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Rad Pro Ch.5
Humerus and Shoulder
| Term | Definition |
|---|---|
| head | The proximal part is the rounded _______ of the humerus. |
| anatomic neck | The slightly constricted area directly below and lateral to the head is the |
| lesser tubercle | The process directly below the anatomic neck on the anterior surface is the _______________________. |
| greater tubercle | The larger lateral process is the ____________________, to where the pectorals major and supra-spinatus muscles attach. |
| intertubercular sulcus | The deep groove between these two tubercles is the _______________________ |
| bicipital groove | Another name for the intertubercular sulcus is? |
| surgical neck | The tapered area below the head and tubercles is the ______________. |
| Body | Distal to the surgical neck is the long _______ (shaft) of the humerus |
| deltoid tuberosity | is the roughened raised triangular elevation along the anterolateral surface of the body to which the deltoid muscle is attached |
| True AP Projection | -external rotation of shoulder - lesser tubercle is located anteriorly & greater tubercle is located laterally |
| neutral rotation | places the humerus in oblique position |
| external rotation | places the humerus in a true AP or frontal position |
| The lesser tubercle is located ________________ in a true AP projection | anteriorly |
| The greater tubercle is located _______________ in a true AP projection | laterally |
| Shoulder girdle | connects to truck anteriorly @ the upper sternum |
| ____________, connection is incomplete because scapula is connected to truck by muscles only | posteriorly |
| The shoulder girdle consists of two bones: | clavicle & scapula |
| The function of the clavicle and the scapula | is to connect each upper limb to the trunk or axial skeleton |
| The upper margin of the scapula is at the level of the _________ & the lower margin is at the level of the ____________ | second posterior rib, seventh posterior rib (T7) |
| Clavicle | is a long bone with a double curvature that has three main parts: two ends and a long central portion |
| The ______________ of the clavicle articulates with he accordion of the scapula (acromioclavicular joint) | acromial extremity |
| Acromioclavicular joint | joint or articulation; generally can be easily palpated |
| Sternal extremity; sternoclavicular joint | articulates with the manubrium, which is the upper part of the sternum; joint is easily palpated |
| jugular notch | the combination of the sternoclavicular joints on either side of the manubrium helps to form an important positioning landmark |
| body | is the elongated portion between the two extremities |
| acromial end | of the clavicle is flattened and has a downward curvature at its attachment with the acromion |
| sternal end | of the clavicle is more triangular in shape, broader, and is directed downward to articulate with the sternum |
| female clavicle | is usually shorter and less curved |
| Male clavicle | tends to be thicker and more curved |
| Scapula | forms the posterior part of the shoulder girdle, is a flat triangular bone with 3 borders, 3 angles, and 2 surfaces |
| medial (vertebral) | is the long edge or border near the vertebrae |
| superior border | the uppermost portion margin of the scapula |
| lateral (axillary) | the border nearest the axilla |
| lateral angle | sometimes called the head of the scapula, is the thickest part and ends lateral in a shallow depression called the gleaned cavity (fossa) |
| The humeral head articulates with the glenoid cavity of the scapula to form the ___________________, also known as the glenohumeral joint, or shoulder joint | scapulohumeral joint |
| Neck | constricted area between the head and the body of the scapula |
| The _________ & _______ refer to the upper and lower ends of the medial or vertebral border | superior & inferior angles |
| The ______ (blade) of the scapula is arched for greater strength | Body |
| costal surface | anterior surface of the scapula because it is proximity to the ribs |
| subscapular fossa | the middle are of the costal surface that presents a large concavity or depression |
| acromion | is a long, curved process that extends laterally over the head of the humerus |
| coracoid process | is a thick, beaklike process that projects anteriorly beneath the clavicle |
| suprascapular notch | is a notch on the superior border that is partially formed by the base of the coracoid process |
| spine (posterior view) | a prominent structure on the dorsal or posterior surface of the scapula |
