Shoulder Girdle Flashcards

1
Q

What is the shoulder girdle made up of?

A

-Scapula
-Clavicle

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2
Q

What does the shoulder girdle articulate with?

A

-head of humerus (shoulder joint)
-manubrium of sternum (sternoclavicular (SC) joint)
-each other (acromioclavicular {AC} joint)

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3
Q

What function does the shoulder girdle have?

A

To connect the upper limb to the trunk of the body

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4
Q

What is not considered to be part of the shoulder girdle?

A

Humerus

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5
Q

What type of joint is the shoulder classified as?

A

ball and socket joint

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6
Q

What type of bone is the clavicle?

A

long bone

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7
Q

What lies just above the first rib?

A

Clavicle

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8
Q

The acrominal extremity (lateral end) of the clavicle articulates with what?

A

Acromion on scapula (AC joint)

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9
Q

The sternal extremity (medial end) of the clavicle articulates with what?

A

manubrium of sternum (SC joint)

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10
Q

True or False
The clavicle has a curve more pronounced in males than in females?

A

True

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11
Q

What type of bone is the scapula?

A

flat bone

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12
Q

What forms the posterior portion of the shoulder girdle and is triangular in shape?

A

Scapula

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13
Q

What are the two surfaces of the scapula?

A

-costal (anterior) ribs
-dorsal (posterior) back

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14
Q

What are the three borders of the scapula?

A

-lateral border
-medial border
-superior border

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15
Q

What are the three angles of the scapula?

A

-superior angle
-inferior angle (T7)
-lateral angle

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16
Q

where is the scapular notch located?

A

Superior border

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17
Q

What is the lateral, thickened end of the scapula spine called?

A

Acromion

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18
Q

Essential Projections: Shoulder

A

AP Projections
-internal rotation
-external rotation
-neutral position
-AP oblique (Grashey method)
-Transthoracic lateral (Lawrence method)
-Inferosuperior axial (Lawrence method)
-PA oblique (scapular Y)

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19
Q

The thumb follows what?

A

The greater tubercle

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20
Q

What is the part position for AP projection of shoulder in (external rotation)

A

-rotate arm externally and supinate hand
-epicondyles are parallel to the IR

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21
Q

What is the distance for the AP projections of the shoulder?

A

40 inches

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22
Q

Where do you center for the AP Projection of shoulder (external rotation)

A

Enters perpendicular 1 inch inferior to coracoid process

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23
Q

What do you see in the AP projection shoulder (external rotation)?

A

-greater tubercle in profile on lateral aspect of humerus
-humeral head in profile
-scapulohumeral joint visualized with slight overlap of humeral head on glenoid cavity
-outline of lesser tubercle between the humeral head and greater tubercle

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24
Q

What is the part position for AP projection of shoulder (internal rotation)

A

-rotate arm internally, rest back of the hand on hip
-epicondyles are perpendicular

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25
Q

Where do you center for the AP projection of shoulder (internal rotation)

A

-CR is perpendicular
-Enters patient 1 inch inferior to coracoid process

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26
Q

What do you see in the AP projection of the shoulder (internal rotation)?

A

-lesser tubercle is in profile and pointing medially
-outline of greater tubercle superimposing humeral head
-collimated field includes superior scapula, lateral half of clavicle, and proximal humerus
-greater amount of humeral overlap of the glenoid cavity than in external and neutral positions

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27
Q

What is the part position for AP Shoulder (neutral rotation)?

A

-patient rest the palm of the hand against the thigh
-epicondyles are at a 45 degrees

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28
Q

Where do you center for the AP projection of shoulder (neutral position)

A

-CR is perpendicular
-Enters patient 1 inch inferior to coracoid process

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29
Q

What do you see in an AP projection of the shoulder (neutral position)?

A

-Neither the greater nor the lesser tubercle should appear in profile
-humeral head will be in partial profile
-greater tubercle will partially superimpose the humeral head
-some overlap of the humeral head and glenoid should be seen

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30
Q

What is the part position for the AP Oblique (Grashey) for shoulder?

A

-put patient 35 to 45 degrees posterior oblique position
-affected shoulder closer to iR
-head of the humerus in contact with IR
-scapula parallel to IR
-more rotation if patient is recumbent (60 degrees)?
-abduct arm slightly internally rotate
-place palm of hand on abdomen

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31
Q

Where do you center for the AP Oblique (Grashey)?

A

-perpendicular to glenoid cavity
-enters 2 inches medially and inferior to superolateral border of shoulder
-free joint space of humerus

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32
Q

What is the breathing technique for the humerus and shoulder?

A

Suspended breathing

33
Q

What do you see in the AP Oblique (Grashey) for the shoulder?

A

-open joint space between the humeral head and glenoid cavity
-glenoid cavity in profile
-tip of coracoid is 0.25 inches on humeral head

34
Q

What position do we do for trauma patients who cannot rotate or abduct arm?

A

Transthoracic Lateral (Lawrence method)

35
Q

What is your position for the Transthoracic Lateral (lawrence)?

A

-Affectedside closer to IR
-Ensure elevated shoulder is higher than injured shoulder
-center at affected shoulder surgical neck

36
Q

Where do you center for the Transthoracic lateral (Lawrence method)?

A

Perpendicular Center at the surgical neck of the humerus

37
Q

What is the breathing technique for Transthoracic lateral (Lawrence method)?

A

Shallow breathing to blur out the ribs and lungs (exposure time of 3 to 5 seconds) if can’t do shallow do expiration instead

38
Q

If the shoulders are in the same plane for the Transthoracic lateral (Lawrence method) what do you do?

