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Radiographic Procedures > Shoulder Girdle > Flashcards

Shoulder Girdle Flashcards

1
Q

What are the 4 main views for Shoulder x-rays?

A

AP, Y view, Axillary and Grashey

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2
Q

What are the 3 types of AP images for shoulder?

A

Internal, External and Neutral

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3
Q

What is the placement of the MSP in AP Shoulder?

A

Perpendicular to the IR

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4
Q

Where is the shoulder placed for AP Shoulder?

A

Centered to the midline of the grid

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5
Q

What is the placement of the Central Ray for an AP Shoulder?

A

1 inch below the coracoid process

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6
Q

What are the 4 evaluation criteria for AP Shoulder?

A
  • Evidence of proper collimation and side marker clear of anatomy of interest
  • Superior scapula, clavicle and proximal humerus
  • Bony trabecular detail and surrounding soft tissue
  • Proper Rotation
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7
Q

How is the arm placed in AP External Rotation of the shoulder?

A

Arm abducted with hand supinated

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8
Q

What position are the epicondyles in for AP External Shoulder?

A

Parallel to the IR

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9
Q

What are the structures demonstrated in the AP External Shoulder?

A
  • Greater Tubercle in profile
  • Site of insertion of the supraspinatus tendon
  • Proximal humerus in the anatomical position
  • Scapulohumeral joint
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10
Q

What are the 4 rotation criteria for AP External Shoulder?

A
  • Humeral head in profile
  • Outline of lesser tubercle
  • Greater tubercle in profile on lateral aspect of humerus
  • Scapulohumeral joint visualized with slight overlap on the humeral head
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11
Q

How is the arm placed in AP Internal Shoulder?

A

Arm down at the side with back of hand placed on the thigh with pinky forward

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12
Q

What positions are the epicondyles in AP Internal Shoulder?

A

Perpendicular to the IR

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13
Q

What are the structures demonstrated in the AP Internal Shoulder?

A
  • Lesser tubercle is free from superimposition from the head of the humerus
  • Proximal humerus in the true lateral position
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14
Q

What are the 3 rotation criteria for AP Internal Shoulder?

A
  • Lesser tubercle in profile and pointed medically
  • Outline of the greater tubercle superimposing the humeral head
  • Greater amount of humeral overlap in glenoid cavity
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15
Q

How is the arm placed in AP Neutral Shoulder?

A

Arm is down at the side with palm against the thigh

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16
Q

What positions are the epicondyles in for AP Neutral rotation of the Shoulder?

A

At a 45 degree oblique angle to the IR

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17
Q

What are the structures demonstrated in the AP Neutral Shoulder?

A
  • Posterior part supraspinatus insertion which may demonstrate calcifications
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18
Q

What are the rotation criteria for AP Neutral Shoulder?

A
  • Greater tubercle partially superimposing the humeral head
  • Humeral head in partial profile
  • Slight overlap of humeral head on the glenoid cavity
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19
Q

What are the two positions for PA Oblique shoulder (Y view)?

A

RAO and LAO

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20
Q

What is another name for the PA Oblique Shoulder projection?

A

Scapular Y

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21
Q

What surface of the body should be facing the IR for PA Oblique: Y view?

A

Anterior side (front of body)

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22
Q

How is the patient rotated for the PA Oblique Y shoulder view?

A

Rotated 45 degrees so the midcoronal plane forms an angle with the IR

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23
Q

What is the position of the scapula in the PA Oblique Y view?

A

Perpendicular to the surface of the IR

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24
Q

What is the placement of the Central Ray for the PA Oblique: Y view?

A

At the level of the scapulohumeral joint

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25
Q

What are the structures demonstrated in the PA Oblique: Y view?

A
  • Humeral head directly superimposed over the “Y”
  • Oblique image of the shoulder
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26
Q

What types of dislocations are shown in the PA Oblique: Y view?

A

Anterior and Posterior dislocation

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27
Q

How is an anterior dislocation demonstrated in a PA Oblique: Y view?

A

Humeral head is under the corocoid process

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28
Q

How is a posterior dislocation demonstrated in a PA Oblique: Y view?

