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Radt 1502 A&P > Exam 4 - Shoulder Girdle & Bony Thorax > Flashcards

Exam 4 - Shoulder Girdle & Bony Thorax Flashcards

1
Q

the shoulder girdle is formed by which two bones?

A

scapula & clavicle

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2
Q

what is the function of the shoulder girdle?

A

connect upper limb to trunk

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3
Q

What kind of joint is the shoulder?

A

diarthrodial joint

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4
Q

what kind of bone is the clavicle?

A

long bone, doubly curved

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5
Q

are clavicles are longer, wider, thicker in males or females?

A

males

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6
Q

what is the function of the clavicle?

A

fulcrum for movements of the arm

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7
Q

what does the acromial extremity articulate with?

A

the acromion process of scapula

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8
Q

what does the sternal extremity articulate with?

A

the manubrium of sternum and 1st costal cartilage

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9
Q

what kind of bone is the scapula?

A

flat bone

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10
Q

what are the parts of the scapula?

A

2 surfaces
3 borders
3 angles

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11
Q

What are the 3 angles on the scapula?

A

superior (medial), inferior, lateral

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12
Q

what is the anterior surface of the scapula called and what does it include?

A

costal & subscapular fossa

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13
Q

what is the posterior surface of the scapula called and what does it include?

A

dorsal & its divided into superior and inferior portions by the spinous process

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14
Q

what is on the end of the spine of the scapula?

A

acromion

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15
Q

What border is by the spine of the scapula?

A

medial

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16
Q

what are the 3 borders of the scapula?

A

medial (vertebral)
lateral (axillary)
superior

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17
Q

what plane from the proximal humerus lay on?

A

horizontal oblique plane

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18
Q

what sides are the lesser and greater tubercles on?

A

lesser = anterior side
greater = lateral side

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19
Q

where do a lot of fractures happen on the humerus?

A

anatomical neck

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20
Q

what are the posterior greater tubercle muscle attachments?
superior:
middle:
inferior:

A

superior: supraspinatus
middle: infraspinatus
inferior: teres minor

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21
Q

what is the anterior lesser tubercle muscle attachment?

A

subscapularis

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22
Q

the long head tendon of the biceps brachii arises from:

A

superior margin of glenoid cavity

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23
Q

the short head tendon of the biceps brachii arises from:

A

coracoid process

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24
Q

where do the muscles of the biceps brachii insert?

A

into the radial tuberosity

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25
Q

what are the small synovial filled sacs that relieve pressure and reduce friction?

A

bursa

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26
Q

can you see calcifications of bursas on x-rays?

A

yes

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27
Q

how do you do the inferosuperior axial projection (lawrence method)?

A

supine position, CR horizontal, arm at about a 90 degree angle

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28
Q

what kind of joint is the scapulohumeral joint?

A

ball and socket

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29
Q

what kind of joint is the acromioclavicular joint?

A

gliding

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30
Q

what kind of joint is the sternoclavicular joint?

A

double gliding

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31
Q

what does an AP projection of the shoulder with external rotation show?

A

greater tubercle and humeral head in profile
supraspinatus tendon insertion visualized

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32
Q

what does an AP projection of the shoulder in a neutral position show?

A

greater tubercle partially superimposing the humeral head
posterior part of supraspinatus insertion demonstrated

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33
Q

what does an AP projection of the shoulder with internal rotation show?

A

lesser tubercle in profile
proximal humerus in true lateral position
insertion site of subscapular tendon demonstrated

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34
Q

RPO or LPO position
 35-45 degrees toward affected side
 Scapula parallel with the plane of the
IR
CR 2 in. medial and 2 in.
inferior to superolateral border
of the shoulder
Joint space between the
humeral head and the glenoid
cavity (scapulohumeral or
glenohumeral joint)

A

AP OBL Glenoid Cavity (Grasey Method)

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35
Q

Patient supine, arm abducted to 90 degrees with external rotation, vertical cassette, CR angle 15-30 degrees pointing into the arm pit

A

Inferosuperior Axial Projection (Lawrence method)

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36
Q

Place the patient in a chair at the end of the
exam table and have them extend the
shoulder over the table.
Shoulder should be over midpoint of IR
Tilt head away from IR
Humeral epicondyles should be vertical

A

Superioinferior Axial Projection (Lawrence Method)

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37
Q

What method shows these?
AC articulation
Joint relationship of proximal humerus and glenoid
cavity
Outer portion of coracoid process
Insertion points of subscapularis muscle (body of scapula) and teres minor muscle (inferior axillary border)

A

Superioinferior Axial Projection (Lawrence Method)

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38
Q

Patient supine, CR cephalic angle of 35 degrees
Demonstrates relationship of humeral head to the glenoid cavity
Useful in diagnosing posterior dislocation

A

AP Axial Trauma Shoulder

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39
Q

Useful in demonstrating
dislocations

A

Scapular Y PA OBL

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40
Q

Head beneath the coracoid
process (what dislocation?)

