RAD 1125 SHOULDER GIRDLE Flashcards by Brittney Baron

What makes up the Shoulder girdle?

Clavicle
Scapula
AC Joints
Humerus (head)

How well did you know this?

Not at all

Perfectly

What are the 2 humeral epicondyles?

Lateral Epicondyle
Medial Epicondyle

How well did you know this?

Not at all

Perfectly

What exactly is the bony thorax made up of?
(Protects heart and lungs)

It is made up of the 12 ribs, 1 sternum and 12 Thoracic Vertebrae

How well did you know this?

Not at all

Perfectly

What is the Clavicle ( collar bone) connected to?

THE CLAVICLE (COLLARBONE) IS ATTACHED TO THE MANUBRIUM (UPPER PART OF THE STERNUM) AT THE SC JOINT ( STERNOCLAVICULAR JOINT)

How well did you know this?

Not at all

Perfectly

What is the lateral border of the Scapula ( Shoulder blade) connected to?

-THE LATERAL BORDER OF THE SCAPULA( SHOULDER BLADE) IS CONNECTED TO THE HUMERUS AT THE GLENOID CAVITY FORMING THE SHOULDER (GLENOHUMERAL) JOINT

How well did you know this?

Not at all

Perfectly

What is the Acromion connected to?

-ACROMION (BONY PROJECTION OF SCAPULA) CONNECTS TO THE CLAVICLE AT AC JOINT (ACROMIOCLAVICULAR JOINT)

How well did you know this?

Not at all

Perfectly

What are the Views of the Shoulder?

-AP External,
-AP Internal,
-AP Neutral
-PA Oblique (Y View), RAO,LAO
-Superior Inferior Axial Shoulder (Lawrence) (AXILLARY VIEW)
- Posterior oblique Grashey Method (LPO. and LPO)
-Neer Method

How well did you know this?

Not at all

Perfectly

What are the hand position for AP External shoulder?

(SUPINATED) OR Anatomical Position with palm supinate and facing tube

How well did you know this?

Not at all

Perfectly

What is expected of the AP External Shoulder?

Due to proper External rotation
The humeral head and Greater Tubercle are in profile on the lateral aspect
Humeral Epicondyles parallel to IR (POSSIBLY AN ALIGNMENT)

How well did you know this?

Not at all

Perfectly

What is the hand position for AP Internal shoulder?

abduct arm slightly, internally rotate and pronate hand until the humeral epicondyles are perpendicular to IR

How well did you know this?

Not at all

Perfectly

What is expected to be seen on an AP Internal shoulder?

If properly internally rotated the Head of the humerus with the lesser tubercle in profile and pointing medially
- Humeral epicondyles perpendicular to IR ( ALIGNMENT?)

How well did you know this?

Not at all

Perfectly

What is the hand position for AP Neutral shoulder?

Palm of the hand placed against hip and epicondyles adjusted at approximately a 45-degree angle with the plane of the IR positions the humerus in neutral position

How well did you know this?

Not at all

Perfectly

What is expected to be seen on an AP Neutral shoulder?

If properly Neutral rotated Neither tubercles are in profile
- Epicondyles is 45 degrees perpendicular to IR
( 45 DEGREES MEDIAL OBLIQUE) MEDIAL (INWARDS)
-Partial superimposition of greater tubercle over humeral head
- Palmar surface of hand positioned on the lateral aspect of the thigh

How well did you know this?

Not at all

Perfectly

What is the CR for AP External, Internal and neutral?

Perpendicular to 1 inch inferior to the coracoid process

How well did you know this?

Not at all

Perfectly

In the AP External shoulder view, the greater tubercle is in the site of insertion of what muscle?

supraspinatus

How well did you know this?

Not at all

Perfectly

How are the humeral epicondyles in AP external shoulder?

The humeral epicondyles are Parallel to the IR

How well did you know this?

Not at all

Perfectly

In AP shoulder internal rotation, what is in profile?

head of humerus -but mostly lesser tubercle in profile and pointing medially ( towards the glenoid cavity)

How well did you know this?

Not at all

Perfectly

How are the humeral epicondyles for AP shoulder internal?

The Humeral Epicondyles are Perpendicular to the IR

How well did you know this?

Not at all

Perfectly

In AP shoulder internal, the arm is _________ enough so that the _________ _________ is free from superimposition from the head of the humerus (where site of insertion of __________ ________ is located)

abducted, lesser tubercle, subscapular tendon

How well did you know this?

