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Donny RAD POS l > Ch 5 Shoulder General, Jeopardy, exam Review (S1) > Flashcards

Ch 5 Shoulder General, Jeopardy, exam Review (S1) Flashcards

1
Q

How many fossa’s on the scapula?
What are the names?

A

4
Supraspinous fossa (superior, posterior)
Infraspinous fossa (inferior, posterior)
Subscapular fossa (ventral/anterior)
Glenoid fossa (lateral, anterior)

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2
Q

What does the acromioclavicular joint articulate with?

A

Clavicle & acromion

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3
Q

What does the sternoclavicular joint articulate with?

A

clavicle & sternum

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4
Q

What is the medial extremity?

A

Sternal extremity
(Near SC joint)

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5
Q

What is the lateral extremity?

A

Acromial extremity
(Near AC joint)

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6
Q

Deep grove between the two tubercles?

A

Intertubercular groove
(Bicipital groove)

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7
Q

What does the sternal extremity articulate with?

A

Manubrium
(A part of the sternum)

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8
Q

What gender has shorter and less curved clavicles?

A

Females
Men’s is thicker and more curved
More muscles = more curve

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9
Q

What are the 3 borders of the scapula?

A

Superior border
Axillary (lateral) border
Vertebral (medial) border

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10
Q

What are the angles of the scapula?

A

Superior angle
Inferior angle

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11
Q

What fossa are on the dorsal side of the scapula?

A

Supraspinous fossa (which is superior)
Infraspinous fossa (which is inferior)

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12
Q

What are the fossa on the costal side of the scapula?

A

Subscapular fossa

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13
Q

On the Y view of the shoulder, what is shown on the scapula?

A

Coracoid process (right side)
Acromion (left side)
Inferior angle
Spine of scapula
Body of scapula

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14
Q

What is the costal surface of the scapula?

A

The anterior side
Aka ventral

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15
Q

What is the dorsal side of the scapula?

A

The posterior side

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16
Q

What kind of joint is the scapulohumeral (glenohumeral) joint?
What is another name for this joint?

A

Ball or socket
Spherodial

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17
Q

AC and SC joints are what type?
What is another name for this joint?

A

Plane
Or
Gliding

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18
Q

The mobility type for the SC, AC, and scapulohumeral joint are:

A

Freely moveable
Or
Diarthrodial

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19
Q

What rotation best shows the greater tubercle?

A

External rotation

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20
Q

What rotation best shows the lesser tubercle?

A

Internal rotation

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21
Q

For external rotation how is the hand?

A

Supinated

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22
Q

How are the epicondyles on a external rotation?

A

Parallel to the IR

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23
Q

How is the humerus in a external rotation?

A

AP

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24
Q

How is the hand in a internal rotation?

A

Pronated

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25
Q

How is the humerus in an internal rotation?

A

Humerus is lateral

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26
Q

How are the epicondyles in an internal rotation?

A

Perpendicular to the IR

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27
Q

How is the hand in a neutral rotation?

A

Palm facing inward (palm to thigh)

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28
Q

How are the epicondyles in a neutral rotation?

A

Oblique 45 degrees to the IR

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29
Q

What is the CR for AP humerus?

A

mid-humerus

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30
Q

What is the CR for Lateral humerus?

A

mid-humerus

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31
Q

What is the CR for Internal Shoulder?

A

1 inch inferior to coracoid process

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32
Q

What is the CR for Grashey?

A

35-45 degree LPO/RPO patient oblique
2 inches inferior 2 inches medially from supralateral border of shoulder

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33
Q

What is the CR for a Y shoulder view?
Neer view?

A

45-60 degrees LAO/RAO patient oblique to affected side
Y: at scaphoid-humeral joint
Neer: 10-15 degrees caudad

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34
Q

What is the CR for an Axillary shoulder?
(Superiorinferior)

A

Scapulohumeral joint

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35
Q

What is the CR for a transthoracic lateral?

A

surgical neck

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36
Q

CR for AP Clavicle:
CR for AP axial clavicle:

A

AP: mid-clavicle
AP-axial: 15-30 degrees cephalic
(25-30 degrees asthenic)
(15-20 for hypersthenic)

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37
Q

CR for AC joints:

A

1 inch above jugular notch, mid-point AC joints
72 Inch SID
2 views (one with weights, one without)

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38
Q

Why or when do we do the neutral rotation?

A

In trauma cases when the patient is unable to rotate

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39
Q

What imaging is useful for shoulder joints and rotator cuff tears?

A

Ultrasound

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40
Q

What is the Hill-Sachs defect?

