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Radiographic Procedures and Positioning > Humerus And Shoulder > Flashcards

Humerus And Shoulder Flashcards

1
Q

Identify the structures of the humerus

A
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2
Q

What are the routine projections for the humerus?

A

AP and lateral

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3
Q

What is the SID and kVp (both grid and non-grid) for the humerus?

A 
SID= 40”
kVp= 80 grid and 60 non-grid
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4
Q

Where should the height of the IR be for an AP humerus?

A

Upper edge should be 1-2 inches above head of humerus

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5
Q

How do you position a patient for an AP projection of the humerus?

A

Patient upright with arm straightened and hand supinated

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6
Q

What does the patient being positioned upright with arm straightened and hand supinated do?

A

Put the humeral epicondyles parallel to the IR

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7
Q

Where do you direct the CR for an AP humerus?

A

Over the humerus to the midpoint of IR

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8
Q

What does the AP projection of the humerus demonstrate?

A

Demonstrates the entire length of the humerus with greater tubercle in profile pointing laterally

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9
Q

How do you position a patient for a lateral humerus?

A

From AP position, have patient flex elbow and rotate arm internally, then place back of hand on hip

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10
Q

What is perpendicular to the IR when the patient is positioned for a lateral humerus?

A

Epicondyles

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11
Q

What is perpendicular to the IR once the patient is positioned for an lateral humerus?

A

Epicondyles

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12
Q

What does a lateral humerus demonstrate?

A

Entire length of humerus with lesser tubercle in profile pointing medially

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13
Q

If a patient is unable to rotate arm for a lateral view, what method can be used instead?

A

Transthoracic lateral or Lawrence method

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14
Q

What does the transthoracic lateral/Lawrence method demonstrate?

A

Demonstrates anterior/posterior displacement of fracture or anterior/posterior dislocation of head of humerus

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15
Q

Where should the upper edge of IR be for transthoracic lateral/Lawrence method?

A

Upper edge of IR 1-2 inches above head of humerus.

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16
Q

How is the patient placed for the transthoracic lateral/Lawrence method?

A

Patient in lateral position with affected arm against IR and uninjured arm raised to forearm on head (to elevate shoulder of uninjured arm)

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17
Q

Why is the affected arm against the IR for the transthoracic lateral/Lawrence method?

A

To minimize magnification

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18
Q

What should be in the center of the IR for a transthoracic lateral/Lawrence method?

A

The affected humerus

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19
Q

Where should the CR be directed for a transthoracic lateral/Lawrence method?

A

Direct CR through humerus to midpoint of IR

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20
Q

When is the exposure taken for a transthoracic lateral/Lawrence method? Why?

A

Taken on full inspiration to improve contrast and decrease exposure necessary to penetrate body

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21
Q

Identify the structures of the shoulder joint

A
22
Q

Between the acromion and coracoid process in the scapula, which one is more anterior? Which one is more posterior?

A

Anterior- coracoid process

Posterior- Acromion

23
Q

What are the routine projections for a shoulder x-ray?

A

AP neutral, AP internal, AP external oblique, axillary view, and scapular Y

24
Q

What is the SID and kVp (grid and non-grid) for shoulders?

A 
SID= 40”
kVp= 80 grid and 60 non-grid
25
Q

How do you position the patient for an AP neutral shoulder?

A

Patient’s arm should hang down by their side with palm of hand against thigh

26
Q

Where should the CR be for an AP neutral shoulder?

A

1 inch inferior to coracoid process (which is medial to head of of humerus)

27
Q

What will the AP neutral shoulder demonstrate?

A

Demonstrate the humerus in neutral position, placing the humeral epicondyles at an angle of about 45° with plane of IR

28
Q

How is a patient positioned for an AP internal?

A

Have patient flex elbow, rotate arm internally, and rest back of hand on hip

29
Q

How does the AP internal position of a shoulder place the humerus?

A

Places humerus in a lateral position so that lesser tubercle will be in profile pointing medially and the epicondyles will be perpendicular to the plane of IR

30
Q

Where is the CR directed for an AP internal shoulder?

A

CR directed 1 inch inferior to coracoid process and center IR to CR

31
Q

An AP external oblique of the shoulder is also known as…

A

Grashey method

32
Q

How do you position the patient for an AP external oblique?

A

Patient externally rotates arm or rests hand across belly

33
Q

How is the patient rotated for AP external oblique of shoulder/Grashey method?

A

35-45° toward affected side

34
Q

In the AP external oblique shoulder/Grashey method, _________ will be in profile pointing laterally and _____ will be parallel to plane of IR.

A

In the AP external oblique shoulder/Grashey method, GREATER TUBERCLE will be in profile pointing laterally and EPICONDYLES will be parallel to plane of IR.

35
Q

What will an AP external oblique of shoulder/Grashey method demonstrate?

A

Demonstrates an open joint space between humeral head and glenoid cavity

36
Q

How do you position the patient for an axillary view of shoulder?

A

Have patient sit at end of table with affected arm abducted and leaning over IR and have the patient tilt their head forward to their chin or opposite side of shoulder being radiographed

37
Q

How is the tube angled for an axillary view of shoulder?

A

5-10° towards elbow

38
Q

Where is the CR directed to for an axillary view of shoulder?

A

Through top of shoulder/shoulder joint

39
Q

What does the CR directed through top of shoulder for an axillary view of shoulder demonstrate?

A

Demonstrates glenohumeral joint space

40
Q

In what positions can you take the scapular Y projection?

A

AP or PA

41
Q

Where should the upper edge of IR be for a scapular Y projection?

A

1-2 inches above shoulder

42
Q

How do you position a patient for a scapular Y PA projection?

A

For PA, patient is upright facing grid. Patient is rotated 45-60° towards affected side (shoulder at center of IR, direct CR to midpoint of IR)

43
Q

How do you position a patient for a scapular Y AP projection?

A

For AP, patient stands at vertical grid obliqued 45-60° With affected side up (direct CR through shoulder joint)

44
Q

What does the scapular Y projection demonstrates?

A

Demonstrates whether a dislocation of humeral head is anterior or posterior

45
Q

How do you collimate for the scapular Y projection?

A

Collimate to shoulder while still including length of scapula

46
Q

What positions (RAO, PRO, LAO, LPO) can the patient be in to demonstrate right shoulder?

A

RAO or LPO

47
Q

What positions (RAO, PRO, LAO, LPO) can the patient be in to demonstrate left shoulder?

A

LAO or RPO

48
Q

What forms the vertical component of the Y shape? What forms the upper limbs of the Y?

A
  • Body of scapula forms vertical component of Y shape
  • Acromion and coracoid process forms upper limbs of Y
49
Q

In a normal shoulder, what is directly superimposed over the junction of the Y?

A

The humeral head

50
Q

In anterior dislocations, where is the humeral head is situated?

A

Beneath coracoid process

51
Q

In posterior dislocations, where is the humeral head situated?

A

Beneath acromion process

Radiographic Procedures and Positioning (22 decks)

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