Hand Anatomy Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the correct Central Ray (CR) location for a PA projection of the hand?

3rd MCP Joint (correct)

Wrist Joint

1st MCP Joint

5th MCP Joint

During a PA oblique projection of the hand, how many degrees should the hand be rotated laterally?

45˚ (correct)

60˚

90˚

30˚

Which positioning term describes the hand orientation for a PA projection?

Elevated

Pronated (correct)

Supinated

Neutral

What should be ensured for the evaluation of a PA hand projection?

Entire hand and carpals are demonstrated Signup and view all the answers

What is a recommended spacing technique for the digits during a PA oblique projection?

All digits spread apart Signup and view all the answers

What is the total number of bones in each hand?

27 Signup and view all the answers

How many phalanges does the thumb consist of?

2 Signup and view all the answers

What is the correct term for bones of the fingers?

Phalanges Signup and view all the answers

Which digit corresponds to the little finger?

5 Signup and view all the answers

What are the three parts of a phalanx?

Head, Body, Base Signup and view all the answers

Which of the following best describes the carpals?

8 bones that make up the wrist. Signup and view all the answers

What type of joint is formed between the proximal and distal phalanges of the thumb?

IP Joint Signup and view all the answers

Which part of the metacarpals articulates with the carpals?

Base Signup and view all the answers

What is the primary reason for using the PA projection for the first digit?

To avoid increased OID effects on image quality Signup and view all the answers

Which condition is characterized by a fracture through the base of the first metacarpal bone with posterior displacement?

Bennett fracture Signup and view all the answers

What is a common symptom of Osteoporosis?

Reduced quantity of bone Signup and view all the answers

What is the ideal alignment of the thumb during the AP projection for the first digit?

Aligned with the long axis of the IR Signup and view all the answers

Which imaging technique is recommended for the 1st digit in a near-lateral position?

PA projection Signup and view all the answers

What are the evaluation criteria for a successful AP projection of the first digit?

No rotation of phalanges is visible Signup and view all the answers

What is a typical cause of Skier’s thumb?

Falling on an outstretched hand Signup and view all the answers

How should the thumb be positioned for the PA oblique projection of the first digit?

Slightly abducted with palmar surface on the IR Signup and view all the answers

What must be included when x-raying the thumb?

1st Metacarpal & Trapezium Signup and view all the answers

Where is the Distal Interphalangeal (DIP) Joint located?

Between the distal and middle phalanges Signup and view all the answers

Which of the following is a requirement when x-raying the 2nd to 5th digits?

Only include through the MCP joint Signup and view all the answers

What is the correct tabletop height during positioning?

Shoulder height Signup and view all the answers

What exposure factors are typically recommended for upper limb radiography?

Lower to medium kVp (60-80) Signup and view all the answers

Which technique is suggested for immobilizing pediatric patients during x-ray procedures?

Using sponges and tape Signup and view all the answers

What should be done before taking x-rays of geriatric patients?

Provide clear and complete instructions Signup and view all the answers

What is the general rule regarding collimation and IR size?

Collimate down without cutting off essential anatomy Signup and view all the answers

What is the correct method for the lateral projection of the first digit?

Start with the hand pronated and thumb abducted. Signup and view all the answers

Where should the central ray (CR) be directed for the PA projection of fingers 2-5?

Perpendicular to IR directed at PIP joint. Signup and view all the answers

What is the recommended collimation for the PA projection of the 4th digit?

Collimate on four sides to the area of affected finger and distal aspect of metacarpal. Signup and view all the answers

What is the acceptable angle for rotating the hand for a PA oblique projection of the 3rd to 5th digit?

45 degrees laterally. Signup and view all the answers

What should be ensured during the lateral projection of the 2nd digit?

The second digit should touch the imaging receptor. Signup and view all the answers

What is the criteria for evaluating the lateral projection of digits 2-5?

The entire phalanx and MCP joint should be demonstrated. Signup and view all the answers

For the PA oblique projection of the 2nd digit, how should the other fingers be positioned?