A

Humeral head is projected under the acromion process

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29
Q

What are the evaluation criteria for PA Oblique: Y view?

A
  • No superimposition of the body of the scapula over the bony thorax
  • Vertebral and lateral borders superimposed
  • Superimposed humeral head and glenoid cavity
  • Shaft of humerus superimposed with scapular body
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30
Q

What does a superimposed humeral head and glenoid cavity demonstrate in a PA Oblique: Y view?

A

Patient is rotated properly 45-60 degrees

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31
Q

What does the shaft of the humerus superimposed with the body of the scapula demonstrate in the PA Oblique: Y view?

A

That the arm is resting down by the patient’s side

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32
Q

What are the two positions for the Grashey Method?

A

RPO or LPO

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33
Q

What surface of the body should be facing the IR for Grashey Method?

A

Posterior side (back of body)

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34
Q

What is the technical name for the Grashey method?

A

AP Oblique projection

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35
Q

What is the placement of the Central Ray for the Grashey method?

A

Centered 2 inch below and 2 inches medial to the scapulolateral border of the shoulder

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36
Q

How much is the patient rotated for the Grashey method?

A

35-45 degrees toward the affected side

37
Q

What are the structures demonstrated in the Grashey Method?

A

The joint spaces between the humeral head and the glenoid cavity

38
Q

What are the 2 evaluation criteria for the Grashey method?

A
  • Open joint spaces between the humeral head and glenoid cavity
  • Glenoid cavity in profile
39
Q

What are the two axial projections for shoulder?

A

Superoinferior axial projection and Inferosuperior axial projection (Lawrence method)

40
Q

How is the patient placed for the superoinferior axial projection?

A

Seated at the end of the table with the arm draped over the table and shoulder centered to the IR

41
Q

What are the structures demonstrated in the Superoinferior Axial projection?

A
  • Proximal humerus and shoulder joint
  • Coracoid process
  • AC joints
42
Q

What is the evaluation criteria for the superoinferior axial projection?

A
  • Lesser tubercle in profile
  • AC joint through the humeral head
  • Coracoid process projected above the clavicle
  • Evidence of proper collimation and centering
  • Scapulohumeral joint
43
Q

What is the position of the central ray for the superoinferior axial projection?

A

Through the top of the shoulder joint through the axilla

44
Q

What is the angle of the tube for the superoinferior axial projection?

A

Angled 5-15 degrees cephalic (towards the head)

45
Q

How is the patient placed for the inferosuperior axial projection?

A

Patient laying supine on the table with arm abducted and humerus externally rotated

46
Q

What is the position of the central ray for the inferosuperior axial projection?

A

Horizontally through the center of the axilla to the AC joint

47
Q

What is the angle of the tube for the inferosuperior axial projection?

A

Angled 15-30 degrees to match abduction angle

48
Q

Where is the image receptors placed for the inferosuperior axial projection?

A

Above the patient’s shoulder resting on the table

49
Q

What is an alternative shoulder projection used?

A

Neer method

50
Q

What is the Neer method used for?

A

To show tangentially the coroacoacromial arch to diagnose shoulder impingement

51
Q

How is the tangential image obtained?

A

By projecting the x-ray beam under the AC joints and the acromion

52
Q

What is the position of the Neer method similar to?

A

The RAO/LAO Y view

53
Q

How is the patient positioned for the Neer method?

A
  • Seated or standing, arm down by the side and facing the upright Bucky
  • Place patient’s affected shoulder centered and in contact with the IR and rotate their unaffected side away
  • Palpate the flat aspect of the scapular and place it perpendicular to the IR and rotate the patient 45-60 degrees from the IR
54
Q

What is the position of the central ray for the Neer method?

A

Entering the superior aspect of the humeral head

55
Q

What is the angle of the tube for the Neer method?

A

Angled 10-15 degrees caudad (away from the head)

56
Q

What are the structures demonstrated in the Neer Method?

A

The posterior surface of the acromion and AC joint which are identified as the superior border of the coracoacromial outlet

57
Q

What is the evaluation criteria for the Neer method?

