Positioning Test #2 Flashcards
1
Q
What consists of the shoulder girdle?
A
Clavicle and scapula
2
Q
What are the articulations of the shoulder girdle?
A
1) head of humerus (shoulder joint)
2) manibrum of sternum (sternoclavicular joint;SC)
3) aceomioclavicular joint; AC
3
Q
What are the shoulder projections?
A
1) AP external
2) AP internal
3) AP neutral
4) AP oblique (Grashey)
5) PA oblique (scapular Y)
6) Transthoracic lateral (Lawrence method)
7) Inferosuperior Axial (Lawrence, Axillary)
4
Q
Where is the central ray for an AP external view for shoulder?
A
1in inferior to coracoid process
5
Q
What are the structures shown for the AP external roster on for shoulder view?
A
Numeral head
Greater tubercle!!
Entire shoulder joint
Glenoid cavity
6
Q
Where are the humoral epicondyles for the AP external rotation for the shoulder?
A
Parallel to IR
7
Q
For the AP neutral rotation for the shoulder, where is the CR?
A
Same as AP external, 1in inferior to Coracoid process
8
Q
What is demonstrated in the AP neutral rotation for the shoulder?
A
The greater tubercle is now partially superimposed on the humoral head
Glenoid also is seen
9
Q
What is different in the AP neutral rotation, compared to the AP external rotation of the shoulder?
A
For neautral position, palm of hand rested on thigh and humoral epicondyles are 45 degrees oblique angle
10
Q
What is the breathing technique for the AP external rotation of shoulder?
A
Suspend respiration
11
Q
What is the breathing technique for the AP neutral rotation of shoulder?
A
Suspend respiration
12
Q
What is the central ray for the AP internal rotation for shoulder view?
A
1in inferior to coracoid process
13
Q
What is demonstrated in the AP internal rotation view of shoulder?
A
1) Lesser tubercle!!
2) Shoulder joint with humoral head overlapping glenoid cavity/fossa
3) true lateral of proximal humerus
14
Q
What is different in the body position for the AP internal rotation of the shoulder compared to the AP external view?
A
The elbow is slightly flexed, arm is internally rotated, and back of hand is on hip
15
Q
Where are the humoral epicondyles for the AP internal rotation for shoulder?
A
Perpendicular to the IR
16
Q
What is the breathing technique for the AP internal rotation of the shoulder view?
A
Suspend respiration
17
Q
What is another name for the shoulder view, transrhoracic lateral?
A
Lawrence method
18
Q
What is the patient position for the shoulder view, transthoracic lateral (Lawrence method)?
A
Patient upright
Affected side against IR
Uninjured arm over head
19
Q
What are the 2 ways you can ask the patient to demonstrate a breathing technique for the shoulder view, transthoracic lateral (Lawrence method)?
A
1) hold on full expiration
2) use breathing technique with a 4-5 second exposure time
20
Q
What is the preferred breathing technique to use for the shoulder view, transthoracic lateral (Lawrence method)?
A
Use breathing technique with a 4-5 second exposure time
21
Q
What is demonstrated when we use the breathing technique with a 4-5 second exposure time for the shoulder view, transthoracic lateral (Lawrence method)?
A
To demonstrate the blurred lungs and ribs
22
Q
What is the central ray for the shoulder view, transthoracic lateral (Lawrence method)?
A
Perpendicular to surgical neck at the midcoronal plane (MCP) exiting at surgical neck
23
Q
If the patient can’t lift their unnefected arm for the shoulder view, transthoracic lateral (Lawrence method), what is to be done?
A
You put a 10-15 degree CEPHALIC angle on the tube
24
Q
What are the structures shown for the shoulder view, transthoracic lateral (Lawrence method)?
A
Lesser tubercle
Proximal humerus
lateral shoulder through thorax
Scapula superimposed on T-spine
25
Which shoulder view is used to demonstrate dislocations and whether they are anterior or posterior dislocations?
PA oblique (scapular Y)
26
What is the patient position for the shoulder view, PA oblique (scapular Y)?
Upright, patient rotated so the midcoronl plane forms a 45-60 degree angle to IR
27
What is the central ray for the shoulder view, PA oblique (scapular Y)?
Perpendicular to shoulder joint
28
What are the structures shown for the scapular Y view of shoulder?
