What would be the required patient position to demonstrate left shoulder using AP Oblique (Grashey method)?
35-45 degrees LPO
Which projection of the shoulder joint requires the patient to be rotated until the midcoronal plane forms an angle of 45-60 degress with the plane of the IR?
PA Oblique (Scapular Y)
In which body position should the patient be placed the demonstrate the left shoulder with the PA Oblique (Scapular Y)?
(Lateral Scapula) The __________process and _________angle should be demonstrated
acromion; inferior
(Lateral Scapula) Images should demonstrate which borders superimposed?
lateral and medial
(PA Scapular Y) CR Placement
crest of spine, exiting scapulohumeral joint
(Lateral Scapula) CR placement
perpendicular to midmedial border of protruding scapula
(Lateral Scapula) What is the arm placement when you wish to demonstrate the acromion and corocoid
place arm on upper chest grasping opposite shoulder
(Lateral Scapula) When the arm is placed over the head, which area of the scapula is of interest?
The Body
(AP Scapula) Images should demonstrate the acromion process and the ___________angle
inferior
T or F (AP Scapula) Images should demonstrate the area of the scapula, including glenoid cavity and coracoid process with superimposition of the ribs
True
(AP Scapula) Which scapular border should be seen free from superimposition with the ribs?
lateral border
(AP Scapula) Breathing instructions
slow breathing
(AP Scapula) CR placement
Perpendicular to a point 2" inferior to coracoid
(PA Axial clavicle) CR angulation
15-30 degrees caudad
(AP axial clavicle) CR angulation
15-30 degrees cephalad
(AP or PA Axial clavicle) What CR angle should you use on a thinner patient in a supine position
30 degrees. less for a heavier patient
(AP or PA clavicle) Evaluation: Lateral half of clavicle above scapula, with the medial half superimposing thorax at which ribs?
between 3-5
(AP or PA Axial clavicle) Most of clavicle projected above ribs and scapula with the medial end overapping which ribs?
first or second
(AP or PA Axial clavicle) breathing instructions
Suspend at end of full inspiration to further elevate angle of clavicle
(AP or PA Axial clavicle) What angle should the CR be directed?
0-15 supine, 15-30 prone
(AP Oblique - Grashey) How should the joint space appear?
open between humeral head and glenoid cavity
(AP Oblique - Grashey) What should be in profile?
Glenoid cavity
(PA Scapular Y) If humeral head is displayed below acromion, then what type of dislocation is evident?
posterior dislocation
(PA Scapular Y) Humeral head in profile at Y. If humeral head is below coracoid process, then what type of dislocation is present?
Anterior dislocation
(PA Scapular Y) Evalution criteria
1. Acromion seen laterally and free of superimposition 2. Coracoid process superimposed on or slightly below clavicle
T or F (PA Scapular Y) Scapular body should overlap thorax
False
T or F (AP or PA clavicle) Should demonstrate the entire clavicles free from superimposition with other bony structures
False
(AP or PA clavicle) Which projection shows best recorded detail?
PA better because of reduced OID
(AP or PA clavicle) Breathing instructions
suspend at end of exhalation
(AP Oblique - Grashey) What is the proper arm position ?
abducted with slight internal rotation
(AP Oblique - Grashey) The scapula should be perpendicular or parallel to the IR
parallel
(AP Oblique - Grashey) What is the correct amount of obliquity towards the affected side?
35-45 degrees
(PA Scapular Y) With reference to the thorax, where should the scapular body be demonstrated in the image of the PA oblique projection?
along the lateral aspect, but not superimposed
How much body rotation is necessary for PA Scapular Y?
45-60 degrees
(PA Scapular Y) Breathing instructions
suspend
T or F (PA Scapular Y) In an image of a normal shoulder, the humeral head should be directly superimposed over junction of scapular Y
True
T or F (PA Scapular Y) The patient should be slightly rotated to the place the affected shoulder in contact with the IR
True
T or F (inferosuperior axial) The AC joint, acromion and acromial end of clavicle should be seen through the humeral head
True
T or F (inferosuperior axial) The lesser tubercle should be in profile pointing anteriorly
True
T or F (inferosuperior axial) The scuplohumeral joint should be seen slightly overlapping
True
T or F (inferosuperior axial) - the greater tubercle should be seen in profile
False
T or F (inferosuperior axial) - the coracoid should be seen pointing anteriorly
True
(Inferosuperior axial) - what positioning factor determines how many degree the CR should be directed medially?
