Lower Extremities 2

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Color of bone marrow for adults and children: Adult: yellow in long bones
red in flat bones

Children: red
Compact Bone: external, dense osseous portion
Periosteum (Aspects of long bone): outer covering of bone
Cancellous Bone Aspects of long bone): spongy bone
Medullary cavity Aspects of long bone): contains bone marrow
Ossification of Long Bones: 1. Epiphysis
2. Epiphyseal plate
3. Diaphysis
4. Metaphysis
5. Callus
Epiphysis: ends of the bone

secondary bone growth center
Epipyseal plate: cartilage between the epiphysis and the metaphysis until growth is complete
Diaphysis (Shaft): 1. Primary growth center
2. Main part of the bone
Metaphysis: between the diaphysis and the epiphyseal plate
Callus: healing bone following bone traum
4 Classification of Bone: a. Long: ex.femur, humerus
b. Short: carpal, tarsals, wrist
c. Irregular: vertebrae, pelvis
d. Flat: scapulae, skull, ribs
e. Sesamoid: patella
Joint Classification: a. Synarthrodial
b. Amphiarthrodial
c. Diarthrodial
d. Largest joint of the body-knee
Synarthrodial: immovable: sutures of skull
Amphiarthrodial: slightly movable; Distal tib-fib joint
Diarthrodial: "freely movable"
1. contains synovial fluid
2. six types
a.Gliding:intercarpals
b.Hinge:interphalangeal,
toes, knees, ankle
elbow
3. Pivot: C-1 & C2, radioulnar
joints
4. Condyloid:metacarpophalangeal
and wrist joints
5. Saddle: thumb
6. Ball & Socket:hip/shoulder
joints
Largest join in the body: knee
Osteoporosis: affects the amount of calcium within the bone
Head (Parts of a Bone): rounded portion usually at the proximal end of bone
Neck (Parts of a Bone): constricted portion below the head
Spine (Parts of a Bone): sharp projection of bone
Process (Parts of a Bone): a prominence or projection
Crest (Parts of a Bone): a projecting ridge of bone
Tuberosity (Parts of a Bone): a large eminence
Notch (Parts of a Bone): a deep indentation in the edge of a part
Fossa (Parts of a Bone): Pit or open cavity
Foramen (Parts of a Bone): hole or opening in a bone
Groove (Parts of a Bone): Elongated depression on the bone surface
Fissure (Parts of a Bone): narrow slit between bones
Sinus (Parts of a Bone): hollow space w/in a bone
Base (Parts of a Bone): expanded portion at the end of a bone opposite the head
Appendicular Skeleton: Extremities
Shoulder & pelvic girdles
Axial Skeleton: skull, vertebrae, sternum, ribs
Fractures: 1. Greenstick:incomplete fx of long bone.
2. Compound: fracture w/c penetrates the skin
3. Comminuted: broken into more than two pieces (could be splintered or many pieces)
4. Potts: distal end of fibula
5. Colles: distal radius
6. pathological; caused by disease, not injury
General Positioning: 1.Proximal: close to the source of origin
2. Distal: far from point of origin
3. Most important position when positioning patient:comfort
4. For long bones:
a. include both joints
b. AP & lat
5. For joints:
a. include a couple inches
on both sides of joint
b. AP,PA,OBL,LAT
Hand (Upper Extremities): Phalanges(thumb/fingers)14 bones
Metacarpals (palm) 5 bones
Carpals (wrist) 8 bones

Joints: Metacarpophalangeal(MCP) Interpphalangeal (IP)
Names of Carpals Which proximal & distal rows?: Proximal Row:
1. Scaphoid 2. Lunate
3. Triquetrum
4. Pisiform (pea like)

Distal Row:
1. Trapezium 2. Trapezoid
3. Capitate 4. Hamate(hook)
Positioning of Hand: a. PA
1. CR: perpendicular to 3rd
mp joint
b. 45 degree OBL
c. Lateral
1. foreign body fingers are
extended
2. fan fingers for possible
fracture
Positioning of Thumb: CR: 1st mp joint
a. AP - best for 1st mp joint
b. 45 Degree OBL-pronate hand
c. LAT-pronate hand w/finger
bent
Positioning of Fingers: CR: PIP joint
a. AP
b. 45 degree OBL
c. LAT
Wrist Joint: 1. Includes: radius & carpals
2. Landmarks: styloid process
3. Positioning:
a.PA
1.flex finger to decrease
OID
2.Styloid process:
parallel to film