A

Humeral head projected below the AC joint

58
Q

What are the two positions for the Scapula?

A

AP and Lateral Scapula

59
Q

How is the patient positioned for the AP Scapula?

A

Upright, with their back to the Bucky and centered to the shoulder. Affected arm is raised at a 90 degree angle

60
Q

What is the position of the central ray for the AP Scapula?

A

2 inches below the coracoid process

61
Q

What are the structures demonstrated in the AP Scapula?

A

An AP projection of the scapula

62
Q

What are the evaluation criteria for the AP scapula?

A
  • Lateral portion free from superimposition of the ribs
  • Scapula horizontal and not oblique
  • Seen through the lung and ribs
63
Q

What is demonstrated by the scapula being placed horizontal in an AP scapula?

A

That the scapula is placed in a true AP to the IR

64
Q

How is the patient positioned for the Lateral Scapula?

A

Upright facing the Bucky, with their shoulder centered, affected arm placed either across the chest touching the opposite shoulder or behind the back with the back of the back of the hand touching the back and patient rotated 45-60 degrees to have the scapula perpendicular to the IR

65
Q

What is the position of the central ray for the Lateral Scapula?

A

Centered to the medial border of the scapula

66
Q

What are the structures demonstrated in the Lateral Scapula?

A

A lateral image of the scapula

67
Q

What are the evaluation criteria for the Lateral scapula?

A
  • Lateral and medial borders superimposed
  • No superimposition of scapula over the ribs
  • Entire scapula
68
Q

What is the result of the arm not being abducted in the Scapula image?

A

The entire scapula will be in the lung field

69
Q

What is the result of the patient being under rotated in the Lateral Scapula?

A

The patient is not in the true lateral position

70
Q

What are the two views for a Clavicle image?

A

AP and AP Axial

71
Q

How is the patient positioned for AP clavicle?

A

Upright standing with their back to the Bucky and shoulder centered

72
Q

What is the position of the central ray for the AP Clavicle?

A

Centered to the midpoint of the clavicle

73
Q

What are the structures demonstrated in the AP Clavicle?

A

An AP image of the entire clavicle

74
Q

What are the evaluation criteria for the AP Clavicle?

A
  • Entire clavicle
  • Uniform density
75
Q

How is the patient positioned for AP Axial clavicle?

A

Upright facing the tube with the shoulder centered

76
Q

What is the position of the central ray for the AP Axial Clavicle?

A

Centered to the mid clavicle

77
Q

What is the angle of the tube for the AP Axial Clavicle?

A

Tube is angled 15-30 degrees cephalic (towards the head)

78
Q

What are the structures demonstrated in the AP Axial Clavicle?

A

An AP axial image of the clavicle is projected above the ribs

79
Q

What is the evaluation criteria for the AP Axial clavicle?

A
  • Most of the the clavicle is projected above the ribs
  • Entire clavicle is shown
  • Horizontal placement
80
Q

What are the two positions for the A-C Joints?

A

AP without weight and AP with weights

81
Q

How is the patient positioned for the AP A-C?

A

Upright and facing the tube with the midline of the body is centered to the Bucky and weights placed evenly in the patients hand for the second image

82
Q

What is the position of the central ray for the AP A-C joint?

A

Perpendicular to the MSP and at the level of the A-C joints

83
Q

What are the structures demonstrated in the AP A-C joint?

A

Dislocation, separation and function of joints

84
Q

What are the evaluation criteria for the AP A-C joint projections?

A
  • Both A-C joints
  • A-C joint separation when the weights are placed
  • No rotation or leaning
  • Some soft tissue
85
Q

What are the two ways shoulder pain is defined?

A

Trauma and non-trauma

86
Q

How is trauma shoulder pain described?

A

Fracture or dislocation

87
Q

How is non-trauma shoulder pain defined?

A

General pain

88
Q

How is an over rotation demonstrated in a Y view?

A

If the scapula is placed over the thorax

89
Q

How is an under rotation demonstrated in the Grashey method?

A

If the joint spaces aren’t shown

Radiographic Procedures (9 decks)

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