** acrimion projected laterally and free of superimposition
Coracoid process
Scapula in profile
29
What other projections can be feeformed for the PA oblique (scapular Y) of the patient is severely injured?
RPO and LPO projections
30
Where does the central ray enter for the inferosuperior Axial (Lawrence/Axillary method) for the shoulder?
Enters inferiorly
31
Where does the central ray exit for the inferosuperior Axial (Lawrence/Axillary method) view of the shoulder?
Exits superiorly
32
Where does the central ray shoot through for the shoulder view, inferosuperior Axial (Lawrence/Axillary method)?
Through the Axila
33
What is the patient position for the inferosuperior Axial (Lawrence/Axillary method) of shoulder?
1) patient supine (recumbent)
2) rotate body to achieve a 90 degree angle
3) abduct the affected arm as much as possible
4) humerus is in external rotation (hand outward)
5) turn head away from affected side
34
Where is the IR placed for the inferosuperior Axial (Lawrence/Axillary method)?
IR at top of shoulder, close to the neck
35
What is the central ray for the shoulder view, inferosuperior Axial (Lawrence/Axillary method)?
Horizontally and perpendicular to IR shooting through axila
36
For the inferosuperior Axial (Lawrence/Axillary method), what can be done to achieve less distortion?
Place the tube at the bottom of the table with a 15-30 degree angle
37
What are the structutires for the inferosuperior Axial (Lawrence/Axillary method)?
** lesser tubercle
Coracoid process
Proximal humerus and shoulder joint
38
What is the patient position for the AP oblique (grashey method) for shoulder?
1) patient supine or upright
2) turn patient towards affected side so body makes a 35-45 degree angle
3) abduct arm internally slightly resting on abdomen
39
What is the centrism ray for the AP oblique (grashey method) for shoulder?
Perpendicular to glenoid cavity, 2in medial and inferior to superior/lateral border do shoulder
40
Structures shown for AP oblique (grashey method)?
* * glenoid cavity in profile
* * looking for space btw humerus and glenoid
* * clavicle is very distorted (night and more vertical)
41
What views of the shoulder demonstrate the lesser tubercle?
1) AP internal rotation
2) transthoracic lateral (Lawrence method)
3) inferosuperior Axial (Lawrence/Axillary method)
42
Which shoulder views demonstrate the greater tubercle?
1) AP external rotation
| 2) AP neutral rotation
43
What are the views for the clavicle?
AP
| AP Axial
44
What are structures shown for AP clavicle?
Entire clavicle
45
Where is the central ray for the AP clavicle?
Perpendicular to midshaft of clavicle
46
What is the breathing technique for the AP clavicle?
Suspend respiration AFTER exhalation
47
Where does the clavicle sit around?
Around the 3rd and 4th rib
48
What are the structures shown for the AP axial projection of the clavicle?
Entire clavicle
* *projected above the ribs
* * clavicle in horizontal placement
49
What is the patient position for the AP Axial projection of clavicle?
1) Patient supine or upright
| 2) Have patient lean back in a lordotic position
50
What is the breathing technique for the AP Axial projection of the clavicle?
Suspend respiration AFTER FULL INSPIRATION
51
Where is the central ray for the AP Axial projection of clavicle?
1) If patient is in lordotoc position:
~ 0-15 degrees CEPHALIC, centered to mid shaft of clavicle
2) If patient is in normal standing position:
~ 15-30 degree CEPHALIC angle of tube (sit the clavicle sits higher in the chest)
52
For the PA Axial projection of the clavicle, what is the central ray?
Angled 15-30 degrees CAUDAD
53
For the PA axial projection of the clavicle, what is the position of the patient?
Same as AP Axial ; patient in lordotic position
54
What is the structures shown for the PA Axial projection of clavicle?
Same as AP axial projection; entire clavicle projected above the ribs sitting horizontally
55
What is the scapula bone classified as?
Flat
56
What is the clavicle bone classified as?
Long
57
What is the name of the Fossa on the anterior surface of the scapula
Subscapular
58
Which border of the scapula extends from the glenoid cavity to the inferior angle?
Lateral
59
Which border of the scapula extends from the superior angle to the inferior angle?
Medial
60
I watch part of the scapula is the acromion on extension?
