forelimb imaging quiz developed by: sorcha mccaughley & mark brims approved by: alison king...
TRANSCRIPT
Forelimb Imaging QuizDeveloped by: Sorcha McCaughley & Mark Brims
Approved by: Alison King & Maureen Bain
Supported by: The Chancellor’s Fund
Forelimb Imaging Quiz
START!
Developed by: Sorcha McCaughley & Mark Brims
Supported by: The Chancellor’s Fund
Set the scene…
• Radiography is an essential part of the veterinary diagnostic process.
• Let’s walk through the basics of the normal Dog Forelimb.
• Don’t forget the other animals – at the end you should look at the comparative species x-rays!
Dog Forelimb
• Choose a question: – Shoulder (Q1)– Shoulder (Q2)– Elbow (Q3)– Elbow (Q4)– Carpus (Q5)– Foot (Q6)
Comparative Forelimb
• Choose a species:
– Cat
– Horse
– Ruminant
– Pig
Dog Shoulder Q1• (i) What is A?
– Cranial Border– Scapular spine– Infraspinous fossa
• (ii) What is B?– Scapular spine– Acromion process– Ventral angle
• (iii) What is C?– Acromion process– Glenoid cavity– Supraglenoid tubercle
A
C B
Correct • Yes! (A) is the Spine of
the scapula!
• Here are some more examples.
• Try (ii)!• Choose a new question.
What can you say about the age of this dog?
Answer.
Spine
A
Spine
Answer
• This is a young dog.
• This is indicated by the presence of growth plates in the animal’s bones.
• The growth plates mark the boundaries between Centres of Ossification.
Growth Plate
Go Back!
Incorrect
• No, (A) is not the Cranial Border.
• The cranial border is labelled here.
• Try again!• Choose a new question.
Cranial border
Incorrect
• No, (A) is not the Infraspinous Fossa.
• The Infraspinous Fossa is labelled here.
• Try again!• Choose a new question.
Infraspinous Fossa
Correct
• Yes! (B) is the Acromion process!
• Here are some more examples.
• Try (iii)!• Choose a new question.
Acromion
Acromion
Can you tell which dog is older?
Answer.
Answer
• The first dog is slightly younger.
• Notice how the growth plate on the second dog has fused / closed. It is still open in the first dog.
• Go Back!
Growth Plate
Incorrect
• No, (B) is not the Ventral Angle.
• This x-ray shows the Ventral Angle.
• Try again!• Choose a new question.
Ventral Angle
Incorrect
• No, (B) is not the Scapular spine.
• This x-ray shows the Scapular spine.
• Try again!• Choose a new question.
Spine
Correct
• Yes! (C) is the Supraglenoid Tubercle!
• Here are some more examples.
• Try Dog Shoulder Q2.• Choose a new question.
Supraglenoid Tubercle
Supraglenoid Tubercle
Growth Plate
Incorrect
• No, (C) is not the Acromion process.
• The Acromion process is labelled in this x-ray.
• Try again!• Choose a new question.
Acromion process
Incorrect
• No, (C) is not the Glenoid cavity.
• The Glenoid cavity is labelled in this x-ray.
• Try again!• Choose a new questi
on.
Glenoid cavity
Dog Shoulder Q2• (i) What is 6?
– Caudal angle – Shoulder joint space– Intertubercular groove
• (ii) What is 7?– Head of Humerus– Neck of Humerus– Greater Tubercle
• (iii) What is 8?– Head of Humerus– Greater Tubercle– Intertubercular Groove
• (iv) Do you know what B is? Answer.
B
Correct • Yes! (6) is the Shoulder
joint space!– This is where the Head of
the Humerus articulates with the Glenoid Cavity of the Scapula to form the shoulder joint.
• Here are more examples.
• Try (ii)!• Choose a new question.
Shoulder joint space
Shoulder joint space
Incorrect
• No, (6) is not the Caudal Angle.
• These x-rays show the Caudal Angle.
• Try again!• Choose a new question. Caudal
Angle
Caudal Angle
Incorrect
• No, (6) is not the Intertubercular Groove
• The Intertubercular Groove is labelled in these x-rays.
• Try again!• Choose a new question.
Intertubercular Groove
Correct • Yes! (7) is the Head of the
Humerus!– Remember: the Head of the
Humerus articulates with the Glenoid Cavity of the Scapula to form the shoulder joint.
• Here are more examples.
• Try (iii)!• Choose a new question.
