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Procedures1. chap 5

Humerus and shoulder girdle

The humerus articulates with the ____ at the ___ joint. scapula, shoulder
The slightly constricted area directly below and lateral to the head of the humerus is the what? Anatomical neck
The anatomical neck appears as a line between what two structures? Between the rounded head and the adjoining greater and lesser tubercles.
The lesser tubercle is directly below the _____ on the ____ surface. Anatomical neck, anterior surface.
The greater tubercle is lateral or medial? Lateral
The pectorals major and supraspinatus muscles attach to what process? Greater tubercle.
What is the inter tubercular groove? deep groove between greater and lesser tubercle
Where is the surgical neck? tapered area below the head and tubercles.
The roughened raised elevation along the anterolateral shaft? Deltoid tuberosity
In a true AP projection of the proximal humerus, the lesser tubercle is located _____ and the greater is located _____. anteriorly, laterally
Upper margin of the scapula is at the level of? The second posterior rib
Lower margin of the scapula is at the level of? seventh posterior rib (T7)
The acromial extremity end of the clavicle articulates with what? The acromion of the scapula, forming the acromioclavicular joint
Medial or sternal extremity end articulates with what? The manubrium, forming the sternoclavicular joint
What and where are the 3 borders of the scapula? Medial- long edge near the vertebrae, superior border- uppermost portion, lateral/axillary border- nearest the axilla.
lateral angle is aka what? head of the scapula
Thickest part and ends laterally in a shallow depression called the glenoid cavity? Lateral angle
Humeral head articulates with glenoid cavity of the scapula to form what joint? scapulohumeral, glenohumeral, shoulder joint.
Anterior surface of the scapula is called what costal surface
middle area of the costal surface presents a large concavity known as what subscapular fossa
Long, curved process that extends laterally over the head of the humerus? acromion
beaklike process that projects anteriorly beneath the clavicle? coracoid process
The scapular notch is located where? And partially formed by what? on the superior border of the scapula, it is formed by the base of the coracoid process
What is the spine? prominent structure on the dorsal/posterior surface of the scapula
The acromion overhangs the shoulder joint ____. posteriorly
Lateral view of the scapula. The upper parts of the "Y"? Acromion and coracoid process
LAT view of scapula. Acromion is where? Coracoid where? Acromion extends superiorly and posteriorly to the glenoid fossa, coracoid process is located more anteriorly to the glenoid cavity.
Scapulohumeral joint movement type? Spheroidal/ball and socket. (flex/ext, ab/add, circumduction, medial/lateral rotation)
Which proximal humerus position demonstrates a true AP projection in the anatomic position? External rotation.
In the external rotation of humerus, where are the greater and lesser tubercles? Greater tubercle is seen laterally in profile, lesser is located more anteriorly- medial to the greater.
What position places the humerus in a true lateral position? Internal rotation.
Where are the greater and lesser tubercles for an internal rotation? Greater is anterior and medial of the proximal humerus, lesser is seen in profile medially.
External _____ in profile, internal ____ is in profile. greater, lesser
neutral rotation places the greater and lesser tubercles where? Greater is anterior but still lateral to the lesser. Midway between external and internal rotation.
Routine for humerus? AP, AP LAT rot, Trauma (if you can't do a lat rotation), Transthoracic (trauma)
Routine for a shoulder? AP ext, AP int, AP neutral, Grashey, Y-view
Clavicle routine? AP and AP Axial
Average kV range for humerus/shoulder? 70-80
AP humerus proj. eval postion criteria? Greater tubercle in profile laterally, minimal superimposition of glenoid cavity. Lateral and medial epicondyles are in profile.
Rotational lateral-lateromedial or mediolateral prom of humerus. eval position criteria? Epicondyles superimposed. lesser tubercle in profile medially and partially superimposed by lower portion of glenoid cavity
Transthoracic lateral proj. trauma humerus. Breathing? Part position? Orthostatic breathing with a min of 2 second exposure at 80-90 kV to blur ribs. Pt's affected arm in a neutral rot, dropped. Elevate opposite arm& shoulder to prevent superimposition. Thorax in true lat pos, or slight anterior rot of unaffected arm.
