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Terms in this set (80)
The anterior surface of the scapula is referred to as the:
costal surface.
Which of the following bones makes up the shoulder girdle?
(1) humerus
(2) scapula
(3) clavicle
2 & 3
Which term describes the medial end of the clavicle?
Sternal extremity
The area of the proximal humerus located directly below the tubercles, which is the site of many fractures, is called the
surgical neck
The large, rounded, elevated process prominently located on the lateral surface of the proximal humerus is the:
greater tubercle
The small, synovial fluid-filled sacs, which relieve pressure and reduce friction in joint tissues, are called:
bursae
The articulation between the glenoid cavity and head of the humerus is called the:
scapulohumeral joint
The scapulohumeral articulation is classified as a:
synovial joint, ball and socket type
In order to demonstrate the greater tubercle of the humerus on an AP projection of the shoulder, the epicondyles must be:
parallel with the plane of the IR
The respiration phase for an AP projection of the shoulder should be:
suspended
For an AP projection of the shoulder, the central ray should enter:
1 inch inferior to the coracoid process
For an AP projection of the shoulder with the arm in a neutral position, the epicondyles of the humerus should be:
45 degrees with the plane of the IR
For an AP projection of the shoulder with the humerus in internal rotation, the epicondyles of the humerus should be:
perpendicular to the plane of the IR
When the arm cannot be rotated or abducted due to injury, which of the following can be used to perform a lateral projection of the shoulder?
Transthoracic lateral projection, Lawrence
method
-projection 90 degrees from AP & shows relationship between proximal humerus & scapula
Where should the center of the IR be positioned for a lateral projection (Transthoracic) of the shoulder?
surgical neck
If the patient cannot elevate the unaffected shoulder for a transthoracic lateral projection of the shoulder, the central ray should be angled:
10 to 15 degrees
How far should the arm be abducted for an inferosuperior projection of the shoulder joint?
90 degrees
Which of the following are clearly demonstrated on the inferosuperior axial projection of the shoulder joint?
(1) proximal humerus
(2) scapulohumeral joint
(3) acromioclavicular articulation
all?
The PA oblique projection of the shoulder joint (scapular Y) is performed in which of the following positions?
RAO or LAO
PA oblique projection of the shoulder (scapular Y) is performed to evaluate:
dislocations
For the PA oblique projection (scapular Y) of the shoulder, the body is rotated so that the midcoronal plane is how many degrees from the IR?
45 to 60 degrees
Which of the following projections clearly demonstrates the glenoid cavity?
AP oblique (Grashey)
How many degrees is the body rotated for the AP oblique projection (Grashey method) of the shoulder joint?
35 to 45 degrees toward the affected side
Two exposures are commonly made of the AC joints—one without weights and one with weights. How are the weights applied?
affixed to the wrists
In an image of an AP axial projection of the clavicle, the clavicle should be demonstrated with:
(1) most of the clavicle projected above the ribs
(2) only the lateral end superimposing the coracoid process
(3) only the medial end superimposing the first or second ribs
1 & 3
To obtain a more uniform image density, the respiration phase for the AP projection of the clavicle should be:
suspended respiration [expiration]
?
In order to elevate the clavicle above the ribs and scapula for the AP axial projection, the phase of respiration should be:
Full inspiration [suspend after]
?
The central-ray angle for an AP axial projection of the clavicle when performed on a patient in the supine position is:
15 to 30 degrees
When the patient is positioned properly for a lateral projection of the scapula, the body of the scapula will be:
perpendicular?
Shoulder gridle is made by & it's function
-by 2 bones
1. clavicle
2. Scapula
3. proximal humerus?
-functions to connect upper limb to trunk
What is not apart of the shoulder gridle?
-the humerus, it is the upper limb
Clavicle
-long bone
-lies in horizontal oblique plane just above the 1st rib
-forms the anterior part of shoulder gridle
-serves as a fulcrum for movement of arm
-double curves for strength
Lateral aspect of clavicle?
