What consists of the shoulder girdle?
What are the articulations of the shoulder girdle?
1) head of humerus (shoulder joint) 2) manibrum of sternum (sternoclavicular joint;SC) 3) aceomioclavicular joint; AC
What are the shoulder projections?
1) AP external 2) AP internal 3) AP neutral 4) AP oblique (Grashey) 5) PA oblique (scapular Y) 6) Transthoracic lateral (Lawrence method) 7) Inferosuperior Axial (Lawrence, Axillary)
Where is the central ray for an AP external view for shoulder?
1in inferior to coracoid process
What are the structures shown for the AP external roster on for shoulder view?
Numeral headGreater tubercle!!Entire shoulder joint Glenoid cavity
Where are the humoral epicondyles for the AP external rotation for the shoulder?
For the AP neutral rotation for the shoulder, where is the CR?
Same as AP external, 1in inferior to Coracoid process
What is demonstrated in the AP neutral rotation for the shoulder?
The greater tubercle is now partially superimposed on the humoral head Glenoid also is seen
What is different in the AP neutral rotation, compared to the AP external rotation of the shoulder?
For neautral position, palm of hand rested on thigh and humoral epicondyles are 45 degrees oblique angle
What is the breathing technique for the AP external rotation of shoulder?
What is the breathing technique for the AP neutral rotation of shoulder?
What is the central ray for the AP internal rotation for shoulder view?
1in inferior to coracoid process
What is demonstrated in the AP internal rotation view of shoulder?
1) Lesser tubercle!! 2) Shoulder joint with humoral head overlapping glenoid cavity/fossa 3) true lateral of proximal humerus
What is different in the body position for the AP internal rotation of the shoulder compared to the AP external view?
The elbow is slightly flexed, arm is internally rotated, and back of hand is on hip
Where are the humoral epicondyles for the AP internal rotation for shoulder?
What is the breathing technique for the AP internal rotation of the shoulder view?
What is another name for the shoulder view, transrhoracic lateral?
What is the patient position for the shoulder view, transthoracic lateral (Lawrence method)?
Patient uprightAffected side against IR Uninjured arm over head
What are the 2 ways you can ask the patient to demonstrate a breathing technique for the shoulder view, transthoracic lateral (Lawrence method)?
1) hold on full expiration
What is the preferred breathing technique to use for the shoulder view, transthoracic lateral (Lawrence method)?
Use breathing technique with a 4-5 second exposure time
What is demonstrated when we use the breathing technique with a 4-5 second exposure time for the shoulder view, transthoracic lateral (Lawrence method)?
To demonstrate the blurred lungs and ribs
What is the central ray for the shoulder view, transthoracic lateral (Lawrence method)?
Perpendicular to surgical neck at the midcoronal plane (MCP) exiting at surgical neck
If the patient can’t lift their unnefected arm for the shoulder view, transthoracic lateral (Lawrence method), what is to be done?
You put a 10-15 degree CEPHALIC angle on the tube
What are the structures shown for the shoulder view, transthoracic lateral (Lawrence method)?
Lesser tubercle Proximal humerus lateral shoulder through thorax Scapula superimposed on T-spine
Which shoulder view is used to demonstrate dislocations and whether they are anterior or posterior dislocations?
What is the patient position for the shoulder view, PA oblique (scapular Y)?
Upright, patient rotated so the midcoronl plane forms a 45-60 degree angle to IR
What is the central ray for the shoulder view, PA oblique (scapular Y)?
Perpendicular to shoulder joint
What are the structures shown for the scapular Y view of shoulder?
** acrimion projected laterally and free of superimposition Coracoid process Scapula in profile
What other projections can be feeformed for the PA oblique (scapular Y) of the patient is severely injured?
Where does the central ray enter for the inferosuperior Axial (Lawrence/Axillary method) for the shoulder?
Where does the central ray exit for the inferosuperior Axial (Lawrence/Axillary method) view of the shoulder?
Where does the central ray shoot through for the shoulder view, inferosuperior Axial (Lawrence/Axillary method)?
What is the patient position for the inferosuperior Axial (Lawrence/Axillary method) of shoulder?
1) patient supine (recumbent) 2) rotate body to achieve a 90 degree angle 3) abduct the affected arm as much as possible 4) humerus is in external rotation (hand outward) 5) turn head away from affected side
Where is the IR placed for the inferosuperior Axial (Lawrence/Axillary method)?