Spine
61
Where is the coracoid process located in reference to the body of the scapula?
Lateral and superior
62
Which borders of the scapula unite to form the superior angle?
Medial and superior
63
Which borders of the scapula unite to form the inferior angle?
Medial and lateral
64
Where is the scapular notch located?
Superior border
65
Which joint is a ball and socket joint?
Scapulohumeral
66
Which portion of the scapula articulates with the humeral head?
Glenoid fossa
67
Which portion of the scapula articulates with the clavicle?
Acromion
68
I’m performing AP projections of the shoulder where should the central ray be directed?
1in inferior to the coracoid process
69
With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP projection of the shoulder with the shoulder in external rotation?
Parallel
70
With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP projection of the shoulder with the shoulder in internal rotation?
Perpendicular
71
With reference to the plane of the IR, how should the humoral epicondyles be positioned for the AP projection of the shoulder with the shoulder in neutral rotation?
45 degrees medial oblique
72
Which projection of the shoulder best demonstrates the greater tubercle of the humerus in profile?
AP projection with external rotation
73
Which production of the shoulder best demonstrates the humeral head in profile?
AP projection with external rotation
74
Which projection of the shoulder best demonstrates the lesser tubercle of the humerus in profile and pointing towards the glenoid cavity?
AP projection with internal rotation
75
Which projection of the shoulder is being performed on the patient in supine with the right shoulder centered to the IR, vertical central ray is being directed perpendicular to the center of the IR, and the humeral epicondyles are parallel with the plane of the IR?
AP projection with external rotation
76
What should be adjusted from the regular procedure for the transthoracic lateral projection (Lawrence method) of the humerus if the patient is unable to elevate the unaffected arm?
Central ray angulation
77
Which projection of the upper limb should be performed to demonstrate a fracture of the proximal humerus on the arm cannot be abducted?
Transthoracic lateral projection (Lawrence method) of the humerus
78
I’m performing the transthoracic lateral projection (Lawrence method) of the humerus which breathing technique should be used to improve best the image contrast and decrease exposure it necessary to penetrate the body?
Suspended full inspiration
79
Which projection of the shoulder requires that a horizontal central ray be directed 15-30 degrees medially and enter the sculls of the affected arm?
Inferosuperior axial projection (Lawrence method)
80
What is the proper positioning of the humerus for the inferosuperior axial projection?
Abducted to a right angle and externally rotated
81
How should the central ray be directed for the PA Oblique projection (scapular Y) of the shoulder?
Perpendicular to IR
82
In which body position should the patient be placed demonstrate the left shoulder with the Pa oblique projection (scapular Y)?
Left anterior oblique (LAO)
83
Which projection of the shoulder joint requires a patient to be rotated until the mid-coronal plane forms a angle of 45 to 60° but the plane of the IR?
PA oblique projection (scapular Y)
84
Where is the humerus generally demonstrated on a Pa oblique projection (scapular Y) image of the shoulder is normal?
Superimposed on the junction of the acromion and coracoid process
85
Where is the humeral head usually seen on a PA oblique (scapular Y) image of the shoulder is anteriorly dislocated?
Beneath the coracoid process
86
When performing a lateral projection of the scapula the patient positioned RAO or LAO, approximately how much body rotation is necessary for the average patient?
45-60 degrees
87
When performing the AP projection of the scapula, the CR should be directed towards a pint 2in what, to the coracoid process?
Inferior
88
How many degrees and in which direction should the central ray be directed for the AP axial projection of the clavicle with the patient supine?
15-30 degrees cephalad
89
How many degrees in which direction should the central ray be directed for the PA axial projection of the clavicle?
15-30 degrees caudad
90
If the patient’s condition permits which joint should be demonstrated with the patient in an upright position for the clavicle?
Acromioclavicular
91
When demonstrating the intertubercular (bicipital) groove with the Fisk modification of the tangential projection, how should the affected humerus be positioned?
Vertical humerus should form an angle of 10-15 degrees
92
What would be required patient position to demonstrate the left shoulder using the AP oblique projection (grashey) method?
35-45 degrees LPO
93
Which projection demonstrates the scapulohumeral joint space open and the glenoid cavity in profile?
AP oblique projection (grashey)
94
All of the following compromise a bony thorax except for...
