ch 6 Flashcards
1
Q
What are the two main components of the shoulder girdle?
A
Clavicle and Scapula
2
Q
With which structures does the shoulder girdle articulate?
A
- Head of humerus laterally (shoulder joint)
- Manubrium of sternum medially (sternoclavicular joint)
- Each other laterally (acromioclavicular joint)
3
Q
What is the primary function of the shoulder girdle?
A
To connect the upper limb to the trunk of the body
4
Q
Is the humerus considered part of the shoulder girdle?
A
No
5
Q
What type of joint is the shoulder joint classified as?
A
Diarthrodial by function and synovial by anatomy
6
Q
What type of joint is the shoulder joint?
A
Ball-and-socket type, capable of all motions
7
Q
What is the classification of the clavicle?
A
Classified as a long bone
8
Q
What are the ends of the clavicle called and with what do they articulate?
A
- Acromial extremity (articulates with acromion on scapula)
- Sternal extremity (articulates with manubrium of sternum)
9
Q
What is the shape of the scapula?
A
Triangular in shape
10
Q
What are the two surfaces of the scapula?
A
- Costal (anterior)
- Dorsal (posterior)
11
Q
What are the three borders of the scapula?
A
- Lateral
- Medial
- Superior
12
Q
What are the three angles of the scapula?
A
- Superior
- Inferior
- Lateral
13
Q
What is the lateral, thickened end of the scapular spine called?
A
Acromion
14
Q
Where is the scapular notch located?
A
On the superior border of the scapula
15
Q
What is required for patient preparation before a shoulder girdle procedure?
A
- Removal of radiopaque artifacts
- Secure patient possessions
16
Q
What are the general patient positions for shoulder procedures?
A
Can be performed in upright or recumbent positions
17
Q
What is the IR/Collimation size for shoulder and clavicle imaging?
A
10 x 12 inches (24 x 30 cm)
18
Q
What should be included in the final image for shoulder imaging?
A
Right or left side markers and other required ID markers
19
Q
What type of shielding should be used according to state regulations?
A
Gonad shielding
20
Q
What are the essential projections for the shoulder?
A
- AP projections
- Internal rotation
- External rotation
- Neutral position
- AP oblique (Grashey method)
- Transthoracic lateral (Lawrence method)
- Inferosuperior axial (Lawrence method)
- PA oblique (scapular Y)
21
Q
What is the patient position for an AP projection with internal rotation?
A
Supine or upright; shoulder joint centered; flex elbow slightly
22
Q
What is the central ray (CR) location for the AP projection in internal rotation?
A
Perpendicular, enters 1 inch inferior to coracoid process
23
Q
What structures are shown in the AP projection in internal rotation?
A
Bony and soft structures of the shoulder and proximal humerus
24
Q
What is the required arm position for the AP projection in external rotation?
A
Abducted slightly and externally rotated
25
What should the CR angle be for the AP projection in external rotation?
Perpendicular, enters 1 inch inferior to coracoid process
26
What is the evaluation criteria for the AP projection in external rotation?
* Superior scapula, clavicle, and proximal humerus
* Humeral head in profile
* Greater tubercle in profile on lateral aspect of the humerus
27
What is the patient position for the AP projection in neutral position?
Supine or upright; arm in neutral position
28
What is the evaluation criteria for the AP projection in neutral position?
* Greater tubercle partially superimposing humeral head
* Humeral head seen in partial profile
29
What is the patient position for the AP oblique (Grashey method)?
Supine or upright; 35 to 45 degrees posterior oblique
30
What is the central ray (CR) for the AP oblique (Grashey method)?
Perpendicular to glenoid cavity
31
What structures are shown in the AP oblique (Grashey method)?
Scapulohumeral or glenohumeral joint
32
What is the benefit of the PA oblique (scapular Y) projection?
Useful to diagnose shoulder dislocations
33
What is the patient position for the PA oblique (scapular Y)?
Upright or recumbent; 45 to 60 degrees anterior oblique
34
What is the central ray (CR) for the PA oblique (scapular Y)?
Perpendicular to scapulohumeral joint
35
What is the evaluation criteria for the PA oblique (scapular Y)?
* Humeral head superimposed over the junction of the Y
* No superimposition of scapular body over bony thorax
36
What is the required patient position to demonstrate the left shoulder in a PA oblique (scapular Y)?
45- to 60-degree LAO
37
How is the affected arm positioned for the inferosuperior axial projection (Lawrence method)?
Abducted to a right angle and in external rotation
38
What is the central ray (CR) angle for the inferosuperior axial projection?
Horizontal with medial angulation of 15 to 30 degrees
39
What structures are shown in the inferosuperior axial projection?
* Proximal humerus
* Scapulohumeral joint
* Lateral portion of the coracoid process
* AC articulation
40
What is the evaluation criteria for the inferosuperior axial projection?
* Scapulohumeral joint with slight overlap
* Coracoid process pointing anteriorly
41
What is the purpose of the AP AC joints (Pearson method)?
