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drg1004 > Week 3 - Humerus & Shoulder > Flashcards

Week 3 - Humerus & Shoulder Flashcards

1
Q

what is the room prep needed for humerus

A
  • SID = 100 - 115 cm
  • CR = 35 x 43 cm cassette
  • kVp = 55 - 65
  • mAs = 2.5 - 5
  • Focal spot size = fine/small
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2
Q

what is the target for AP humerus

A

Horizontal central ray centred to mid humerus

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3
Q

what is the collimation of AP humerus

A

upper = shoulder joint
side = surrounding soft tissue margins
lower = elbow joint

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4
Q

what is the target for AP humerus

A

horizontal central ray centred to mid humerus

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5
Q

what is the collimation for AP humerus

A

upper = shoulder joint
side = surrounding soft tissues
lower = elbow joint

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6
Q

what is the ideal position for AP humerus

A
  • medial & lateral epicondyles shown
  • greater tubercle shown
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7
Q

what is the ideal area for AP humerus

A

shoulder joint, elbow joint, surrounding soft tissues included

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8
Q

what is the ideal position for lateral humerus

A
  • lesser tubercle shown medially
  • anterior surfaces of capitulum & medial trochlea nearly aligned
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9
Q

what is the ideal area for lateral humerus

A

shoulder joint, elbow joint, surrounding soft tissues included

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10
Q

what is the target for AP shoulder

A

horizontal central ray centred at 3 - 4 cm inferior to mid-clavicular line

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11
Q

what is the collimation for AP shoulder

A

superior = soft tissue margins of upper shoulder
lateral = surrounding soft tissue margins
medial = sternoclavicular joint
inferior = proximal third of humerus

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12
Q

what is the ideal position for AP shoulder

A
  • clavicle not foreshortened
  • glenoid cavity partially shown w/ superimposition of humeral head
  • greater tubercle shown
  • humerus not abducted
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13
Q

what is the ideal area for AP shoulder

A

entire clavicle, inferior angle of scapula, proximal third of humerus included

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14
Q

what is the target for Axial clavicle

A

horizontal central ray directed 30 degrees cranially & centred to mid of affected clavicle

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15
Q

what is the collimation for AP clavicle

A

superior = soft tissue margins above shoulder
lateral = surrounding soft tissue margins
medial = sternoclavicular joint of affected side
inferior = humeral head

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16
Q

what is the collimation for axial clavicle

A

superior = soft tissue margins above shoulder
lateral = surrounding soft tissue margins
medial = sternoclavicular joint of affected side
inferior = humeral head

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17
Q

what is the position for AP clavicle

A
  • clavicle w/o foreshortened
  • clavicle & superior scapular angle visualized at same transverse level
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18
Q

what is the area for AP clavicle

A

entire clavicle & acromion process included

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19
Q

what is the ideal position for Axial clavicle

A
  • superior scapular angle visualized 1.25 cm inferior to clavicle
  • proximal end of clavicle superimposed over 1st - 3rd ribs
  • middle & distal third of clavicle projected slightly above acromion

Clavicle PMS

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20
Q

what is the area for axial clavicle

A

entire clavicle & acromion process included

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21
Q

what kind of injuries are acromioclavicular joint

A

traumatic injuries to AC joint disrupts AC ligaments of coracoclavicular ligaments

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22
Q

what is the target for AP AC joints

A

horizontal central beam to centre at affected AC joint

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23
Q

what is the collimation for AP AC joints

A

superior = soft tissue margins of upper border of shoulder
medial = distal half of clavicle of affected side
lateral = surrounding soft tissue margins
inferior = humeral head

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24
Q

what is the ideal position for AC joints

A
  • distal clavicle not superimposed on acromion process
  • clavicle & superior scapular angle seen at same transverse level
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25
Q

what is the ideal area for AC joints

A

distal half of clavicle & acromion process included

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26
Q

what is the cassette used for CR

A

35 x 43 in bucky tray

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27
Q

what is the kVp & mAs of humerus

A

55 - 65 kVp
2.5 - 5 mAs

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28
Q

when do patients need to wear radiolucent gown

A

humerus & shoulder radiography

29
Q

what is the SID for humerus & shoulder

A

100 - 115 cm

30
Q

what is the kVp & mAs for shoulder

A

70 - 75 kVp
6 mAs

31
Q

is bucky needed for shoulder

A

yes because thick region

32
Q

how to position patient for AP shoulder

A
  • fully extended elbow, palm supinated
  • head towards unaffected side
  • back & posterior shoulder in contact w/ bucky
33
Q

how to position patient for AP humerus

A
  • back against bucky
  • head towards unaffected side
  • elbow fully extended with palm supinated
  • humerus abducted
34
Q

how to position patient for lateral humerus

A
  • flexed affected elbow, hands resting on hip
  • lateral humerus contact vertical bucky
35
Q

how to position patient for AP & axial clavicles

A
  • back against vertical bucky
  • turn head away from affected side
  • affected elbow fully extended
  • affected forearm rotated until palmar side facing tube
36
Q

how to position for AP AC joints non weight bearing

A
  • patient facing x-ray tube
  • back against vertical bucky
  • not rotated
37
Q

