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Forelimb Imaging Quiz Developed by: Sorcha McCaughley & Mark Brims Approved by: Alison King & Maureen Bain Supported by: The Chancellor’s Fund.

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Presentation on theme: "Forelimb Imaging Quiz Developed by: Sorcha McCaughley & Mark Brims Approved by: Alison King & Maureen Bain Supported by: The Chancellor’s Fund."— Presentation transcript:

1 Forelimb Imaging Quiz Developed by: Sorcha McCaughley & Mark Brims Approved by: Alison King & Maureen Bain Supported by: The Chancellor’s Fund

2 Forelimb Imaging Quiz START! Developed by: Sorcha McCaughley & Mark Brims Supported by: The Chancellor’s Fund

3 Set the scene… Radiography is an essential part of the veterinary diagnostic process. Let’s walk through the basics of the normal Dog Forelimb. Dog Forelimb Don’t forget the other animals – at the end you should look at the comparative species x-rays!comparative species

4 Dog Forelimb Choose a question: –Shoulder (Q1)Shoulder (Q1) –Shoulder (Q2)Shoulder (Q2) –Elbow (Q3)Elbow (Q3) –Elbow (Q4)Elbow (Q4) –Carpus (Q5)Carpus (Q5) –Foot (Q6)Foot (Q6) Comparative Forelimb Choose a species: –CatCat –HorseHorse –RuminantRuminant –PigPig

5 Dog Shoulder Q1 (i) What is A? –Cranial BorderCranial Border –Scapular spineScapular spine –Infraspinous fossaInfraspinous fossa (ii) What is B? –Scapular spineScapular spine –Acromion processAcromion process –Ventral angleVentral angle (iii) What is C? –Acromion processAcromion process –Glenoid cavityGlenoid cavity –Supraglenoid tubercleSupraglenoid tubercle A C B

6 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

7 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!

8  Incorrect  No, (A) is not the Cranial Border. The cranial border is labelled here. Try again! Choose a new question. Cranial border

9  Incorrect  No, (A) is not the Infraspinous Fossa. The Infraspinous Fossa is labelled here. Try again! Choose a new question. Infraspinous Fossa

10 Correct Yes! (B) is the Acromion process! Here are some more examples. Try (iii)! Choose a new question. Acromion Can you tell which dog is older? Answer.

11 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

12  Incorrect  No, (B) is not the Ventral Angle. This x-ray shows the Ventral Angle. Try again! Choose a new question. Ventral Angle

13  Incorrect  No, (B) is not the Scapular spine. This x-ray shows the Scapular spine. Try again! Choose a new question. Spine

14 Correct Yes! (C) is the Supraglenoid Tubercle! Here are some more examples. Try Dog Shoulder Q2. Choose a new question. Supraglenoid Tubercle Growth Plate

15  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

16  Incorrect  No, (C) is not the Glenoid cavity. The Glenoid cavity is labelled in this x-ray. Try again! Choose a new question.Choose a new question. Glenoid cavity

17 Dog Shoulder Q2 (i) What is 6? –Caudal angleCaudal angle –Shoulder joint spaceShoulder joint space –Intertubercular grooveIntertubercular groove (ii) What is 7? –Head of HumerusHead of Humerus –Neck of HumerusNeck of Humerus –Greater TubercleGreater Tubercle (iii) What is 8? –Head of HumerusHead of Humerus –Greater TubercleGreater Tubercle –Intertubercular GrooveIntertubercular Groove (iv) Do you know what B is? Answer.Answer. B

18 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

19  Incorrect  No, (6) is not the Caudal Angle. These x-rays show the Caudal Angle. Try again! Choose a new question. Caudal Angle

20  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

21 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

22  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

23  Incorrect  No, (7) is not the Greater Tubercle. The Greater Tubercle is shown here. Try again! Choose a new question. Greater Tubercle

24 Correct Yes! (8) is the Greater Tubercle! Here are some more examples. Try (iv)! Choose a new question. Greater Tubercle

25  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

26  Incorrect  No, (8) is not the Intertubercular Groove. The Intertubercular Groove is shown here. Try again! Choose a new question. Intertubercular Groove

27 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

28 Dog Elbow Q3 (i) What is 1? –Anconeal ProcessAnconeal Process –Olecranon ProcessOlecranon Process –Medial Coronoid ProcessMedial Coronoid Process (ii) What is 2? –Olecranon ProcessOlecranon Process –Medial Coronoid ProcessMedial Coronoid Process –Anconeal ProcessAnconeal Process (iii) Structure 2 articulates with which part of 7? –Olecranon FossaOlecranon Fossa –Supracondyloid ForamenSupracondyloid Foramen (iv) What is 5? –RadiusRadius –UlnaUlna (v) What is 6? –RadiusRadius –UlnaUlna 7 5 6

29 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

30  Incorrect  No, (1) is not the Anconeal Process. Here are x-rays showing the Anconeal Process. Try again! Choose a new question. Anconeal Process

31  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

32 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

33  Incorrect  No, (2) is not the Olecranon process. Here are some x-rays showing the Olecranon process. Try again! Choose a new question. Olecranon

34  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

35 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

36  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

37 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

38  Incorrect  No, (5) is not the Radius. Here are some x-rays of the Radius. Try again! Choose a new question. Radius

39 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

40  Incorrect  No, (6) is not the Ulna. Here are some x-rays of the Ulna. Try again! Choose a new question. Ulna

41 Dog Elbow Q4 (i) What is 7? –Medial Coronoid ProcessMedial Coronoid Process –Medial EpicondyleMedial Epicondyle –Lateral EpicondyleLateral Epicondyle (ii) What is 8? –Anconeal processAnconeal process –Olecranon processOlecranon process –Head of RadiusHead of Radius (iii) What is 12? –Distal humeral growth plateDistal humeral growth plate –Supracondyloid ForamenSupracondyloid Foramen –Olecranon FossaOlecranon Fossa

42 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 What can you say about the age of this animal? Answer.