To evaluate acromioclavicular joint dislocation
42
What is the patient position for the AP AC joints (Pearson method)?
Upright required; arms hanging by side
43
What is the central ray (CR) for the AP AC joints if bilateral image?
Perpendicular to midline of body at level of AC joints
44
What is the required patient position for the AP projection of the AC joints?
Upright required to avoid reducing dislocation if present
45
What is the part position for the AP projection of the AC joints?
Arms hanging by side, unsupported; shoulders in the same horizontal plane
46
How many exposures are made for the AP AC joints (Pearson method)?
Two exposures: one without weights and one with weights affixed to arms
47
What is the central ray (CR) direction for bilateral images of the AC joints?
Perpendicular to midline of body at level of AC joints
48
What is the recommended SID for the AP AC joints projection?
72 inches (183 cm)
49
What structures are shown in the AP AC joints projection?
Bilateral images of AC joints, dislocation, separation, and function of the joints
50
What evaluation criteria must be met for the AP AC joints projection?
Both AC joints visible, no rotation or leaning, separation clearly seen with weights
51
What is the collimation size for the AP projection of the clavicle?
8 × 12 inches (18 × 30 cm)
52
What is the patient position for the AP projection of the clavicle?
Upright or supine
53
What is the central ray (CR) direction for the AP projection of the clavicle?
Perpendicular to midshaft of clavicle
54
When should the exposure be made for the AP clavicle?
At the end of exhalation
55
What structures are shown in the AP clavicle projection?
Entire clavicle centered; lateral half above scapula, medial half superimposing thorax
56
What is the patient position for the PA projection of the clavicle?
Standing, seated upright, or prone
57
What is the CR direction for the PA projection of the clavicle?
Perpendicular exiting midshaft of the clavicle
58
What is the patient position for the AP axial projection of the clavicle?
Standing, lordotic if possible, or supine with shoulders in same plane
59
What is the CR angle for the AP axial projection of the clavicle in a standing position?
5 to 30 degrees cephalic
60
What is the evaluation criteria for the PA axial projection of the clavicle?
Lateral 2/3 of clavicle above ribs, scapula with medial end superimposing thorax
61
What is the patient position for the AP projection of the scapula?
Upright or supine, affected scapula centered to grid
62
What is the CR direction for the AP projection of the scapula?
Perpendicular to point 2 inches inferior to coracoid process
63
What is the recommended exposure technique for the AP scapula?
Exposure made during slow breathing
64
What structures are evaluated in the AP scapula projection?
Lateral portion free of superimposition, scapula horizontal, bony trabecular detail
65
What is the patient position for the lateral projection of the scapula?
Standing or seated in RAO or LAO, 45 to 60 degrees
66
What is the CR direction for the lateral projection of the scapula?
Perpendicular to mid-medial border of scapula
67
What evaluation criteria must be met for the lateral projection of the scapula?
Lateral and medial borders superimposed, no humeral overlap, inclusion of acromion and inferior angle
68
True or False: PA projections are preferred due to reduced OID and improved image quality.
True
69
Fill in the blank: The radiation field for the AP projection of the scapula is _______.
10 × 12 inches (24 × 30 cm)
70
What is the CR angle and direction for the AP axial projection of the clavicle when the patient is positioned supine?
15 to 30 degrees cephalad
71
How is the affected upper limb positioned to demonstrate the acromion and coracoid on the lateral projection of the scapula?
Elbow flexed with the back of the hand resting on the posterior thorax
72
What is hill-sachs defect?
impacted fracture of posterolateral aspaect of the humeral head with dislocation
73
What is osteoporosis?
loss of bone density
74
What is osteopetrosis?
increased density of atypically soft bone
75
bursae
synovial fluid filled sacs outside the main joint cavity
76
What is a fracture?
disruption in the continuity of bone
77
What is chondrosacoma?
malignant tumor arising from cartilage cells
78
What is a synarthrodial joint?
A synarthrodial joint is a joint that connects bones with fibrous tissue and allows little or no movement.
79
What is a callus?
a rough, thickened area of skin that appears because of repeated irritation or pressure to an area of skin
80
What is ewing sarcoma?
malignant tumor of bone arising in medullary tissue
81
What is a compund fracture?
a bone fracture that is accompanied by breaks in the skin, causing the broken ends of bone to come into contact with the outside environment
82
What is a spiral fracture?
broken bone in a spiral
83
What is a nonunion?
A fracture that fails to heal
84
What is a greenstick fracture?
broken bone that happens when a bone bends enough to crack on one side
85
What is a compression fracture?
type of broken bone that can cause your vertebrae to collapse
86
What is a Colles fracture?
fracture of the distal radius with posterior displacement
87
What is the relationship of the epicondyles to the IR when the hand is externally rotated?
parallel
88
What is the relationship of the epicondyles to the IR when the hand is neutral rotated?
45 degrees
89
