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shoulder and humerus
bontrager
| Question | Answer |
|---|---|
| What is the largest and longest bone of the upper limb? | The humerus. |
| What is the approximate length of the humerus in adults? | About one-fifth of body height. |
| With which bone does the humerus articulate at the shoulder joint? | The scapula. |
| What is the rounded part of the proximal humerus called? | The head of the humerus. |
| What is the name of the line of demarcation between the head and the adjoining tubercles of the humerus? | The anatomic neck. |
| What are the two tubercles located below the anatomic neck of the humerus? | The greater tubercle and the lesser tubercle. |
| What is the deep groove between the greater and lesser tubercles called? | The intertubercular sulcus (bicipital groove). |
| What is the tapered area below the head and tubercles of the humerus known as? | The surgical neck. |
| What is the roughened raised triangular elevation on the humerus where the deltoid muscle attaches? | The deltoid tuberosity. |
| What is the function of the shoulder girdle? | To connect each upper limb to the trunk or axial skeleton. |
| What are the two bones that make up the shoulder girdle? | The clavicle and the scapula. |
| Where does the clavicle articulate with the scapula? | At the acromioclavicular joint. |
| What is the articulation between the medial end of the clavicle and the sternum called? | The sternoclavicular joint. |
| What is the jugular notch? | An important positioning landmark formed by the combination of the sternoclavicular joints. |
| What is the shape of the scapula? | A flat triangular bone. |
| What are the three borders of the scapula? | Medial (vertebral), superior, and lateral (axillary) borders. |
| What is the thickest part of the scapula called? | The lateral angle. |
| What is the shallow depression at the lateral angle of the scapula called? | The glenoid cavity (fossa). |
| What joint is formed by the humeral head and the glenoid cavity? | The scapulohumeral (glenohumeral) joint. |
| What is the constricted area between the head and the body of the scapula called? | The neck of the scapula. |
| What is the significance of the surgical neck of the humerus? | It is the site of frequent fractures requiring surgery. |
| What is the position of the humerus in a neutral rotation radiograph? | Oblique position midway between anteroposterior (AP) and lateral. |
| What does the AP radiograph of the shoulder taken with external rotation show? | The humerus in a true AP or frontal position. |
| What is the typical difference in clavicle size and shape between males and females? | The female clavicle is usually shorter and less curved than the male clavicle. |
| What are the three main parts of the clavicle? | Two ends (acromial and sternal extremities) and a long central portion (body). |
| What is the purpose of the acromioclavicular joint? | To connect the acromial extremity of the clavicle with the acromion of the scapula. |
| What anatomical landmarks correspond to the upper and lower margins of the scapula? | Upper margin at the level of the second posterior rib and lower margin at the level of the seventh posterior rib (T7). |
| What is the common name for the clavicle? | The collarbone. |
| What is the primary role of the shoulder girdle? | To facilitate movement and stability of the upper limb. |
| What is the neck of the scapula? | The constricted area between the head and the body of the scapula. |
| What are the superior and inferior angles of the scapula? | The upper and lower ends of the medial or vertebral border of the scapula. |
| What is the costal surface of the scapula? | The anterior surface of the scapula, named for its proximity to the ribs. |
| What is the subscapular fossa? | A large concavity or depression in the middle area of the costal surface of the scapula. |
| What is the acromion? | A long, curved process that extends laterally over the head of the humerus. |
| What is the coracoid process? | A thick, beaklike process that projects anteriorly beneath the clavicle. |
| What is the suprascapular notch? | A notch on the superior border of the scapula, partially formed by the base of the coracoid process. |
| What does the spine of the scapula do? | It separates the posterior surface into the infraspinous fossa and the supraspinous fossa. |
| What is the glenoid cavity? | The articulating surface of the lateral angle of the scapula that forms the scapulohumeral joint. |
| What type of joint is the scapulohumeral joint? | A ball-and-socket (spheroidal) joint allowing great freedom of movement. |
| What movements are allowed by the scapulohumeral joint? | Flexion, extension, abduction, adduction, circumduction, and medial and lateral rotation. |
| What are the three joints of the shoulder girdle? | Sternoclavicular joint, acromioclavicular joint, and scapulohumeral joint. |
| What type of joint is the sternoclavicular joint? | A double plane or gliding joint. |