A

Anterior Subcoracoid
dislocation

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41
Q

Head projected beneath
acromion process (what dislocation?)

A

Posterior Subacromial
dislocation

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42
Q

Profiles the intertubercular groove free from superimposition of the surrounding shoulder structures
Patient supine
CR: 10-15 degrees posterior
Hand supinated

A

Intertubercular Groove Tangential Projection

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43
Q

SID: 72 in
Upright position
CR to midline at level of AC joints
With and without weights
Demonstrates dislocation, separation, and the function of joints

A

Acromioclavicular Articulations AP Projection: Bilateral

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44
Q

AC joint and clavicle projected above the acromion
CR 15 degrees cephalic

A

Acromioclavicular Articulations Alexander Method

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45
Q

Project clavicle off of scapula and ribs
Pt supine: CR 25-30 degrees
Pt upright leaning back: CR 15-25 degrees
Thinner patients require more angulation

A

AP Axial Projection Lordotic Position

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46
Q

Where is the CR for a Scapula AP projection?

A

CR perpendicualr to point 2 in below coracoid

47
Q

Patient flexes elbow and places hand on posterior thorax
Delineates the acromion and coracoid process
Adjust body of scapula to be
perpendicular to the IR
Position of the arm
determines what portion of
the scapula will be
superimposed by the
humerus
Extending the arm
upward demonstrates
the body of the scapula
best

A

Scapula Lateral Projection

48
Q

Examination of a joint after the injection of contrast material that outlines soft tissue and joint structures
Most commonly used to rule out bursitis

A

Shoulder Arthography

49
Q

Immovable joint
Ex: skull sutures

A

synarthrodial

50
Q

Slightly moveable joint
Ex: vertebrae

A

amphiarthrodial

51
Q

Freely movable joint
Ex: hip, shoulder

A

diarthrodial

52
Q

What is the advantage of a PA clavicle projection?

A

Closer to IR
Less exposure to gonads

53
Q

How do you treat a fractured clavicle?

A

Sling for several weeks

54
Q

what makes up the bony thorax?

A

sternum, 12 ribs, 12 thoracic vertebrae

55
Q

Supports walls of pleural cavity & diaphragm
Volume of cavity able to change during respiration
Protects heart and lungs

A

functions of the bony thorax

56
Q

flat bone, 6 inches in length, supports clavicles and provides attachment to 1st seven costal cartilages of ribs

A

sternum

57
Q

which ribs are true ribs?

A

1-7, attached to sternum

58
Q

which ribs are false ribs?

A

8-12, do not attach directly to the sternum; attach to costal cartilage of 7th rib

59
Q

which ribs are floating ribs?

A

11-12, attached only to the vertebrae

60
Q

articulate with C7 but rarely attach to sternum

A

cervical ribs

61
Q

angle ______ from ribs 1-9 and then ______ from ribs 9-12

A

increases, decreases

62
Q

production of red blood cells

A

erythropoiesis

63
Q

where does erythropoiesis occur in the fetus?

A

mesodermal cells of yolk sac

64
Q

where does erythropoiesis occur in 3-4 months to adolescence?

A

spleen, liver, and skeletal involvement

65
Q

where does erythropoiesis occur in adulthood?

A

vertebrae, sternum, pelvis, ribs

66
Q

what are the 8 joints that make up the bony thorax articulations?

A

Sternoclavicular
Costovertebral (1-12)
Costotransverse (1-10)
Costochondral (1-10)
Sternocostal (1-7)
Interchondral (6-10)
Manubriosternal
Xiphisternal

67
Q

only points of articulation between the upper limbs and the trunk
gliding joints

A

sternoclavicular

68
Q

rib head closely bound to the demifacets and 2 adjacent vertebral bodies
synovial gliding

A

costovertebral

69
Q

tubercle of rib articulates with tranverse process of lower vertebrae
synovial gliding

A

costotransverse

70
Q

articulation between costal cartilages and true ribs
no movement
cartilaginous synchondosis

A

sternocostal

71
Q

articulation between rib costal cartilages and sternum
1st rib: cartilaginous
2-7: synovial gliding

A

costochondral

72
Q

between 6-9 ribs: synovial gliding
between 9-10 ribs: fibrous syndesmosis

A

interchondral

73
Q

cartilaginous synchondrosis
sternum

A

manubriosternal & xiphersternal

74
Q

respiratory movement
Olique rib orientation
changes little

A

quiet respiration

75
Q

respiratory movement
Degree of obliquity
decreases
Ribs carried
anteriorly, superiorly,
and laterally while
necks are rotated
inferiorly

A

deep inspiration

76
Q

respiratory movement
Degree of obliquity
increases
Ribs carried inferiorly,
posteriorly, and
medially while the
necks are rotated
superiorly

A

deep expiration

77
Q

degree of angulation for oblique projection of sternum depends on the ____ of the chest

A

depth

78
Q

more or less angulation for a deep chest?

