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RAD115 Shoulder Gird
Shoulder Girdle and Humerus
| Question | Answer |
|---|---|
| Which classification of bone is the scapula? | Flat |
| Which classification of bone is the clavicle? | Long |
| What is the name of the fossa on the anterior surface of the scapula? | Subscapular |
| Which border of the scapula extends from the glenoid cavity to the inferior angle? | Lateral |
| Which border of the scapula extends from the superior angle to the inferior angle? | Medial |
| Of which part of the scapula is the acromion an extension? | Spine |
| Where is the coracoid process located in reference to the body of the scapula? | Lateral and superior |
| Which borders of the scapula unite to form the superior angle? 1. Medial 2. Lateral 3. Superior | 1 and 3 only |
| Which borders of the scapula unite to form the inferior angle? 1. Medial 2. Lateral 3. Superior | 1 and 2 only |
| Where is the scapular notch located? | Superior border |
| Which joint is a ball and socket joint? | Scapulohumeral |
| Which portion of the scapula articulates with the humeral head? | Glenoid fossa |
| Which portion of the scapula articulates with the clavicle? | Acromion |
| Which two structures articulate to form the sternoclavicular joint? | Manubrium of the sternum and the medial end of the clavicle |
| When performing AP projections of the shoulder, where should the CR be directed? | 1 inch 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? | Parallel |
| 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? | Perpendicular |
| 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 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 projection of the shoulder best demonstrates the humeral head in profile? | AP projection with external rotation |
| Which projection of the shoulder best demonstrates the lesser tubercle of the humerus in profile and pointing toward the glenoid cavity? | AP projection with internal rotation |
| Which projection of the shoulder is being performed when the patient is supine with the right shoulder centered on the IR, a vertical CR is 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? | Central Ray angulation |
| Which projection of the upper extremity should be performed to demonstrate a fracture of the proximal humerus when that arm cannot be abducted? | Transthoracic lateral projection (Lawrence method) |
| When performing the transthoracic lateral projection (Lawrence method), which breathing technique should be used to improve image contrast and decrease the exposure necessary to penetrate the body? | suspended full inspiration |
| Which projection of the shoulder requires that a horizontal central ray be directed 15 to 30 degrees medially and enter the axilla of the affected arm? | Inferosuperior axial projection (Lawrence method) |
| What is the proper position of the humerus for the inferosuperior axial projection? | Abducted to a right angle and externally rotated |
| How should the CR be directed for the PA oblique projection (scapular Y) of the shoulder? | Perpendicular to the IR |
| Which general body position would be used to demonstrate the left shoulder with the PA oblique projection (scapular Y)? | Left anterior oblique |
| Which two projections of the shoulder joint require the patient to be rotated until the midcoronal plane forms an angle of 45 to 60 degrees with the plane of the IR? | PA Oblique projection (scapular Y) Tangential projection (Neer method) |
| Where is the humerus generally demonstrated on a PA oblique shoulder (scapular Y) image if the shoulder is normal? | Superimposed on the junction of the acromion and coracoid process |
| Where is the humeral head usually seen on a PA oblique (scapular Y) image if the shoulder is anteriorly dislocated? | Beneath the coracoid process |
| Which projection demonstrates the scapulohumeral joint space open and the glenoid cavity in profile? | AP oblique projection (Grashey method) |
| What would be the required patient position to demonstrate the left shoulder using the AP oblique projection (Grashey method)? | 35 to 45 degrees LPO |
| Which projection is useful in diagnosing shoulder impingement? | tangential (Neer method) |
| If the patient's condition permits, which joint should be demonstrated with the patient in an upright position? | acromioclavicular |
| How many degrees and in which direction should the CR be directed for the PA axial projection of the clavicle? | 15 to 30 degrees cephalad |
| How many degrees and in which direction should the CR be directed for the AP axial projection of the clavicle with the patient supine? | 15 to 30 degrees cephalad |
| When performing the AP projection of the scapula, the CR should be directed toward a point 2 inches _____________ to the coracoid process. | Inferior |
| When performing a lateral projection of the scapula with the patient positioned RAO or LAO, approximately how much body rotation is necessary for the average patient? | 45 to 60 degrees |
| What type of joint is the Scapulohumeral joint? | Ball and socket |
| What type of joint is the Acromioclavicular (AC) joint? | Gliding |
| What type of joint is the Sternoclavicular (SC) joint? | Double gliding |
| What is the definition of Hill-Sachs defect? | Impacted fracture of posterolateral aspect of the humeral head with dislocation |
| What is the definition of Osteoarthritis, also known as degenerative joint disease? | Form of arthritis marked by progressive cartilage deterioration in synovial joints and vertebrae |