| What is the primary movement of the acromioclavicular joint? | A gliding action between the end of the clavicle and the acromion. |
| What is the function of the shoulder girdle joints? | They provide mobility and stability to the shoulder area. |
| What is the dorsal surface of the scapula? | The posterior surface of the scapula. |
| What is the ventral surface of the scapula? | The anterior surface of the scapula, also known as the costal surface. |
| What is the lateral (axillary) border of the scapula? | The thicker edge or border that extends from the glenoid cavity to the inferior angle. |
| What is the significance of the scapula's shallow glenoid cavity? | It allows for the greatest freedom of mobility of any joint in the human body. |
| What can cause dislocation of the scapulohumeral joint? | Stretching of the muscles and tendons surrounding the joint. |
| What is the inferior angle of the scapula? | The lowest point of the scapula where the medial and lateral borders meet. |
| What is the relationship between the humerus and the glenoid cavity? | The head of the humerus articulates with the glenoid cavity to form the shoulder joint. |
| What is the anatomical position of the coracoid process? | It is located anteriorly in relation to the glenoid cavity. |
| What is the clinical importance of the shoulder girdle joints? | They require frequent radiographic examinations to evaluate for structural damage due to dislocations. |
| What is the shape of the scapula in a lateral view? | It resembles the letter Y. |
| What is the crest of the spine of the scapula? | The thickened posterior border or ridge of the spine. |
| What are the fossae associated with the scapula? | The infraspinous fossa and supraspinous fossa, which serve as attachment surfaces for shoulder muscles. |
| What is the purpose of rotational views of the proximal humerus? | To delineate the scapulohumeral joint and reveal possible calcium deposits or other pathology. |
| What anatomical landmarks are important in external rotation of the humerus? | The epicondyles of the distal humerus should be parallel to the image receptor. |
| In external rotation, where is the greater tubercle located? | Laterally in profile. |
| What is the positioning requirement for internal rotation of the humerus? | The epicondyles of the distal humerus must be perpendicular to the image receptor. |
| What does the internal rotation position reveal about the greater tubercle? | It is rotated to the anterior and medial aspect of the humerus. |
| What is the neutral rotation position used for? | It is appropriate for trauma patients when rotation of the part is unacceptable. |
| What angle do the epicondyles appear at in neutral rotation? | Approximately 45° to the image receptor. |
| What is the purpose of using a boomerang filter in shoulder radiography? | To clearly demonstrate both soft tissues and bony anatomy. |
| Why is gonadal shielding important during upper limb radiography? | To protect radiosensitive tissues due to the proximity of upper limb parts to the gonads. |
| What organs are considered radiosensitive during shoulder region radiography? | Thyroid, lungs, and breasts. |
| What is the recommended kVp for adult shoulders thicker than 4 inches? | 70 to 85 kVp with a grid. |
| What adjustments are necessary for pediatric patients in radiography? | Exposure technique must be decreased to compensate for less tissue quantity. |
| What should be considered when radiographing geriatric patients? | Clear instructions and possible reduction in radiographic technique due to destructive pathologies. |
| What palpation points should be used for bariatric patients during shoulder projections? | The jugular notch and AC joint. |
| What is the significance of the greater tubercle in neutral rotation? | It remains anteriorly but lateral to the lesser tubercle. |
| What is the recommended source-image receptor distance (SID) for shoulder radiography? | 40 to 44 inches (100 to 110 cm), except for AC joints which may use 72 inches (180 cm). |
| What is the effect of using a grid during AC joint radiography? | It reduces scatter radiation but increases the dose to the patient. |
| What is the role of immobilization in pediatric radiography? | To assist the child in maintaining the proper position during the examination. |
| What is a common challenge when radiographing pediatric patients? | Patient motion can significantly affect image quality. |
| How should a technologist communicate with pediatric patients? | In a soothing manner using words they can easily understand. |
| What should be done if parents are present during a pediatric radiographic examination? | Proper shielding must be provided. |
| What is the importance of collimating the field size during shoulder radiography? | To minimize radiation exposure to radiosensitive organs. |
| What is the effect of using virtual grid software during imaging processing? | No physical grid is necessary, reducing patient dose. |
| What is the positioning requirement for the humerus in the external rotation view? | The hand must be supinated and the elbow externally rotated. |