Not at all

Perfectly

What can be said about the greater tubercle for AP shoulder neutral?

THE GREATER TUBERCLE CANNOT BE SEEN IN PROFILE and also In AP shoulder neutral, there is partial superimposition of greater tubercle over humeral head.

How well did you know this?

Not at all

Perfectly

What part of hand should be on the lateral aspect of thigh for AP shoulder neutral? Also how should the humeral epicondyle be positioned in neutral?

The Palmar surface of the hand positioned on the lateral aspect of the thigh.
The humeral epicondyles should be placed 45 degrees on the lateral oblique

How well did you know this?

Not at all

Perfectly

Review: What’s in profile for AP shoulder external, internal, and neutral?
Also which view the HUMERAL HEAD IS IN PROFILE?

External: Greater Tubercle, Humeral head
Internal: Lesser Tubercle
Neutral: Neither Tubercle in Profile, humeral head in partial profile

How well did you know this?

Not at all

Perfectly

AP Neutral gives you a better view of what kind of pathology?

Calcified deposits

How well did you know this?

Not at all

Perfectly

AP Neutral Structures Demonstrated
Posterior part of __________ insertion which may
demonstrate small _________ ________

Supraspinatus, Calcified deposits.

How well did you know this?

Not at all

Perfectly

What is bursitis?

inflamed bursa, very painful

PA Oblique Y view can be either ____ or ____?

RAO OR LAO

What's another name for PA oblique Y-view?

Scapular Y view

What can be said about the PA Oblique (Y VIEW) Shoulder view? (SCAPUALAR Y)

-No superimposition of the body of the scapula over the bony thorax (Separate from the body of scapula from ribs) -* Vertebral and lateral borders superimposed * Superimposed humeral head and glenoid cavity - Patient rotated properly 45-60 degrees * Shaft of humerus superimposed with the body of the scapula - Arm resting down by patient’s side

Rotation of patient is how many degrees for Scapular Y /PA Oblique Y view?

Patient rotated properly 45-60 degrees

Structures demonstrated in PA Oblique Y-view _________ ______ directly superimposed over the "Y"

Humeral Head

Which borders of the scapula are superimposed?

The Vertebral (Medial) Border and the lateral (axillary) border are superimposed

If there is superimposition of the body of the scapula over the bony thorax in Scapular y-view, you have?

Over Rotation

Proper rotation of 45-60 degrees in Scap Y is shown by ?

Superimposed Humeral head and Glenoid Cavity The humeral head will superimpose the glenoid cavity with proper rotation

Why do we rotate the patient in Scapular Y VIEW/ PA OBLIQUE Y VIEW?

So that the scapula is free from superimposition of the of the bony thorax (rib)

For pa oblique y view, shaft of humerus superimposed with the body of the scapula demonstrates that

Arm resting down by patient's side which is the correct positioning

review on positioning for PA oblique Y view: Rotate them enough so that your thumb is on their medial border and your hand (on their scapula) becomes __________ to the IR.

Perpendicular to IR

The "y" is made up of the _________ ________ and __________ _________

acromion process and coracoid process

PA oblique y view is mainly done to check for ___________

Dislocation

When looking at a PA oblique y view of the shoulder in an x-ray, proof of an ___________ dislocation is demonstrated by the humeral head being under the coracoid process

anterior dislocation

When looking at a PA oblique y view of the shoulder in an x-ray, proof of an ___________ dislocation is demonstrated when the humeral head projected under the acromion process

posterior dislocation

AP oblique grashey method can be either ____ or ____

RPO or LPO

What are we looking for in an AP OBLIQUE (GRASHEY METHOD) ?

Open joint space between the humeral head and the glenoid cavity -NO SUPERIMPOSING OF THE HUMERAL HEAD * Glenoid cavity in profile The patient properly rotated 35 to 45 degrees toward the affected side to place the scapula parallel to the IR. Improper rotation: Under rotated. Joint space not opened

When doing the AP oblique grashey method, you are looking open joint space of the"

Open joint space between the Humeral head and the glenoid Cavity

What should be in profile in the Grashey Method?

1. The Glenoid Cavity in profile 2. Also no superimposing of the humeral head

What helps place the scapula perpendicular to the IR?

