Shoulder Girdle and Humerus Flashcards

1
Q

why use grids?

A

minimize scatter radiation
used when body part Is thicker than 10cm
used with higher kVp

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2
Q

Markers

A

on correct side of body
lateral aspect
int the beam not obstructing anatomy
patient face up - marker face up
patient face down - marker face down

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3
Q

what are compensating filters?

A

even out the density of the anatomy
- improve image quality
- may reduce radiation exposure
know how to position filters, and when
won’t use filters at Fanshawe, but maybe at placement

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4
Q

Filter placement

A

thickest part of filter corresponds with thinnest part of anatomy
collimator mounted and contact

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5
Q

What placement of a filter could decrease skin entrance exposure to the patient?

A

collimator mounted

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6
Q

What do you usually see on humeral and shoulder girdle images?

A

fractures
dislocations
arthritis
bone cysts/neoplasms
- usually located proximal humerus or distal knee)

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7
Q

What are the humerus views?

A

AP
Lateral
Transthoracic lateral

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8
Q

Humerus - AP projection

A

humerus true AP position
CR - perpendicular
CP - middle of humerus, may angle collimator
suspend respiration

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9
Q

Humerus - AP evaluation criteria

A

Both joints on image
no rotation
humeral head and greater tuberosity in profile
lesser tubercle between head and greater tubercle
use a practice breath when positioning to ensure you are not clipping any anatomy when they hold breath

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10
Q

Humerus - lateromedial

A

RPO
back of hand on hip
CR - perpendicular
CP - middle of humerus
- include 5cm/2” above/below humerus
Suspend respiration
epicondyles need to be stacked on top of each other

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11
Q

Humerus - Mediolateral

A

LAO
Arm and hand in same position as lateromedial
patient facing bucky
marker face down

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12
Q

Humerus - lateral projection evaluation criteria

A

both joints on image
superimposed epicondyles
lesser tubercle in profile
greater tubercle superimposed with head

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13
Q

Humerus - transthoracic lateral projection

A

injured humerus against bucky
raise remote arm above head
include all the humerus
use breathing technique - say act like breathing through a straw to ensure no shoulder movement

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14
Q

Humerus - transthoracic evaluation criteria

A

entire humerus on image
scapula, clavicle and humerus seen through lung field
breathing technique will blur ribs
increase time and decrease mA

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15
Q

What are the shoulder projections?

A

AP - internal, external and neutral rotation
Inferosuperior axial
Superoinferior axial
PA/AP oblique - scapular Y
AP oblique

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16
Q

Shoulder - AP projections

A

arm hanging by side - external (true anatomical position), nuetral (oblique, hand to side) and internal (same position as lateromedial humerus)
CP - 2.5cm inferior to coacoid
suspend respiration

17
Q

Shoulder - external, neutral and interior series

A

entire shoulder girdle for the first image
- full collar bone, apex of scapula and above shoulder
Shows the rotation of humeral head
tighten the collimation after the first image

18
Q

Shoulder - AP evaluation criteria

A

entire scapula, clavicle, proximal humerus
external - head and greater tubercle in profile
neutral - greater tubercle partially superimposing head
internal - lesser tubercle in profile

19
Q

Shoulder - Glenoid Fossa (AP Oblique) projection

A

RPO
patient rotated 35-45 degrees to injured side
CP - 5cm/2” medial, 5cm inferior to superolateral border of shoulder
feel for spine of scapula - rotate until it is flat against the IR
glenoid cavity in profile
open scapulohumeral joint

20
Q

Shoulder - transthoracic lateral projection

A

same as position for humerus
breathing technique

21
Q

Shoulder - transthoracic lateral evaluation criteria

A

scapula, clavicle and proximal humerus send through the lung field

22
Q

Shoulder - inferosuperior axial projection

A

marker face up
Use CR cassette crosswise
patient supine with arm abducted - hand supine
CR - horizontal with 15-30 degree angle - more abduction, more angle
CP - exit at acromion
detector and CR same angle
as close as you can get within reason

23
Q

Shoulder - inferosuperior axial evaluation criteria

A

scapulohumeral joint with some overlap
coracoid process anterior above the clavicle
lesser tubercle in profile anteriorly
AC joint projected through humerus

24
Q

Shoulder - Rafert Modification

A

looks for a Hills-Sachs defect
external rotation of arm - inferosuperior position with thumb down
CR about 15 degrees medially, exiting acromion

25
Q

Shoulder - superoinferior axial projection

A

patient leans, shoulder over table - make sure back is straight
CR - 5-15 degrees laterally
CP - glenohumeral joint
Suspend respiration
angle from acromion to armpit
marker facedown

26
Q

Shoulder - superoinferior axial evaluation criteria

A

coracoid process above clavicle
lesser tubercle in profile
AC joint through humeral head

27
Q

Shoulder - PA Oblique - Lateral “Y Scap”

A

Rotate injured shoulder 45-60 degrees towards IR - feel for scapula
CP - midpoint of scapula
Marker face down
medial border of scapula and acromion need to be lined up

28
Q

Shoulder - PA Oblique Evaluation criteria

A

No superimposition of scapular body over bony thorax
Lateral scapula
Humeral head and glenoid between coracoid and acromion
demonstrates anterior and posterior dislocations

29
Q

Which shoulder dislocation is most common?

A

anterior