| What does the AP projection in internal rotation show? | A lateral position of the proximal humerus. |
| What is the typical thickness measurement for adult shoulders? | 4 to 6 inches (10 to 15 cm). |
| What is the significance of the lesser tubercle in external rotation? | It is located anteriorly, just medial to the greater tubercle. |
| What is the purpose of using a compensating filter in radiography? | To enhance visualization of both soft tissue and bony anatomy. |
| What is the purpose of collimation in imaging? | To reduce scatter reaching the image receptor and ensure optimal image quality. |
| What is the ALARA principle? | As Low As Reasonably Achievable; it aims to minimize patient exposure to radiation. |
| What imaging modality is used to evaluate soft tissue pathologies like rotator cuff tears? | Arthrography. |
| What is the role of computed tomography (CT) in shoulder imaging? | To evaluate soft tissue and skeletal involvement of lesions and soft tissue injuries. |
| How does magnetic resonance imaging (MRI) assist in shoulder evaluations? | It is useful for diagnosing rotator cuff injuries and assessing soft tissue damage. |
| What is the significance of nuclear medicine scans? | They are sensitive in demonstrating conditions like osteomyelitis and metastatic bone lesions. |
| What is diagnostic medical sonography (DMS) used for? | To evaluate soft tissues within joints for possible injuries, such as rotator cuff tears. |
| What is AC joint separation? | Trauma resulting in a partial or complete tear of the AC or coracoclavicular ligaments. |
| What causes acromioclavicular dislocation? | Usually caused by a fall, resulting in the distal clavicle being displaced superiorly. |
| What is a Bankart lesion? | An injury of the anteroinferior aspect of the glenoid labrum, often due to anterior dislocation. |
| What is bursitis? | Inflammation of the bursae, often caused by repetitive motion, trauma, or infection. |
| What is a Hill-Sachs defect? | A compression fracture of the articular surface of the humeral head associated with dislocation. |
| What is idiopathic chronic adhesive capsulitis? | Also known as frozen shoulder, it causes pain and limitation of motion due to chronic inflammation. |
| What is impingement syndrome? | Impingement of the greater tuberosity and soft tissues on the coracoacromial arch during arm abduction. |
| What characterizes osteoarthritis? | Gradual deterioration of articular cartilage with hypertrophic bone formation, common in aging. |
| What is osteoporosis? | A reduction in bone quantity or atrophy of skeletal tissue, leading to increased fracture risk. |
| What is rheumatoid arthritis? | A chronic systemic disease characterized by inflammatory changes in connective tissues and joints. |
| What is rotator cuff pathology? | An acute or chronic injury to one or more rotator cuff muscles, limiting shoulder range of motion. |
| What is the most common type of shoulder dislocation? | Anterior dislocation, where the humeral head is projected anterior to the glenoid cavity. |
| What is tendonitis? | An inflammatory condition of the tendon usually resulting from a strain. |
| What is the importance of accurate centering in digital imaging? | It ensures the body part and the central ray are correctly aligned with the image receptor. |
| What does the postprocessing evaluation of the exposure indicator involve? | Assessing if the exposure factors met ALARA standards and produced a quality image. |
| What is the benefit of using a grid during imaging of the proximal humerus? | It reduces scatter radiation and increases image contrast and visibility of anatomy. |
| What is the effect of virtual grid software on imaging? | It eliminates the need for a physical grid while still managing scatter during image processing. |
| What are the classifications of AC joint separation? | There are six classifications, ranging from a sprain to complete separation of the distal clavicle. |
| What is the most common cause of bursitis in the shoulder? | Repetitive motion. |
| What is the typical age demographic for osteoarthritis? | Individuals older than 50 years. |
| What is the common outcome of repeated shoulder dislocations? | Increased risk of a Bankart lesion and other soft tissue injuries. |
| What imaging projections are used for shoulder assessment? | AP internal rotation, PA oblique (scapular Y), and AP oblique (Grashey). |
| What does an AP projection of the humerus show? | The entire humerus, including the shoulder and elbow joints. |
| What is the recommended SID for humerus imaging? | Minimum SID is 40 inches (100 cm). |
| What is the significance of the Neer method? | It is used to evaluate shoulder impingement by visualizing the acromion and humeral head. |
| What are the common radiographic appearances of osteoarthritis? | Narrowing of joint space, bony erosion, and bony deformity. |
| What is the typical kVp range for shoulder imaging? | 70-85 kVp. |
| What does a lateral projection of the humerus demonstrate? | The entire humerus, including the elbow and shoulder joints, with epicondyles superimposed. |