Head of Humerus
Head of Humerus
Incorrect • No, (7) is not the Neck of
the Humerus.– Remember: the Neck extends
from the Head to become the Body of the Humerus.
• The Neck of the Humerus is labelled here.
• Try again!• Choose a new question.
Neck of Humerus
Neck of Humerus
Incorrect
• No, (7) is not the Greater Tubercle.
• The Greater Tubercle is shown here.
• Try again!• Choose a new question.
Greater Tubercle
Greater Tubercle
Correct
• Yes! (8) is the Greater Tubercle!
• Here are some more examples.
• Try (iv)!• Choose a new question.
Greater Tubercle
Greater Tubercle
Incorrect
• No, (8) is not the Head of the Humerus.
• The Head of the Humerus is shown here.
• Try again!• Choose a new question.
Head of Humerus
Head of Humerus
Incorrect
• No, (8) is not the Intertubercular Groove.
• The Intertubercular Groove is shown here.
• Try again!• Choose a new question.
Intertubercular Groove
Answer• B is an Endo-Tracheal
Tube. • This is placed in the
Trachea to provide anaesthetic and oxygen during procedures such as x-rays and surgery.
• Here is another one.
• Try Dog Elbow Q3• Choose a new question!
ET tube
Dog Elbow Q3• (i) What is 1?
– Anconeal Process– Olecranon Process– Medial Coronoid Process
• (ii) What is 2?– Olecranon Process– Medial Coronoid Process– Anconeal Process
• (iii) Structure 2 articulates with which part of 7?– Olecranon Fossa– Supracondyloid Foramen
• (iv) What is 5?– Radius– Ulna
• (v) What is 6?– Radius– Ulna
7
5
6
Correct • Well done! (1) is the
Olecranon process!– Remember: the Olecranon
Process is the point of insertion for the Triceps muscle, the main extensor muscle of the elbow.
• Here are more examples
• Try (ii)!• Choose a new question.
Olecranon
Olecranon
Incorrect
• No, (1) is not the Anconeal Process.
• Here are x-rays showing the Anconeal Process .
• Try again!• Choose a new question.
Anconeal Process
Anconeal Process
Incorrect
• No, (1) is not the Medial Coronoid Process.
• These x-rays show the Medial Coronoid Process.
• Try again!• Choose a new question.
Coronoid Process
Coronoid Process
Correct • Well done! (2) is the
Anconeal Process!– Remember: the Anconeal
Process articulates with the Olecranon Fossa of the Humerus
• Here are some more examples.
• Try (iii)!• Choose a new question.
Anconeal Process
Anconeal Process
Incorrect
• No, (2) is not the Olecranon process.
• Here are some x-rays showing the Olecranon process.
• Try again!• Choose a new question.
Olecranon
Olecranon
Incorrect • No, (2) is not the Medial
Coronoid Process.– Remember: the Medial and
Lateral Coronoid Processes of the radius are the points of attachment for the annular ligament that holds the ulna in place.
• The Coronoid Process is labelled in these x-rays.
• Try again!• Choose a new question. Coronoid
Process
Coronoid Process
Correct
• Well done!
• The Anconeal Process of the Ulna articulates with the Olecranon Fossa of the Humerus!
• Try (iv)!• Choose a new question.
Olecranon Fossa
Anconeal Process
Incorrect • No, the Anconeal Process
does not articulate with the Supracondyloid Foramen.
• This x-ray shows the Supracondyloid foramen – Remember: this is present
in the cat but not the dog and blood vessels pass through it.
• Try again!• Choose a new question.
Supracondyloid Foramen
Correct • Yes! (5) is the Ulna!
– Remember: the Ulna has the large Olecranon Process proximally and tapers distally in the dog.
• Here are more x-rays of the Ulna.
• Try (v)!• Choose a new question.
Ulna
Ulna
Incorrect
• No, (5) is not the Radius.
• Here are some x-rays of the Radius.
• Try again!• Choose a new question.
Radius
Radius
Correct
• Yes! (6) is the Radius!– Remember: the Radius is
the main weight bearing bone in the antebrachium
• Here are more x-rays of the radius.
• Try Dog Elbow Q2!• Choose a new question.
Radius
Radius
Incorrect
• No, (6) is not the Ulna.
• Here are some x-rays of the Ulna.
• Try again!• Choose a new question.
Ulna
Ulna
Dog Elbow Q4• (i) What is 7?
