1
Q
What are fingers called?
A
Digits
2
Q
What are fingers composed of?
A
Phalanges
3
Q
What are the first-fifth digits in order?
A
1: thumb
2: pointer
3: middle
4: ring
5: pinky
4
Q
What makes the 1st digit different/what is it composed of?
A
2 parts: Proximal and distal phalanx
5
Q
What are the 2nd-5th digits composed of?
A
3 parts: Proximal, middle, and distal phalanx
6
Q
What is the distal rounded part of the phalanx?
A
Head
7
Q
What is the middle section or shaft of the phalanx?
A
Body
8
Q
What is the flattened proximal portion of the phalanx?
A
Base
9
Q
What bones make up the palm of the hand?
A
Metacarpals (1-5)
10
Q
What is the head of the metacarpal?
A
Distal rounded part
11
Q
What does the head of the metacarpal have?
A
A neck tapered just proximal to the head
12
Q
What is the body of the metacarpal?
A
Shaft, long curved portion
13
Q
What is the base of the metacarpal?
A
Proximal end, articulates with carpals
14
Q
What occurs frequently near joint spaces [of hand]?
A
Small chip fractures
15
Q
What joint: Between the proximal and distal phalanx of thumb
A
Interphalangeal (IP) joint
16
Q
What joint: Between the distal and middle phalanx of digits 2-5
A
Distal interphalangeal (DIP) joint
17
Q
What joint: Between the middle and proximal phalanx of digits 2-5
A
Proximal interphalangeal (PIP) joint
18
Q
What joint: Between proximal phalanx and metacarpal of each digit
A
Metacarpophalangeal (MCP) joint
19
Q
What joint: Between the metacarpal and appropriate carpal of the distal row of the wrist
A
Carpometacarpal (CM) joint
20
Q
What does the 1st digit’s CM joint attach?
A
First MC with trapezium
21
Q
What does the 2nd digit’s CMC joint attach?
A
Second MC with trapezoid
22
Q
What does the 3rd digit’s CM joint attach?
A
Third MC with capitate
23
Q
What does the 4th and 5th digit’s CM joint attach?
A
The Fourth and Fifth MC each attach to the hamate (2 MC with 1 carpal)
24
Q
What must be included when imaging thumb?
A
Phalanges of entire first metacarpal
25
What must be included when imaging digits 2-5?
All of the phalanges and the distal portion of the metacarpal
26
What are carpals?
Bones that make up the wrist
27
What is the proximal row of carpals, starting from the thumb side (digit 1)
Scaphoid
Lunate
Triquetrum
Pisiform
28
What is the distal row of carpals, starting from the thumb side (digit 1)
Trapezium
Trapezoid
Capitate
Hamate
29
What is another [older] term for the scaphoid bone?
Navicular
30
What shape is the scaphoid?
Boat shaped
31
What is the largest bone of the proximal row?
Scaphoid
32
What is the most frequently fractured carpal bone?
Scaphoid
33
What does the scaphoid articulate with proximally?
Radius
34
What shape is the lunate?
Moon shaped
35
What does the lunate articulate with?
The radius proximally and the capitate distally
36
What shape is the triquetrum?
Pyramidal shape
37
What does the triquetrum articulate with?
Pisiform anteriorly
38
What shape is the pisiform?
Pea shaped
39
What is the smallest carpal?
Pisiform
40
What shape is the trapezium?
Kind of a trick. It's "irregularly" shaped
41
Where is the trapezium located?
Between the scaphoid medially and the 1st metacarpal distally
42
What shape is the trapezoid?
Wedge-shaped
43
What is the smallest carpal in the distal row?
Trapezoid
44
What is the capitate also known as?
Os Magnum
45
What is the largest carpal bone?
Capitate
46
What does the capitate articulate with?
The scaphoid and lunate proximally and the 3rd metacarpal distally
47
What does the hamate look like?
Hooklike
48
What is the hamate AKA?
Hamulus
49
How does the hamate project?
Projects from palmar surface
50
What bone is lateral on the forearm? Medial?
Lateral/thumb-side: radius
Medial: ulna
51
What do the radius and ulna articulate with each other at?
Proximal and distal radioulnar joints
52
What do the proximal and distal radioulnar joints allow for?
Rotational movement of the hand and wrist
53
What are small conical projections at the distal end of both the radius and ulna?
Styloid processes
54
Which styloid process extends more distally?
Radial styloid process
55
Can you feel the styloid processes?
Yes, both are palpable
56
Where is the ulnar notch?
On the medial aspect of the distal radius where the head of the ulna sits
57
Where is the head of the ulna located?
At the distal end of the ulna, proximal to the styloid process
58
Where is the head of the radius located?
Proximal end of the radius
59
What does the radial head look like?
Round and flat
60
What is the radial "neck"?
Constricted area just distal to the head of the radius
61
What is the radial tuberosity?
Rough oval process on the medial and anterior side of the radius just distal to the neck
62
What is the long midportion of both the radius and ulna?
Body
63
What is the body AKA?
Shaft
64
Is the radius or ulna shorter?
Radius
65
What bone of the forearm articulates directly with the wrist joint?
Radius
66
During pronation, which forearm bone rotates?
The radius rotates around the more stationary ulna
67
What is the proximal ulna primarily involved in?
Formation of the elbow joint
68
What is the beaklike process that is easily palpated on the posterior aspect of the elbow?
Olecranon process
69
What is the olecranon process AKA?
Funny bone
70
What is a large concave depression articulating with the distal humerus?