| What is the purpose of the Zanca method? | To assess the acromioclavicular joint for separation or dislocation. |
| What is a rotator cuff injury? | An injury to the group of muscles and tendons that stabilize the shoulder. |
| What is the appearance of a complete rotator cuff tear on imaging? | Partial or complete tear in musculature, often requiring MRI for confirmation. |
| What is the clinical indication for using the horizontal beam lateral projection? | To visualize fractures and dislocations of the mid and distal humerus. |
| What are the key evaluation criteria for an AP humerus projection? | Clear visualization of the entire humerus, alignment with the long axis of the IR, and minimal superimposition of the glenoid cavity. |
| What does the term 'calcified tendons' refer to? | Tendons that have developed calcium deposits, often leading to pain and reduced mobility. |
| What is the importance of suspending respiration during exposure? | To prevent motion blur and ensure a clear image. |
| What is the appearance of an AC joint separation on imaging? | Asymmetric widening of the AC joint space compared to the contralateral side. |
| What is the significance of a compression fracture of the humeral head? | It indicates trauma and may require surgical intervention depending on severity. |
| What is the role of MRI in shoulder imaging? | To assess soft tissue injuries, including rotator cuff tears and tendonitis. |
| What does a PA oblique (scapular Y) projection visualize? | The scapula and the relationship between the humeral head and glenoid cavity. |
| What are common imaging findings in rheumatoid arthritis (RA)? | Loss of joint space, bony erosion, and deformity. |
| What is the typical appearance of a shoulder dislocation on imaging? | Separation between the humeral head and glenoid cavity. |
| What does the term 'fluid-filled joint space' indicate? | Possible joint effusion or inflammation, often seen in conditions like bursitis. |
| What is the recommended field size for humerus imaging? | 14 x 17 inches (35 x 43 cm) to include the entire humerus. |
| What is the optimal image receptor exposure for visualizing sharp cortical borders? | Optimal image receptor exposure and contrast should visualize sharp cortical borders and clear, sharp bony trabecular markings. |
| What is the recommended field size for a transthoracic lateral projection of the humerus? | 14 x 17 inches (35 x 43 cm), portrait. |
| What is the minimum SID for a transthoracic lateral projection? | 40 inches (100 cm). |
| What is the kVp range for a transthoracic lateral projection of the humerus? | 75-90 kVp. |
| What patient position is preferred for a transthoracic lateral projection? | Erect position is preferred for comfort, but supine can be used. |
| What is the purpose of using orthostatic breathing technique during a transthoracic lateral projection? | It allows the best visualization of the humerus by blurring out ribs and lung structures. |
| What should be done if the patient cannot elevate the uninjured arm during a transthoracic lateral projection? | Angle the CR 10° to 15° cephalad. |
| What anatomy should be visualized in a transthoracic lateral projection? | Lateral view of the entire humerus and glenohumeral joint without superimposition of the opposite humerus. |
| What is the evaluation criteria for a transthoracic lateral projection? | The outline of the humerus should be clearly visualized anterior to the thoracic vertebrae. |
| What are the clinical indications for an AP projection of the proximal humerus? | Fractures or dislocations of the proximal humerus and shoulder girdle, calcium deposits, and degenerative conditions. |
| What is the recommended field size for an AP projection of the proximal humerus? | 10 x 12 inches (24 x 30 cm), landscape or portrait. |
| What is the kVp range for an AP projection of the proximal humerus? | 70-85 kVp. |
| What is the correct patient position for an AP external rotation of the shoulder? | Patient should be in an erect or supine position with the shoulder in contact with the IR. |
| How should the arm be positioned for an AP external rotation of the shoulder? | Abduct the extended arm slightly and externally rotate until the epicondyles are parallel to the IR. |
| What is the CR direction for an AP projection of the proximal humerus? | CR perpendicular to IR, directed to 1 inch (2.5 cm) inferior to the coracoid process. |
| What should be visualized in an AP projection of the proximal humerus? | The relationship of the humeral head to the glenoid cavity and the lateral two-thirds of the clavicle. |
| What indicates full external rotation in an AP projection of the proximal humerus? | The greater tubercle visualized in full profile on the lateral aspect of the proximal humerus. |
| What is the evaluation criteria for an AP projection of the proximal humerus? | Clear, sharp bony trabecular markings with soft tissue detail visible for possible calcium deposits. |
