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Merrill's chapter 5
| Question | Answer |
|---|---|
| What is the CR direction for an AP shoulder in neutral, internal and external rotation? | Perpendicular 1" inferior to the coracoid process |
| What projection demostrates the greater tubercle more anterior? | AP shoulder projection - neutral rotation |
| What projection demostrates the lesser tubercle in profile? | AP shoulder projection internal rotation |
| What projection demostrates the greater tubercle lateral to the shoulder joint? | AP shoulder projection - external rotation |
| What structures are shown on a transthoracic Lateral - Lawrence method? | Fractured and/or dislocations of proximal humeral head. |
| What is the CR direction for a transthoracic Lateral - Lawrence method? | Perpendicular to IR, entering the mid coronal plane at the level of the surgical neck? |
| What structure is shown with a superoinferior axial projection of the shoulder? | The Scapulohumeral joint |
| What is the direction of the CR for a superoinferior axial projection of the shoulder? | 5 to 15 degrees through the shoulder joint towards the elbow |
| What is the CR direction for a PA oblique projection - scapula "Y"? | Perpendicular to the Scapulohumeral joint ( mid scapula of medial boarder) |
| What structures are shown on a PA oblique projection - scapula "Y"? | Anterior (subcoracoid) dislocations and posterior (subacromial) dislocations. |
| Patient position for PA oblique scapula "Y" | Anterior surface of affected shoulder against the upright grid Rotate patient 45 to 60 degrees angle to IR Position center of IR at the level of the Scapulohumeral joint |
| Epicondyle position in AP shoulder neutral rotation | About a 45 degree angle to IR |
| Epicondyles position for AP projection internal rotation | Perpendicular to IR |
| Epicondyles position for AP projection internal rotation | Parallel to IR |
| Patient position for AP projection of shoulder in neutral rotation | Upright whenever possible Coronal plane plane parallel to IR Rest palm of hand on hip |
| Patient position for AP projection of shoulder in internal rotation | Upright whenever possible Coronal plane parallel to IR Flex.elbow and rotate arm internally and rest back of.hand on the hip |
| Patient position for AP projection of shoulder in external rotation | Upright whenever possible Coronal plane parallel to IR Supine hand and and abduct arm slightly |
| What is the CR direction for the inferosuperior axial projection with Lawrence or Rafer method? | Horizontally through axillary at a medial angulation of 15 to 30 degrees |
| What projections shows a Hill - Sachs defect? | Inferosuperior axial projection - Rafert method |
| Patient position for a transthoracic Lateral - Lawrence method | Mid coronal plane perpendicular to IR Center IR to surgical neck of affected humerus Raise non-injured arm and rest forearm on head |
| IR size and direction for transthoracic lateral | 10 x 12 inch lengthwise |
| What projections require a 72" SID? | AC joints AP bilateral or unilateral |
| Patient position for Inferosuperior axial projection (Lawrence and Rafert) | Supine with head, shoulders and elbow elevated about 3" on a radiolucent sponge |
| Patient position for superoinferior axial projection of shoulder | Seat at end of table high enough to enable extension of shoulder well over IR |
| Image evaluation criteria for a superoinferior axial projection | Coracoid process projected above clavicle Lesser tubercle in profile AC joint through humeral head |
| Image evaluation criteria for a PA oblique projection - scapula " Y " | Humeral head and glenoid cavity superimposed Humeral shafts and sca poo ukar body super imposed Scapula in lateral profile with lateral and veteran boarders superimposed |
| What projection demostrates the glenoid cavity free of superimposition? | AP oblique shoulder Grashey method |
| CR direction for a AP oblique - Grashey method | Perpendicular at a point 2" medial and 2" inferior to the scapulohumeral boarder of the shoulder |
| Patient position for AP oblique - Grashey method | Supine or upright. Upright is more comfortable for patients and assist in accurate adjustment of the part |
| Collimation for tangential - intertubercular groove | 4 x 4 inches |
| Structures shown on a tangential - intertubercular groove | Intertubercular groove free of superimposition of surrounding shoulder structures |
| CR direction for tangential - intertubercular groove | Horizontal, angled 10 to 15 degrees downward angle. Enters patient at superior surface of humeral head |
| Patient position for tangential - intertubercular groove | Supine or upright (seated or standing) for Fisk modification |
| Part position for tangential - intertubercular groove | Supine: IR against the the shoulder and neck with hand supinated Upright: Elbow (flexed) and forearm on table with IR on top. The hand is supinated holding IR in place. |
| CR direction for AP or PA clavicle | Perpendicular to midshaft of clavicle |
| AP axial clavicle CR direction | Lordotic: 0 to 15 degrees Cephalon towards midclavicle Supine or upright: 15 to 30 degrees Cephalon towards midclavicle |
| Structures shown on AP & AP axial | Posterior dislocations Relationship of humeral head to glenoid cavity |
| CR direction for PA clavicle | Perpendicular, exits midshaft of clavicle |
| CR direction for PA axial clavicle | 15 to 30 degrees caudal to supraclavicular fossa and midshaft of clavicle |
| Advantage of PA clavicle | The clavicle is closer to the IR so OID is reduced |
| Position for all clavicle projections | Clavicle center to IR, arms at side and shoulders in same horizontal plane |
| CR for bilateral AC joint | Perpendicular to the midline of the body at the level of the AC joints |
| Part position for bilateral AP projection with and without weights | Midpoint of IR lies at the level of the AC joints 2 exposures, one without weights and one with weights ( 5 to 10 lb weights) |
| Projections used to show dislocation, separation and function of AC joints | Bilateral AP with and without weights or unilateral AP with and without weights |
| CR for unilateral AP projection with and without weights | Perpendicular to AC joint |
| CR for AP scapula | Perpendicular to midscapular area at a point approximately 2" inferior to the coracoid process |
| Respiration for AP scapula | Exposure made during slow breathing to obliterate lung detail |
| Position for AP scapula | Upright or supine; upright preferred Center affected scapula to midline of grid Abduct arm at a right angle to body to draw the scapula laterally Flex.elbow and support hand IR 2" above top of shoulder |
| CR for lateral projection of sscapula | Mid medial boarder of scapula |
| Patient position for lateral scapula | Upright or seated facing grid PA upright preferably RAO or LAO 45 to 60 degree rotation with affected against IR Affected arm on posterior thorax to see Acromioclavicular and coracoid |
Created by:
Scannon27