IR at top of shoulder, close to the neck
What is the central ray for the shoulder view, inferosuperior Axial (Lawrence/Axillary method)?
Horizontally and perpendicular to IR shooting through axila
For the inferosuperior Axial (Lawrence/Axillary method), what can be done to achieve less distortion?
Place the tube at the bottom of the table with a 15-30 degree angle
What are the structutires for the inferosuperior Axial (Lawrence/Axillary method)?
** lesser tubercle Coracoid process Proximal humerus and shoulder joint
What is the patient position for the AP oblique (grashey method) for shoulder?
1) patient supine or upright 2) turn patient towards affected side so body makes a 35-45 degree angle 3) abduct arm internally slightly resting on abdomen
What is the centrism ray for the AP oblique (grashey method) for shoulder?
Perpendicular to glenoid cavity, 2in medial and inferior to superior/lateral border do shoulder
Structures shown for AP oblique (grashey method)?
** glenoid cavity in profile ** looking for space btw humerus and glenoid ** clavicle is very distorted (night and more vertical)
What views of the shoulder demonstrate the lesser tubercle?
1) AP internal rotation 2) transthoracic lateral (Lawrence method) 3) inferosuperior Axial (Lawrence/Axillary method)
Which shoulder views demonstrate the greater tubercle?
1) AP external rotation
What are the views for the clavicle?
What are structures shown for AP clavicle?
Where is the central ray for the AP clavicle?
Perpendicular to midshaft of clavicle
What is the breathing technique for the AP clavicle?
Suspend respiration AFTER exhalation
Where does the clavicle sit around?
Around the 3rd and 4th rib
What are the structures shown for the AP axial projection of the clavicle?
Entire clavicle **projected above the ribs ** clavicle in horizontal placement
What is the patient position for the AP Axial projection of clavicle?
1) Patient supine or upright
What is the breathing technique for the AP Axial projection of the clavicle?
Suspend respiration AFTER FULL INSPIRATION
Where is the central ray for the AP Axial projection of clavicle?
1) If patient is in lordotoc position: ~ 0-15 degrees CEPHALIC, centered to mid shaft of clavicle 2) If patient is in normal standing position: ~ 15-30 degree CEPHALIC angle of tube (sit the clavicle sits higher in the chest)
For the PA Axial projection of the clavicle, what is the central ray?
Angled 15-30 degrees CAUDAD
For the PA axial projection of the clavicle, what is the position of the patient?
Same as AP Axial ; patient in lordotic position
What is the structures shown for the PA Axial projection of clavicle?
Same as AP axial projection; entire clavicle projected above the ribs sitting horizontally
What is the scapula bone classified as?
What is the clavicle bone classified as?
What is the name of the Fossa on the anterior surface of the scapula
Which border of the scapula extends from the glenoid cavity to the inferior angle?
Which border of the scapula extends from the superior angle to the inferior angle?
I watch part of the scapula is the acromion on extension?
Where is the coracoid process located in reference to the body of the scapula?
Which borders of the scapula unite to form the superior angle?
Which borders of the scapula unite to form the inferior angle?
Where is the scapular notch located?
Which joint is a ball and socket joint?
Which portion of the scapula articulates with the humeral head?
Which portion of the scapula articulates with the clavicle?
I’m performing AP projections of the shoulder where should the central ray be directed?
1in inferior to the coracoid process
With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP projection of the shoulder with the shoulder in external rotation?
With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP projection of the shoulder with the shoulder in internal rotation?
With reference to the plane of the IR, how should the humoral epicondyles be positioned for the AP projection of the shoulder with the shoulder in neutral rotation?
45 degrees medial oblique
Which projection of the shoulder best demonstrates the greater tubercle of the humerus in profile?
AP projection with external rotation
Which production of the shoulder best demonstrates the humeral head in profile?
AP projection with external rotation
AP projection with internal rotation
Which projection of the shoulder is being performed on the patient in supine with the right shoulder centered to the IR, vertical central ray is being directed perpendicular to the center of the IR, and the humeral epicondyles are parallel with the plane of the IR?
AP projection with external rotation
What should be adjusted from the regular procedure for the transthoracic lateral projection (Lawrence method) of the humerus if the patient is unable to elevate the unaffected arm?
Which projection of the upper limb should be performed to demonstrate a fracture of the proximal humerus on the arm cannot be abducted?