| What is the purpose of an AP internal rotation projection of the shoulder? | To visualize fractures or dislocations of the proximal humerus and shoulder girdle. |
| What is the correct arm position for an AP internal rotation of the shoulder? | Internally rotate the arm until the epicondyles are perpendicular to the IR. |
| What should be visualized in an AP internal rotation projection of the shoulder? | The relationship of the humeral head to the glenoid cavity and the lateral two-thirds of the clavicle. |
| What is the CR direction for an AP internal rotation projection of the shoulder? | CR perpendicular to IR, directed to 1 inch (2.5 cm) inferior to the coracoid process. |
| What is the evaluation criteria for an AP internal rotation projection of the shoulder? | The lesser tubercle visualized in full profile on the medial aspect of the humeral head. |
| What is the warning for performing a shoulder projection? | Do not attempt to rotate the arm if a fracture or dislocation is suspected. |
| What are the clinical indications for shoulder imaging? | Degenerative conditions, including osteoporosis and osteoarthritis; Hill-Sachs defect with exaggerated rotation of affected limb. |
| What is the recommended minimum SID for shoulder imaging? | 40 inches (100 cm). |
| What is the recommended field size for shoulder imaging? | 8 x 10 inches (18 x 24 cm) or 10 x 12 inches (24 x 30 cm). |
| What is the kVp range for shoulder imaging? | 70-85. |
| What is the patient position for the inferosuperior axial projection? | Patient supine with shoulder raised approximately 2 inches (5 cm) from the tabletop. |
| What is the part position for the inferosuperior axial projection? | Abduct arm 90° from body, keep in external rotation, palm up. |
| What anatomy is demonstrated in the inferosuperior axial projection? | Lateral view of proximal humerus in relationship to scapulohumeral cavity. |
| What is the CR angle for the inferosuperior axial projection? | Direct CR medially 25° to 30°. |
| What should be done if the arm abduction is less than 90°? | Decrease the CR medial angle to 15° to 20°. |
| What is the evaluation criteria for the inferosuperior axial projection? | Optimal image receptor exposure and contrast with clear bony trabecular markings. |
| What is the clinical indication for the modified Bernageau method? | Fractures or dislocations of the proximal humerus. |
| What is the patient position for the PA transaxillary projection? | Lateral recumbent position with the affected arm up. |
| What is the CR direction for the PA transaxillary projection? | Direct horizontal CR perpendicular to IR. |
| What is the evaluation criteria for the PA transaxillary projection? | Lateral view of proximal humerus in relationship to scapulohumeral cavity. |
| What is the clinical indication for the Grashey method? | Fractures or dislocations of proximal humerus, Bankart lesion, erosion of glenoid rim. |
| What is the part position for the Grashey method? | Rotate body 35° to 45° toward affected side. |
| What is the CR direction for the Grashey method? | CR is centered at the midscapulohumeral joint. |
| What is the purpose of collimation in shoulder imaging? | To closely limit the field size to the area of interest. |
| What should be done during exposure in shoulder imaging? | Suspend respiration. |
| What is the alternative position for the inferosuperior axial projection? | Exaggerated external rotation with the thumb pointed down and posteriorly. |
| What is the significance of the Hill-Sachs defect? | It may result in a compression fracture of the articular surface of the humeral head. |
| What is the evaluation criteria for the superoinferior transaxillary projection? | Lateral view of proximal humerus with clear bony trabecular markings. |
| What is the CR angle for the superoinferior transaxillary projection? | CR is directed 30° caudally. |
| What is the recommended field size for the superoinferior transaxillary projection? | 8 x 10 inches (18 x 24 cm) or 10 x 12 inches (24 x 30 cm), landscape. |
| What should be avoided if a fracture or dislocation is suspected? | Do not attempt to rotate, force extension, or abduct the arm. |
| What is the importance of the coracoid process in shoulder imaging? | It is seen on end in the lateral view of the proximal humerus. |
| What is the significance of the acromion in shoulder imaging? | Bony margins of the acromion are visible through the humeral head. |
| What is the evaluation criteria for the modified Bernageau method? | Clear visualization of the relationship of the humeral head and glenoid cavity. |
| What is the patient position for the superoinferior transaxillary projection? | Patient sitting at the end of the table, affected side toward the table. |
| What should be done if the patient cannot abduct the arm 90° in the PA transaxillary projection? | Angle the tube 5° to 15° toward the axilla. |
| What is the recommended position for the image receptor when adjusting for shoulder imaging? | The top of the image receptor should be approximately 2 inches (5 cm) above the shoulder. |
