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Merrill's chapter 5
| Question | Answer |
|---|---|
| IR size for AP shoulder (neutral, internal and external rotation) | 10 x 12 crosswise |
| CR direction for AP shoulder (neutral, internal and external rotation | Perpendicular 1" inferior to the coracoid process |
| Which projection and position demostrates the greater tubercle more anterior? | AP shoulder neutral rotation |
| Which projection and position demostrates the lesser tubercle in profile? | AP shoulder internal rotation |
| Which projection and position demostrates the greater tubercle lateral to the shoulder joint? | AP shoulder external rotation |
| Position for AP shoulder neutral rotation | Upright used whenever possible Coronal plane parallel to IR Palm of hand on hip Epicondyles about 45 degree angle to IR |
| Position for AP shoulder internal rotation | Upright used whenever possible Coronal plane parallel to IR Flex elbow, rotate arm internally and rest back of hand on hip Epicondyles perpendicular to IR |
| Position for AP shoulder external rotation | Upright used whenever possible Coronal plane parallel to IR Supinate hand and abduct arm slightly Epicondyles parallel to IR |
| IR size and direction for transthoracic Lateral - Lawrence method | 10 xÂ12 lengthwise |
| CR direction for transthoracic Lateral - Lawrence method | Perpendicular to IR, entering the mid coronal plane at the level of the surgical neck |
| Positioning for transthoracic Lateral - Lawrence method | Upright or supine; upright preferred Midcoronal plane perpendicular to IR Center IR to surgical neck of affected humerus Raise non-injured arm and rest forearm on the head. |
| Structures shown on a transthoracic Lateral - Lawrence method | Fractures and/or dislocations of proximal humerus |
| IR size and direction for Inferosuperior axial projection - Lawrence method and Rafert | 10 x 12 grid crosswise, placed in the vertical position in contact with the shoulder |
| CR for for Inferosuperior axial projection - Lawrence method | Horizontally through axilla at a medial angulation of 15 to 30 degrees |
| CR for Inferosuperior axial projection - Rafert method | Horizontal and angled approximately 15 degrees medially entering the axillary and passing through the AC joint |
| Which projection shows a Hill - Sachs defect? | Inferosuperior axial projection - Rafert method |
| Structures shown on a inferosuperior axial projection - Lawrence method | Anterior dislocation of humeral head |
| Define Hill-Sachs defect | Impacted fracture of posterolateral aspect of humeral head with dislocation |
| Positing for Inferosuperior axial projection - Lawrence method | Supine with head, shoulders and elbow elevated about 3" Abduct the affect arm as much as possible to a right angle from the body. Have patient turn head away from affected side Place IR as close as possible to the neck and affected shoulder |
| Positioning for Inferosuperior axial projection - Rafert method | Modification of the Lawrence method. Exaggeration of external rotation of the arm until the thumb is pointing downward ( about 45 degree angle). |
| CR direction for a superoinferior axial projection | 5 to 15 degrees through the shoulder joint towards the elbow |
| Positioning for a superoinferior axial projection | Seated at end of table high enough to extend shoulder over IR. Lean laterally over IR until shoulder joint is over the midpoint. Flex elbow 90°, rest it on the table and pronation the hand. Have patient tilt head towards unaffected shoulder |
| Structures shown on superoinferior axial projection | Scapulohumeral joint Coracoid process is projected above the clavicle |
| CR for PA oblique projection - scapula " Y " | Perpendicular to scapulohumeral joint (midscapula) |
| Structures shown on a PA oblique projection - scapula " Y " | Anterior (subcoracoid) and posterior (subacromial) dislocations of humeral head |
| Positioning for PA oblique projection - scapula " Y " | Upright or recumbent; upright preferred Position scapulohumeral joint of affected shoulder to center of IR Roane patients to a 45 to 65 degree angle |
| What projection and position demostrates the glenoid cavity free of superimposition? | AP oblique - Grashey method |
| CR direction for AP oblique - Grashey method | Perpendicular at a point 2" medial and 2" inferior to the scapulohumeral boarder of the shoulder |
| Positioning for a AP oblique - Grashey method | Supine or upright (upright is more comfortable for patients and assist in accurate adjustment of the part) Center IR to scapulohumeral joint Rotate body 35° to 45° toward affected side and place arm on abdomen |
| CR for tangential - intertubercular groove | Horizontal, angled 10°to 15° downward. Enters patient at superior surface of humeral head |
| Positioning for tangential - intertubercular groove | Supine Place the IR against the affected shoulder and neck Supinated the hand |
| Positioning for tangential - intertubercular groove Fisk modification | Instruct the patient to flex the elbow and lean forward far enough to place the posterior surface of the forearm on the table. The patient supports and grasps the IR |
| Tangential - intertubercular groove collination | 4" x 4" |
| CR for AP clavicle | Perpendicular to midshaft of clavicle |
| Positioning for AP clavicle | Upright bucky or supine Center clavicle to midpoint of IR Arms relaxed AR patient's side |
| CR AP axial clavicle | Lordotic: 0° to 15° Cephalic Supine: 15° to 30° Cephalic Enters midshaft of clavicle |
| CR for a PA clavicle | Perpendicular to midshaft of clavicle |
| CR for a PA axial clavicle | 15° to 30° caudal to supraclavicular fossa and midshaft of the clavicle |
| Positioning for a PA and PA axial clavicle | Seated or upright facing bucky Center clavicle to midline Arms relaxed by patient's sidde |
| Advantage of a PA clavicle vs AP | The clavicle is closer to the IR so OID is reduced |
| What structure requires a 72" SID? | AC joints |
| CR for AP projection of the scapula | Perpendicular to the midscapular area at a point approximately 2" inferior to the coracoid process |
| Respiration for AP scapula | Exposure made during slow breathing to obliterate the lungs |
| Positioning for AP projection of the scapula | Upright or supine; upright preferred Center affect we'd scapula to midline of the grid Abduct arm at a right angle with the body Flex the elbow and support the hand Top of IR 2" above the shoulder |
| CR for lateral projection of the scapula | Mid medial boarder of scapula |
| Positioning for a lateral scapula | Upright or seated facing grid Rotate 45° to 60° with affected side against the IR Place hand on posterior lower thorax |
| CR for bilateral AP projection with and without weights for AC joints | Perpendicular to the midline of the body at the level of the AC joints |
| Positioning for a bilateral AP with and without weights for AC joints | Upright, seated or standing Midlpoint of IR at t he level of the AC joints Midline of body to midline of grid 2 exposures: 1 without weights and 1 with weights (5 to 10 lbs) |
| Structures shown on AP projection of AC joints | Dislocations, separation, function of AC joints |
| CR for unilateral AP projection with and without weights | Perpendicular to AC joints |
| CR for tangential - intertubercular groove Fisk modification | Perpendicular to the IR when the patient is leaning forward and the vertical humerus is positioned 10 to 15 degrees |
| Impacted fracture of posterolateral aspect of the humeral head with dislocation |
Created by:
Scannon27