A. Sternum
B. 12 pairs of ribs
C. 12 thoracic vertebrae
D. Scapulae
D. Scapulae
95
What is the proper name for the structure commonly called the breastbone?
Sternum
96
Which bone classification is the sternum?
Flat
97
Which three bony parts compose the sternum?
Manubrium, body, Xiphoid process
98
Which part of the sternum is most superior?
Manubrium
99
Ribs :
| What articulates with the articular facets located just lateral to the jugular notch?
Clavicles
100
Ribs:
| The junction of which structures creates the sternal angle?
Manubrium and sternal body
101
Ribs:
| Which part of the sternum is the elongated central portion?
Body
102
Ribs:
| Where on the sternum is the jugular notch located?
Superior border of the manubrium
103
What is the smallest part of the sternum?
Xiphoid process
104
Which part of the sternum is located at the level of T10?
Xiphoid process
105
With which part of the sternum does the first pair of ribs articulate?
Lateral border if the manubrium
106
Which classification refers to ribs that attach third costal cartilage is directly to the sternum?
True ribs
107
Which classification route refers to the ribs that have no anterior attachments?
Floating ribs
108
Which classification first to the 8th-12th pairs of ribs?
False ribs
109
What two bony structures form the top of the “Y”in a scapular Y view?
Acromion and coracoid processes
110
Which projection of the shoulder will best demonstrate the glenoid fossa in profile?
Grashey method
111
Why should clavicles be performed PA?
Sit closer to the IR
112
Where is the central ray location for an AP clavicle?
Midshaft of clavicle
113
In the AP axial for clavicle if the patient is supine how many degrees in which direction is the tube angled?
15-30 degrees cephalic
114
In the AP axial for clavicle if the patient is lordotic how many degrees in which direction is the tube angled?
0-15 degrees cephalic
115
How many degrees is the patient rotated and a scapular Y?
45-60 degrees
116
What projection is the scapular Y?
Oblique
117
How many degrees in which direction is the patient rotated and the Grashey method?
35-45 degrees toward affected side
118
In the inferosuperior axial (Axillary) how many degrees is the arm abducted?
90 degrees
119
Where is the central ray location for transthoracic shoulder?
Perpendicular, midcoronal plane at surgical neck
120
Which production of the shoulder will best demonstrate the lesser tuberosity?
AP internal rotation
121
In the AP neutral rotation of the shoulder, what is the position of the humoral epicondyles?
45 degrees medial oblique
122
What is the central relocation for an AP external rotation shoulder
1in inferior to coracoid process
123
In the AP external rotation of the shoulder what is the position of the humeral epicondyles?
Parallel
124
Which two bony structures make up the shoulder joint?
Humeral head and glenoid fossa
125
Which phones make up the shoulder girdle?
Scapula and clavicle
126
How many rib pairs are demonstrated on an AP upper ribs?
10
127
How many rib pairs of true ribs are there?
7
128
Which ribs are considered floating ribs?
11-12
129
Why are lower ribs done on expiration?
So the diaphragm gets raised which demonstrates lower ribs better
130
Two best demonstrate the anterior 7th right rib without vertebral superimposition which oblique would be performed?
LAO
131
Which projection of the posterior left ribs will demonstrate them forshortened?
RPO
132
Where is the central ray location for upper ribs?
T7
133
Where is the central ray location for AP lower ribs with the film crosswise?
Perpendicular to IR
134
Which projection of the ribs will best demonstrate Axillary border?
Oblique
135
In an RPO projection for left upper ribs, where is the central ray located?
Center to IR
136
How many degrees is the patient rotated in an LAO of the right ribs?
45 degrees
137
Where is the top of the cassette placed for upper posterior ribs?
1 1/2 in above shoulders
138
What are the breathing instructions for an AP clavicle?
Suspend expiration
139
What is the central ray for the PA upper anterior ribs?
Perpendicular centered to IR at T7 and midsagittal plane
140
What is the breathing technique for the PA upper anterior ribs?
Suspend it respiration after full inspiration
141
What are the structure Shawnnn for the PA upper anterior ribs?
- ribs above diaphragm
| - rib pairs 1-9
142
What must the patient be measured in for the PA upper anterior ribs?
