Ch 5 Shoulder rough review Flashcards
infraspinous fossa
subscapular fossa
Supraspinous fossa
What is abduction? (of the humerus)
What fossa is located on the distal posterior humerus?
Olecranon fossa
what is extension of the humerus?
What is adduction?
what is flexion of the humerus
In an AP humerus is the humerus flexed or extended?
extended
AP external shoulder/humerus
greater tubercle in profile
supination of hand
epicondyles parallel to the IR
for a lateral humerus is the humerus flexed or extended?
flexed
What projection causes the lesser tubercle to be in profile?
Internal rotation/projection
Internal shoulder/humerus
humerus is true lateral
hand is pronated
epicondyles perpendicular to the IR
Lesser Tubercle in profile
neutral shoulder/humerus
appropriate for trauma patient when rotation is not possible
epicondyles are 45 degrees to the IR
palm of the hand is facing inward
what projections causes the greater tubercle to be in profile?
external rotation/projection
if the epicondyles are parallel what is in profile?
greater tubercle
GELI abbreviation
if the epicondyles are perpendicular what is in profile?
lesser tubercle
Colles fx
smiths fx
boxers fx
what is a rotator cuff tear?
inferosuperior axillary projection
patient supine
CR 25 to 30 degrees centered horizontally to axilla and humeral head
best shows Hill-Sachs defect
what consists of the shoulder girdle?
scapula
clavicle
NOT humerus
internal shoulder positioning
abduct arm slightly
pronate arm (internally rotate arm)
epicondyles perpendicular to IR
CR 1 inch inferior to coracoid process
40” SID
10 x 12 landscape
80 kvp
External shoulder positioning
abduct arm slights
hand supinated (externally rotate arm)
epicondyles parallel to IR
CR 1 inch inferior to coracoid process
Grashey method
patients body rotated 35 to 45 degrees toward affected side
abduct arm slightly with arm flexed in neutral rotation
CR is 2 inferior and 2 inches medial to scapulohumeral joint
10 x 12 landscape
40” SID
80 KVP
Neer Method (Y view)
BONUS: What does internal shoulder show and look for?
BONUS: What does external shoulder show and look for?
BONUS: What does inferosuperior shoulder show and look for?
BONUS: What does superiorinferior shoulder show and look for?
BONUS: What does Neer (Y view) show and look for?
BONUS: why do we rotate the patient in the grashey?
Inferosuperior axillary position is also known as the
west point projection
(T/F) we use a breathing technique for transthoracic lateral projection
True
what do we see in profile on the inferosuperior projection?
What is an alternative to the breathing technique of a transthoracic?
Tell the patient to hold there breath
to expose on full inspiration
What is the CR for transthoracic?
surgical neck (or mid-diaphysis)
In a Grashey we oblique the patient
35 to 45 degrees toward affected side
LPO and RPO
In a Neer we oblique the patient
oblique the patient 45 to 60 degrees depending on the patient
RAO/ LAO
10 to 15 degrees caudal angle
LPO/RPO oblique 45 degree angle, projection is
Grashey
RAO/LAO 45 degree oblique, with a 10-to-15-degree tube angle projection is
NEER or Y view
For internal rotation how is the hand?
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?
External or AP
(keyword to this is the epicondyle placement)
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 side of the scapula. Which view would this be?
Grashey
(hint is the CR and epicondyles)
superstinatus view how is the scapula to the IR?
perpendicular
(because of the oblique)
For external rotation how is the hand?
What is most inferior portion in the shoulder?
What is the anterior portion of the shoulder?
coracoid process
what is the most posterior portion of the shoulder?
acromion
What are the inferior angles and borders of the scapula?
scapular notch
coracoid
The scapula spine extends laterally into a flattened triangle shape process known as the
acromion
what kind of joint is the scapulohumeral (glenohumeral) joint?
Ball and socket
freely moveable (diarthrodial)
What kind of joints are the AC and SC joints?
plane or gliding
freely moveable (diarthrodial)
what kind of joints are the radioulnar joint?
Inferosuperior axillary projection is
the axillary
(Mayo shoots this superoinferior)
Coracoid should be up and flipped to the right side
Where are the AC and SC joint located?
CR for internal shoulder
1 inch below the coracoid
CR for a NEER view
mid-scapula
angle 10-15 degree caudad
CR for Axial clavicle
mid clavicle
15 to 30 degrees cephalad
hyperstenic 15-20 degrees
asthenic 25 to 30 degrees
how many projections for AC joint?
2 projections
one without weights (WOW)
one with weight bearing
14x17 inches landscape
what do we do for a better divergent beam on AC joints to include both joints?
72 inch SID
Bursitis
Inflammation of bursar
Fluid filled sacs enclosing the joints
if you can angle for a clavicle you can position the patient to be
lordotic
Idiopathic chronic adhesive capsulitis
(Frozen shoulder)
Chronic inflammation around joint
Causes pain and limitation in motion
(Idiopathic means unknown)
Osteoarthritis
Degenerative joint disease (DJD)
Non inflammatory characterized by gradual deterioration of cartilage
Most common type of arthritis, normal with age
Osteopetrosis
Reduction of quantity of bone
More likely to have fx’s
Rotator cuff
Limits range of motion in shoulder
Injury to shoulder muscles:
Teres minor, supraspinatus, infraspinatus, subcapularis.
Shoulder dislocation
Traumatic removal of humeral head from glenoid cavity
95% are anterior (humeral head is anterior to glenoid cavity)
