the fingers not be flexed during a DP hand x-ray?
The interphalangeal joints will not be demonstrated properly
On which surface are the extensor tendons found?
Dorsal
What types of bones are the metatarsals and the metacarpals?
Miniature long bones
Why should the hand be raised no more than 45 degrees from the detector in a DP oblique hand x-ray?
To prevent over rotation
What does the 5th phalange not have?
Interphalangeal joint and intermediate phalanges
What movements do the interphalangeal joints possess?
Flexion and extension
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