Transthoracic lateral projection (Lawrence method) of the humerus
I’m performing the transthoracic lateral projection (Lawrence method) of the humerus which breathing technique should be used to improve best the image contrast and decrease exposure it necessary to penetrate the body?
Suspended full inspiration
Which projection of the shoulder requires that a horizontal central ray be directed 15-30 degrees medially and enter the sculls of the affected arm?
Inferosuperior axial projection (Lawrence method)
What is the proper positioning of the humerus for the inferosuperior axial projection?
Abducted to a right angle and externally rotated
How should the central ray be directed for the PA Oblique projection (scapular Y) of the shoulder?
In which body position should the patient be placed demonstrate the left shoulder with the Pa oblique projection (scapular Y)?
Left anterior oblique (LAO)
Which projection of the shoulder joint requires a patient to be rotated until the mid-coronal plane forms a angle of 45 to 60° but the plane of the IR?
PA oblique projection (scapular Y)
Where is the humerus generally demonstrated on a Pa oblique projection (scapular Y) image of the shoulder is normal?
Superimposed on the junction of the acromion and coracoid process
Beneath the coracoid process
When performing a lateral projection of the scapula the patient positioned RAO or LAO, approximately how much body rotation is necessary for the average patient?
When performing the AP projection of the scapula, the CR should be directed towards a pint 2in what, to the coracoid process?
How many degrees and in which direction should the central ray be directed for the AP axial projection of the clavicle with the patient supine?
How many degrees in which direction should the central ray be directed for the PA axial projection of the clavicle?
If the patient’s condition permits which joint should be demonstrated with the patient in an upright position for the clavicle?
When demonstrating the intertubercular (bicipital) groove with the Fisk modification of the tangential projection, how should the affected humerus be positioned?
Vertical humerus should form an angle of 10-15 degrees
What would be required patient position to demonstrate the left shoulder using the AP oblique projection (grashey) method?
Which projection demonstrates the scapulohumeral joint space open and the glenoid cavity in profile?
AP oblique projection (grashey)
All of the following compromise a bony thorax except for...A. Sternum B. 12 pairs of ribs C. 12 thoracic vertebrae D. Scapulae
What is the proper name for the structure commonly called the breastbone?
Which bone classification is the sternum?
Which three bony parts compose the sternum?
Manubrium, body, Xiphoid process
Which part of the sternum is most superior?
Ribs :
Ribs:
Manubrium and sternal body
Ribs:
Ribs:
Superior border of the manubrium
What is the smallest part of the sternum?
Which part of the sternum is located at the level of T10?
With which part of the sternum does the first pair of ribs articulate?
Lateral border if the manubrium
Which classification refers to ribs that attach third costal cartilage is directly to the sternum?
Which classification route refers to the ribs that have no anterior attachments?
Which classification first to the 8th-12th pairs of ribs?
What two bony structures form the top of the “Y”in a scapular Y view?
Acromion and coracoid processes
Which projection of the shoulder will best demonstrate the glenoid fossa in profile?
Why should clavicles be performed PA?
Where is the central ray location for an AP clavicle?
In the AP axial for clavicle if the patient is lordotic how many degrees in which direction is the tube angled?
How many degrees is the patient rotated and a scapular Y?
What projection is the scapular Y?
How many degrees in which direction is the patient rotated and the Grashey method?
35-45 degrees toward affected side
In the inferosuperior axial (Axillary) how many degrees is the arm abducted?
Where is the central ray location for transthoracic shoulder?
Perpendicular, midcoronal plane at surgical neck
Which production of the shoulder will best demonstrate the lesser tuberosity?
In the AP neutral rotation of the shoulder, what is the position of the humoral epicondyles?
45 degrees medial oblique
What is the central relocation for an AP external rotation shoulder
1in inferior to coracoid process
In the AP external rotation of the shoulder what is the position of the humeral epicondyles?
Which two bony structures make up the shoulder joint?
Humeral head and glenoid fossa
Which phones make up the shoulder girdle?
How many rib pairs are demonstrated on an AP upper ribs?
How many rib pairs of true ribs are there?
Which ribs are considered floating ribs?
Why are lower ribs done on expiration?
So the diaphragm gets raised which demonstrates lower ribs better
Two best demonstrate the anterior 7th right rib without vertebral superimposition which oblique would be performed?
