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Rad tech subjects > Procedures shoulder review for final exam > Flashcards

Procedures shoulder review for final exam Flashcards

1
Q

The shoulder consists of the _______,________ and ________

A

proximal humorous, scapula, clavicle

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2
Q

The intertubercular groove is also known as the ______ _________.

A

bicipital groove

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3
Q

The greater and lesser tubercle of the humerus can also be called the _________

A

tuberosity

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4
Q

what are the three aspects of the clavicle?

A

The sternal extremity, body, acromial extremity

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5
Q

The mail clavicle is thicker and more______

A

curved

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6
Q

The three angles of the scapula are?

A

lateral angle, superior angle and inferior angle

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7
Q

what is the anterior surface of the scapula referred to?

A

The costal surface

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8
Q

jis the coronoid process part of the shoulder girdle?

A

no

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9
Q

The glenoid cavity is also called the?

A

Glenohumeral joint and the scapulohumeral joint

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10
Q

The medial border of the scapula is also called the_____?

A

vertebral border

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11
Q

The costal surface of the scapula is also called the ________

A

ventral

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12
Q

internal rotation of the humerus places it in a _________position with the epicondyles of the distal humerus ________to the IR

A

lateral, perpendicular

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13
Q

The humerus in external rotation places it in a _________position with the epicondyles of the distal humerus ___________to the IR

A

AP, Parallel

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14
Q

what is the correct term for a Y projection?

A

scapular Y lateral anterior oblique projection

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15
Q

in what position are the humeral epicondyle’s angled 45° to the IR?

A

neutral rotation

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16
Q

in which position are the epicondyles perpendicular to the IR?

A

internal rotation

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17
Q

in which position are the epicondyles parallel to the IR?

A

external rotation

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18
Q

when is the proximal humerus in a lateral position?

A

with internal rotation

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19
Q

in which position must the Arm be for the humerus to be seen as an AP projection?

A

external rotation

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20
Q

True or false Low mA with short exposure times should be used for adult shoulder studies

A

false

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21
Q

what S ID is recommended for most shoulder girdle studies?

A

40-44

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22
Q

what is the KV range in analog that should be used for a shoulder series on an average size adult?

A

70 to 80

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23
Q

what type of study demonstrates signs of osteomyelitis and cellulitis?

A

nuclear medicine bone scans

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24
Q

what type of study is recommended to provide a functional evaluation of joint movement?

A

ultrasound

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25
Q

compression between the greater tuberosity and soft tissues on the ligaments and osseous arch…

A

impingement syndrome

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26
Q

injury of the glenoid labrum

A

Bankart lesion

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27
Q

compression fracture of the humeral head

A

Hill Sachs defect

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28
Q

define a rotator cuff tear

A

injury to one or more of the supportive of muscles of the shoulder girdle

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29
Q

impingement syndrome presents Radiographically as_______

A

subacromial spurs

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30
Q

an abnormal widening of acromial clavicular joint space.

A

Acromioclavicular joint separation

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31
Q

if a patient has tendinitis we will see….

A

calcified tendons

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32
Q

what is Bankart lesion Seen as….

A

you will see an avulsion fracture of the glenoid rim

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33
Q

what does rheumatoid arthritis look like on the radiograph?

A

it will appear to have a closed joint space

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34
Q

if the patient has Hill sachs defect they will have a

A

compression fracture of the humeral head

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35
Q

specifically, where is the central ray placed for an AP projection of the shoulder?

A

The CR should be perpendicular to the IR 1 inch below the coracoid process

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36
Q

what type of central ray angle is required for the inferosuperior axial projection of the shoulder?

A

25 to 30° medial

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37
Q

which projection places the glenoid process in profile?

A

Grashey also known as posterior oblique

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38
Q

which projection is best for demonstrating a possible dislocation of the proximal humerus?

A

scapular Y projection

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39
Q

which special projection of the shoulder best shows sub acromial spurs in the acromial humeral space

A

tangential or it can also be called NEER method (supraspinatous outlet)

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40
Q

which nontrauma projection can be done to provide a lateral view of the proximal humerus in relationship to the glenohumeral joint?

A

PA transaxillary projection (hobbs)

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41
Q

how much is the CR angled for Clements also known as inferosuperior axial projection, if the patient cannot fully abducted the arm 90°?

A

5 to 15°

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42
Q

when doing an AP axial projection also known as Alexander method, for AC joints what CR angle is required?

A

15° cephalad

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43
Q

in simple terms describe neer method…

A

supraspinatus outlet tangential

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44
Q

in simple terms, Lawrence method…

A

inferosuperior axial

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45
Q

when doing a projection for the AP scapula where do you center the CR?