– Medial Coronoid Process– Medial Epicondyle– Lateral Epicondyle
• (ii) What is 8?– Anconeal process– Olecranon process– Head of Radius
• (iii) What is 12?– Distal humeral growth plate– Supracondyloid Foramen– Olecranon Fossa
Correct • Yes! (7) is the Medial
Coronoid Process!– Remember: the Medial and
Lateral Coronoid Processes of the radius are the points of attachment for the annular ligament that holds the ulna in place.
• Here are other x-rays showing the Medial Coronoid Process.
• Try (ii)!• Choose a new question.
Coronoid Process
Coronoid Process
What can you say about the age of this animal?
Answer.
Answer
• This is a young dog!
• Notice the growth plates – they are particularly obvious at the proximal end of the radius.
• Go Back!
Incorrect
• No, (7) is not the Medial Epicondyle.
• This x-ray shows the Medial Epicondyle.
• Try again!• Choose a new question.
Medial Epicondyle
Incorrect
• No, (7) is not the Lateral Epicondyle.
• This x-ray shows the Lateral Epicondyle.
• Try again!• Choose a new question.
Lateral Epicondyle
Correct
• Yes! (8) is the Olecranon process!
• Here are more examples.
• Try (iii)!• Choose a new question.
Olecranon
Olecranon
Incorrect
• No, (8) is not the Anconeal process.
• These x-rays show the Anconeal process.
• Try again!• Choose a new question.
Anconeal process
Anconeal process
Incorrect
• No, (8) is not the Head of the Radius.
• These x-rays show the Head of the Radius.
• Try again!• Choose a new question.
Head of Radius
Head of Radius
Correct
• Yes! (12) is the Olecranon Fossa!
• Here is another example.
• Try Dog Carpus Q1.• Choose a new question.
Olecranon Fossa
Incorrect
• No, (12) is not the Distal Humeral growth
plate / physis.
• This x-ray shows the Distal Humeral growth plate / physis.
• Try again!• Choose a new question.
Distal humeral growth plate
Incorrect • No, (12) is not the
Supracondyloid Foramen.
• Remember: this is only found in the cat!
• Try again!• Choose a new question.
This is a kitten foetus. The supracondyloid foramen can be seen forming.
Supracondyloid foramen
Dog Carpus Q5• (i) What is 2?
– Radial Carpal Bone– Distal Radial Epiphysis
• (ii) What is 4?– Styloid Process of Ulna– Ulnar Carpal Bone
• (iii) What is 7?– Ulnar Carpal Bone– Accessory Carpal Bone
• (iv) What is 10?– Second Carpal Bone– Fourth Carpal Bone
• (v) Do you know the others now? – Answers.
Hint: Is this a young or old dog?
Correct • Yes! (2) is the Distal
Radial Epiphysis!
• Here is another example.
• Try (ii)!
• Choose a new question.
Distal Radial Epiphysis
Incorrect • No, (2) is not the
Radial Carpal Bone.
• These x-rays show the Radial Carpal Bone.
• Try again!• Choose a new questi
on.
Radial Carpal Bone
Radial Carpal Bone
Correct • Yes! (4) is the Styloid
Process of the Ulna!
• Here are more examples.
• Try (iii)!• Choose a new questio
n. Styloid Process
Styloid Process
Incorrect • No, (4) is not the Ulnar
Carpal Bone.
• These x-rays show the Ulnar Carpal Bone.
• Try again!• Choose a new questio
n.
Ulnar Carpal Bone
Ulnar Carpal Bone
Correct • Yes! (7) is the
Accessory Carpal Bone!
• Here are more examples.
• Try (iv)!• Choose a new questi
on.
Accessory Carpal Bone
Accessory Carpal Bone
Incorrect • No, (7) is not the
Ulnar Carpal Bone.
• These x-rays show the Ulnar Carpal Bone.
• Try again!• Choose a new questi
on.
Ulnar Carpal Bone
Ulnar Carpal Bone
Correct
• Yes! (10) is the 4th Carpal Bone!
• Here are more examples.
• Try (v)!• Choose a new questi
on.
4th Carpal Bone
4th Carpal Bone
Incorrect • No, (10) is not the 2nd
Carpal Bone.
• The 2nd Carpal Bone is labelled in these x-rays.
• Try again!• Choose a new questi
on.
2nd Carpal Bone
2nd Carpal Bone
Answers• 2 = Distal Radial
Epiphysis• 4 = Styloid Process of
Ulna• 5 = Radial Carpal Bone• 6 = Ulnar Carpal Bone• 7 = Accessory Carpal
Bone• 8 = Second Carpal
Bone• 9 = Third Carpal Bone• 10 = Fourth Carpal
Bone• Try Dog Foot Q1!