| What is the correct CR direction for glenoid fossa imaging? | CR is directed perpendicular to the glenoid fossa, approximately 5-15° toward the elbow. |
| What anatomical structures should be visualized in profile during shoulder imaging? | The glenoid cavity should be seen in profile without superimposition of the humeral head. |
| What is the purpose of using a sponge during shoulder imaging? | A sponge can be used to rotate the glenoid cavity away from the chest wall into a more vertical position. |
| What is the optimal exposure for shoulder imaging? | Optimal exposure should visualize soft tissue margins and clear, sharp bony trabecular markings. |
| What should be done with respiration during shoulder imaging exposure? | Suspend respiration during exposure. |
| What does the AP oblique projection (Grashey method) demonstrate? | It demonstrates the scapulohumeral joint space and the relationship of the humeral head and glenoid cavity. |
| What is the clinical indication for the apical AP axial projection? | It demonstrates narrowing of the acromiohumeral space and possible spurring of the acromion. |
| What is the minimum SID recommended for shoulder imaging? | Minimum SID is 40 inches (100 cm). |
| What is the purpose of the tangential projection (Fisk modification)? | It is used to visualize pathologies of the intertubercular sulcus, including bony spurs. |
| What is the correct CR angle for the Fisk modification? | CR is angled 10° to 15° posterior from horizontal, directed to the groove at midanterior margin of the humeral head. |
| What should be the arm position for the Fisk modification? | The arm should be extended and slightly abducted with the hand in neutral rotation. |
| What is the evaluation criteria for the AP projection in neutral rotation? | The anterior margin of the humeral head should be seen in profile, with the humeral tubercles and intertubercular sulcus also visible. |
| What should be avoided if a fracture or dislocation is suspected during shoulder imaging? | Do not attempt to rotate the arm; perform in neutral rotation. |
| What anatomical structures are visualized in the lateral view of the proximal humerus? | The coracoid process of the scapula and the relationship of the humeral head and glenoid cavity. |
| What is the significance of the acromiohumeral space in shoulder imaging? | It may indicate injury to the supraspinatus tendon or signs of shoulder impingement syndrome. |
| What should be visualized in the apical AP axial projection? | The anteroinferior aspect of the acromion should be demonstrated. |
| What is the recommended patient position for the tangential projection? | Patient can be standing, leaning over the end of the table, or supine with the arm at the side. |
| What is the importance of the 30° caudal CR angle in the apical AP axial projection? | It helps to visualize the acromiohumeral joint space more clearly. |
| What should be done to reduce backscatter to the image receptor during shoulder imaging? | Place a lead shield between the back of the image receptor and the forearm. |
| What is the evaluation criteria for the tangential projection? | The outline of the medial aspect of the humeral head should be visible through the glenoid cavity. |
| What is the significance of visualizing soft tissue detail in shoulder imaging? | It can help to demonstrate possible calcium deposits or other pathologies. |
| What is the correct positioning of the patient's head during shoulder imaging? | Tilt the patient's head away from the affected shoulder. |
| What should be the relationship of the humeral head and glenoid cavity in shoulder imaging? | The relationship should be evident and clearly visualized. |
| What is the clinical indication for the Lawrence Method? | Fractures or dislocations of the proximal humerus. |
| What is the recommended minimum SID for the transthoracic lateral projection? | 40 inches (100 cm). |
| What is the recommended field size for the transthoracic lateral projection? | 10 x 12 inches (24 x 30 cm), portrait. |
| What is the kVp range for the transthoracic lateral projection? | 70-80. |
| What technique is used to blur surrounding pulmonary structures during the transthoracic lateral projection? | Orthostatic (breathing) technique with a minimum of 3 seconds exposure time. |
| What position should the patient be in for the transthoracic lateral projection? | Erect or supine position; erect is usually less painful. |
| How should the patient's arm be positioned for the transthoracic lateral projection? | At the side in 'as is' neutral rotation. |
| Where should the CR be directed for the transthoracic lateral projection? | To the midscapulohumeral joint, approximately 3/4 inch (2 cm) inferior and slightly lateral to the coracoid process. |
| What should be the collimation for the transthoracic lateral projection? | Collimate on four sides to the area of interest. |
| What is the respiration instruction during exposure for the transthoracic lateral projection? | Suspend respiration during exposure. |
