Positioning Test #2 Flashcards
What consists of the shoulder girdle?
Clavicle and scapula
What are the articulations of the shoulder girdle?
1) head of humerus (shoulder joint)
2) manibrum of sternum (sternoclavicular joint;SC)
3) aceomioclavicular joint; AC
What are the shoulder projections?
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)
Where is the central ray for an AP external view for shoulder?
1in inferior to coracoid process
What are the structures shown for the AP external roster on for shoulder view?
Numeral head
Greater tubercle!!
Entire shoulder joint
Glenoid cavity
Where are the humoral epicondyles for the AP external rotation for the shoulder?
Parallel to IR
For the AP neutral rotation for the shoulder, where is the CR?
Same as AP external, 1in inferior to Coracoid process
What is demonstrated in the AP neutral rotation for the shoulder?
The greater tubercle is now partially superimposed on the humoral head
Glenoid also is seen
What is different in the AP neutral rotation, compared to the AP external rotation of the shoulder?
For neautral position, palm of hand rested on thigh and humoral epicondyles are 45 degrees oblique angle
What is the breathing technique for the AP external rotation of shoulder?
Suspend respiration
What is the breathing technique for the AP neutral rotation of shoulder?
Suspend respiration
What is the central ray for the AP internal rotation for shoulder view?
1in inferior to coracoid process
What is demonstrated in the AP internal rotation view of shoulder?
1) Lesser tubercle!!
2) Shoulder joint with humoral head overlapping glenoid cavity/fossa
3) true lateral of proximal humerus
What is different in the body position for the AP internal rotation of the shoulder compared to the AP external view?
The elbow is slightly flexed, arm is internally rotated, and back of hand is on hip
Where are the humoral epicondyles for the AP internal rotation for shoulder?
Perpendicular to the IR
What is the breathing technique for the AP internal rotation of the shoulder view?
Suspend respiration
What is another name for the shoulder view, transrhoracic lateral?
Lawrence method
What is the patient position for the shoulder view, transthoracic lateral (Lawrence method)?
Patient upright
Affected side against IR
Uninjured arm over head
What are the 2 ways you can ask the patient to demonstrate a breathing technique for the shoulder view, transthoracic lateral (Lawrence method)?
1) hold on full expiration
2) use breathing technique with a 4-5 second exposure time
What is the preferred breathing technique to use for the shoulder view, transthoracic lateral (Lawrence method)?
Use breathing technique with a 4-5 second exposure time
What is demonstrated when we use the breathing technique with a 4-5 second exposure time for the shoulder view, transthoracic lateral (Lawrence method)?
To demonstrate the blurred lungs and ribs
What is the central ray for the shoulder view, transthoracic lateral (Lawrence method)?
Perpendicular to surgical neck at the midcoronal plane (MCP) exiting at surgical neck
If the patient can’t lift their unnefected arm for the shoulder view, transthoracic lateral (Lawrence method), what is to be done?
You put a 10-15 degree CEPHALIC angle on the tube
What are the structures shown for the shoulder view, transthoracic lateral (Lawrence method)?
Lesser tubercle
Proximal humerus
lateral shoulder through thorax
Scapula superimposed on T-spine
Which shoulder view is used to demonstrate dislocations and whether they are anterior or posterior dislocations?
PA oblique (scapular Y)
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
What is the central ray for the shoulder view, PA oblique (scapular Y)?
Perpendicular to shoulder joint
What are the structures shown for the scapular Y view of shoulder?
** acrimion projected laterally and free of superimposition
Coracoid process
Scapula in profile
What other projections can be feeformed for the PA oblique (scapular Y) of the patient is severely injured?
RPO and LPO projections
Where does the central ray enter for the inferosuperior Axial (Lawrence/Axillary method) for the shoulder?
Enters inferiorly
Where does the central ray exit for the inferosuperior Axial (Lawrence/Axillary method) view of the shoulder?
Exits superiorly
Where does the central ray shoot through for the shoulder view, inferosuperior Axial (Lawrence/Axillary method)?
Through the Axila
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
Where is the IR placed for the inferosuperior Axial (Lawrence/Axillary method)?
IR at top of shoulder, close to the neck
What is the central ray for the shoulder view, inferosuperior Axial (Lawrence/Axillary method)?
Horizontally and perpendicular to IR shooting through axila
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
What are the structutires for the inferosuperior Axial (Lawrence/Axillary method)?
** lesser tubercle
Coracoid process
Proximal humerus and shoulder joint
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
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
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)
What views of the shoulder demonstrate the lesser tubercle?
1) AP internal rotation
2) transthoracic lateral (Lawrence method)
3) inferosuperior Axial (Lawrence/Axillary method)
Which shoulder views demonstrate the greater tubercle?
1) AP external rotation
2) AP neutral rotation
What are the views for the clavicle?
AP
AP Axial
What are structures shown for AP clavicle?
Entire clavicle
Where is the central ray for the AP clavicle?
Perpendicular to midshaft of clavicle
What is the breathing technique for the AP clavicle?
Suspend respiration AFTER exhalation
Where does the clavicle sit around?
Around the 3rd and 4th rib
What are the structures shown for the AP axial projection of the clavicle?
Entire clavicle
- *projected above the ribs
- clavicle in horizontal placement
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
What is the breathing technique for the AP Axial projection of the clavicle?
Suspend respiration AFTER FULL INSPIRATION
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)
For the PA Axial projection of the clavicle, what is the central ray?
Angled 15-30 degrees CAUDAD
For the PA axial projection of the clavicle, what is the position of the patient?
Same as AP Axial ; patient in lordotic position
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
What is the scapula bone classified as?
Flat
What is the clavicle bone classified as?
Long
What is the name of the Fossa on the anterior surface of the scapula
Subscapular
Which border of the scapula extends from the glenoid cavity to the inferior angle?
Lateral
Which border of the scapula extends from the superior angle to the inferior angle?
Medial
I watch part of the scapula is the acromion on extension?
Spine
Where is the coracoid process located in reference to the body of the scapula?
Lateral and superior
Which borders of the scapula unite to form the superior angle?
Medial and superior
Which borders of the scapula unite to form the inferior angle?
Medial and lateral
Where is the scapular notch located?
Superior border
Which joint is a ball and socket joint?
Scapulohumeral
Which portion of the scapula articulates with the humeral head?
Glenoid fossa
Which portion of the scapula articulates with the clavicle?
Acromion
I’m performing AP projections of the shoulder where should the central ray be directed?
1in inferior to the coracoid process
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
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
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
Which projection of the shoulder best demonstrates the greater tubercle of the humerus in profile?
AP projection with external rotation
Which production of the shoulder best demonstrates the humeral head in profile?
AP projection with external rotation