| What is the definition of Osteopetrosis? | Increased density of atypically soft bone |
| What is the definition of Osteoporosis? | Loss of bone density |
| What is the definition of Rheumatoid arthritis? | Chronic, systemic, inflammatory collagen disease |
| What is the definition of Tendinitis? | Inflammation of the tendon and tendon-muscle attachment |
| What is the definition of Chondrosarcoma? | Malignant tumor arising from cartilage cells |
| What is the definition of Fracture? | Disruption in the continuity of bone |
| When taking an AP shoulder projection and the patient's hand is supinated, what position does this place the humeral epicondyles in? | Parallel to the IR |
| When taking an AP shoulder projection and the patient's hand is supinated, what aspect of the humerus is seen in profile? | The Greater Tubercle |
| When taking an AP shoulder projection and the patient's hand is supinated, what type of rotation does this place the humerus in? | External rotation |
| When taking an AP shoulder projection and the patient's hand is placed palm against thigh, what position does this place the humeral epicondyles? | 45 degree angle with the plane of the IR |
| What type of rotation is achieved when taking an AP shoulder projection and the patient's hand is positioned palm to thigh? | Neutral rotation |
| What type of rotation is achieved when taking an AP shoulder projection and the patient's hand is positioned with the posterior aspect placed against the hip? | Internal rotation |
| When taking an AP shoulder projection and the patient's hand is positioned with the posterior aspect against the hip, what position are the humeral epicondyles in? | Perpendicular to the plane of the IR |
| Where should the CR be centered for an AP shoulder projection? | 1 inch inferior to the coracoid process |
| What should the collimation be for an AP Shoulder projection? | Collimate to 10x12, including 1.5 inches above the shoulder and 1 inch beyond the lateral aspect of the shoulder |
| What structure is seen on an AP shoulder projection with External rotation? | the site of insertion of the supraspinatus tendon |
| What structure is seen on an AP shoulder projection with neutral rotation? | The posterior part of the supraspinatus insertion, which can profile small calcific deposits |
| What structure is seen on an AP shoulder projection with Internal rotation? | the subscapular tendon insertion |
| In a proper AP shoulder projection with external rotation, which structures should be seen in profile? | Humeral head Greater Tubercle on lateral aspect of humerus |
| In a proper AP shoulder projection with neutral rotation, how should the greater tubercle be seen? | Partially superimposed over the Humeral head |
| In a proper AP shoulder projection with internal rotation, what structure can be seen in profile? | Lesser tubercle pointing medially |
| What is the roughened process of the humerus superior and lateral to the intertubercular groove? | Greater tubercle |
| Which bony process is located on the anterior surface of the proximal humerus? | Lesser tubercle |
| How many articulations does the humerus have? | 3 |
| Which depression is located between the lesser and greater tubercles of the proximal humerus? | Intertubercular groove |
| Which positioning characteristics best indicates that the humerus is properly positioned for the AP projection of the humerus? | The humeral epicondylar coronal plane is parallel with the IR |
| Which evaluation criterion indicates that the humerus was properly positioned for the AP projection? | The humeral head and greater tubercle are both seen in profile |
| With reference to the plane of the IR, how is it determined that the humerus is properly positioned in a true lateral position? | the humeral epicondylar coronal plane is perpendicular |
| Which evaluation criterion indicates that the humerus was properly positioned for the lateral position? | the lesser tubercle is seen in profile |
| What is the appropriate collimated field for the AP and Lateral projection of the humerus? | 2 inches distal to the elbow and superior to the shoulder, and 1 inch on the sides |
| How is a lateral with the IR placed between the arm and thorax different than a true lateral humerus projection? | You see less than the entire humerus |
| What positioning maneuver should be avoided if the patient possibly has a fractured humerus or dislocation of the scapulohumeral joint? | Rotation of the arm |
| For AP shoulder projections, the patient's breathing should be: | suspended |
| What patient position would be required if the patient's right shoulder is to be examined using the Grashey Method? | 35 to 45 degrees RPO |
| When using the Grashey method, the _______________ should be parallel with the plane of the IR. | plane of the superior angle and acromion |
| What is the proper arm position for the Grashey Method? | Abducted in slight internal rotation |
| A properly positioned AP oblique (Grashey Method) image will demonstrate the ______________ in profile. | Glenoid Cavity |
| The transthoracic lateral projection (Lawrence Method) may be performed with the patient positioned upright or: | Supine |
| To what specific area of the humerus should the IR be centered for the transthoracic lateral projection (Lawrence method)? | Surgical Neck |
| How many degrees and in which direction should the CR be directed if it cannot be directed perpendicular to the IR because the patient is unable to elevate the unaffected shoulder? | 10 to 15 degrees cephalad |
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