A

perpendicular to mid scapula 2 inches below coracoid

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46
Q

name three projections that can be done to demonstrate a Bankart lesion…

A

AP internal rotation, scapular Y lateral, posterior oblique Grashey

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47
Q

which part of the scapula extends most anteriorly?

A

coracoid process

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48
Q

which part of the scapula is most posterior?

A

Acromion

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49
Q

what type of joint movement is the scapulohumeral joint?

A

spheroidal

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50
Q

which imaging modality best demonstrates osteomyelitis?

A

nuclear medicine

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51
Q

which projection is done for impingement syndrome?

A

NEER ( tangential)

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52
Q

which projection best demonstrates the supraspinatus outlet region ?

A

NEER (tangential)

53
Q

what is the central ray angle for neer method

A

10 to 15° caudad

54
Q

this projection requires the CR to be centered 2 inches below and medial from the superolateral border of the shoulder…

A

scapula Y lateral projection

55
Q

what anatomy is seen with the Alexander method

A

AC joints

56
Q

Acromioclavicular (AC) dislocation

A

-Injury in which the distal clavicle usually is displaced superiorly. -Most common cause is a fall

57
Q

AC joint separation

A

Trauma to the upper shoulder region resulting in a partial or complete tear of the AC or coracoclavicular (CC) ligament or both ligaments.

58
Q

Bankart lesion

A

-Injury of the anteroinferior aspect of the glenoid labrum. -often caused by anterior dislocation of the proximal humerus. -repeated dislocation may result in a small avulsion fracture in the anteroinferior region of glenoid rim.

59
Q

Bursitis

A

-Inflammation of the bursae (fluid filled sacs) enclosing the joints. -generally involves the formation of calcification in associated tendons, causing pain and limitation of joint movement.

60
Q

Hill-Sachs defect

A

-Compression fracture of the articulate surface of the posterolateral aspect of the humoral head - often associated with an anterior dislocation of the humoral head

61
Q

Idiopathic chronic adhesive capsulitis (frozen shoulder)

A

-Disability of the shoulder joint that is caused by chronic inflammation in and around the joint. -characterized by pain and limitation of motion.

62
Q

Impingement syndrome

A

-Impingement of the greater tubercle and soft tissues on the coracoacromial ligamentous and osseous arch -generally during abduction of the arm

63
Q

Osteoarthritis (degenerative joint disease)

A

-noninflammatory joint disease characterized by gradual deterioration of the articular cartilage with hypertrophic bone formation. -most common type of arthritis, normal part of aging process, ages older than 50, chronically obese persons and athletes.

64
Q

Osteoporosis

A

-Resultant fractures are due to a reduction in the quantity of bone or atrophy of skeletal tissue. -occurs in premenopausal women and elderly men. -results in bone trabeculae that are scanty and thin.

65
Q

Rheumatoid arthritis

A

Chronic systemic disease characterized by inflammatory changes that occur throughout the connective tissues of the body.

66
Q

Rotator cuff

A

-Acute or chronic and traumatic injury to one or more of the muscles that make up the rotator cuff (teres minor, supraspinatus, infraspinatus, and subscapularis. -limit range of motion of the shoulder

67
Q

Most common rotator cuff injury

A

Impingement of the supraspinatus muscle as it passes beneath the acromion caused by a sunacromial bone spur.

68
Q

Shoulder dislocation

A

-Occurs as a traumatic removal of humeral head from the glenoid cavity -95% are anterior, in which the humeral head is projected anterior to the glenoid cavity.

69
Q

Tendonitis

A

Inflammatory condition of the tendon that usually results from a strain.

70
Q

Humerus (Nontrauma and Trauma Routine)

A

Routine -AP -AP rotational lateral -Horizontal beam lateral Special -Transthoracic lateral

71
Q

Shoulder (Nontrauma Routine)

A

-AP external rotation -AP internal rotation

72
Q

Shoulder (Nontrauma Routine) Special

A

-Inferosuperior axial (Lawrence Method) -PA transaxillary (Hobbs modification) -Inferosuperior axial (Clements modification) -Posterior oblique-Glenoid cavity (Grashey Method) -Tangenital projection-intertubercular groove (Fisk modification)

73
Q

Shoulder (Trauma Routine)

A
  • AP neutral rotation -Transthoracic lateral (Lawrence method) -Scapular Y lateral
74
Q

Shoulder (Trauma Routine) Special

A

-Tangenital projection-supraspinatus outlet -AP apical oblique axial (Garth Method)

75
Q

Clavicle

A

-AP -AP axial

76
Q

what projections are done for AC joints?