A

A compression fx of the humeral head
Located posterolateral on articulated surface

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41
Q

What is idiopathic chronic adhesive capsulitis?

A

Frozen shoulder
Caused by chronic inflammation around the shoulder joint
Pain and limited movement

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42
Q

What is osteoarthritis?

A

Degenerative joint disease
Non-inflammatory
Gradual deterioration
Most common arthritis and normal due to age

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43
Q

What is Osteopetrosis?

A

Causes bone to become abnormal dense
Hereditary disease

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44
Q

What a rotator cuff injury?

A

Acute or chronic trauma injury to the rotator cuff muscles:
Tere’s minor
Supraspinatus
Infraspinatus
Subcapularis

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45
Q

What is a shoulder dislocation?

A

Removal of humeral head from glenoid cavity
95% of dislocations are anterior

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46
Q

Radiograph visuals osteoarthritis:

A

Narrowing of joint space

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47
Q

Radiograph visuals hill-sachs defect:

A

Compression fx of humeral head

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48
Q

Radiograph visuals impingement syndrome:

A

Bone spurs near acromiohumeral space

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49
Q

Radiograph visuals idiopathic chronic adhesive capsulitis (frozen shoulder):

A

Possible calcification

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50
Q

Radiograph visuals shoulder dislocation:

A

Humeral head out of the glenoid cavity

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51
Q

Criteria for AP humerus

A

External rotation
Abduct arm, Hand supinated
CR mid humerus
48” SID
IR 14 x 17
70kvp _mAs
Include both joints (shoulder and elbow)
Epicondyles parallel to IR

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52
Q

Criteria for lateral humerus

A

Internal rotation
Hand pronated placed on hip
CR mid humerus
IR 14 x 17
SID 48”
70 kvp mAs
Include shoulder and elbow joint
Epicondyles perpendicular to IR

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53
Q

What is the trauma projection for lateral humerus?

A

Transthoracic lateral humerus
(Shoot through the body)

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54
Q

Criteria for transthoracic lateral projection (trauma lateral humerus)

A

Opposite arm on top of head
Humerus in profile place in a neutral rotation
CR: surgical neck
48” SID
IR size 14 x 17
exposure on full inspiration
70 kvp

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55
Q

Criteria for inferosuperior axial projection:

A

Supine
48” SID
CR 25 to 30 degrees medially from supralateral border

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56
Q

Criteria for Grashey:

A

48” SID
CR is 2 inches inferior 2 inches medial to the supralateral border of the shoulder
70 kvp
10 x 12 portrait
patient rotated 35-45 degrees toward affected side (LPO/RPO)
shows glenoid cavity
EXT markers

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57
Q

Criteria for internal shoulder:

A

hand pronated
CR 1 inch inferior to coracoid
SID 48”
70 KVP
shows lesser tubercle
INT markers

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58
Q

Criteria for Y view shoulder:

A

patient rotated 45-60 degrees toward affected side (LAO/RAO)
48” SID
10 x 12 portrait
CR is scapulohumeral joint

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59
Q

Criteria for Neer method Y view:

A

patient rotated 45-60 degrees toward affected side (LAO/RAO)
48” SID
10 x 12 portrait
CR is mid-scapula
10-15 degrees caudad

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60
Q

Criteria for AP clavicle:

A
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61
Q

(Exam review)
Colles vs smiths vs boxer fx

A
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62
Q

(Jeopardy) What position is the greater tubercle superimposed over the humeral head?

A

Internal rotation

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63
Q

(Jeopardy) When performing the west point projection this is free of superimposition?

A

Coracoid process

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64
Q

(Jeopardy) The scapular notch is located on what part of the scapula?

A

Superior border

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65
Q

(Jeopardy) Other than getting both AC joints on one image what is another reason we do 72 SID?

A

reduce magnification and distortion

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66
Q

(Jeopardy) To prevent the medial aspect of clavicles from superimposing the spine in the Grashey we would:

A

Oblique the patient
rotate the patient to the affected side

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67
Q

(Jeopardy) Why do we add weights to the AC joint projection?

A

to separate the joint spaces
(weight add stress and allow the shoulders to “naturally” fall)

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68
Q

(Jeopardy) What projection has the CR at 2 inches inferior and 2 inches medially (from axilla) to the coracoid process?

A

Grashey

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69
Q

(Jeopardy) You would use this CR on a asthenic patient when performing an Axial Clavicle exam?

A

25-30 degrees
(15-20 degrees for larger “hyperstenic” patients)

70
Q

(Jeopardy) (most likely test question) What is the CR for a transthoracic lateral projection?

