Anatomy And Positioning - Shoulder

Front 1

What are the 2 bones of the shoulder girdle?

Back 1

Clavicle and Scapula

Front 2

what bones make up the shoulder joint?

Back 2

clavicle, scapula and humerus

Front 3

What is the lateral end of clavicle called?

Back 3

acromial end

Front 4

What is the joint on the lateral end?

Back 4

AC Joint (acromial clavicular joint)

Front 5

What is the medial end of the clavicle called?

Back 5

sternal end

Front 6

What is the joint on the medial end?

Back 6

SC Joint (sterno clavicular joint)

Front 7

What does the sternal end of the clavicle articulate with?

Back 7

The manubrium of the sternum

Front 8

What is the length of the scapula in terms of ribs?

Back 8

runs from the 2nd to the 7th ribs

Front 9

What are the 3 borders of the scapula called?

Back 9

Medial, Lateral and Superior

Front 10

What are the 3 angles of the scapula called?

Back 10

Superior, Inferior and lateral

Front 11

Which angle is the thickest?

Back 11

the lateral with the Glenoid cavity

Front 12

What are the 2 processes and which one is anterior;posterior?

Back 12

Coracoid (anterior); Acromion (posterior)

Front 13

what are the 2 surfaces of the scapula?

Back 13

anterior or costal and posterior or dorsal

Front 14

What is the fossa called on the costal surface?

Back 14

Subscapular fossa

Front 15

What are the 2 fossas called on the dorsal surface?

Back 15

Supraspinous and infraspinous fossa

Front 16

What side of the humerus has the greater tubercle?

Back 16

lateral side

Front 17

Where is the lesser tubercle found on the humerus?

Back 17

anterior aspect

Front 18

What is the bursae for?

Back 18

it is synovial fluid filled sacs that facilitate joint movement, located between bones and skin

Front 19

What is bursitis?

Back 19

inflammation of bursae resulting from calcium deposits

Front 20

Textbook name for shoulder joint?

Back 20

Scaplohumeral or Glenohumeral joint

Front 21

What is AC joint?/what type?

Back 21

acromialclavicular joint/synovial plane/gliding type, gliding and rotary movement

Front 22

what is the SC joint?/what type?

Back 22

Sternoclavicular joint/synovial gliding joint

Front 23

What is a seperated shoulder?

Back 23

when AC joint is seperated, usually sports injury

Front 24

what is the only bony articulation between axial and appendicular skeleton?

Back 24

The SC joint

Front 26

What are the 2 types of conditions to consider when examing patient's shoulder joint?

Back 26

Pain or Trauma

Front 27

What are the 3 views for shoulder for pain?

Back 27

AP External, AP Internal and AP Neutral

Front 28

What are the 3 views for trauma on shoulder?

Back 28

AP neutral, AP Int and ext (only if able) and Scap "Y"

Front 29

What is view done specifically at St. Joes for pain situation?

Back 29

Superoinferior Axillary

Front 30

Does patient have to be supine or erect?

Back 30

Either, depending on your preference and patient's condition

Front 31

Cassette size to use

Back 31

10x12 or 8x10

Front 32

shielding?

Back 32

gonadal and opposite breast shielding

Front 33

for all AP views where is CR centered?

Back 33

1" below and 1" medial to coracoid process

Front 34

for all AP views how is the scapula in relation to IR?

Back 34

parallel

Front 35

how is the hand situated for AP external and what is the end result we will see?

Back 35

hand is supinated so epicondyles of humerus are parallel to IR/we see the greater tubercle in profile

Front 36

how is the hand situated for AP Neutral?/end result we will see?

Back 36

hand is pronated (place on thigh) so epicondyles of humerus are at 45 deg/greater tubercle now partially superimposed

Front 37

how is the hand situated for AP Internal/end result we will see?

Back 37

hand rotated internally so humerus is in true lateral position and epicondyles are perpendicular to IR/can see lesser tubercle pointing medially into Glenoid cavity

Front 38

what is the purpose of Scap Y exam?