A

-AP bilateral with weights -AP bilateral without weights

77
Q

Scapula

A

-AP -Lateral -Erect -Recumbent

78
Q

Trauma

A

-As Is -Y

79
Q

AP Projection: Humerus

A

-Pt position: erect or supine/ body rotated toward affected side/ hand and forearm extended as far as Pt can tolerate/arm abducted slightly/hand supinated slightly to bring epicondyles parallel to IR. -CR: perpendicular to IR; midpoint of humerus -In profile: greater tubercle in profile medially, minimal superimposition of glenoid cavity. Lateral and medial epicondyles both seen in profile **suspend breathing

80
Q

Rotational Lateral (Lateromedial) Humerus

A

-Pt position: erect or supine/ back to IR/ body rotated toward affected side/internally rotate arm/epicondyles perpendicular to IR -CR: Perpendicular to IR; midpoint of humerus -In profile: epicondyles directly superimposed/lesser tubercle in profile medially, partially superimposed by lower portion of glenoid cavity. **suspend breathing

81
Q

Rotational lateral (Mediolateral) Humerus

A

-Pt position: Facing IR/oblique as needed (20-30degrees from PA)/ elbow flexed 90 degrees -CR: perpendicular to IR; midpoint of humerus -In profile: epicondyles directly superimposed/lesser tubercle shown in profile medially, partially superimposed by lower portion of glenoid cavity ** suspend breathing

82
Q

Trauma Horizontal Beam Lateral-Lateromedial : Humerus

A

-Pt position: recumbent/support under arm/arm flexed if possible 90 degrees/cassette between humerus and thorax. -CR: horizontal, perpendicular to midpoint of distal 2/3 of humerus. -In profile: include elbow joint and distal 2/3 of humerus **suspend breathing

83
Q

Transthoracic lateral Projection: Humerus (Trauma)

A

-Pt position: lateral position w/ affected side closest to IR in a neutral rotation (drop shoulder if possible)/place other arm above head (shoulder raised as much as possible), slight anterior rotation of unaffected shoulder -CR: perpendicular to IR; through thorax to mid-diaphysis -In profile: outline of shaft of humerus anterior to thoracic vertebrae/relationship if the humeral head and glenoid cavity **orthostatic (breathing) technique preferred

84
Q

AP Projection-External Rotation: Shoulder (NonTrauma) AP Proximal Humerus

A

-Pt position: erect or supine/affected side rotated toward IR or tabletop/ scapulohumeral joint centered to IR/ abduct slightly and externally rotate arm until epicondyles parallel to IR. -CR: perpendicular to IR; 1 inch below coracoid process (3/4 in below lateral clavicle) -In profile: Greater tubercle laterally/Lesser tubercle superimposed over humeral head **suspend respiration

85
Q

AP Projection-Internal Rotation: Shoulder (NonTrauma) Lateral Proximal Humerus

A

-Pt position: center scapulohumeral joint to center of IR/abduct extended arm slightly/internally rotate arm (pronate hand)/ epicondyles perpendicular to IR -CR: perpendicular to IR/ 1 inch below coracoid process (3/4in below lateral clavicle) -In profile: Lesser tubercle visualized in full profile on medial aspect of humeral head/outline of greater tubercle superimposed over the humeral head **suspend breathing

86
Q

Inferosuperior Axial Projection: Shoulder (NonTrauma) Lawrence Method

A

-Pt Position: Supine/shoulder raised 2in from tabletop with support/ arm abducted 90 if possible/ externally rotated,Palm up/head rotated opposite side/ cassette close to neck as possible -CR:medially 25-30 degrees(15-20 if arm is less than 90) /centered to Axilla and humeral head -In profile: superior and inferior borders of glenoid cavity should be directly superimposed from CR angle. ** suspend breathing

87
Q

Inferosuperior Axial projection: Shoulder (NonTrauma) Lawrence Method Alternative

A

-Exaggerated external rotation/thumb pointed down and posteriorly about 45 degrees -best for Hills-Sachs defect

88
Q

Posterior Oblique Position-Glenoid Cavity: shoulder (NonTrauma) Grashey Method

A

-Pt position: rotate body 35-45 degrees toward affected side/center midscapulohumeral joint to IR/cassette 2 in above shoulder and 2in from lateral border of humerus/abduct arm slightly with arm in neutral rotation -CR: perpendicular; center at midscapulohumeral joint -In profile: scapulohumeral joint space should be open/anterior and posterior rims of glenoid cavity superimposed. ** suspend breathing