greater abduction-- greater angle (If patient can abduct 90 degrees then CR is at 30 degrees)
(Inferosuperior axial) - how many degress should the CR be directed in the medial direction
15-30 degrees
(Inferosuperior axial) - Into which rotational position should the humerus be placed
external
T or F (inferosuperior axial) When using a horizontally directed CR, the patient should be placed in a supine body position
True
T or F (inferosuperior axial) When the patient is recumbent, the head and upper torso should be elevated 3 inches
True
T or F (inferosuperior axial projection) When the patient is recumbent, the IR should be placed in the bucky tray
False
(Transthoracic Lateral projection) How many degrees and in which direction should the CR be directed if it cannot be directed perpendicular to IR because patient cannot elevate uneffected shoulder
10-15 degrees cephalad
which change in techical factors should be used to aid the blurring of lung detail by the action of the heart when the patient is able to hold his or her breath for a sustained period?
Use low mA/long exposure time combination with the usual mAs factor
the transthoracic lateral projection may be performed with patient upright or_______
supine
Which projection of the shoulder shows the outline of the lesser tubercle between the humeral head and greater tubercle in?
AP neutral rotation
Which projection of the shoulder shows the lesser tubercle in profile?
AP - Internal rotation
Which projection of the shoulder shows the greater tubercle in profile?
AP - External rotation
Which positioning maneuver puts the humeral epicondyles perpendicular to the IR
AP - Internal rotation
Which positioning maneuver puts the humeral epicondyles at 45 degrees to the IR
AP neutral rotation
Which positioning maneuver puts the humeral epicondyles parallel to the IR
AP - External rotation
For AP projections for the shoulder the patient's respiration should be__________?
suspended
Where should the central ray be be directed in AP Shoulder projection
perpendicular to a point 1" inferior to coracoid process
What type (functional) of joint are the joints of the shoulder girdle
AC - gliding, SC - double gliding, SH - ball and socket
what type of movement do the articulations of the shoulder girdle have?
freely moveable (Synovial)
how many articulations does the shoulder girdle have?
3 --- SC, AC, SH joints
Large depression on the costal surface
subscapular fossa
small synovial fluid filled sacs that relieve pressure and reduce friction in tissue are called______?
bursae
what bone forms the anterior part of the shoulder girdle
clavicle
How many surfaces, borders and angles does scapula have?
Surfaces 2, Borders 3, Angles 3
chronic systemic inflammatory collagen disease
Rheumatoid arthritis
malignant tumor arising from cartilage cells
chrondrosarcoma
increased density of atypically soft bone
Osteopetrosis
form of arthritis marked by progressive cartilage deterioration in synovial joints and vertebrae
Osteoarthritis
transfer of a cancerous region from one area to another
metastases
New tissue growth where cell proliferation is uncontrolled
tumor
Which gender of adults has more sharply curved clavicles?
Males
What type of joints are the SC and AC joints?
Gliding
What classificatio of joint are the SC and AC joints?
Synovial
At what level of the clavicle (in reference to the ribs)
horizontal oblique plane just above 1st rib
What classification of bone is clavicle?
Long Bone
clavicle articulates with what structures?
Manubrium of sternum(SC) and acromion of scapula (AC)
medial end of clavicle
sternal
lateral end of clavicle
acromial
bone classification for scapula
flat
what is the name of the ridge of the scapular spine
crest
scapularhumoral joint is what type
ball and socket
deep depression of humerus that seperates the two tubercles
intertubecular groove
bony process on the lateral surface of the humerus
greater tubercle
bony process on the anterior surface of shaft of humerus, inferior from the anatomic neck
lesser tubercle
narrow constriction of humerus superior to tubercles
anatomic neck
constriction of shaft inferior to tubercles of humerus
surgical neck
large rounded eminence of humerus that articulates with glenoid cavity
humoral head
large broad area below spine on dorsal surface
infraspinous fossa
area above the scapular spine on dorsal surface
supraspinous fossa
large depression on the costal surface
subscapular fossa
slender, fingerlike projection extending anteriorly and laterally from near the lateral angle
Coracoid process
extends from the superior angle to coracoid process
Superior border
extends from the glenoid cavity to the inferior angle
lateral border
the junction at the medial and superior borders
Superior angle
The junction at the lateral and medial borders
Inferior Angle
Lage fossa at lateral angle
Glenoid cavity
Extends from the superior angle to the inferior angle