A

less

79
Q

more or less angulation for a shallow chest?

A

more

80
Q

Estimate body rotation by placing one hand on patient’s sternum and the other hand on the thoracic vertebrae to act as a guide
Top of IR 1.5 inches above jugular notch
Average body rotation is 15-20 degrees

A

PA Oblique Projection (RAO)
Sternum

81
Q

Minimal rotation
Sternum projected free
from superimposition
of the spine
Sternum projected over
the heart

A

PA Oblique Projection (RAO, LPO) Sternum

82
Q

Rotate patients hands posteriorly
Lock hands behind back
Film 24 x 30 cm lengthwise
IR 1.5 inches above jugular notch
Suspend deep inspiration

A

Lateral Projection (Upright)
Sternum

83
Q

Bring hands above head
Film 24 x 30 cm lengthwise
IR 1.5 inches above jugular notch
Suspend deep inspiration

A

Lateral Projection (Supine)
Sternum

84
Q

Sunken or “caved in” chest
Most common congenital chest wall abnormality in children
The problem is with the cartilage piece that connects each rib to the sternum. This costal cartilage connector is deformed, pushing the breastbone inward

A

pectus excavatum

85
Q

IR @ T3 (just posterior
to jugular notch)
Arms rest by side of
patient with palms up
Turn head toward
affected side
Rotates spine slightly
away from side being
examined
Better visualization of
lateral manubrium
Suspend at end of
expiration

A

PA Projection Sternoclavicular Articulations

86
Q

Rotate patient 10-
15 degrees
CR perpendicular
to SC Joint closest
to the IR (T2-T3)
LAO: Left side of interest
RAO: Right side of interest

A

PA Oblique Projection (RAO, LAO) SC Joints

87
Q

Rib x-ray
localized point of interest: anterior ribs

A

PA projection

88
Q

Rib x-ray
localized point of interest: posterior ribs

A

AP projection

89
Q

Rib x-ray
localized point of interest: axillary portion of ribs

A

Oblique projection

90
Q

how to image ribs above diaphragm

A

AP projection
1.5 in above shoulders
full inspiration

91
Q

how to image ribs below diaphragm

A

lower edge of IR at iliac crest
full expiration

92
Q

45 degree Oblique
Place affected side
closest to the IR
Center affected side
midway between
midsagittal plane and
lateral surface
Abduct arm of affected
side and elevate to
carry scapula away
from rib cage

A

Axillary Ribs AP Oblique Projection (RPO, LPO)

93
Q

2 x distance between vertebral column and lateral border affected side
visualized
Axillary ribs free
of superimposition

A

Axillary Ribs AP Oblique Projection (RPO, LPO)

94
Q

What are the 3 names the refer to the mid section of the sternum?

A

Corpus, body, gladiolus

95
Q

The body is also called the

A

gladiolus

96
Q

Xiphoid process is also called

A

ensiform

97
Q

Sternal angle between ____ and _______

A

body, manubrium

98
Q

what is between the ribs and sternum

A

costocartilage

99
Q

which rib is the longest?

A

7th

100
Q

Which rib articulates with the sternal angle?

A

2nd rib

101
Q

What’s the space between the ribs called?

A

intercostal space

102
Q

Width of the ribs gradually ________ from 1-12

A

decreases

103
Q

Angle ______ from ribs 1-9 and then _______ 9-12

A

increases, decreases

104
Q

which rib is shortest and widest?

A

1st

105
Q

which ribs is shortest and skinniest?

A

12th

106
Q

what is the purpose of erythropoiesis?

A

delivering oxygen to the body

107
Q

What is the only point of articulation between upper limbs and trunk?

A

SC joints

108
Q

Why must you do an oblique projection of the sternum verses?

A

Rotate so that the sternum is over the heart to provide a better background to see sternum

109
Q

What position and breathing is best to see sternum?

A

RAO with shallow breathing

110
Q

Bony landmark that can be used to utilize injury is above or below your diaphragm?

A

xiphoid process

111
Q

what should your technique be for a rib x-ray compared to a chest x-ray?

A

80 kVp, increases mAs

112
Q

PA oblique of ribs looking at:

A

side away

113
Q

AP oblique of ribs looking at:

A

side closest

Radt 1502 A&P (5 decks)

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