RAD 141 CH.5 PROXIMAL HUMERUS + SHOULDER

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anatomy12
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246749
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RAD 141 CH.5 PROXIMAL HUMERUS + SHOULDER
Updated:
2013-12-14 14:26:33
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xray
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xray
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  1. what is the joint classification of the shoulder girdle
    synovial and diarthrodial (freely moveable)
  2. what joint is the scapulohumeral joint or shoulder joint
    spheroidal or ball and socket joint
  3. what type of joint or movement classification are the AC and SC joints
    gliding joints
  4. what is the shoulder routine positions (non trauma) and special
    • ap external rotation
    • ap internal rotation

    • inferosuperior - Lawrence method
    • Inferosuperior Axial - West Point Method
    • Posterior Oblique _glenoid Cavity (grashey Method)
    • Tangential Projection - Intertubercular groove (fisk method)
  5. what position shoulder is used to isolate the greater tubercle of the humerus in profile laterally
    ap external rotation
  6. what position of shoulder would you use to view the lesser tubercle in profile more medially
    ap internal rotation
  7. when do we perform the neutral rotation of the scapula
    when the patient is in pain and cannot move it at all
  8. what are the exposure factors
    • 70-80 kvp use a grid depending on size of patient
    • high mA short exposure time
    • small FSS
    • center cell AEC
    • 40-44in SID
  9. what joint calls for a 72 inch SID
    AC joint or acromioclavicular joint
  10. List all positioning requirements for ap shoulder external rotation
    • 10x12 crosswise or lengthwise
    • erect or supine
    • abduct arm slightly; then externally rotate the arm until epicondyles of distal humerus are parallel to IR
    • Hold respiration
    • CR perpendicular to the IR centered 1 inch inferior to the coracoid process (above armpit midway)(3/4 inch inferior to the lateral portion of the clavicle)
  11. where is the lesser tubercle on an ap external rotation
    superimposed by the humeral head so will not be seen best
  12. List all positioning requirements for ap shoulder internal rotation
    • 10x12 crosswise or lengthwise
    • erect or supine
    • abduct arm slightly; then internally rotate the arm until epicondyles of distal humerus are perpendicular to IR

    Hold respiration

    CR 1in inferior to the coracoid process (above armpit midway)(abt 3/4 inch inferior to the lateral portion of the clavicle
  13. where is the lesser tubercle on an ap internal rotation radiograph
    where is the greater tubercle
    • medial aspect of the humerus it puts lesser tubercle into profile
    • superimposed over the humeral head
  14. what is the position of the arm in an inferosuperior axial projection
    externally rotated
  15. what is the position factors in an inferosuperior axial projection
    • shoulder raised 2 inches from table top
    • rotate head toward opposite sideĀ  place vertical IR on the table as close to neck as possible
    • abduct the arm 90 degrees and arm externally rotated (palm up)
  16. why is the exaggerated rotation of the arm done for an inferiorosuperior axial projection
    what is this reason
    • hill sachs defect
    • it is a compression fracture of the articular surface of the humeral head
  17. what are other reasons we would use the inferosuperior axial projection
    osteoperosis osteoarthritis and fractions and dislocations of the proximal humerus
  18. what is the best position to view the glenoid cavity in perfect profile
    posterior oblique position (grashey method)
  19. how do we position for the grashey method
    where is the CR
    • erect or supine
    • rotate body 35-45 degrees toward affected side
    • CR perpendicular to the IR centered to the scapulohumeral joint which is 2 inferior and medial to the superolateral border of the shoulder
    • suspend respiration
  20. what are the routine trauma positions if the patient cannot move
    • AP neutral
    • transthoracic lateral -lawrence method
    • scapular y lateral (patients arm over the stomach
  21. what structures are best shown when doing the FISK method
    what position of the body is this method best done
    • anterior margin of the humeral head and intertubercular groove and other pathologies
    • supine
  22. what is the positioning for the tangential projection -fisk method
    • best supine
    • set up like an inferosuperior but do no abduct the arm
    • CR is 10-15 degrees posterior from horizontal directed to intertubercular groove
  23. where is the CR when doing an ap projection neutral rotation position and position
    what is the breathing instructions
    • leave patients arm "as is" erect or supine
    • perpendicular to IR centered to
    • midscapulohumeral joint (3/4 inch and slightly lateral to the coracoid process)
    • suspend respiration
  24. why do we do a transthoracic lateral projection (lawrence method)
    if patient cannot get into position so this position is used to see certain structures through the ribs that are on the shoulder

    Demonstrates fractures and dislocations of the proximal humerus
  25. list the positioning factors for a transthoracic lateral projection
    where is the CR
    what is the breathing technique
    • erect or supine
    • place patient in a lateral position with a side of interest against IR
    • leave affected arm in a neutral position and aks patient to drop shoulder as much as possible
    • raise opposite arm and place hand over head
    • surgical neck of the affected side
    • shallow breaths like panting and (long exposure tech factors)
  26. what do we do to prevent superimposition of the shoulder if the patient is unable to drop the shoulders and raised the unaffected arm in a transthoracic lateral projection
    angle the tube 10+15 degrees cephalad
  27. why do we perform a scapular y and transthoracic positioning (reason pathologically)
    demonstrates fractures and dislocations of proximal humerus and scapula
  28. how do we perform a scapular y
    where is the CR
    • 10x12 crosswise or lengthwise
    • erect or recumbent
    • rotate the patient into a 45 to 60 degree oblique
    • palpate scap borders to determine correct rotation for a true lateral
    • CR perpendicular to the IR centered to midscapulohumeral joint
    • affected side arm stays down
    • suspend respiration

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