| What anatomy should be demonstrated in the transthoracic lateral projection? | The proximal one-third of the humerus, upper scapula, and lateral two-thirds of the clavicle. |
| What is the optimal image receptor exposure for the transthoracic lateral projection? | Demonstrate the entire outline of the humeral head and proximal half of the humerus. |
| What should be done if the patient is in too much pain to drop the injured shoulder? | Angle the CR 10° to 15° cephalad. |
| What should be the patient position for the PA oblique (scapular Y lateral) projection? | Erect or recumbent position, with side of interest against the IR. |
| What is the clinical indication for the PA oblique (scapular Y lateral) projection? | Fractures or dislocations of the proximal humerus and scapula. |
| What should the CR be directed to for the PA oblique (scapular Y lateral) projection? | To the scapulohumeral joint, 2 inches (5 cm) below the AC joint. |
| What anatomy should be visualized in the PA oblique (scapular Y lateral) projection? | True lateral view of the scapula, proximal humerus, and scapulohumeral joint. |
| What is the kVp range for the PA oblique (scapular Y lateral) projection? | 70-85. |
| What is the recommended field size for the PA oblique (scapular Y lateral) projection? | 10 x 12 inches (24 x 30 cm), portrait. |
| What should be the position of the arm during the PA oblique (scapular Y lateral) projection? | Abducted slightly to avoid superimposing the proximal humerus over ribs. |
| What is the purpose of the Neer method in the tangential projection? | To demonstrate the coracoacromial arch for supraspinatus outlet region for possible shoulder impingement. |
| What is the recommended patient position for the Neer method? | Erect or recumbent position. |
| What is the minimum SID for the Neer method? | 40 inches (100 cm). |
| What is the kVp range for the Neer method? | 70-85. |
| What should the CR be directed to for the Neer method? | To the scapulohumeral joint, centered to the IR. |
| What should be the respiration instruction during exposure for the Neer method? | Suspend respiration during exposure. |
| What is the evaluation criteria for the Neer method? | Visualize the coracoacromial arch and the supraspinatus outlet without superimposition. |
| What is the recommended CR angle for the scapulohumeral joint projection? | 10° to 15° caudal angle. |
| Where should the CR be centered for the scapulohumeral joint? | At the scapulohumeral joint, approximately 1 inch superior to the medial aspect of the scapular spine. |
| What is the recommended patient position for the scapulohumeral joint radiograph? | Erect or supine position, rotated 45° toward the affected side. |
| What should be done with the arm during the scapulohumeral joint radiograph? | Flex the elbow and place the arm across the chest or at the side in case of trauma. |
| What anatomy should be demonstrated in the scapulohumeral joint radiograph? | Humeral head, glenoid cavity, neck and head of the scapula, and coracoid process. |
| What is the purpose of the Garth method? | To obtain an optimal trauma projection for possible scapulohumeral dislocations. |
| What should be visible in the AP axial projection of the clavicle? | Entire clavicle visualized, including both AC and sternoclavicular joints. |
| What is the CR angle for the AP axial projection of the clavicle? | 15° to 30° cephalad to midclavicle. |
| What is the minimum SID recommended for clavicle projections? | 40 inches (100 cm). |
| What is the recommended field size for the AP axial clavicle projection? | 10 x 12 inches (24 x 30 cm), landscape. |
| What should be done with the patient's respiration during exposure? | Suspend respiration during exposure. |
| What is the evaluation criterion for the AP projection of the AC joints? | Widening of one joint space compared with the other indicates AC joint separation. |
| What is the purpose of using weights in AC joint studies? | To compare joint spaces and assess for possible AC joint separation. |
| What is the CR positioning for the AP projection of AC joints? | CR perpendicular to midpoint between AC joints, 1 inch above the jugular notch. |
| What should be included in the collimation for the clavicle projection? | Collimate to the area of clavicle, ensuring both AC and sternoclavicular joints are included. |
| What is the optimal image receptor exposure for the scapulohumeral joint? | Clear, sharp bony trabecular markings and soft tissue detail for possible calcifications. |
| How should the patient be positioned for the Garth method? | Erect position with posterior shoulders against the cassette. |
| What is the significance of the coracoid process in the scapulohumeral joint radiograph? | It should be projected over part of the humeral head, which appears elongated. |
| What should be demonstrated in the AP axial projection of the clavicle? | Correct angulation of CR projects most of the clavicle above the scapula. |
| What is the evaluation criterion for the AP axial projection of the clavicle? | Bony margins and trabecular markings should appear sharp, indicating no motion. |