Where is the central ray location for upper ribs?
Where is the central ray location for AP lower ribs with the film crosswise?
Which projection of the ribs will best demonstrate Axillary border?
In an RPO projection for left upper ribs, where is the central ray located?
How many degrees is the patient rotated in an LAO of the right ribs?
Where is the top of the cassette placed for upper posterior ribs?
What are the breathing instructions for an AP clavicle?
What is the central ray for the PA upper anterior ribs?
Perpendicular centered to IR at T7 and midsagittal plane
What is the breathing technique for the PA upper anterior ribs?
Suspend it respiration after full inspiration
What are the structure Shawnnn for the PA upper anterior ribs?
-ribs above diaphragm
What must the patient be measured in for the PA upper anterior ribs?
60’s for upper ribs
Where is the top of the image receptor for the PA upper anterior ribs?
Top light is 1 1/2 above shoulders
Structures shown for the PA lower anterior ribs?
What much the patient measure in the PA lower anterior ribs? And if above measurement, what do you do?
-measure 70’s
What is the central ray for the PA lower anterior ribs?
Perpendicular center to IR, at midsagittal plane
Where is the IR placed for the PA lower anterior ribs?
Bottom of light at level of iliac crest
What is the breathing technique for the PA lower anterior ribs?
Suspend respiration after full exhalation
Where is the IR for the AP upper posterior ribs?
Top of light 1 1/2in above the shoulders
What is the breathing technique for the AP upper posterior ribs?
Suspend respiration after full inspiration
What is the central ray for the AP upper posterior ribs?
Perpendicular centered to IR at midsagittal plane
What is demonstrated in the AP upper posterior ribs?
Where is the IR for the AP lower posterior ribs?
Bottom of light at level of the iliac Crest
What is the breathing technique for the AP lower posterior ribs?
Suspend respiration after the end of full exhalation
Where is the central ray for the AP lower posterior ribs?
Perpendicular centered to IR at midsagittal plane
What is demonstrated for the AP lower posterior ribs?
How much is the body rotated for the AP oblique RPO/LPO rib positions?
Where is the IR centered when doing the upper ribs for the AP oblique RPO/LPO views?
Ir centered at T7 with bottom of light 1 1/2in above shoulders
Where is the IR placed for the lower ribs for the AP oblique (RPO/LPO) views?
Bottom of IR at level of iliac crest
What is the central ray for the AP oblique (RPO/LPO) rib views?
Perpendicular, centered to IR, midway btw medsagittal plane and lateral border of affected side
What are the structures shown for the AP oblique (RPO/LPO) rib views?
-Axillary portion of ribs projected free of superimposition -ribs elongated for foreshortened depending on which oblique
Is the patient is in the AP, LPO position for the oblique views for ribs, which side is elongated?
If the patient was in the AP, RPO position for the rib views, which side is elongated?
If the patient was in the PA, LAO position for the oblique rib views, which side is elongated and foreshortened?
Right side elongated
If the patient was in the PA, RAO position for the oblique rib views, which side is elongated and foreshortened?
Left side is elongated
If you are in the AP position for the oblique views for the ribs, which side will typically be demonstrated and elongated?
If you were in a PA position for the oblique rib views, which side of the body will be demonstrated and elongated?
The side father away from the IR will be demonstrated and elongated
What do foreshortened ribs demonstrate?
When demonstrating the upper ribs, how many rib pairs are visible?
When demonstrating the lower ribs, how many rib pairs are visible?
Where are the ribs found in the body?
In the thorax anteriorly and posteriorly
How many rib pairs are in the body?
What determines whether a particular rib is a true rib or a false rib?
What structures form costovertebral joints?
Heads of ribs with thoracic vertebral bodies
True or false:
True or false:
Which location of the thoracic column does the sternum angle correspond?
Disk space between T4 and T5
Where is the sternsl angle located?
At the junction of manumbrium and sternal body
What is the name of the notch found on the superior border of sternum?
The jugular Notch is found anterior to which precise location of the thoracic vertebral column?
Disk space between T2 and T3
Approximately length of sternum for a regular adult?
Purpose of bony thorax is?
Protect the heart and lungs
How many thoracic vertebrae are there?
What part of the sternum supports the sternal ends of the clavicles? |
Which projection of the shoulder best demonstrates the lesser tubercle of the humerus in profile?
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