89
Q

Tangenital Projection- Intertubercular (Bicipital) Groove: Shoulder (NonTrauma) Fisk Modification

A

-Pt Position: erect/standing or leaning over end of table with elbow flexed/posterior surface of arm resting on table/ hand supinated holding cassette/ humerus flexed 10-15 degrees -CR: perpendicular to IR; groove area at mid anterior margin of humeral head -In profile: Intertubercular groove and tubercles without superimposition of the acromion process ** suspend respiration

90
Q

AP projection-Neutral Rotation: Shoulder (Trauma)

A

-Pt position: center scapulohumeral joint to IR/pts arm at side “as is” neutral rotation/ epicondyles approx. 40 degrees to plane of IR. -CR: perpendicular to IR; midscapulohumeral joint (3/4in below and slightly lateral to coracoid process) -In profile: both greater and less tubercles

91
Q

The 3 aspects of the clavicle

A

Acromial extremity Body (shaft) Eternal extremity

92
Q

3 angles of the scapula

A

Inferior Superior Lateral

93
Q

What is the anterior surface of the scapula called

A

Costal surface

94
Q

What are the names of the two fossae located on the posterior scapula

A

Infraspinous and supraspinous

95
Q

All the joints of the shoulder are classified as

A

Synovial joints

96
Q

What rotation shows the greater tubercle in profile laterally

A

External

97
Q

What rotation puts the humerus epicondyles at 45 degree angle to IR

A

Neutral position

98
Q

What rotation puts epicondyles perpendicular to IR

A

Internal rotation

99
Q

Which rotation involves supination of hand

A

External rotation

100
Q

Which rotation puts humoral epicondyles parallel to IR

A

External rotation

101
Q

Which rotation puts the lesser tubercle in profile medially

A

Internal rotation

102
Q

Which position puts humerus in lateral position

A

Internal rotation

103
Q

Which position puts humerus in AP projection

A

External rotation

104
Q

Which clinical indication requires a decrease in exposure factors

A

Osteoporosis

105
Q

Which lateral projection demonstrates the entire humerus with a midhumeral fracture

A

Tranathoracic lateral projection

106
Q

what 2 bones make up the shoulder girdle?

A

clavicle and scapula

107
Q

where does the shoulder girdle connect to the trunk?

A

anteriorly at the upper sternum

108
Q

The upper margin of the scapula is at the level of the _________and the lower margin is at the level of the ________

A

Second posterior rib level of the seventh posterior rib

109
Q

what are the two joints associated with the clavicle?

A

Acromioclavicular and sternoclavicular

110
Q

what are the three borders of the scapula?

A

medial, superior, lateral

111
Q

what are the three angles of the scapula?

A

lateral, superior, inferior

112
Q

in which position is the humerus in a true AP? and how is this evident?

A

external rotation The greater tubercle of the humeral head is in profile laterally

113
Q

in which position is the humerus in a lateral position? how is this evident ?

A

internal rotation lesser tubercle of the humeral head is in profile medially

114
Q

what type of technique should be used for the humerus and AC joint?

A

manual

115
Q

what S I D is used for an AC joint?

A

72 inch

116
Q

which S ID is used for shoulder and humerus?

A

40-44 Sid

117
Q

summarize all of the projections for humerus:

A

AP Ext rotation AP internal rotation, horizontal beam lateral, special : transthoracic lateral

118
Q

which bones make up the shoulder girdle :

A

humeral head scapula clavicle

119
Q

what is the best position for the trauma shoulder

A

upright

120
Q

in order to demonstrate the greater tubercle of the humerus and AP projection of the shoulder the epicondyles must be

A

parallel with the plane of the IR

121
Q

for an AP projection of the shoulder the central ray should enter:

A

1 inch below the coracoid process

122
Q

what position is the humerus in if the patient places the palm of the hand against the thigh

A

neutral rotation

123
Q

The PA oblique projection of the shoulder joint (Y) is done in what position??

A

RAO LAO

124
Q

what projection is done to evaluate dislocation?

A

pa oblique scapular Y

125
Q

for delineation of the acromion on and coracoid processes of the scapula in the lateral projection, the arm is positioned:

A

with the elbow flexed and the hand on the posterior thorax

126
Q

what projection best demonstrates the Coracoacromial arch?

A

NEER method

127
Q

what is the most common dislocation of the shoulder

A

anterior dislocation

128
Q

and AP humerus requires that the humeral epicondyles are __________ to the IR

A

parallel

129
Q

what type of CR angle is required for the superoinferior axial projection or (Hobbs modification?)

A

no angle the CR should be perpendicular to the IR

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