Forelimb Imaging Quiz

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.


Infraspinous Fossa

Correct

• Yes! (B) is the Acromion process!


• 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.


Ventral Angle

Incorrect

• No, (B) is not the Scapular spine.

• This x-ray shows the Scapular spine.


Spine

Correct

• Yes! (C) is the Supraglenoid Tubercle!


• 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.


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.


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.


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

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.


Neck of Humerus

Neck of Humerus

Incorrect

• No, (7) is not the Greater Tubercle.

• The Greater Tubercle is shown here.


Greater Tubercle

Greater Tubercle

Correct

• Yes! (8) is the Greater Tubercle!


• 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.


Head of Humerus

Head of Humerus

Incorrect

• No, (8) is not the Intertubercular Groove.

• The Intertubercular Groove is shown here.


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


Olecranon

Olecranon

Incorrect

• No, (1) is not the Anconeal Process.

• Here are x-rays showing the Anconeal Process .


Anconeal Process

Anconeal Process

Incorrect

• No, (1) is not the Medial Coronoid Process.

• These x-rays show the Medial Coronoid Process.


Coronoid Process

Coronoid Process

Correct • Well done! (2) is the

Anconeal Process!– Remember: the Anconeal

Process articulates with the Olecranon Fossa of the Humerus



Anconeal Process

Anconeal Process

Incorrect

• No, (2) is not the Olecranon process.

• Here are some x-rays showing the Olecranon process.


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.


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.


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.


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.


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.


Medial Epicondyle

Incorrect

• No, (7) is not the Lateral Epicondyle.

• This x-ray shows the Lateral Epicondyle.


Lateral Epicondyle

Correct

• Yes! (8) is the Olecranon process!



Olecranon

Olecranon

Incorrect

• No, (8) is not the Anconeal process.

• These x-rays show the Anconeal process.


Anconeal process

Anconeal process

Incorrect

• No, (8) is not the Head of the Radius.

• These x-rays show the Head of the Radius.


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.


Distal humeral growth plate

Incorrect • No, (12) is not the

Supracondyloid Foramen.

• Remember: this is only found in the cat!


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!


• Try (ii)!

• Choose a new question.

Distal Radial Epiphysis


Radial Carpal Bone.

• These x-rays show the Radial Carpal Bone.


on.

Radial Carpal Bone

Radial Carpal Bone

Correct • Yes! (4) is the Styloid

Process of the Ulna!


• 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!


• Try (iv)!• Choose a new questi

on.

Accessory Carpal Bone

Accessory Carpal Bone


Ulnar Carpal Bone.

• These x-rays show the Ulnar Carpal Bone.


on.

Ulnar Carpal Bone

Ulnar Carpal Bone

Correct

• Yes! (10) is the 4th Carpal Bone!


• 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.


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!


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!


– 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!


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!


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


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


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


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).


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.


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.


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.


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.

*

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Forelimb Imaging Quiz