60’s for upper ribs
| -over 60,s: decrease by 15%, mAs doubles
143
Where is the top of the image receptor for the PA upper anterior ribs?
Top light is 1 1/2 above shoulders
144
Structures shown for the PA lower anterior ribs?
-lower rib pairs 8-12
145
What much the patient measure in the PA lower anterior ribs? And if above measurement, what do you do?
- measure 70’s
| - decrease by 15%: double mAs
146
What is the central ray for the PA lower anterior ribs?
Perpendicular center to IR, at midsagittal plane
147
Where is the IR placed for the PA lower anterior ribs?
Bottom of light at level of iliac crest
148
What is the breathing technique for the PA lower anterior ribs?
Suspend respiration after full exhalation
149
Where is the IR for the AP upper posterior ribs?
Top of light 1 1/2in above the shoulders
150
What is the breathing technique for the AP upper posterior ribs?
Suspend respiration after full inspiration
151
What is the central ray for the AP upper posterior ribs?
Perpendicular centered to IR at midsagittal plane
152
What is demonstrated in the AP upper posterior ribs?
Rib pairs 1-10
153
Where is the IR for the AP lower posterior ribs?
Bottom of light at level of the iliac Crest
154
What is the breathing technique for the AP lower posterior ribs?
Suspend respiration after the end of full exhalation
155
Where is the central ray for the AP lower posterior ribs?
Perpendicular centered to IR at midsagittal plane
156
What is demonstrated for the AP lower posterior ribs?
Rib pairs 8-12
157
How much is the body rotated for the AP oblique RPO/LPO rib positions?
45 degrees
158
Where is the IR centered when doing the upper ribs for the AP oblique RPO/LPO views?
Ir centered at T7 with bottom of light 1 1/2in above shoulders
159
Where is the IR placed for the lower ribs for the AP oblique (RPO/LPO) views?
Bottom of IR at level of iliac crest
160
What is the central ray for the AP oblique (RPO/LPO) rib views?
Perpendicular, centered to IR, midway btw medsagittal plane and lateral border of affected side
161
What are the structures shown for the AP oblique (RPO/LPO) rib views?
- Axillary portion of ribs projected free of superimposition
- ribs elongated for foreshortened depending on which oblique
162
Is the patient is in the AP, LPO position for the oblique views for ribs, which side is elongated?
Left ribs are elongated
163
If the patient was in the AP, RPO position for the rib views, which side is elongated?
Right ribs elongated
164
If the patient was in the PA, LAO position for the oblique rib views, which side is elongated and foreshortened?
Right side elongated
| Left side foreshortened
165
If the patient was in the PA, RAO position for the oblique rib views, which side is elongated and foreshortened?
Left side is elongated
| Right side is foreshortened
166
If you are in the AP position for the oblique views for the ribs, which side will typically be demonstrated and elongated?
The side touching the IR
167
If you were in a PA position for the oblique rib views, which side of the body will be demonstrated and elongated?
The side father away from the IR will be demonstrated and elongated
168
What do foreshortened ribs demonstrate?
Brings the spine in view
169
When demonstrating the upper ribs, how many rib pairs are visible?
1-10 rib pairs
170
When demonstrating the lower ribs, how many rib pairs are visible?
8-12 rib pairs
171
Where are the ribs found in the body?
In the thorax anteriorly and posteriorly
172
How many rib pairs are in the body?
12
173
What determines whether a particular rib is a true rib or a false rib?
Anterior articulations
174
What structures form costovertebral joints?
Heads of ribs with thoracic vertebral bodies
175
True or false:
| Anterior end of a rib is generally located 3-5in below the level of its head
True
176
True or false:
| Ribs increase in thickness the closer they are to the lumbar column
False
177
Which location of the thoracic column does the sternum angle correspond?
Disk space between T4 and T5
178
Where is the sternsl angle located?
At the junction of manumbrium and sternal body
179
What is the name of the notch found on the superior border of sternum?
Jugular notch
180
The jugular Notch is found anterior to which precise location of the thoracic vertebral column?
Disk space between T2 and T3
181
Approximately length of sternum for a regular adult?
6in
182
Purpose of bony thorax is?
Protect the heart and lungs
183
How many thoracic vertebrae are there?
12
184
What part of the sternum supports the sternal ends of the clavicles?
Manubrium