| acromion (posterior view) | overhangs the shoulder joint posteriorly |
| crest (posterior view) | The posterior border ridge of the spine is thickened and is termed the _________. |
| infraspinous fossa & supraspinous fossa | serve as surfaces of attachment for shoulder muscles |
| acromion (lateral view) | is the expanded distal end of the spine that extends superiorly and posteriorly to the glenoid cavity or shoulder joint |
| coracoid process (lateral view) | is located more anteriorly in relationship to the glenoid cavity or shoulder joint |
| Body | bottom leg of the "Y" |
| dorsal surface | posterior surface of thin body portion of the scapula |
| Ventral (costal) surface | anterior surface of the body |
| Inferosuperior Axial Projection: Shoulder | - results in lateral view of the head/neck of humerus -demonstrates relationship of humerus to gleaned cavity that makes the scapulohumeral joint |
| lateral (axillary) surface | thicker edge or border that extends from the gleaned cavity to the inferior angle |
| AP Humerus | -Position: humerus aligned to long axis of IR; abduct arm slightly; supinate hand (epicondyles parallel to IR) -Central Ray: perpendicular to mid-humerus -Demonstrates: shoulder & elbow; both tubercles; greater tubercle in profile |
| Rotational Lateral: Lateromedial or Mediolateral | Position: IR centered to include both elbow & shoulder joints -Erect (PA) = elbow flexed 90; patient rotated 15-20 from PA to bring humerus & shoulder in contact w/ IR -Erect/Supine AP: elbow slightly flexed; arm/wrist rotated for lateral position (pal |
| Trauma: Horizontal Beam Lateral (mid-to-distal humerus | Position: support block under arm; rotate hand into lateral position -Central Ray: horizontal & perpendicular to IR, centered to distal 2/3 of humerus -Demonstrates: 90 degree perspective; epicondyles superimposed; unaffected limb above head |
| Transthoracic Lateral: proximal lateral | -Position: affected arm in neutral rotation; opposite arm over top of head; elevate shoulder; center mid-diaphysis of affected humerus & IR to CR as projected through thorax -Central Ray: directed through thorax to mid-diaphysis |
| AP Shoulder Girdle: external rotation | -Position: arm slightly abducted; rotate thorax to place posterior shoulder against IR; center of IR to scapulohumeral joint & CR; rotate arm until hand is supinated & epicondyles are parallel to IR -CR: perpendicular to 1" inferior to coracoid process |
| AP Shoulder Girdle: internal rotation | -Position: same as external, except rotate arm internally until hand is pronated & epicondyles are perpendicular to IR -CR: perpendicular to 1" inferior to coracoid process -Demonstrates: lesser tubercle profiled medially |
| Inferosuperior Axial (Lawrence Method) | -Position: supine; head turned away from IR; arm abducted 90 degrees from body; rotate arm externally w/ hand supinated -CR: horizontal, directed 25-30 degrees medially to axilla -Demonstrates: Hill-Sachs defect w/ exaggerated rotation of affected limb |
| PA Transaxillary (Hobbs Modification) | -Position: recumbent or erect PA; affected arm raised superiorly & fully extended; head turned away -CR: perpendicular to the IR; centered to glenohumeral joint -Demonstrates: shoulder impingement |
| Inferosuperior Axial (Clements Modification) | -Position: lateral recumbent (unaffected side); affected arm up; abduct arm 90 from body-CR: direct horizontal; perpendicular to IR; angle tube 15-20 degrees twd axilla if unable to abduct arm 90 degrees-Demonstrates: Hill-Sachs defect w/ exaggerated |
| AP Oblique (Grashey Method | Position: oblique 35-45 twd side of interest; body of scapula parallel w/ IR; hand & arm in neutral position-CR: perpendicular to scapulohumeral of joint; 2" inferior & medial to superlateral border of shoulder-Demonstrates: want to see where humerus |
| Apical AP Axial | -Position: erect; no rotation; affected hand in neutral position -CR: angle 30 degrees caudad entering 1/2" above coracoid process -Demonstrates: Impingement Syndrome |
| Tangential - Intertubercular (Bicipital) Sulcus (Fisk Modification) | Position: -Supine = abduct arm slightly; supinated hand -Alt. Erect = patient standing, leaning over end of table to place humerus 10-15 degrees from vertical |
| Tangential -inter tubercular (Bicipital) Sulcus(Fisk modification) | CR: -Supine = 10-15 degrees posterior from horizontal position of tube; centered to groove; IR vertical against top of shoulder, perpendicular to CR -Alt. Erect = vertical, perpendicular to IR -Demonstrates: anterior humeral head visualized; groove pro |
