Forelimb Imaging Quiz Developed by Sorcha Mc Caughley
Forelimb Imaging Quiz Developed by: Sorcha Mc. Caughley & Mark Brims Approved by: Alison King & Maureen Bain Supported by: The Chancellor’s Fund
Forelimb Imaging Quiz START! Developed by: Sorcha Mc. Caughley & 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 (Q 1) Shoulder (Q 2) Elbow (Q 3) Elbow (Q 4) Carpus (Q 5) Foot (Q 6) Comparative Forelimb • Choose a species: – Cat – Horse – Ruminant – Pig
Dog Shoulder Q 1 • (i) What is A? – Cranial Border – Scapular spine – Infraspinous fossa A • (ii) What is B? – Scapular spine – Acromion process – Ventral angle C B • (iii) What is C? – Acromion process – Glenoid cavity – Supraglenoid tubercle
Correct • Yes! (A) is the Spine of the scapula! Spine What can you say about the age of this dog? Answer. • Here are some more examples. • Try (ii)! • Choose a new question. Spine A
Answer • This is a young dog. • This is indicated by the presence of growth plates in the animal’s bones. Growth Plate Go Back! • The growth plates mark the boundaries between Centres of Ossification.
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! Acromion Can you tell which dog is older? Answer. • Here are some more examples. • Try (iii)! • Choose a new question. Acromion
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 Supraglenoid Tubercle • Yes! (C) is the Supraglenoid Tubercle! • Here are some more examples. • Try Dog Shoulder Q 2. • Choose a new question. 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 question. Glenoid cavity
Dog Shoulder Q 2 • (i) What is 6? – Caudal angle – Shoulder joint space – Intertubercular groove B • (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.
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. Shoulder joint space • Here are more examples. • Try (ii)! • Choose a new question. 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
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. Head of Humerus • Here are more examples. • Try (iii)! • Choose a new question. 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. Neck of Humerus • The Neck of the Humerus is labelled here. • Try again! • Choose a new question. Neck of Humerus
Incorrect Greater Tubercle • No, (7) is not the Greater Tubercle. • The Greater Tubercle is shown here. • Try again! • Choose a new question. Greater Tubercle
Correct • Yes! (8) is the Greater Tubercle! Greater Tubercle • Here are some more examples. • Try (iv)! • Choose a new question. 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
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 Q 3 • Choose a new question! ET tube
Dog Elbow Q 3 • (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? 6 5 7 – Olecranon Fossa – Supracondyloid Foramen • (iv) What is 5? – Radius – Ulna • (v) What is 6? – Radius – Ulna
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
Incorrect • No, (1) is not the Anconeal Process. • Here are x-rays showing the Anconeal Process. • Try again! • Choose a new question. 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
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
Incorrect • No, (2) is not the Olecranon process. • Here are some x-rays showing the Olecranon process. Olecranon • Try again! • Choose a new question. 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. Coronoid Process • The Coronoid Process is labelled in these x-rays. • Try again! • Choose a new question. 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. Anconeal Process Olecranon Fossa
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. Ulna • Here are more x-rays of the Ulna. • Try (v)! • Choose a new question. Ulna
Incorrect • No, (5) is not the Radius • Here are some x-rays of the Radius. • Try again! • Choose a new question. Radius
Correct • Yes! (6) is the Radius! Radius – Remember: the Radius is the main weight bearing bone in the antebrachium • Here are more x-rays of the radius. • Try Dog Elbow Q 2! • Choose a new question. Radius
Incorrect • No, (6) is not the Ulna. • Here are some x-rays of the Ulna • Try again! • Choose a new question. Ulna
Dog Elbow Q 4 • (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. Coronoid Process • Here are other x-rays showing the Medial Coronoid Process. What can you say about the age of this animal? Answer. • Try (ii)! • Choose a new question. Coronoid Process
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.
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. Olecranon • Try (iii)! • Choose a new question. Olecranon
Incorrect • No, (8) is not the Anconeal process • These x-rays show the Anconeal process. • Try again! • Choose a new question. Anconeal process
Incorrect Head of Radius • 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
Correct • Yes! (12) is the Olecranon Fossa! • Here is another example. • Try Dog Carpus Q 1. • 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. 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.