Transthoracic lateral proj. trauma humerus. pt is in too much pain to elevate unaffected arm and drop other arm, what can be done? angle CR 10-15 cephalad.
AP projection- external rotation shoulder. IR size? CR @? Eval criteria for anatomy? 10x12. CR 1 inch inferior to coracoid process. Lateral 2/3rds of clavicle and upper scapula
AP projection- external rotation shoulder. Eval criteria for position? Full ext. rotation is evident by greater tubercle in full profile on lateral aspect. Lesser tubercle is superimposed over humeral head. (epicondyles parallel to IR)
AP projection- internal rotation shoulder. pt position and eval criteria position? Internally rotate arm (pronate hand), epicondyles perpendicular to IR. Rotate body slightly to place shoulder in contact with IR. Full rot evident by lesser tubercle in profile on medal aspect. Outline of greater tub superimposed over the humeral head.
What is the grashey method? Posterior oblique position of shoulder - glenoid cavity
Grashey. part and patient position? rotate body 35-45 towards affected side. CR @ midscapulohumeral joint. IR about 2 inches above shoulder and 2 in from lateral border of humerus. Abduct arm slightly in neutral rotation. (standing AP)
Grashey. eval criteria? Glenoid cavity sen in profile without superimposition. Scapulohumeral joint space open, anterior and posterior rims of glenoid cavity are superimposed.
AP neutral rotation shoulder - trauma. Pt position and eval criteria position? Erect is usually less painful, pt's arm in neutral or "as is" position/rotation. Both tubercles most often superimposed by the humeral head.
Scapular Y Lateral- Anterior oblique position shoulder. How do you know if it is an anterior or posterior dislocation? If humeral head is inferior to coracoid process it is anterior dislocation. If humeral head is inferior to acromion process it is posterior dis. (less common)
Scapular Y Lateral- Anterior oblique position shoulder. Excellent projection to demonstrate what? Profile of coracoid process and scapular spine
Scapular Y Lateral- Anterior oblique position shoulder. Pt position? rotate into an anterior oblique facing IR. Palp superior angle of the scapula and AC joint, rotate Pt until an imaginary line between those two points is perp to IR (45-60 degree usually). May SLIGHTLY abduct arm to prevent superimposed humerus over ribs
Scapular Y Lateral- Anterior oblique position shoulder. Eval criteria anatomy and position True lat of scapula, prox humerus, and scapulohumeral joint. Body of scap (base of Y) free of superimp of ribs. Acromion and coracoid nearly symmetric Y. Heral head superimposed over base of Y if humerus is not dislocated.
AP clavicle. AEC? Respiration? Eval criteria? No AEC. Inhale and suspend resp to help elevate clavicles. Entire clavicle and joints, the mid clavicle is superimposed on superior scapular angle.
AP axial clavicle. Eval criteria? Most of clavicle above 2nd and 3rd ribs, only medial portion of clavicle superimposed by first and second ribs.
The head of the scapula is AKA? The lateral angle
Posterior border/ridge of the spine is termed the what? Crest
Spine starts at what and continues laterally to end at the what? Starts at vertebral border, ends at acromion
For a scapular lateral "Y" view, which upper part is the acromion? The expanded distal end tat extends superiorly and posteriorly to the glenoid cavity.
For a scapular lateral "Y" view, which upper part is the coracoid process? In relation to the glenoid cavity, the more anterior process.
Anteriorly, the shoulder girdle connects to the trunk at what? Upper sternum
Posteriorly, the connection of the shoulder girdle to the trunk is? Incomplete because the scapula is only connected to the trunk by muscles
What is the function of the clavicle and scapula? To connect each upper limb to the trunk or axial skeleton.
External rotation of the proximal humerus places the humerus in a what? True AP/frontal position
Proximal humerus: AP is _____ rotation, lateral is ____ rotation. External, internal.
An AP projection with internal rotation of the shoulder is basically the same positioning as for what? AP erect lateral-lateromedial projection of humerus. (back to IR, internally rotate arm, epicondyle perpendicular to IR..)
Created by: Zoest35