-acromial extremity
-articulates with acromion of
scapula
Medial Aspect of clavicle
-sternal extremity
-articulates with manubruim of sternum & 1st costal cartilage
Scapula
-flat bone
-forms posterior shoulder gridle
-triangular shape
-2 surfaces, 3 borders, 3 angles
-between 2 & 7 rib
Medial border of scapula
-runs parallel with vertebral column
-
Flat aspect of scapula lies how many degrees in relation to anatomic position?
45 to 60 degrees
Costal [anterior] surface of scapula
-slightly concaved & subscapular fossa
-subscapularis muscle
dorsal [posterior] surface of scapula
-divided into 2 portions by spinous process
-upper portion above spine is supraspinous fossa
-bottom portion: below spine is insupraspinous fossa
Crest of the spine
-superior third of medial border
Acromion
-
Superior border of scapula
-superior angle of coracoid process & its lateral end has deep depression scapular notch
Medial border Scapula
-superior to inferior angles
Lateral border Scapula
-from glenoid cavity to inferior angle
Superior angle scapula
-formed by superior & medial borders
Inferior angle scapula
-formed by medial and lateral borders
-level of 7th rib
Lateral angle scapula
-thickest part of body
-ends in shallow oval depression glenoid cavity
Glenoid cavity
...
What is common positioning landmarks for shoulder?
-acromion
-coracoid process
-superior/inferior angle
Proximal end of humerus
-head, anatomic neck, 2 prominent process [greater/lesser tubercles], and surgical neck
What is below the tubercles on the humerus?
-surgical neck
-site of many fractures
Lesser tubercle
-anterior surface of humerus
-right below anatomic neck
Greater tubercle
-lateral surface of bone
-separated by lesser by intertubercular groove
bursae
-small synovial fluid filled sacs that relieve pressure & reduce friction
-largest in shoulder: subacromial bursa
Scapulohumeral joint
-AKA glenohumeral joint
-synovial ball & socket
-allow movement in all directions
-concerned with insertion points of short rotator cuff muscles
-any rotation of hand will cause joint to rotate
Acromioclavicular joint
-AC articulation
-between acromion of scapula & acromial extremity of clavicle
-forms synovial gliding joint
-movement: gliding & rotary [elevation, depression, protraction, & retraction]
-normally displaces acromion downward
Sternoclavicular joint
-SC articulation
-sternal extremity of clavicle &
manubrium & first rib cartilage
-only attachment with upper limb & trunk
-synovial double gliding joint
-movement: circumduction, elevation, depression, forward & backwards movement
-has fibocartilaginous disk
AP shoulder? [external, internal, neutral]
-shoulder joint to center of IR
-CR: Perpendicular to 1 inch inferior to coracoid process
-Criteria: superior
scapula, clavicle, proximal humerus
-Shows: scapulohumeral joint
-Respiration: suspended
-Sheild
AP shoulder ? [external rotation]
-supinate hand
-abduct slightly & rotate so epicondyles are parallel
-puts entire humerus & shoulder in true anatomic position
-Shown: greater tubercle
-Criteria: humerus head in profile, greater tubercle profile
laterally,
AP humerus [neutral]
-epicondyles at 45 angle to IR
-Shown: posterior part of supraspinatous insertion which sometimes shows profiles of small calcific deposits
-greater tubercle partially superimposed on humeral head
-humeral head in partial profile
-
AP humerus [internal rotation]
-flex elbow &
rotate arm internal
-epicondyles are perpendicular
-Shown: proximal humerus in true lateral
-Criteria: lesser tubercle in profile & pointing medially
-outline of greater tubercle superimposed humeral head
-greater amount of overlap of humerus over glenoid cavity
AP oblique projection [glenoid cavity] [grashey method]
-PT in RPO or LPO
-rotate body 35 to 45
degrees toward affected side to make scapula parallel
-CR: 2 inches medial & 2 inches inferior to superolateral border of shoulder
-Shown: joint space between humeral head & glenoid cavity [glenohumeral joint]
-Criteria: glenoid cavity in profile, open joint space
Transthoracic Lateral projection Shoulder [Lawerence]
-Right or left
-grid
-rise noninjured arm which
drops the affected side to stop superimposition
-Center IR to surgical neck of affected humerus
-Shield
-Respiration: full inspiration [improves contrast & decrease tech]
-epicondyles perpendicular?
