Transcript No Slide Title

Equine Forelimb
Carpal and Shoulder Joints
Paragraphs 187-188
February 24, 2000
Overview of February's Lecture Topics
Date
PP
Topic
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
Shoulder Joint
• “Collateral ligaments”
– there are no true collateral ligaments
– muscle insertions perform this function
– 1 major medial muscle - ?
– 2 lateral muscles - ? and ?
• Synovial structures
– shoulder joint sac
– bicipital bursa (no communication with above)
– infraspinatus bursa
3
Bursae and Joint Sacs of the
Shoulder and Elbow
shoulder joint
infraspinatus bursa
(red)
subtendinous
olecranon bursa
bicipital bursa
subcutaneous
olecranon bursa
elbow joint
(blue)
4
lateral view
Carpal Ligaments
lateral
dorsal
lateral collateral
ligament
medial collateral
ligament
ligaments of
accessory carpal
bone
dorsal intercarpal
ligaments
dorsal
carpometacarpal ligaments
5
Carpus - Review Bones
http://cal.vet.upenn.edu/larad/index.html - radiology web site
6
Access to Carpal
Joints (D553)
lat.
7
view
Dorsopalmar Radiographs
X-Rays
“free edges” those that appear
on the edge of the
shadow. Can
resolve those
surfaces
individually.
Film
Shadow
8
Break: Example Quiz Question
• This joint is in
– extension
– flexion
– hyperextension
• T or F.
Distension of
the digital
sheath may
cause swelling
in this area.
9
Dorsopalmar Radiographs
10
Lateromedial Radiographs
X-Rays
Film
“free edges” those that appear
on the edge of the
shadow. Can
resolve those
surfaces
individually.
Lateromedial Radiographs
Oblique Radiographs
• 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.
13
DLPM-O Carpal Radiograph
X-Rays
Dorsolateral
Palmarolateral
Film
DLPM-O: x-ray beams directed from
dorsolateral toward palmaromedial.
Note: accessory carpal and MCIV
will be more easily visible in this
view.
Dorsomedial
Palmaromedial
Free edges seen on the
film are the palmarolateral
and dorsomedial edges.
14
DLPM-O Carpal
Radiograph
X-Rays
Dorsomedial
Palmarolateral
Free edges seen on the
film are the palmarolateral
and dorsomedial edges.
Example Quiz Question
• Name the view.
– Dorsolateral
palmaromedial oblique
• This is the
(dorsomedial,
dorsolateral) surface of
the carpus.
– Dorsomedial surface
• This surface belongs to
the (2nd, 3rd, 4th) carpal
bone.
– 3rd and 4th
(superimposed)
• Identify the bone.
– Second metacarpal
16
DLPM-O Carpal Radiograph
dorsomedial
aspect of carpus
intermediate
carpal
palmarolateral
aspect of carpus
accessory
carpal (not
superimposed)
ulnar carpal
radial carpal
second carpal
third carpal
MC II
MC III
fourth carpal
MC IV
(not
superimposed)
DMPL-O Carpal Radiograph
DMPL-O: x-ray beams directed
from dorsomedial toward
palmarolateral.
Dorsolateral
X-Rays
Dorsomedial
Note: accessory carpal
is less easily observed in
this view.
Palmarolateral
Free edges seen on the film
are the dorsolateral and
palmaromedial edges.
Palmaromedial
Film
18
DMPL-O Carpal Radiograph
Free edges seen on the film
are the dorsolateral and
palmaromedial edges.
Dorsolateral
Palmaromedial
Film
19
DMPL-O Carpal Radiograph
palmaromedial
aspect of carpus
accessory
carpal
radial carpal
dorsolateral
aspect of carpus
intermediate
carpal
ulnar carpal
second carpal
third carpal
fourth carpal
MC II
MC IV
MC III
20
Happy Viewing!
21