| What is the recommended field size for AC joint projections? | 14 x 17 inches (35 x 43 cm), landscape. |
| What is the recommended CR angle for thin patients during clavicle projection? | 25° to 30° CR angle. |
| What should be ensured during the collimation for AC joint projections? | Upper light border should be to upper shoulder soft tissue margins. |
| What should be checked before performing AC joint projections? | Shoulder or clavicle projections should be completed first to rule out fracture. |
| What is the importance of the supraspinatus outlet in the scapulohumeral joint radiograph? | It should appear open, free of superimposition by the humeral head. |
| What is the optimal exposure for the distal clavicle and AC joint? | Should be demonstrated without excessive image receptor exposure. |
| What is the minimum weight to strap to each wrist for large adult patients during radiographic exposure? | 8 to 10 lb (3.5 to 4.5 kg) |
| What should patients not do with the weights during the radiographic procedure? | Patients should not hold onto the weights with their hands. |
| What is the purpose of not allowing patients to hold onto the weights? | Holding onto weights may result in false-negative radiographs due to muscle contraction. |
| What is the cephalic angle used in the Alternative AP Axial Projection (Alexander Method)? | 15° cephalic angle |
| What does the Alexander Method project? | It projects the AC joint superior to the acromion for optimal visualization. |
| What is the kVp range recommended for scapula radiographs? | 70-85 kVp |
| What is the minimum SID for scapula radiographs? | 40 inches (100 cm) |
| What is the recommended field size for scapula radiographs? | 10 x 12 inches (24 x 30 cm), portrait |
| What should be demonstrated in the evaluation criteria for AC joint radiographs? | Both AC joints, entire clavicles, and SC joints should be demonstrated. |
| What is the recommended exposure time for scapula radiographs? | Minimum of 3 seconds, with 4 to 5 seconds being desirable. |
| What should be the position of the patient's arm during the AP scapula projection? | The arm should be gently abducted 90° and the hand supinated. |
| What is the CR location for the AP scapula projection? | 2 inches (5 cm) inferior to the coracoid process. |
| What is the evaluation criterion for the lateral scapula position? | The entire scapula should be visualized in a lateral position. |
| What should be avoided to prevent superimposition in scapula radiographs? | The humerus should not superimpose the area of interest of the scapula. |
| What is the purpose of using a breathing technique during scapula radiographs? | To minimize motion and demonstrate clear bony trabecular markings. |
| What is the recommended patient position for the lateral scapula projection? | The patient should be in an erect or recumbent position. |
| What is the clinical indication for performing a lateral scapula radiograph? | Horizontal fractures of the scapula. |
| What should be palpated to ensure proper positioning of the scapula? | The superior angle of the scapula and the AC joint articulation. |
| What is the recommended technique for the AP projection of the scapula? | The patient should face the IR in an anterior oblique position. |
| What is the significance of the midscapular area in radiographic positioning? | It should be centered to the CR for accurate imaging. |
| What is the purpose of the alternative supine position in radiography? | To accommodate patients whose condition requires it. |
| What should be done to the patient's legs during the supine position for scapula radiography? | Knees should be partially flexed. |
| What should be the orientation of the patient's body for a true lateral position? | The vertebral and lateral borders of the scapula should be superimposed. |
| What is the importance of collimation in radiographic procedures? | To limit exposure and focus on the area of interest. |
| What should be done if the patient's condition allows during radiographic procedures? | The erect position should be preferred for comfort. |
| What is the effect of arm position on the amount of body rotation required? | Less rotation is required with the arm up across the anterior chest. |
| What is the evaluation criterion for optimal image quality in scapula radiographs? | Sharp bony borders and trabecular markings without decreased image quality. |
| What should be demonstrated to confirm the absence of rotation in AC joint imaging? | Symmetric appearance of the sternoclavicular joints on each side of the vertebral column. |
| What is the purpose of using a long strip of gauze in the supine position? | To tie the patient's wrists and assist in positioning. |
| What is the clinical indication for the AP projection of the scapula? | Fractures and other pathologies of the scapula. |
| What should be evaluated regarding technical factors in radiographs? | Optimal exposure and collimation field size. |
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