• Choose a new question.
Dog Foot Q6• (i) What is A?
– Fifth Metacarpal Bone– Proximal Phalanx -1st digit
– Proximal Phalanx - 5th digit
• (ii) What are B?– Ungual Process– Proximal Palmar Sesamoids– Metacarpal pad
• (iii) What is C?– Metacarpo-phalangeal Joint– Distal Inter-phalangeal Joint– Proximal Inter-phalangeal Jo
int
A
B
C
Correct • Yes! (A) is the 5th Metacarpal Bone!
• Here is another example.
– Remember: you can use the location of the 1st digit / dew claw (if present) to determine which side of the limb is medial.
– Note though that this image has been presented with medial to the left while in the previous example it was to the right!
• Try (ii)!• Choose a new question.
5th Metacarpal Bone
1st digit
Incorrect • No, (A) is not the Proximal
Phalanx – 1st Digit.
• These x-rays show the
1st Digit / dew claw
– Remember: there only 3 bones present in this digit and there is debate as to which these are (3 phalanges or metacarpal + 2 phalanges)
• Try again!
• Choose a new question.
1st Digit
1st Digit
Incorrect • No, (A) does not show the
Proximal Phalanx – 5th Digit.
• These x-rays show the Proximal Phalanx – 5th Digit.– Remember that you can use
the location of the styloid process of the ulna (*) to determine which side of the limb is lateral
• Try again!• Choose a new question.
Proximal Phalanx – 5th Digit
Proximal Phalanx – 5th Digit
*
Correct
• Yes! (B) are the Proximal Palmar Sesamoids.
• Here is another example.– Note that the proximal, middle and
distal phalanges have been amputated from the 5th digit
• Try (iii)!• Choose a new question.
Proximal Palmar Sesamoids
Incorrect • No, (B) is not the Ungual
Process.
• This x-ray shows Ungual Processes. – Remember that they are
located on the distal phalanx and support the nail
• Try again!• Choose a new question.
Ungual Processes
Incorrect • No, (B) is not the Metacarpal pad
• These x-rays show the Metacarpal pad. – Remember that it is
superimposed over the metacarpal joints in the DP view (1st image) but can be seen more clearly in the lateral view (2nd
image).
• Try again!• Choose a new question.
Metacarpal pad
Metacarpal pad
Correct • Yes! (C) is the Proximal
Inter-phalangeal Joint.
• Here are more examples, this time of the 5th digit.
• Look at the comparative section.
• Choose a new question.
Proximal Inter-phalangeal Joint
Proximal Inter-phalangeal Joint
Incorrect • No, (C) is not the Middle
Inter-phalangeal Joint.
• These x-rays show Metacarpo-phalangeal Joints.
• Try again!• Choose a new question.
Metacarpo-phalangeal Joint
Metacarpo-phalangeal Joint
Incorrect
• No, (C) is not the Distal Inter-phalangeal Joint.
• These x-rays show the Distal Inter-phalangeal Joints.
• Try again!• Choose a new question.
Distal Inter-phalangeal Joint
Distal Inter-phalangeal Joint
Cat Forelimb – Differences
• Clavicle may be visible
• Scapula– Suprahamate Process
of Acromion
• Humerus– Supracondyloid
Foramen
• Ulna & Radius– Square Olecranon
Clavicle
• Horse Comparative.
Supracondyloid foramen
Horse Forelimb – Differences
Foal – ulna fusing to radius.
• Ruminant Comparative.
Bones of carpus:Radial, Intermediate, Ulnar and Accessory 2nd, 3rd & 4th
3rd Digit bears weight.
2nd & 4th Metacarpals = splint bones
Navicular Bone
Ruminant Forelimb - Differences
Radius & Ulna complete
Bones of Carpus:Radial, Intermediate, Ulnar & Accessory2/3 fused (+)& 4
Metacarpals 3 & 4 fused
Digits 3&4 bear weight
• Pig Comparative.
Cartilage plate not visible in x-rays
Supratrochlear Foramen present in sheep but not cattle.
+
Pig Forelimb - Differences
Large tuber on scapular spine (*)
Radius & Ulna present and similar diameter. All carpal bones present:
R / I / U / A 1 / 2 / 3 / 44 digits present:3 & 4 bear weight.Back to the start.
*