Chapter 5 Positions Flashcards
AP Projection: Humerus
SID 40”
IR 14*17
75 to 80 kV
CR perpendicular to IR, directed to midpoint of humerus
Anatomy demonstrated AP projection shows the entire humerus, including the shoulder and elbow
True AP is evidenced at proximal humerus by the following: greater tubercle is seen in profile laterally: humeral head is partially seen in profile medially, with minimal superimposition of the glenoid cavity.
Distal humerus: lateral and medial epicondyles both are visualized in profile
Rotational Lateral —Lateromeidal or Mediolateral Projections: Humerus
SID 40”
CR perpendicular, centered to Midpoint of humerus
Lateral projection of the entire humerus, including elbow and shoulder joints, is visible.
True lateral projection is evidenced by the following:
epicondyles are directly superimposed by lower portion of glenoid cavity
Inferosuperior Axial Projection: Shoulder (nontrauma)
Lawrence Method
SID 40”
Direct CR medially 25 to 30 degrees, centered horizontally to axilla and humeral head. If abducted of arm is less than 90 degrees the CR medial angle also should be decreased to 15 to 20 degrees if possible
suspend breathing during exposure
Lateral View of proximal humerus in relationship to scapulohumeral cavity
Coracoid process of scapula and lesser tubercle of humerus are seen in profile
The spine of the scapula is seen on edge below scapulohumeral joint
Arm is seen to be abducted about 90 degrees from the body
Superior and inferior borders of the glenoid cavity should be directly superimposed, indicating correct CR angle
PA Transaxillary Projection: Shoulder (NonTrauma)
Hobbs Modification
SID 40”
CR is directed perpendicular to the axilla and the humeral head to pass through the glenohumeral joint
Lateral view of proximal humerus in relationship to glenohumeral articulation is visualized
coracoid process of scapula is s seen one end
Arm is seen to be raised superiorly above the body
AP Projection–External Rotation: Shoulder (Non-Trauma)
AP Proximal Humerus
SID 40”
CR perpendicular to IR, directed to 1 inch inferior to coracoid process
Suspend respiration during exposure
AP projection of proximal humerus and lateral two-thirds of clavicle and upper scapula, including relationship of the humeral head to the glenoid cavity.
Full external rotation is evidenced by greater tubercle visualized in full profile on the lateral aspect of the proximal humerus
Lesser tubercle is superimposed over humeral head
AP Projection —Internal Rotation: Shoulder (Nontrauma)
Lateral Proximal Humerus
SID 40”
CR perpendicular to IR, directed to 1 inch inferior to coracoid process
Lateral view of proximal humerus and lateral two-thirds of clavicle and upper scapula is demonstrated, including the relationship of the humeral head to the glenoid cavity
Full internal rotation position is evidenced by lesser tubercle visualized in full profile on the medial aspect of the humeral head
An outline of the greater tubercle should be visualized superimposed over the humeral head
Inferosuperior Axial Projection: Shoulder (Nontrauma)
Clements Modification
SID 40”
CR Perpendicular
If patient cannot abduct the arm 90 degrees, angle the tube 5 to 15 degrees toward the axilla
Lateral view of proximal humerus in relationship to scapulohumeral cavity
Arm is seen to be abducted about 90” from the body
Relationship of the humeral head and glenoid cavity should be evident
Posterior Oblique Position–Glenoid Cavity: Shoulder (Nontrauma)
Grashey Method
SID 40”
CR perpendicular to IR centered to scapulohumeral joint, which is approximately 2 inches inferior and medial from the superolateral border of shoulder
Suspend respiration during expsure
Rotate body 35 to 45 degrees toward affected side.
Gllenoid cavity should be seen in profile without superimposition of humeral head.
Scapulohumeral joint space should be open.
Anterior and posterior rims of glenoid cavity are superimposed.
Tangential Projection–Intertubercular (Bicipital) Groove: Shoulder (Nontrauma)
Fisk Modification
SID 40”
CR 10-15 degrees posterior to horizontal, directed to groove at midanterior margin of humeral head.
Anterior margin of the humeral head is seen in profile.
Humeral tubercles and the intertubercular groove are seen in profile
Correct CR angle of 10 and 15 degrees to the long axis of the humerus demonstrates the intertubercular groove and the tubercles in profile without superimposition of the acromion process.
AP Projection–Neutral Rotation: Shoulder (Trauma)
SID 40”
CR perpendicular to IR, Directed to midscapulohumeral joint, which is approximately 3/4 inch inferior and slightly lateral to coracoid process
The proximal one-third of the humerus and upper scapula and the lateral two-thirds of the clavicle are shown, including the relationship of the humeral head to the glenoid cavity.
with neutral rotation, both the greater and the lesser tubercles most often are superimposed by the humeral head
transthoracic Lateral Projection: Proximal Humerus (Trauma)
Lawrence Method
SID 40”
CR perpendicular to IR, directed through thorax to level of affected surgical n.eck
Lateral view of proximal half of the humerus and scapulohumeral joint should be visualized through the thorax without superimposition of the opposite shoulder.
Outline of the shaft of the proximal humereus should be clearly visualized anterior to the thoracic vertebrae. Relationship of the humeral head and the glenoid cavity should be demonstrated.
Orthostatic breathing technique is preferred
Scapular Y lateral —Anterior Oblique Position:
Shoulder (Trauma)
SID 40”
CR perpendicular to IR, Directed to scapulohumeral joint (2 or 2 1/2 inches below top of shoulder)
True lateral view of the scapula, proximal humerus, and scapulohumeral joint.
The thin body of the scapula should be seen on end without rib superimposition.
The acromion and coracoid processes should appear as nearly symmetric upper limbs of the Y
The humeral head should appear superimposed over the base of the Y if the humerus is not dislocated.
Tangential Projection —Supraspinatas Outlet:
Shoulder (Trauma)
Neer Method
SID 40”
Requires 10 to 15 Degrees CR Caudal angle, centered posteriorly to pass through superior margin of humeral head
Proximal humerus is superimposed over thin body of the scapula, which should be seen on end without rib superimposition.
Acromion and coracoid processes should appear as nearly symmetric upper limbs of the Y
The humeral head should appear superimposed and centered to the glenoid fossa just below the supraspinatus outlet region.
The supraspinatus outlet region appears open, free of superimposition by the humeral head
AP Apical Oblique Axial Projection: Shoulder (Trauma)
Garth Method
SID 40”
CR 45” Caudad, centered to scapulohumeral joint
Humeral head, glenoid cavity, and neck and head of the scapula are well demonstrated free of superimposition.
The Coracoid process is projected over part of the humeral head, which appears elongated
Acromion and AC joint are projected superior to the humeral head
AP and AP Axial Projections: Clavicle
SID 40”
CR AP perpendicular to midclavicle
AP Axial –CR 15 to 30 degrees cephalad to midclavicle
AP No angulation
Entire clavicle visualized, including both AC and sternoclavicular joints and acromion.
Clavicle is demonstrated without any foreshortening
The midclavicle is superimposed on the superior scapular angle
AP Axial
Entire clavicle visualized including both AC, and sternoclavicular joints and acromion
Correct angulation of CR projects most of the clavicle above the scapula and second and third ribs
Only the medial portion of the clavicle is superimposed by the first and second ribs.