Dog Carpus Q 5 • (i) What is 2? Hint: Is this a young or old dog? – 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.
Correct • Yes! (2) is the Distal Radial Epiphysis! • Here is another example. Distal Radial Epiphysis • Try (ii)! • Choose a new question.
Incorrect • No, (2) is not the Radial Carpal Bone • These x-rays show the Radial Carpal Bone. • Try again! • Choose a new question. Radial Carpal Bone
Correct • Yes! (4) is the Styloid Process of the Ulna! Styloid Process • Here are more examples. • Try (iii)! • Choose a new question. Styloid Process
Incorrect • No, (4) is not the Ulnar Carpal Bone. • These x-rays show the Ulnar Carpal Bone. • Try again! • Choose a new question. Ulnar Carpal Bone
Correct • Yes! (7) is the Accessory Carpal Bone! • Here are more examples. • Try (iv)! • Choose a new question. 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 question. Ulnar Carpal Bone
Correct • Yes! (10) is the 4 th Carpal Bone! • Here are more examples. • Try (v)! • Choose a new question. 4 th Carpal Bone
Incorrect • No, (10) is not the 2 nd Carpal Bone • The 2 nd Carpal Bone is labelled in these xrays. 2 • Try again! • Choose a new question. nd Carpal Bone
Answers • Try Dog Foot Q 1! • Choose a new question. • 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
Dog Foot Q 6 • (i) What is A? – Fifth Metacarpal Bone – Proximal Phalanx -1 st digit – Proximal Phalanx - 5 th digit • (ii) What are B? B A – Ungual Process – Proximal Palmar Sesamoids – Metacarpal pad • (iii) What is C? C – Metacarpo-phalangeal Joint – Distal Inter-phalangeal Joint – Proximal Inter-phalangeal Joint
Correct • Yes! (A) is the 5 th Metacarpal Bone! • Here is another example. 1 st digit – Remember: you can use the location of the 1 st 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. 5 th Metacarpal Bone
Incorrect • No, (A) is not the Proximal Phalanx – 1 st Digit. • These x-rays show the 1 st 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. 1 st Digit
Incorrect • No, (A) does not show the Proximal Phalanx – 5 th Digit • These x-rays show the Proximal Phalanx – 5 th 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 – 5 th 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 5 th 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 (1 st image) but can be seen more clearly in the lateral view (2 nd image). • Try again! • Choose a new question. Metacarpal pad
Correct • Yes! (C) is the Proximal Inter-phalangeal Joint. • Here are more examples, this time of the 5 th digit. • Look at the comparative section. • Choose a new question. Proximal Interphalangeal Joint
Incorrect • No, (C) is not the Middle Inter-phalangeal Joint. • These x-rays show Metacarpo-phalangeal Joints. • Try again! • Choose a new question. Metacarpophalangeal Joint
Incorrect • No, (C) is not the Distal Inter-phalangeal Joint. • These x-rays show the Distal Inter-phalangeal Joints. Distal Interphalangeal Joint • Try again! • Choose a new question. Distal Interphalangeal Joint
Cat Forelimb – Differences • Clavicle may be visible • Scapula – Suprahamate Process of Acromion • Humerus – Supracondyloid Foramen • Ulna & Radius – Square Olecranon • Horse Comparative. Clavicle Supracondyloid foramen
Horse Forelimb – Differences Foal – ulna fusing to radius. Navicular Bone 3 rd Digit bears weight. 2 nd & 4 th Metacarpals = splint bones Bones of carpus: Radial, Intermediate, Ulnar and Accessory 2 nd, 3 rd & 4 th • Ruminant Comparative.
Ruminant Forelimb - Differences Cartilage plate not visible in x -rays Supratrochlear Foramen present in sheep but not cattle. Metacarpals 3 & 4 fused Radius & Ulna complete Bones of Carpus: Radial, Intermediate, Ulnar & Accessory 2/3 fused (+)& 4 • Pig Comparative. + Digits 3&4 bear weight
Pig Forelimb - Differences * Large tuber on scapular spine (*) Back to the start. Radius & Ulna present and similar diameter. All carpal bones present: R/I/U/A 1/2/3/4 4 digits present: 3 & 4 bear weight.
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