Back 38

evaluate dislocated shoulder

Front 39

how do you position patient to do a Scap Y?/CR?/end result?

Back 39

AP position with 60 deg oblique(supine or erect), CR perpendicular to shoulder @ level of head of humerus and end result is that vertebra and lateral border of scapula are superimposed

Front 40

when you do a scap y in AP what is it called?

Back 40

Grashey method

Front 41

how do you position patient for a Grashey method?/CR?

Back 41

AP oblique rotated 35 to 40 deg, internal rotation and slight abduction of arm, injured side to IR, CR is centered 2" medial and 2" inf to upper part of shoulder joint

Front 42

If the humerus is seen dislocated under Coracoid process which way is it displaced?

Back 42

anteriorly

Front 43

If the humerus is seen dislocated under the acromion process which way is it displaced?

Back 43

posteriorly

Front 44

If the patient cannot abduct or rotate arm what method do use?

Back 44

The Transthoracic (Lawrence) method

Front 45

What is the Lawrence method for?

Back 45

The upper humerus

Front 46

What is positioning and CR for Lawrence method?

Back 46

upright or supine, lateral with affected arm closest to IR, raise good arm above head, mid-coronal plane is perpendicular to IR, CR centered on surgical neck of humerus, angle tube 10-15 deg if patient cannot raise arm. Best to have patient hold breath for 5-6 sec and take long exposure to remove lung markings

Front 47

What is the inferosuperior Axial/Lawrence method?

Back 47

it is a projection through the humerus angleing the CR 15-30 deg away from the mid saggital plane shooting from inferior to superior to see the humerus, SC, coracoid process and AC joint

Front 48

positioning for inferosuperior axial/lawrence method?

Back 48

position patient supine, raise head and shoulder, externally rotate and abduct arm, CR medially rotated 15-30 deg depending on patient's ability to abduct arm, turn patient's head and set up cassette against superior part of shoulder and up against neck.

Front 49

what is the West Point method?

Back 49

same as inferosuperior axial lawrence method but patient is in prone position

Front 50

how is the tube configured for west point?

Back 50

25 deg from medial and up 25 deg from coronal plane

Front 51

What projection is done on the shoulder joint while patient is in sitting position?

Back 51

superoinferior Axial

Front 52

how do you position the CR for the superoinferior axial?

Back 52

angle it 5-15 deg to get shoulder joint

Front 53

What are the 2 views for clavicle?

Back 53

AP or PA (PA is better) and Axial 15-30deg cephalic for AP and 15-30 deg caudad for PA

Front 54

how do you position for AP/PA clavicle?

Back 54

can be done erect or supine, center clavicle to IR and CR is perpendicular to IR

Front 55

why do we do an axial projection on the clavicle and what kind of patient would require more of an angle?

Back 55

to project the clavicle above the lungs/ the thinner the patient the more of an angle you need

Front 56

why would a PA be better? But why is AP easier?

Back 56

PA puts the injured part closer to IR to reduce magnification and give a clearer radiograph but the patient who is in pain can do AP easier

Front 57

what are the 2 projections for AC joints?

Back 57

erect, AP one with weights and one without (have to be labeled)

Front 58

what cassette do you use for most people/large people?

Back 58

2 projections on 1 14x17/ 1 projection 4 individual 8x10's

Front 59

How do you position for the Scapula?

Back 59

erect or supine, center the affected scapula, abduct the arm at right angle to the body, CR is centered at 2" below the coracoid process

Front 60

What view is similar to the lateral scapula?

Back 60

The Scap Y

Front 61

what is the only difference from scap Y to lateral scapula?

Back 61

arm position, arm is placed back to make scapula stand out, whereas the scap Y has the arm in neutral position

Front 62

how is the body postioned in relation to IR for lateral scapula?

Back 62

oblique 45 to 60 deg