Flexed to prevent overlap. Signup and view all the answers

What is the significance of the 40 SID during the projections of fingers?

It eliminates the need for a grid. Signup and view all the answers

Study Notes

Hand Anatomy

The hand consists of 27 bones: 14 phalanges (fingers and thumb), 5 metacarpals (palm), and 8 carpals (wrist)

Phalanges

Each finger and thumb is called a digit
Each digit contains 2 or 3 bones called phalanges (singular: phalanx)
Phalanges are numbered 1-5, with thumb being 1 and little finger being 5
Digits 2, 3, 4, and 5 are composed of 3 phalanges:
Proximal (closest to the palm)
Middle
Distal (farthest from the palm)
Thumb (digit 1) is composed of 2 phalanges: proximal and distal

Metacarpals

Make up the palm of the hand
5 Metacarpals in each hand
Numbered the same as the digits
3 parts:
- Head - Distal round portion
- Body (Shaft) - Long curved portion
- Base - Expanded proximal end articulates with carpals

Carpals

Make up the wrist
8 total carpals in each wrist
All have specific names

Joints of the Hand

1st Digit (Thumb):
- Interphalangeal (IP) Joint: Located between proximal and distal phalanges of the thumb
- 1st Metacarpophalangeal (MCP) Joint: Located between proximal phalanx and 1st metacarpal
- 1st Carpometacarpal (CMC) Joint: Located between the proximal metacarpal and the trapezium (carpal)
2nd - 5th Digits:
- Distal Interphalangeal (DIP) Joint: Located between the distal and middle phalanges
- Proximal Interphalangeal (PIP) Joint: Located between the middle and proximal phalanges
- Metacarpophalangeal (MCP) Joint: Located between the proximal phalanx and the distal metacarpal

General Positioning Considerations

Typically performed with patient seated sideways at the end of the table
Tabletop height should be near shoulder height for full arm support
40" SID (Source Image Distance)

Trauma Patients

X-rays can be completed with patient on stretcher

Pediatric Patients

Patient motion is a concern
Immobilization needed using sponges and tape
Involve parents
Use soothing language that a child can understand

Geriatric Applications

Provide clear and complete instructions
May have difficulty holding strenuous positions
Reduce technique due to potential osteoporosis

Exposure Factors

Lower to medium kVp (60-80)
Short exposure time
Small focal spot
Correctly exposed images should reveal soft tissue margins and fine trabecular markings of all bones
Grids not used unless body part is greater than 10cm

Collimation, Positioning, and Markers

Collimate down without cutting off essential anatomy
General rule regarding IR size: Select the smallest IR for the part being imaged
Positioning rule: Always place the long axis of the part being imaged parallel to the long axis of the IR being exposed
Correct marker should be demonstrated on each image

Clinical Indications

Dislocation: displacement from joint
Fractures:
- Bennett fx: fracture through base of the first metacarpal bone, extending into the CMC joint with subluxation w/ posterior displacement
- Boxer fx: Transverse fx that extends through the metacarpal neck – most commonly seen on 5th metacarpal
- Skier’s thumb: sprain or tear of the ulnar collateral ligament of the thumb near the MCP joint of the hyperextended thumb (occurs from falling on outstretched arm and hand)
Osteoarthritis: AKA degenerative joint disease (considered normal in the aging process)
Rheumatoid Arthritis: Chronic systemic disease with inflammatory changes throughout connective tissues (3x more common in women than men)
Osteoporosis: reduction in the quantity of bone or atrophy of skeletal tissue (occurs in postmenopausal women and elderly men)
Foreign Objects

Positioning of the 1st Digit (Thumb)

Routine Views:
- AP
- PA Oblique
- Lateral

AP Projection - 1st Digit

40" SID
No Grid
Smallest IR available
Arm extended in front
Rotate arm internally to supinate thumb
Align thumb with long axis of IR
CR: 1st MCP joint

PA Projection - 1st Digit

Used if patient is unable to be positioned for AP
40" SID
Place hand in near-lateral position
Rest thumb on sponge support block that is high enough to keep thumb from rotating
CR: 1st MCP joint
PA is not advisable because of loss of definition caused by increased OID

Evaluation Criteria for 1st Digit - AP and PA

Entire thumb demonstrated (including first CMC joint)
Center field at first MCP joint
No rotation of phalanges
Exposure factors
PA is not advisable because of loss of definition.