Transthoracic Lateral projection shoulder [Lawerence] CR, shown, criteria
-CR: perpendicular to IR, entering midcoronal plane at surgical neck
-if can't rise unaffected arm
angle 15 degree cephalad
-shoulder & proximal shoulder thru thorax
-Criteria: proximal humerus, scapula, clavicle, humerus,
-scapula superimposed over spine, and unaffected projected above shoulder closest to IR
Shoulder joint [inferosuperior axial projection] lawerence method
-abduct arm of affected at 90 degrees but at least 20
-humerus external rotation
-turn pt head away
from side being x-rayed
-CR: horizontal thru axilla with angle of 15 to 30 [greater abduction = greater angle]
-IR in vertically & in contact with affected side
Shoulder joint [inferosuperior axial projection] lawerence method {shown, criteria}
-SHOWS: proximal humerus, scapulohumeral joint, lateral portion of coracoid process & AC joint, greater & lesser tubercles?
-CRITERIA:
scapulohumeral joint with slight overlap, coracoid process pointing anteriorly, lesser tubercle in profile & pointing anteriorly, AC joint, acromion
Shoulder Y [PA oblique projection]
-RAO or LAO
-useful to see suspected shoulder dislocation
-lengthwise IR
-anterior surface of affected side against IR
-midcoronal plane forms angle 45 to 60
-Shield
-Suspend
respiration
-CR:perpendicular to scapulohumeral joint
Shoulder Y [shown, criteria]
-SHOWN: humeral head directly superimposed over junction of the Y
-Criteria: humeral head & glenoid cavity superimposed
-humeral shaft & scapular body superimposed
-acromion projected laterally
-scapula in lateral profile with lateral & vertebral border superimposed
Anterior dislocation shown on Y
-subcoracoid dislocation
-humeral head below coracoid process
-do comprassion to AP
-head of humerus in ribs
Posterior dislocation of shoulder
-shown in Y
-subacrominal
-below acromion
-Do a comprassion to AP
AC joints AP projection
-bilateral exam
-SID 72
-weight equal on each foot
-2 exposures: 1 with weights [5 to 10 pounds] & 1 without
-shield & use thyroid shield
-CR: perpendicular midline of body at level of AC joints
AC joints AP projection [SHOWN, CRITERIA]
-SHOWN: AC joints and if there is any dislocation, separation, and function of joints
-Criteria: AC joints both with & without
weights [on 1 image each]
-no rotation or leaning
-right & left & with weight & without weight markers
AP clavicle
-Crosswise 10 x 12
-Shield
-Respiration: suspend at end of exhalation for more even density
-CR: perpendicular to midshaft of clavicle
AP clavicle [shown, criteria]
-shows
frontal image of clavicle
-CRITERIA: entire clavicle & center
-lateral half above scapula & medial superimposed the thorax
AP axial Clavicle
-crosswise 10 x 12
-shield
-repsiration: suspend at end of full inspiration to elevate & angle clavicle more
-15 to 30 degree angle on tube
-
AP axial clavicle [shows, criteria]
-shows: axial image of clavicle above ribs
-CRITERIA: most of clavicle above ribs & scapula with medial end overlapping 1 or 2 rib
-clavicle horizontal
-entire clavicle with AC & SC joints
-Clavicle above apices
AP scapula
-10 x 12 lengthwise
-abduct arm to 90 degrees to make scapula lateral
-respiration: during
slow breathing to blur out lung markings [clinic suspend]
-CR: perpendicular to midscapular area at a point approx. 2 inches inferior to coracoid process
AP scapula [shows, criteria]
-Shows AP scapula
-CRITERIA: Lateral border free of superimposition of ribs
-scapula horizontal
-acromion & inferior angle
Lateral scapula
-RAO or LAO on affected side
-45 to 60 angle of body causing scapula to perpendicular to IR
-Respiration: suspend
-CR: midmedial border of the protruding scapula
Lateral scapula [shows, criteria]
-SHOWS: lateral scapula
-CRITERIA: lateral & medial border of scapula superimposed
-no superimpositon of humerus
-no
superimposition of scapula on ribs
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