b. 45 degree OBL
1. Styloid processes 45
degrees to film

c. Lateral
1. Styloid processes
perpindicular to film

d. Navicular:
1. Ulnar flexion (radial
deviation)
2. CR: 20 degrees cephalad
Forearm: 2nd group of upper limb bones radius on the lateral or thumb side & the ulna on the medial side.
Parts of Ulna: Ulna
1. Olecranon process
2. Coronoid tubercle (medial)
3. Body (Shaft)
4. Ulnar notch(on radius)
5. Head
6. Styloid process
Olecranon or Coronoid Process: two beaklike processes of the proximal ulna

olecranon proces can be palpated easily on the posterior aspect of the elbow joint
Coronoid Tubercle: medial margin of the coronoid process opposite the radial nmotch
Trochlear Notch: large concave depression or notch articulating the distal humerus
Radial Notch: small shallow depression located on the lateral aspect of the proximal ulna
Body (Shaft): long midportion of both the radius and ulna
Head of ulna: located near the wrist at the distal end of the ulna
Head of radius: located at the proximal end of the radius near the elbow joint.
Radial Tuberosity: rough oval process on the medial and anterior side of the radius, just distal to the neck
Styloid Process: small conical projections, located at the extreme distal ends of both th eradius and ulna. Can be palpated on the thumb side of the wrist joint.
Elbow: 1. Includes: radius,ulna,humerus
2. Landmarks: epicondyles of
humerus
3. Positioning:
a. AP-
1.hand supinated
2.epicondyles parallel
b. Inter 45 degree OBL
1. epicondyles 45 degree
to film
2. shows coranoid process
c. Exter. 45 degree OBL
1. epicondyles 45 degrees
2. shows radial head
d. LAT
1.Hand lateral w/thumb up
2.Arm flexed 90 degrees
3.Epicondyles superimpo-
sed.
Humerus: is the largest & longest bone of the upper limb. lenght on adult equals approx. 1/5 of the body height. Humerus articulates with the scapula.
Humerus Parts: 1. Body
2. Coronoid fossa
3. Medial epicondyle
4. Humeral condyle
5. Trochlea
6. Trochlear sulcus(groove)
7. Ulna
8. Radial fossa
9. Lateral epicondyle
10.Capitulum
11. Head of radius
Coronoid fossa: 2 shallow anterior depressions
Medial Epicondyle: larger & more prominent than the lateral & located on the meidal edge of the distal humerus
Humeral condyle: expanded distal end of the humerus
Trochlea: shaped like a pulley or spool
Trochlear Sulcus (Humerus): two rimlike outer margins and a smooth depressed center portion
Coronoid Fossa & Radial Fossa (Humerus): two shallow anterior depressions, as elbow is flexed the coronoid process and the radial head are received by these respective fossae
Capitulum (Humerus): meaning little head is located on the lateral aspect and articulates with the head of the radius
Shoulder: 1. Includes head of humerus &
glenoid fossa of scapula
2. Landmarks: Epicondyles of
humerus
3. Non-trauma(CR:Coracoid proc
ess)
a. AP internal rotation
1. Epicondyles perpendi
cular to film
2. Show: lesser
tuberosity
b.AP external rotation
1.epicondyles parallel
to film
2.Show: greater tubero-
sity

4. Trauma
a. AP neutral (CR coracoid
process
b. Transthoracic lateral
1. unaffected arm above
head
2. CR:perpendicular to
surgical neck
Shoulder Girdle: consists of two bones:
clavicle & scapula
Parts of Shoulder Girdle: 1. Surgical neck: tapered area below the head & tubercles. Site of frequent fractures requiring surgery

2. Anatomic neck: appears as a line of demarcation between the rounded head and the adjoining greater and lesser tubercle.

3.Lesser Tubercle: below the anatomic neck on the anterior surface.

4. Greater Tubercle: lateral process and the pectoralis major and supraspinatus muscles attach.

5. Clavicle - collarbone w/double curvature have 3 main parts. Articulates w/lateral or acromia extremity (end) of the clavicle articulates with the acromion of the scapula. This joint or articulation is clld acromioclavicular.

6. Scapula - shoulder blade

7. Acromion -is a long curved process extending laterally over the head of the humerus

8. Coracoid Process: is a thick, beaklike process projecting anteriorly beneath the clavicle.

9. Glenoid Fossa -
A-C Joints: 1.AP with and w/out weights
2.taken to check for subluxation (dislocation)

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