A

surgical neck
(on the humerus in profile)

71
Q

(Jeopardy) Where do the medial and lateral borders of the scapula meet?

A

at the inferior angle

72
Q

(Jeopardy) Medial aspect of the clavicle is called?

A

Sternal extremity (end)

73
Q

(Jeopardy) What is the CR for an Axial AC joint projection?

A

15 degrees cephalic
(15-30 degrees cephalic 1 inch above jugular notch)

74
Q

(Jeopardy) What is the dislocation of the radial head called?

A

Nurse maid’s jerked elbow
or
Pulled elbow

75
Q

(Jeopardy) The scapula is required to be in this position for the Neer method?

A

scapula needs to be lateral
perpendicular to IR

76
Q

(Jeopardy) (most likely test question) What is the flattened triangular part on the scapula?

A

Acromion

77
Q

(Jeopardy) What is the CR for an axial clavicle when the patient is erect?

A

15-30 degrees cephalic
see under clavicles
(we want to replicate a lordotic view)

78
Q

(Jeopardy) The AC joints is the articulation of what parts?

A

Scapula (acromion)
&
Clavicle

79
Q

(Jeopardy) What is the other name for a ball and socket?

A

Spheroidal

80
Q

(Jeopardy) What is the name of the larger depression on the anterior surface of the scapula?

A

subscapular fossa

81
Q

(Jeopardy) What type of fractures force the splinted pieces through the skin?

A

Open or compound fx

82
Q

(Jeopardy) How many joints in the clavicle?
What are the names?

A

2 joints
AC (acromioclavicular joint)
SC (sternoclavicular joint)

83
Q

(Jeopardy) This is the only bony articulation between the upper extremity and the torso:

A

Sternoclavicular joint (SC joint)

84
Q

(Jeopardy) Another name for the lateral border of the scapula:

A

Axillary border

85
Q

(Jeopardy) The AC joint is what joint classification?

A

Plane or gliding

86
Q

(Jeopardy) The SC joint is what type of joint?

A

Plane or gliding

87
Q

(Jeopardy) What is the CR for the NEER view?

A

Mid-scapula
15 degrees caudad

88
Q

(Exam Review) What is abduction?

A

moving limb away from mid-line of your body

89
Q

(Exam Review) What is adduction?

A

moving a limb toward the mid-line of your body
(adduction= adding body part)

90
Q

(Exam Review) Where is the supraspinous fossa located?

A

superior portion of the dorsal surface of the scapula
(supra= superior)

91
Q

(Exam Review) Where is the subscapular fossa located?

A

on the costal surface (anterior) of the scapula

92
Q

(Exam Review) Where is the infraspinous fossa located?

A

on the inferior portion of the dorsal (posterior) surface of the scapula

93
Q

(Exam Review) What fossa is located on the distal posterior aspect of the humerus?

A

Olecranon fossa

94
Q

(Exam Review) What fossa is located on the distal anterior aspect of the humerus?

A

Coronoid fossa

95
Q

(Exam Review) What does extension mean?
EX: Humerus (what projection)

A

straightening movement
AP humerus extends humerus forward
(opposite of the flexion)

96
Q

(Exam Review) What does flexion mean?
EX: Humerus

A

bending a joint/movement
Lateral Humerus causes internal rotation that flexes the arm
(bicep flex)

97
Q

(Exam Review) In an AP humerus, is the humerus flexed or extended?
What is the rotation of the AP humerus?

A

extended
external rotation

98
Q

(Exam Review) What rotation shows the lesser tubercle in profile?

A

Internal rotation/projection

99
Q

(Exam Review) What projection causes the greater tubercle to be in profile?

A

Grashey
External rotation

100
Q

(Exam Review) if the epicondyles are parallel to the IR what is in profile?

A

greater tubercle

101
Q

(Exam Review) When the epicondyles are parallel to the IR what is the rotation?

A

External rotation

102
Q

(Exam Review) if the epicondyles are perpendicular to the IR what anatomy is in profile?

A

lesser tubercle

103
Q

(Exam Review) If the epicondyles are perpendicular to the IR what is the rotation?

A

Internal rotation

104
Q

(Exam Review) What does GELI stand for?

A

GE - greater tubercle/ external rotation
LI - Lesser tubercle/ internal rotation

105
Q

(Exam Review) What is a colles fx?

A

radius and ulna go anterior
distal part goes posterior

106
Q

(Exam Review) What is a boxers fx?

A

fx of the fifth metacarpal
(trauma common from fights)

107
Q

(Exam Review) What is a smiths fx?