A

angle tube 10-15 degrees cephalic

39
Q

What distance is the Transthoracic lateral (Lawrence method) done?

A

40 inches

40
Q

What do you see in the Transthoracic lateral (Lawrence method)?

A

-proximal humerus, scapula, clavicle seen through the lung field
-scapula superimposed over the thoracic spine
-unaffected clavicle and humerus projected above

41
Q

What is the part position for the Inferosuperior Axial Projection (Lawrence Method)?

A

-supine
-head turned away from CR
-abduct arm to right angle 90 degrees

42
Q

What is the central ray for the Inferosuperior Axial Projection (Lawrence Method)?

A

-CR is horizontal
-Medial angulation of 15 to 30 degrees
-Enters axilla (armpit) passes through the AC joint
-angle depends on abduction of humerus
-more abduction=more angle

43
Q

When the hand is supinated in the Inferosuperior Axial Projection (Lawrence Method) what happens?

A

-epicondyles are parallel
-lesser tubercle in profile anteriorly

44
Q

What do you see in the Inferosuperior Axial (Lawrence Method)?

A

-scapulohumeral joint with slight overlap
-coracoid process pointing anteriorly
-epicondyles are parallel

45
Q

What happens when you externally rotate the hand (thumb pointing to the floor) for the Inferosuperior Axial Projection?

A

-epicondyles are at a 45-degree
-demonstrates the Hill-Sacs defect (posterolateral aspect of the humeral head dislocation)

46
Q

If you can’t lay the patient on the table for the Inferosuperior Axial projection what do you do instead?

A

Superoinferior Axial Projection

47
Q

What is the position and centering for the Superoinferior Axial Projection?

A

-5 to 10 degrees toward the elbow through shoulder joint
-keep head out of the way

48
Q

What makes up the “Scapular Y”?

A

Your ABC
-Acromion
-Body
-Coracoid Process

49
Q

An anterior dislocation of the shoulder where will the head of the humerus be located?

A

Located under the coracoid

50
Q

An posterior dislocation of the shoulder where will the head of the humerus be located?

A

Located below acromion

51
Q

What is the part position for the PA Oblique (Scapular Y)? for shoulder

A

-upright, 45 to 60 degrees anterior oblique
-affected shoulder closer to IR
-RAO or LAO
-side down being demonstrated

52
Q

Where do you center for the PA Oblique (Scapular Y)?

A

-CR perpendicular
-Enters the vertebral (medial) border and exits the axillary (lateral ) border

53
Q

In a “Scapular Y “ what should you see?

A

A space between the ribcage and body of the scapula

54
Q

In the PA Oblique (Scapular Y) what do you see?

A

-humeral head and glenoid cavity sumperimposed
-humeral shaft and scapular body superimposed
-acromion projected laterally and free of superimposition
-scapula in lateral profile with lateral and vertebral borders superimposed
-coracoid possibly superimposed or projected below the clavicle

55
Q

What is the part position for the AP Oblique (Scapular Y)?

A

-upright, 45 to 60 degrees posterior oblique
-rotate patient away from affect side
-unaffected shoulder closer to IR
-RPO or LPO
-side up being demonstrated

56
Q

Where do we center for the AP Oblique (Scapular Y)?

A

-CR perpendicular
-Enters the lateral border and exits the medial border

57
Q

What is the part position for the Supraspinatus “Outlet” Neer Method?

A

-rotate body 45 to 60 degreess
-RAO or LAO
-CR angle 10 to 15 degrees caudad

58
Q

Where do we center for the Neer Method?

A

Enter superior aspect of humeral head
-looking at the Y

59
Q

Why do we do the Tangenital projection (fisk modification)?

A

To demonstrate the intertubercular groove

60
Q

What is the part position for AP AC joints (Pearson)?

A

-upright required
-arms to the side
-bilateral image
-with/without weights

61
Q

What is the distance for the AP AC Joint (Pearson)?

A

72 inches (divergence of the beam)

62
Q

Where do we center for the AP AC joints (pearson)?

A

perpendicular to midline of body at level of AC joint

63
Q

If doing a unilateral AC joint what is the distance?

A

40 inches

64
Q

What is the distance used for the clavicle?

A

40 inches

65
Q

Where do you center for the clavicle?

A

Perpendicular to midshaft of the clavicle

66
Q

In the PA clavicle

A
67
Q

What two joints must you get on for the projection of the clavicle?

A

AC and SC

68
Q

What is the breathing technique for AC joints?

A

expiration

69
Q

What is the degree of angulation for the AP axial for the clavicle?

A

15-30 degrees cephalic (throw clavicle off the ribcage)

70
Q

What is the angulation for the PA axial for the clavicle?

A

15-30 degrees caudal

71
Q

For AP you angle

A

Up

72
Q

For PA you angle

A

Down

73
Q

Essential projections: Scapula

A

-AP
-Lateral

74
Q

What is the part position for the AP Scapula?

A

-abduct arm to right angle (90 degrees)
-flex elbow
-draws scapula laterally clear from the thoracic structures(off the ribcage)
-supinate hand
-scapula is parallel to the IR

75
Q

Where do you center for the AP Scapula?

A

Perpendicular to point 2 inches (5cm) inferior to coracoid process

76
Q

What is the breathing technique for AP Scapula?

A

expiration

77
Q

What do you see in the lateral scapula?

A

-humerus is not align over the body of the scapula
-lateral and medial border superimposed
-inclusion of the acromion and inferior angle

78
Q

What do you do for the lateral scapula?

A

-y method
-put hand behind your back
-hand over the head

79
Q
A