how to position for AP AC joints weight bearing

A
  • patient facing x-ray tube
  • back against vertical bucky
  • not rotated
  • patient carry sandbags (between 5 - 8 pounds) fully extended elbow
38
Q

what complications arise from shoulder dislocation

A
  • axillary nerve damage
  • anterior & posterior circumflex artery rupture
39
Q

what are possible causes of posterior shoulder dislocation

A

fits, seizures or electrocutions, FOOSH

40
Q

what is the purpose of fully extending elbow & carry sandbags

A

to open up joint space

41
Q

what is not seen when there is inadequate angulation of axial clavicle

A
  • superior scapular angle visualized 1.25 cm inferior to clavicle
  • proximal end of clavicle superimposed over 1st - 3rd ribs
  • middle & distal third of clavicle projected slightly above acromion
42
Q

what is not seen when the patient’s back is not straight / hunched of AP clavicle

A
  • clavicle w/o foreshortened
  • clavicle & superior scapular angle visualized at same transverse level
43
Q

when can the lesser tubercle be seen in profile for lateral humerus

A

when medial & lateral epicondyles are aligned

44
Q

what are the 2 types of tendinosis

A

rotator cuff tendinosis = tendon degeneration

calcifying tendinosis = painful shoulder due to calcium deposits

45
Q

what are frequent sites of crystal deposits

A

supraspinatus
infraspinatus
teres minor
subscapularis
biceps

46
Q

what is the cassette used for CR of AP shoulder

A

24 x 30 cm into bucky tray

47
Q

what is not seen in AP shoulder when patient’s body is too over rotated

A
  • clavicle shown w/o foreshortening
  • glenoid cavity partially shown w/ superimposition of humeral head
48
Q

what are the 2 classifications of dislocations

A

anterior or posterior

49
Q

what complications occur due to shoulder dislocations

A

axillary nerve damage
ant. & post. circumflex artery rupture

50
Q

what causes shoulder dislocations

A
  • Forceful external rotation in abducted position
  • FOOSH
  • Direct hit to shoulder from the back
51
Q

what is the target of AP clavicle

A

HCR perpendicular to IR & center at mid-point of clavicle

52
Q

what is the patient prep for humerus, shoulder, clavicle, AC joint

A
  • female patients change into radiolucent gown & remove undergarments
  • correct patient ID via double patient identifier
  • confirm site & side
  • ensure not pregnant
  • explain procedure to patient
  • remove radio-opaque objects & safe keeping of valuables
53
Q

when are the medial & lateral epicondyles are shown for AP humerus

A

only if they are equidistant from IR

54
Q

when is the lesser tubercle shown for lateral humerus

A

only if medial & lateral epicondyles are aligned

55
Q

what and how to position the humerus

A

supinate hand (anatomical position) = external rotation
palm against hip = neutral rotation
dorsum of hand against hip = internal rotation

56
Q

what are the KRFs of internal & external rotation

A

external rotation KRF = greater tubercle
internal rotation KRF = lesser tubercle

57
Q

what is the room prep for shoulder

A
  • SID = 100 - 115 cm
  • CR = 24 x 30 cm cassette
  • kVp = 70 - 75
  • mAs = 6
  • AEC = centre
  • focal spot size = fine/small
58
Q

what is the room prep for humerus

A
  • SID = 100 - 115 cm
  • CR = 35 x 43 cm cassette
  • kVp = 55 - 65
  • mAs = 2.5 - 5
  • Focal spot size = fine/small
59
Q

what is the room prep for clavicle

A
  • SID = 100 - 115
  • CR = 18 x 24 cm cassette
  • kVp = 70
  • AEC = centre chamber
  • focal spot size = fine/small
60
Q

what is the room prep for AC joint

A
  • SID = 100 - 115
  • CR = 30 x 40 cm cassette
  • kVp = 70
  • AEC = centre chamber
  • focal spot size = fine/small
61
Q

what is not seen if the patient’s body is over rotated (delete)

A

clavicle w/o foreshortening & clavicle and superior scapular angle seen at same transverse level

62
Q

what is not seen if the patient’s body is not straight/hunched for AP clavicle

A

clavicle w/o foreshortening & clavicle and superior scapular angle seen at same transverse level

63
Q

what is not seen if the patient’s body is over rotated

A
  1. clavicle w/o foreshortening
  2. glenoid cavity partially shown w/ superimposition of humeral head
64
Q

what are the views of the shoulder

A

axillary, Y scapular, outlet, AP

65
Q

what is the weight the patients need to carry for AP joint preparation

A

5 to 8 pounds

66
Q

what is not seen if there is over/under rotation of patient’s body for AC joint

A

distal clavicle not superimposed on acromion process

67
Q

what is not seen if patient is hunched/not straight for AC joint

A

clavicle and superior scapular angle seen at same transverse level

68
Q

what is not seen if there is inadequate angulation for axial clavicle

A

will not see ideal position for axial clavicle
1. proximal part of clavicle superimposes 1st - 3rd ribs
2. middle/distal part of clavicle slightly superior to acromion
3. superior scapular angle is 1.25 cm inferior to clavicle

drg1004 (12 decks)

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