A

radius and ulna go posterior
distal part goes anterior

108
Q

(Exam Review) What is a rotator cuff tear?

A

a traumatic injury to the rotator cuff muscles

109
Q

(Exam Review) What does the criteria look like for a inferosuperior projection?

A

patient supine
CR 25-30 degrees horizontal to axilla and humeral head

110
Q

(Exam Review) what consists in the shoulder girdle?

A

Clavicle
Scapula
NOT HUMERUS

111
Q

(Exam Review) What is the internal shoulder positioning?

A

abduct arm slightly
pronate arm (internally rotate arm)
epicondyles perpendicular to IR
CR 1 inch inferior to coracoid process

112
Q

External shoulder positioning

A

abduct arm slights
hand supinated (externally rotate arm)
epicondyles parallel to IR
CR 1 inch inferior to coracoid process?

113
Q

(Exam Review) What does the Grashey positioning look like?

A

patients body rotated 35 to 45 degrees toward affected side (RPO vs LPO)
abduct arm slightly with arm flexed in external rotation
CR is 2 inferior and 2 inches medial to coracoid
epicondyles parallel to the IR

114
Q

(Exam Review) (most likely test question) What is an alternative to the breathing technique of a transthoracic?
(proximal humerus)

A

Tell the patient to hold there breath
to expose on full inspiration

115
Q

(Exam Review) LPO/RPO oblique 45 degree angle (35-45), projection is

A

Grashey

116
Q

(Exam Review) RAO/LAO 45 degree oblique (45-60), with a 10-to-15-degree caudad tube angle projection is

A

Neer method of the Y view

117
Q

(Exam Review) For internal rotation how is the hand?

A

Pronated

118
Q

(Exam Review) If you are working in the ED and the patient comes in with severe abdominal and shoulder pain he or she is unable to stand for the upright projections and you have positioned the patient for a shoulder projection with the humeral epicondyles parallel to the IR with the CR being 1 Inches inferior to the coracoid. This projection would be?

A

External or AP
(keyword to this is the epicondyle placement)

119
Q

(Exam Review) your patient is in a 45-degree posterior oblique position with the affected side closest to the IR. The humeral epicondyles are parallel to the image receptor. CR is 2 inches inferior and 2 inches medial to the supralateral border of the shoulder. Which view would this be?

A

Grashey
(hint is the CR and epicondyles)

120
Q

(Exam Review) how is the scapula in the supraspinatus view (Neer/Y) to the IR?

A

perpendicular to the IR
(because of the oblique)

121
Q

(Exam Review) what projections causes the greater tubercle to be in profile?

A

External rotation

122
Q

(Exam Review) what is a rotator cuff tear?

A

traumatic injury to one or more of the rotator cuff muscles

123
Q

(Exam Review) (T/F) we use a breathing technique for transthoracic lateral projection

A

True

124
Q

(Exam Review) What is the CR for transthoracic?

A

surgical neck (or mid-diaphysis)

125
Q

(Exam Review) For external rotation how is the hand?

A

Supinated

126
Q

(Exam Review) CR for Axial clavicle

A

mid clavicle
15 to 30 degrees cephalad
hyperstenic 15-20 degrees
asthenic 25 to 30 degrees

127
Q

(Exam Review) how many projections for AC joint?

A

2 projections
one without weights (WOW)
one with weight bearing
14x17 inches landscape

128
Q

(Exam Review) what do we do for a better divergent beam on AC joints to include both joints?

A

72 inch SID

129
Q

(Exam Review) what does inferosuperior axillary projection best show? (pathology)

A

Hill-Sachs defect
osteopetrosis/osteoartritus

130
Q

(Exam Review) Inferosuperior axillary position is also known as the
(most likely on exam)

A

west point projection

131
Q

(Exam Review) Where is the subscapular fossa located?

A

middle area of costal (front) surface of scapula

132
Q

(Exam Review) where is the infraspinous fossa located?

A

on the inferior portion of the dorsal surface of scapula

133
Q

(Exam Review) where is the supraspinous fossa located?

A

on the superior portion of the dorsal surface of the scapula

134
Q

(Exam Review) Where is the crest of spine located?

A

on the dorsal (posterior) surface of the scapula in between the 2 Fossas (supraspinous and infraspinous)
extends from acromion to vertebral border on dorsal surface

135
Q

(Exam Review) Where is the glenoid fossa located?

A

located between the scapula and humerus
(glenoid cavity)

136
Q

(Exam Review) Where is the radial fossa located?

A

distal anterior of the humerus
superior to the capitulum

137
Q

(Exam Review) When is the lesser tubercle seen in profile?

