humerus and shoulder girdle Flashcards
what makes up the shoulder girdle
proximal humerus
clavicle
scapula
where is the scapula
T2-T7
female clavicle
shorter and less curved
male clavicle
most curved in heavily muscled males
more curved than females
what is the most frequently broken bone in the body
clavicle
scapula has 2 surfaces
costal surface
posterior surface
scapula has three borders
medial border
superior border
lateral border
scapula has 3 angles
superior angle
inferior angle
lateral angle
scapulohumeral joint
the shoulder joint where the humeral head articulates with the scapula
what are the articulations of the shoulder girdle
sternoclavicular joint
acromioclavicular joint
scapulohumeral joint
humerus
basic projections
AP
AP rotational lateral
horizontal beam lateral
humerus
special projections
transthoracic lateral
shoulder
basic nontrauma projections
AP external rotation
AP internal rotation
shoulder
special nontrauma projections
inferosuperior axial (lawrence method) superoinferior axial (hobbs modification) inferosuperior axial (clements modification) posterior oblique glenoid cavity (grashey method) tangential projection intertuburcular groove (fisk method)
shoulder
basic trauma projections
AP neutral rotation
transthoracic lateral (lawrence method)
Scapular Y lateral
shoulder
special trauma projections
tangential projection supraspinatus outlet (Neer method) apical oblique (garth method)
clavicle
basic projections
AP
AP axial
AC joints
basic projections
AP bilateral with weights
AP bilateral without weights
Scapula
basic projections
AP
Lateral “Y”
erect
recumbent
HUMERUS
clinical indications
fractures and dislocations of humerus
osteoporosis
HUMERUS
technical factors
SID = 40
75-85 kVp
Humerus AP projection
central ray perpendicular to midpoint of humerus
epicondyles parallel to IR
need elbow and shoulder joints
how do you know you have a true AP projection of the humerus
greater tuburcle in profile
humeral head partially seen in profile
epicondyles in profile
rotational lateral of the humerus
arm is internally rotated
epicondyles perpendicular to IR
central ray at midpoint of humerus
respiration suspended
how do you know you have a true rotational lateral of the humerus
epicondyles are directly superimposed
lesser tuburcle in profile medially
horizontal beam lateral humerus
trauma
done for the mid and distal humerus on a trauma patient
70-85 kVp
patient is supine
elbow flexed
IR placed between arm and thorax -top of IR at axilla
horizontal beam lateral humerus
evaluation criteria
elbow joint visible
distal 2/3rds of humerus is well visualized
transthoracic lateral humerus
clinical indications
fractures of diaphysis of humerus
transthoracic lateral humerus
80-90 kVp
orthostatic breathing technique 2-4 seconds
affected arm in neutral position opposite arm raised above head
central ray centered to mid thorax
what do you do if the pt. cannot lift the arm above their head for a transthoracic projection
drop the shoulder and angle the CR 10-15 degrees cephalad
clavicle AP and AP axial projections
clinical indications
fractures and dislocations of the clavicle
SID = 40
75-85 kVp
10x12 IR
Clavicle
AP projection positioning
clavicle centered to IR and CR
CR perpendiclar to midclavicle
Clavicle
AP axial projection positioning
CR angled 15-30 degrees cephalad to mid clavicle
asthenic patients require more angulation
AC joints
bilateral with/without weights
SID = 72
70-80 kVp
CR is directed midway between the AC joints one inch above the jugular notch
why do we use the weights for AC joints
to separate the AC joint
AC joints
Weights for large adults
8-10 lbs
AC joints
weights for smaller adults
5-8 lbs
Alternate AP axial projection of the AC joints
(alexander method)
CR 15 degrees cephelad centered at AC joints
Scapula AP projection
SID = 40
75-85 kVp
orthostatic breathing technique 3-4 seconds
abduct arm 90 degrees and supinate the hand
CR perpendicular to midscapula
2 inches below the coracoid process
Scapula
Lateral projection RAO or LAO
horizontal fractures of the scapula
rotate pt. about 45 degrees or until the AC joint is perpendicular to the IR
CR is perpendicular to mid vertebral border of the scapula
for demonstrating the body of the scapula
the pt. reaches across the front of the chest and grasps opposite shoulder
for demonstrating the acromion and coracoid
flex the elbow and place hand on lower back
bankart fracture
fracture of the anteroinferior glenoid rim
seen in 85% of cases after a traumatic anterior dislocation
impingement syndrome
impingement of the greater tuberosity and soft tissues on the coracoacromial ligamnetous and osseous arch
