1. Equine Forelimb Carpal and Shoulder Joints Paragraphs 187-188 February 24, 2000 Carpal and Shoulder Joints Paragraphs 187-188 February 24, 2000

2. Overview of February's Lecture Topics DatePPTopic Feb. 9: 112-120 Shoulder and arm region; brachial plexus Feb. 10: 121-127 Vessels and nerves of the upper limb; intro to lower limb nerves Feb. 15: 128-136 Metacarpal structures; digital vessels and nerves; major arterial route of forelimb Feb. 16: 137-142 Forelimb bones and joints Feb. 17: 143-150 Stay apparatus and forelimb muscles; diagnostic nerve blocks; hoof and foot Feb. 22: 151-166 Hoof and foot; digital vessels and nerves; ligaments and joints of the manus Feb. 23: 167-186 Digit and suspensory apparatus Feb. 24: 187-188 Carpal and shoulder joints

3. 3 Shoulder Joint “Collateral ligaments”“Collateral ligaments” –there are no true collateral ligaments –muscle insertions perform this function –1 major medial muscle - ? –2 lateral muscles - ? and ? Synovial structuresSynovial structures –shoulder joint sac –bicipital bursa (no communication with above) –infraspinatus bursa

4. 4 Bursae and Joint Sacs of the Shoulder and Elbow lateral view shoulder joint bicipital bursa subtendinous olecranon bursa subcutaneous elbow joint (blue) infraspinatus bursa (red)

5. 5 Carpal Ligaments ligaments of accessory carpal bone lateral collateral ligament medial collateral ligament dorsal intercarpal ligaments dorsal carpometacarpal ligaments lateraldorsal

6. 6 Carpus - Review Bones http://cal.vet.upenn.edu/larad/index.htmlhttp://cal.vet.upenn.edu/larad/index.html - radiology web site http://cal.vet.upenn.edu/larad/index.html

7. 7 Access to Carpal Joints (D553) lat. view

8. 8 Dorsopalmar Radiographs Film X-Rays Shadow “free edges” - those that appear on the edge of the shadow. Can resolve those surfaces individually.

9. 9 Break: Example Quiz Question This joint is inThis joint is in –extension –flexion –hyperextension T or F. Distension of the digital sheath may cause swelling in this area.T or F. Distension of the digital sheath may cause swelling in this area.

10. 10 Dorsopalmar Radiographs

11. Lateromedial Radiographs FilmFilm X-Rays “free edges” - those that appear on the edge of the shadow. Can resolve those surfaces individually.

12. Lateromedial Radiographs

13. 13 Oblique Radiographs X-rays enter the carpus on the dorsolateral or dorsomedial aspect of the carpus.X-rays enter the carpus on the dorsolateral or dorsomedial aspect of the carpus. The objective is to highlight particular bone surfaces that are not normally isolated with lateral or dorsopalmar views.The objective is to highlight particular bone surfaces that are not normally isolated with lateral or dorsopalmar views.

14. 14 DLPM-O Carpal Radiograph Dorsolateral Dorsomedial Palmarolateral Palmaromedial DLPM-O: x-ray beams directed from dorsolateral toward palmaromedial. Film Free edges seen on the film are the palmarolateral and dorsomedial edges. X-RaysX-Rays Note: accessory carpal and MCIV will be more easily visible in this view.

15. DLPM-O Carpal Radiograph Dorsomedial Palmarolateral Free edges seen on the film are the palmarolateral and dorsomedial edges. X-RaysX-Rays

16. 16 Example Quiz Question Name the view.Name the view. –Dorsolateral palmaromedial oblique This is the (dorsomedial, dorsolateral) surface of the carpus.This is the (dorsomedial, dorsolateral) surface of the carpus. –Dorsomedial surface This surface belongs to the (2 nd, 3 rd, 4 th ) carpal bone.This surface belongs to the (2 nd, 3 rd, 4 th ) carpal bone. –3 rd and 4 th (superimposed) Identify the bone.Identify the bone. –Second metacarpal

17. DLPM-O Carpal Radiograph palmarolateral aspect of carpus dorsomedial radial carpal ulnar carpal intermediatecarpal second carpal third carpal fourth carpal MC II MC III MC IV (not superimposed) accessory carpal (not superimposed)

18. 18 DMPL-O Carpal Radiograph Dorsolateral Dorsomedial Palmarolateral Palmaromedial DMPL-O: x-ray beams directed from dorsomedial toward palmarolateral. Film Free edges seen on the film are the dorsolateral and palmaromedial edges. X-Rays Note: accessory carpal is less easily observed in this view.

19. 19 DMPL-O Carpal Radiograph Dorsolateral Palmaromedial Film Free edges seen on the film are the dorsolateral and palmaromedial edges.

20. 20 DMPL-O Carpal Radiograph radial carpal ulnar carpal intermediatecarpal second carpal third carpal fourth carpal MC II MC III MC IV palmaromedial aspect of carpus dorsolateral accessorycarpal

21. 21 Happy Viewing!