| AP Scapula | -Position: erect/supine; abduct arm 90 degrees; supinate hand; IR (2" above shoulder) & entire scapula center to CR-CR: to mid-scapula for body of scapula; to acromion or coracoid for upper scapula-Demonstrates: entire scapula; lateral border of scapula |
| Lateral Scapula “erect” | -Position: rotate thorax until body of scapula is perpendicular to IR (45-60 degree rotation)-CR: perpendicular to mid-vertebral border of scapula -Demonstrates: what they want to look @ dictates placement of arm |
| AP Bilateral W/ & W/O Weights (Pearson Method | -Position: erect; arms @ sides; 1 exposure w/o weights & 2nd exposure w/ 8-10 lb. min. (5-8 for smaller patient); weights tied to wrists; shoulders & arms relaxed |
| AP Bilateral W/ & W/O Weights (Pearson Method) | -CR: perpendicular to midpoint btw AC joints, 1" above jugular notch -Demonstrates: AC joint images |
| AP Axial | -Position: erect/recumbent; center clavicle/IR -CR: 15-30 degrees cephalad (PA is angled caudad) |
| Lateral Scapula | -Recumbent -Position: rotate thorax until body of scapula is perpendicular to IR (45-60 degree rotation |
| Lateral Scapula | CR: perpendicular to mid-vertebral border of scapula Demonstrates: border of scapula superimposed, free of superimposition by ribs, arm elevated to demonstrate scapular body |
| AP Clavicle & AC Joints | -Position: erect; center clavicle & IR to CR -CR: perpendicular to mid-clavicle -Demonstrates: entire clavicle; 4 sided collimation (can be done PA) |
| AP Apical Oblique Axial (Garth Method) | -CR: 45 degrees caudad to medial aspect of scapulohumeral joint -Demonstrates: humeral head, glenoid, & neck free of superimposition |
| AP Apical Oblique Axial (Garth Method) | -Position: rotate thorax 45 degrees w/ affected shoulder against IR; flex affected elbow & place hand on opposite shoulder |
| Tangential: Supraspinatus Outlet (Neer Method) | -Position: -CR: angled 10-15 degrees caudad to better demonstrate acromiohumeral space; CR to superior margin of humeral head |
| Tangential: Supraspinatus Outlet (Neer Method) | -Demonstrates: supraspinatus outlet open & in profile; coracoacromial arch demonstrated |
| PA Oblique: Scapular Y Lateral | -Position: erect / recumbent; from PA, rotate affected shoulder into 45-60 degree posterior oblique as for a lateral scapula; center scapulohumeral joint & CR |
| PA Oblique: Scapular Y Lateral | -CR: to proximal humerus (2" below top of shoulder) -Demonstrates: humeral head & glenoid superimposed; acromion & coracoid in profile |
| Transthoracic Lateral (Lawrence Method | -Position: affected arm against IR; unaffected arm above head; elevate unaffected shoulder or angle CR 10-15 cephalad; true lateral |
| Transthoracic Lateral (Lawrence Method | CR: perpendicular through thorax to surgical neck -Demonstrates: proximal humerus clearly seen; humeral head & glenoid cavity seen; humeral head in neutral rotation |
| AP: Neutral Rotation | -Position: arm slightly abducted; rotate thorax slightly to place posterior shoulder against IR; arm in neutral position (palm inward) |
| AP: Neutral Rotation | -CR: perpendicular to 3/4" inferior to coracoid process -Demonstrates: greater tubercle superimposed |
| synovial joints | are characterized by a fibrous capsule that contains synovial fluid |
| Synovial joint movement: | freely movable or diathrodial |
| scapulohumeral (glenohumeral) joint | involves the articulation between the head of the humerus and the gleaned cavity of the scapula; ball and socket or spheroidal joint |
| sternoclavicular joint | is a double plane or gliding joint; limited amount of gliding in nearly all directions |
| external rotation | parallell to the IR |
| acromioclavicular joint | is a small synovial joint of the plane or gliding movement btw acromial end of clavicle & medial aspect of the acromion of the scapula |
| internal rotation | perpendicular to the IR |
| neutral rotation | 45 degree angle to the IR; the palm of the hand is facing inward toward the thigh |
| superior and inferior angles | refer to the upper and lower ends of the medial or vertebral border |
| Means "of unknown cause" | Idiopathic |
| humerus | largest & longest bone of the upper limb |
| Trauma Horizontal Beam Lateral: Mid to Distal Humerus | Proximal Humerus |
| Inferosuperior Axial Projection: Shoulder Projection | Lawerence Method |
| PA Transaxillary Projection: Shoulder | Hobbs Modification |
| Inferosuperior Axial Projection: Shoulder | Clements Modification |
| Grashey Method |
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sassyrad
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