Shoulder Flashcards
AP Projection: Place IR __1___ to the coracoid process. Slightly rotate pt toward __2__ to overcome natural curve of back and shoulder. May need to support pt when performing the procedure __3__.
- 1” inferior
- The affected side
- Recumbent
External rotation: __1__ the hand and __2__ the arm slightly; this places the epicondyles __3__ to the IR; places the shoulder and humerus in true anatomic position.
- Supinate
- Abduct
- Parallel
AP Neutral: rest __1__ of the hand against __2__: epicondyles will __3__ @ an approximate angle of 45 degrees.
- Palm
- Thigh
- Lie
AP Projection: Internal rotation….flex elbows slightly, rotate __1__ and rest the back of the hand on the hip; epicondyles will be __2__ to the IR.
- Arm internally
2. Perpendicular
AP Projection: Structures Shown…
- External Rotation: __A__: seen at the site of insertion of the __B__
- Neutral: __A__ portion of the __B__ insertion
- Internal rotation: __A__ humerus in a true __B__ position; when adequately abducted the __C__ tendon insertion is seen.
1) A: Greater Tubercle
B: supraspinatous tendon
2. A) posterior
B) supraspinatous
3. A) proximal
B) lateral
C) subscapularWhen the AP shoulder is in external rotation the __1__ will be seen in profile on the __2__ surface.
- Greater tubercle
2. Lateral
When in the AP Neutral Position the greater tubercle __1__ superimposed on the head: __2__ impartial profile; alight overlap of the humeral head over the __3__.
- Partially superimposed
- Humeral head
- Glenoid Cavity
Evaluation Criteria of the AP Projection in neutral position the __1__ partially superimposed on the head; __2__ impartial profile; slight overlap of the humeral head over the glenoid cavity.
- Greater tubercle
2. Humeral head
Evaluation criteria for the AP projection, internal rotation: __1__ in profile and pointing __2__; outline of the greater tubercle __3__ the __4__. Greater amount of humeral overlap of the __5__ cavity.
- Lesser tubercle
- Medially
- Superimposing
- Humeral head
- Glenoid
Transthorasic Lateral Position AKA ______
Lawrence Method
Trans Thoracic Lateral Position (__1__ Method): Regardless if pt is upright or recumbent, __2__ side against the board. Have pt raise __3__ arm, elevate it as much as possible. MCP is __4__ to IR.
- Lawrence
- Affected
- Unaffected
- Perpendicular
Breathing instructions for transthoracic projection:
- __A__ to improve __B__ and decrease exposure necessary for penetration
- __A__ with a minimum exposure time of __B__; this gives excellent results when a low __C__ is used
1) A. Full inspiration
B. Contrast
2) A. Slow, deep breathing
B. 3-4 seconds
C. MaTransthoracic Projection: If pt is unable to elevate the unaffected shoulder, angle the CR __1__ degrees __2__
- 10-15
2. Cephalic
The transthoracic projection is used when a trauma exists and the pt can neither abduct nor __1__ the arm due to an injury. This will demonstrate the proximal __2__ in a __3__ degree projection from the AP or frontal projection and show its relationship to the __4__ and __5__.
- Rotate
- Humerus
- 90
- Scapula
- Clavicle
Infernosuperior Axial Projection AKA ______
Lawrence Method
Infernosuperior: pt in a __1__ position, place IR __2__ in a vertical position in a contact with the __3__ portion o the shoulder. When supine, elevate the head, shoulders and __4__ approx __5__”
As much as possible abduct the affected arm at a __6__ to keep the body keeping the humerus in external rotation adjusting forearm and hand comfortably.
- Supine
- CW
- Superior
- Elbow
- 3
- Right angle
Inferosuperior Axial Projection the CR should be directed __1__ through the axilla to the __2__ joint region. The degree of medial rotation is dependent on the degree of arm __3__; the CR medial angulation is often between __4__ degrees.
- Horizontally
- AC
- Abduction
- 15-30
The evaluation criteria for the infernosuperior:
- scapula humeral joint with slight overlap
- __1__ pointing anteriorly
- __2__ in profile pointing anteriorly
- __3_, acromion, and the __4__ end of the clavicle projected through the humeral head
- soft tissue of the __5__ and adequate bony __6__
- Coracoid process
- Lesser tubercle
- AC joint
- Acromial
Superiorinferior Axial Projection: __1__ IR LW. CR angled __2__ degrees through the shoulder joint and toward the __3__ side elbow. The less the pt is able to extend over the IR, the __4__ the CR angle is needed.
- 8X10
- 5-15
- Affected
- Greater
Evaluation criteria for the superioinferior axial projection:
- open __1__ joint
- coracoid process protected above the __2__
- __3__ in profile
- AC joint through the __4__
- Scapulohumeral
- Clavicle
- Lesser tubercle
- Humeral head
Scapular Y: may be preformed on a standing or recumbent pt, but standing is preferred. Place __1__ surface against the upright grid and rotate so that the MCP forms and angle of of __2__ degrees with the IR.
CR will be directed perpendicular to IR and __3__ joint.
- Anterior
- 45-60
- Scapulohumeral
Scapular Y:
- Normal Shoulder: humeral head __1__ directly __2__ the junction of the Y
- Anterior dislocation: humeral head beneath the __3__
- Posterior dislocation: humeral head beneath the __4__
- Superimposed
- Over
- Coracoid process
- Acromion process
Scapular Y:
-PA projection places the __1__ side down or closer to the IR
-AP projection will place the affected side __2__ or __3__ from IR (higher __4__); with the pt supine or facing the tube, rotate the affected side __5__ IR 45-60 degrees. The CR remains perpendicular to IR passing through __6__.
AP Axial Projection may also be helpful in diagnosing __7__ dislocations.
- Affected
- Up
- Away
- OID
- Affected
- Scapulohumeral
- Posterior
Glenoid Cavity
AP Oblique Projection (__1__ Method). __2__ or __3__ position.
Pt maybe supine or __4__. Center IR to the scapulohumeral joint (approx __5__” medial and inferior to the __6__ border). Rotate body __7__ degrees __8__ affected side. The scapula will be __9__ to the IR.
- Grashey
- RPO
- LPO
- Upright
- 2
- Superolateral
- 35-45
- Towards
- Parallel
If the pt is supine during the Grashey Method you may need to rotate the body __1__ degrees in order to place scapula and IR __2__. You may also need to support the pt’s __3__ side with __4__ and/or __5__
- 45
- Parallel
- Elevated
- Sponge
- Sandbags
Interubercular groove
Tangential Projection AKA __1__ Modification:
In all modifications of this position, the CR should be __2__ to the Interubercular groove (lies on the __3__ surface of the humerus). Dependent upon the capabilities of your tube, the performance of this exam may be limited. The pt may be either __4__, seated, or __5__: extend the chin or rotate away from the __6__ side.
- Fisk
- Tangential
- Anterior
- Supine
- Standing
- Affected
Fisk Modification:
With the pt supine palate the anterior surface to locate __1__ .
Have hand in __2__ position, place IR against the superior shoulder surface and immobilize with sandbags/sponges.
CR angled __3__ degrees posterior to the long axis of the humerus for the supine position. Perpendicular to IR when pt is leaning forward and the __4__ humerus is positioned __5__ degrees.
- Groove
- Supinated
- 10-15
- Vertical
- 10-15