43 Answer This is a young dog! Notice the growth plates – they are particularly obvious at the proximal end of the radius. Go Back!

44  Incorrect  No, (7) is not the Medial Epicondyle. This x-ray shows the Medial Epicondyle. Try again! Choose a new question. Medial Epicondyle

45  Incorrect  No, (7) is not the Lateral Epicondyle. This x-ray shows the Lateral Epicondyle. Try again! Choose a new question. Lateral Epicondyle

46 Correct Yes! (8) is the Olecranon process! Here are more examples. Try (iii)! Choose a new question. Olecranon

47  Incorrect  No, (8) is not the Anconeal process. These x-rays show the Anconeal process. Try again! Choose a new question. Anconeal process

48  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

49 Correct Yes! (12) is the Olecranon Fossa! Here is another example. Try Dog Carpus Q1. Choose a new question. Olecranon Fossa

50  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

51  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

52 Dog Carpus Q5 (i) What is 2? –Radial Carpal BoneRadial Carpal Bone –Distal Radial EpiphysisDistal Radial Epiphysis (ii) What is 4? –Styloid Process of UlnaStyloid Process of Ulna –Ulnar Carpal BoneUlnar Carpal Bone (iii) What is 7? –Ulnar Carpal BoneUlnar Carpal Bone –Accessory Carpal BoneAccessory Carpal Bone (iv) What is 10? –Second Carpal BoneSecond Carpal Bone –Fourth Carpal BoneFourth Carpal Bone (v) Do you know the others now? –Answers.Answers Hint: Is this a young or old dog?

53 Correct Yes! (2) is the Distal Radial Epiphysis! Here is another example. Try (ii)! Choose a new question. Distal Radial Epiphysis

54  Incorrect  No, (2) is not the Radial Carpal Bone. These x-rays show the Radial Carpal Bone. Try again! Choose a new question.Choose a new question. Radial Carpal Bone

55 Correct Yes! (4) is the Styloid Process of the Ulna! Here are more examples. Try (iii)! Choose a new question.Choose a new question. Styloid Process

56  Incorrect  No, (4) is not the Ulnar Carpal Bone. These x-rays show the Ulnar Carpal Bone. Try again! Choose a new question.Choose a new question. Ulnar Carpal Bone

57 Correct Yes! (7) is the Accessory Carpal Bone! Here are more examples. Try (iv)! Choose a new question.Choose a new question. Accessory Carpal Bone

58  Incorrect  No, (7) is not the Ulnar Carpal Bone. These x-rays show the Ulnar Carpal Bone. Try again! Choose a new question.Choose a new question. Ulnar Carpal Bone

59 Correct Yes! (10) is the 4 th Carpal Bone! Here are more examples. Try (v)! Choose a new question.Choose a new question. 4 th Carpal Bone

60  Incorrect  No, (10) is not the 2 nd Carpal Bone. The 2 nd Carpal Bone is labelled in these x- rays. Try again! Choose a new question.Choose a new question. 2 nd Carpal Bone

61 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.

62 Dog Foot Q6 (i) What is A? –Fifth Metacarpal BoneFifth Metacarpal Bone –Proximal Phalanx -1 st digitProximal Phalanx -1 st digit –Proximal Phalanx - 5 th digitProximal Phalanx - 5 th digit (ii) What are B? –Ungual ProcessUngual Process –Proximal Palmar SesamoidsProximal Palmar Sesamoids –Metacarpal padMetacarpal pad (iii) What is C? –Metacarpo-phalangeal JointMetacarpo-phalangeal Joint –Distal Inter-phalangeal JointDistal Inter-phalangeal Joint –Proximal Inter-phalangeal JointProximal Inter-phalangeal Joint A B C

63 Correct Yes! (A) is the 5 th Metacarpal Bone! Here is another example. –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 1 st digit

64  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

65  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 Proximal Phalanx – 5 th Digit *

66 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

67  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

68  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

69 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.Look at the comparative section. Choose a new question. Proximal Inter- phalangeal Joint

70  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

71  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

72 Cat Forelimb – Differences Clavicle may be visible Scapula –Suprahamate Process of Acromion Humerus –Supracondyloid Foramen Ulna & Radius –Square Olecranon Clavicle Horse Comparative. Supracondyloid foramen

73 Horse Forelimb – Differences Foal – ulna fusing to radius. Ruminant Comparative. Bones of carpus: Radial, Intermediate, Ulnar and Accessory 2 nd, 3 rd & 4 th 3 rd Digit bears weight. 2 nd & 4 th Metacarpals = splint bones Navicular Bone

74 Ruminant Forelimb - Differences Radius & Ulna complete Bones of Carpus: Radial, Intermediate, Ulnar & Accessory 2/3 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. +

75 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 / 4 4 digits present: 3 & 4 bear weight. Back to the start. *


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