PA Oblique Projection - 1st Digit

40" SID
Smallest IR Size available
No Grid
Abduct thumb slightly with palmar surface of hand in contact with IR (this naturally places thumb in 45˚ oblique)
CR: 1st MCP joint

Evaluation Criteria for 1st Digit - PA Oblique

Entire thumb demonstrated
Joints partially open as in 45° oblique
Center of field at first MCP joint
Exposure factors

Lateral Projection - 1st Digit

40" SID
Smallest IR Size
No Grid
Start with hand pronated and thumb abducted
Fingers slightly arched
Medial rotate hand slightly till thumb is in true lateral position
CR: 1st MCP joint

Evaluation Criteria for 1st Digit - Lateral

Entire thumb demonstrated
Center of field at first MCP joint
No rotation from lateral evident
Exposure factors

Positioning of Fingers/Digits 2-5

Routine Views:
- PA
- PA Oblique
- Lateral

PA Projection - Fingers 2-5

40" SID
No Grid
Smallest IR available
Pronate hand with fingers extended
Center and align long axis of affected finger with long axis of IR
CR perpendicular to IR directed at PIP joint
Recommended collimation: Collimate on four sides to area of affected finger and distal aspect of metacarpal

Evaluation Criteria for PA Projection - Fingers 2-5

Entire finger and minimum ⅓ of MCP demonstrated
Center field at PIP joint
No rotation of phalanges
Exposure factors

PA Oblique Projection - 2-5th Digits

40" SID
No Grid
With fingers extended rotate hand laterally 45˚ - 3rd – 5th digit (separate fingers and carefully position the finger being examined against a block)
CR: PIP Joint
2nd digit: Rotate medially 45˚- other fingers flexed to prevent superimposition.

Evaluation Criteria for PA Oblique Projection - 2-5th Digits

Entire phalanx and MCP joint demonstrated
IP and MCP joints open
Center field at PIP
Exposure factors

Lateral Projection - 2-5th Digits

40" SID
No Grid
CR: PIP Joint
Lateromedial (3-5th digit): Place hand in lateral position (thumb side up) with finger to be examined fully extended, flex unaffected fingers, finger is parallel to IR
Mediolateral (2nd digit): Rotate hand medially till thumb side is down and second digit is touching IR, flex unaffected fingers
Use a radiolucent sponge to support the hand as needed

Evaluation Criteria for Lateral Projections - 2-5th Digits

Entire phalanx and MCP joint demonstrated
Center field at PIP
True lateral position
Digit parallel to IR
Exposure factors

Positioning of the Hand

Routine Views:
- PA
- PA Oblique
- Lateral “Fan

PA Projection - Hand

40" SID
No Grid
Pronate hand with palmar surface on IR
Spread fingers slightly
CR: 3rd MCP Joint

Evaluation Criteria for PA Projection - Hand

Entire hand and carpals demonstrated
Center of field at third MCP joint
No rotation of phalanges or metacarpals
Exposure factors

PA Oblique Projection - Hand

40" SID
No Grid
Pronate hand on IR
Rotate entire hand and wrist laterally 45˚ with digits parallel to IR (support with a radiolucent sponge if necessary)
Separate all digits
CR: 3rd MCP Joint
Only allow thumb & fingertips to touch the IR if digits are not of interest
This position is used to open up the carpal joints for better visualization.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the anatomy of the hand with this quiz. Explore the structure of the phalanges, metacarpals, and carpals, as well as the different joints involved. Ideal for students studying human anatomy or biology.