A

internal rotation/projection

138
Q

(Exam Review) When is the greater tubercle seen in profile?

A

external rotation
Grashey projection

139
Q

(Exam Review) If epicondyles are parallel to IR what tubercle is in profile?
What is the rotation?

A

Greater tubercle
external rotation

140
Q

(Exam Review) If the epicondyles are perpendicular to the IR what tubercle is in profile?
What is the rotation?

A

lesser tubercle
internal rotation

141
Q

(Exam Review) inferosuperior projection is also known as:

A

the west point projection

142
Q

(Exam Review) What do we see in profile on a west point/inferosuperior projection:

A

coracoid process (most important)
lesser tubercle
proximal humerus
glenoid cavity

143
Q

(Exam Review) T/F we use a breathing technique for transthoracic projections for the ribs?
If we are unable to do the technique what else could we do?

A

TRUE
Have the patient hold their breath/expose on full inspiration

144
Q

(Exam Review) CR for transthoracic:

A

surgical neck

145
Q

(Exam Review) how many degrees do we oblique for a Grashey projection?

A

35-45 degrees toward affected side (patient rotation)
RPO or LPO

146
Q

(Exam Review) How much do we oblique the patient for a Neer view?

A

45-60 degrees toward affected side (patient oblique)
LAO or RAO
10–15-degree caudad angle

147
Q

(Exam Review) if the patient is in a 45 degree LPO oblique what are we looking at?

A

glenoid cavity
Grashey projection

148
Q

(Exam Review) For humerus, if the hand is pronated the humerus is what rotation?
how are the epicondyles?

A

internal rotation
perpendicular to the IR

149
Q

(Exam Review) For the humerus if the hand is supinated how are the epicondyles?
What is the rotation?

A

parallel to the IR
external rotation

150
Q

(Exam Review) In a supraspinatous view (Y or Neer) how is the scapula to the IR?

A

perpendicular to the IR
(the oblique makes is perpendicular to the IR)

151
Q

(Exam Review) What is inferior to the bicipital groove/ intertubercular groove?

A

surgical neck

152
Q

(Exam Review) What is superior to the bicipital groove/ intertubercular groove?

A

greater tubercle

153
Q

(Exam Review) What is medial to the bicipital groove/ intertubercular groove?

A

lesser tubercle

154
Q

(Exam Review) what is superior to the anatomic neck?

A

head of the humerus

155
Q

(Exam Review) What is inferior to the surgical neck?

A

Deltoid tuberosity

156
Q

(Exam Review) What is most inferior/anterior: the coracoid process or the acromion?

A

coracoid

157
Q

(Exam Review) Where is the inferior angles of the scapula located?

A

at the most inferior portion of the scapula
(where the medial and lateral borders meet)

158
Q

(Exam Review) Where is the superior angle of the scapula located?

A

Superior angle is medial and most superior

159
Q

(Exam Review) What are the angles of the scapula?

A

superior angle
inferior angle
Lateral angle

160
Q

(Exam Review) What are the borders of the scapula?

A

superior border
Axillary (lateral) border (armpit)
Vertebral (medial) border (closest to spine)

161
Q

(Exam Review) where is the scapular notch located?

A

superior border of the scapula
between coracoid and superior angle

162
Q

(Exam Review) The scapula spine extends laterally into a flat triangle shape process known as what?

A

Acromion

163
Q

(Exam Review) inferosuperior axillary postition is what projection we do at Mayo?

A

Axillary shoulder
(Mayo is superiorinferior projection)

164
Q

(Exam Review) In the inferosuperior projection we look at:
In the superiorinferior projection we look at:

A

Inferior: Coracoid process
superior (Mayo): acromion

165
Q

(Exam Review) Where is the AC joint located?

A

between the Acromion and clavicle

166
Q

(Exam Review) Where is the SC joint located?

A

between the sternum and clavicle

167
Q

(Exam Review) whats the CR for a neer view?

A

Mid-scapula
(10-15 degrees caudad)

168
Q

(Exam Review) What’s the CR for internal shoulder?

A

1 inch below coracoid

169
Q

(Exam Review) What’s the angle we use for axial clavicle?

A

15-30 degrees cephalic
25-30 degrees asthenic
15-20 hypersthenic

170
Q

(Exam Review) if you can’t angle for an AP axial clavicle you can position the patient in:

A

Lordotic position

171
Q

(Exam Review) what tubercle is in profile on a lateral humerus?
How are the epicondyles?

A

Less tubercle
Epicondyles perpendicular to IR/superimposed

Donny RAD POS l (9 decks)

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