The patient is rotated properly at 35-45 degrees towards the affected side

When the patient is rotated properly at 35-45 degrees this helps the scapula to?

Place the Scapula parallel to IR

If there is improper rotation/under rotated, will the joint space be open or not?

The joint space not open

Proper Rotation will make the joint space?

Joint space will be open with proper rotation

What is proper rotation in AP oblique grashey method?

35-45 degrees toward the affected side

Rotating the patient 35-45 degrees in Grashey method toward the affected side makes the scapula

parallel to the IR

On an xray, how do you know you properly rotated patient for AP oblique Grashey method?

Glenoid cavity in profile And scapula parallel to the IR.

Improper rotation/Under rotation for AP oblique grashey method would be demonstrated by ?

the shoulder joint space (glenohumeral or scapulohumeral) would not be open

The neer method we look for?

THE HUMERAL HEAD PROJECTED BELOW THE AC JOINT

NEER METHOD tube angulation

ANGLED 10-15 DEGREES CAUDAD (15)

CR FOR NEER

CENTERED AT SUPERIOR ASPECT OF HUMERUS

Supero-inferior Axial Projection (LAWRENCE) (Axillary View) tube angulation

Angled 5 to 15 degrees through the shoulder joint and toward the elbow

According to Ingrassia, the key to this view is trying to get the axilla ...

as close to the IR as you can, have patient lean in, lower table

What should we look for in ap scapula view?

1. The lateral portion of the scapula is free from the superimposing of the Ribs 2. The scapula should be horizontal, Not oblique 3. IF OBLIQUE, the scapula is not placed in true AP to the IR 4. Scapula should be seen through the lung and rib

Why do we abduct our arm when taking an AP Scapula x ray?

We abduct the arm to remove/pulls the scapula from superimposing the ribs and lungs

What portion of the scapula should be free from the superimposition of the lungs?

The lateral portion

How should the scapula be placed when taking an AP SCAPULA X RAY?

The scapula should be placed horizontally and NOT OBLIQUE

Why should we not place the scapula oblique?

if we place the scapula oblique, the scapula will not be ina. true AP to the IR (TRUE AP TO IR= SCAPULA HORIZONTAL)

The scapula should be seen through?

Seen through the lung and the Ribs

What should be seen on the lateral scapula?

1. Lateral and medial border is superimposed 2. No superimposing of the scapula over the ribs (bony thorax) 3. Entire Scapula seen/ visible

What projection is the lateral scapula?

When positioning patient for lateral scapula x ray? ARM POSITIONED FOR LATERAL SCAPULA?

Place patient In oblique position and rotate 45-60 degrees and center affected scapula to IR ARM SHOULD BE BEHIND PATIENT

What borders are superimposed in the Lateral border?

The Medial and Lateral Borders

What should be visible/seen when doing the Lateral Scapula x ray?

The entire scapula

What should the body of scapula not superimposed with?

Not superimposed with the ribs (bony thorax)

What should be seen when taking an AP Clavicle?

- Entire Clavicle (centered on image) - Achieving Uniform density -Must include the (medial end) SC JOINT AND (lateral end) AC Joints

What must be seen in the AP AXIAL CLAVICLE? (ANGLED 15-30 DEGREES cephalad towards head) known as AP SHOOT UP

-Entire Clavicle ( with AC AND SC JOINTS) -Clavicle in a horizontal placement -Most clavicle projected above the Ribs -if not, tube was not angled enough

Why do we angle the tube in the AP AXIAL Clavicle X-ray?

for the clavicle to be projected above the ribs

If the clavicle or most of it is not projected above the ribs then?

It means there was not enough tube angulation

If you were to keep the tube perpendicular and not angled at 15-30 degrees then?

The clavicle is superimposed of the part of the lung apices

What should be seen in the AC JOINTS with weights and without weights?

1. Both right and left A-C Joints 2. Some soft tissues 3. No rotation or leaning- can cause ac to be clipped from image -BOTH MARKERS

SID FOR AC JOINTS and

72 SID/ 14x17

Why dont we do the weights first the taking the AC joint x ray?

It will take too long for AC JOINTS TO GO UP ITS PLACE AGAIN

Why do we AC JOINT WITHOUT WEIGHTS first?

This helps to allow AC joint in a relaxed state

Why do we do AC JOINT WITH WEIGHTS last?

Weight will increase the stress on the AC JOINT -Also with weights help to identify joint separation