Trochlear or semilunar notch
71
What is the beaklike process separated from the olecranon process by the trochlear (semilunar) notch?
Coronoid process
72
What is found on the medial margin of the coronoid process?
Coronoid tubercle
73
What is a small shallow depression on the lateral side of the proximal ulna that articulates with the head of the radius to form the proximal radioulnar joint?
Radial notch
74
How do you remember what the radial head attaches to?
"Radial head wears a cap"
The capitulum is above the radial head
75
What is the distal humerus considered part of?
The elbow joint
76
What is the long center section of the humerus bone?
Body/shaft
77
What is the expanded distal end of the humerus?
Humeral condyle
78
What is the trochlea shaped like?
Pulley or spool with 2 rim-like outer margins
79
Where is the trochlea?
Medially on the humerus, articulates with the ulna
80
What is the depressed center portion between the rim-like outer margins of the trochlea?
Trochlear sulcus (or groove)
81
What does the trochlear sulcus appear as on a lateral view?
Circular
82
What is located laterally and articulates with the head of the radius?
Capitulum
83
What does capitulum mean
Little head
84
What is the small projection on the lateral aspect of the distal humerus above the capitulum?
Lateral epicondyle
85
What is the projection located on the medial edge of the distal humerus?
Medial epicondyle
86
Which epicondyle of the humerus is larger?
Medial epicondyle
87
What are the 2 anterior depressions of the humerus?
Coronoid fossa
Radial fossa
88
What is the posterior depression of the humerus?
Olecranon fossa
89
What is the area in which the coronoid process is when the elbow is flexed?
Coronoid fossa
90
What is the area in which the radial head is located when the elbow is flexed?
Radial fossa
91
What is the area where the olecranon process is located when the arm is fully extended?
Olecranon fossa
92
What is essential for evaluation of elbow joint pathology?
A true lateral elbow projection
93
What indicates elbow trauma?
Visualization of the displaced posterior fat pad
94
What will a good lateral elbow image demonstrate?
3 concentric arcs
95
What is the first and smallest concentric arc?
Trochlear sulcus
96
What is the second concentric arc?
Outer rims of the capitulum
97
What is the third and largest concentric arc?
Trochlear or semilunar arc
98
What is a sign your elbow is not truly lateral?
The concentric arcs will not appear symmetrical and the joint space will not be optimally visualized
99
What are all joints of the upper limb classified as?
Synovial/diarthrodial/freely moveable.
It is the types of movement that are different
100
What type of joints are: interphalangeal (IP)
What type of movement can they do?
Ginglymus or hinge
Allows for flexion and extension
101
What type of joints are: Metacarpophalangeal (MP)
What type of movement can they do?
Ellipsoidal or condyloid
Allows mvt in 4 directions (flexion, extension, abduction, adduction) as well as circumduction
102
What is circumduction?
Conelike sequential movement
103
What type of joints are: FIRST (thumb) Carpometacarpal (CM)
What type of movement can they do?
Sellar or saddle
Large range of mvt (flexion, extension, abduction, adduction, circumduction, opposition, some rotation)
104
What type of joints are:
2-5th Carpometacarpal (CM)
What type of movement can they do?
Plane or gliding
Least amount of movement of synovial class of joints
105
What type of joints are: Intercarpal
Plane or gliding
106
What type of joints are:
Radiocarpal
Ellipsoidal or condyloid
107
What is another name for the radiocarpal joint?
Wrist joint
108
What forms the radiocarpal joint?
Radius and scaphoid and lunate carpals
109
What type of joints are: Elbow joint
Ginglymus or hinge
110
Where is the elbow joint?
Between radius, ulna, and humerus
111
What does the complete elbow joint include?
Three joints enclosed in one articular capsule
112
What three joints are in the complete elbow joint?
Humerus/radius
Humerus/ulna
Proximal radioulnar joint
113
What type of joint is the proximal radioulnar joint?
Trochoidal or pivot
114
Is the forearm taken AP or PA? Why?
AP with the hand supinated
This prevents the radius and ulna from being superimposed proximally
115
What movement causes the radius and ulna to be superimposed?
Pronating the hand (like you were taking a PA) causes movement of the proximal and distal radioulnar joints
116
What position separates the radius and ulna best demonstrating the radial head and neck?
Rotating the elbow laterally from true AP
117
What position superimposes the radius and ulna and best demonstrates the coronoid process of the ulna?
Rotating the elbow medially from true AP
118
Where are fat pads (fat bands, stripes)? Where can they be found?
Outside the synovial sac but within the joint capsule of wrist and elbow joints
119
Are fat pads easy to see?
No, as they are only slightly more lucent than surrounding soft tissue
120
Is it normal to see posterior fat pad on a lateral elbow image?
No- this means there's a significant injury. It is normally located deep within the olecranon fossa and not visible
121
Should ambulatory patients be erect or sitting for upper limb exams?
Patient comfortably seated at the end of the table
122
How can trauma PTs be imaged for upper limb exams?
On the stretcher or x-ray table
123
Can you shield for upper limb?
You should collimate.
Notes say "gonadal shielding will not obscure pertinent anatomy"
124
High or low kVp for upper limb exams?
Low kVp (55-70)
125
Long or short exposure time for upper limb?
Short exposure time
126
Large or small focal spot for upper limb?
Small
127
What should correctly exposed images demonstrate for upper limb?
Soft-tissue margins for fat pad visualization and fine trabecular markings of all bones
128
Dose technique change for casts?
Yes, increase exposure factors
129
What should you collimate to for upper limb?
Part size
130
What axis should be parallel with the image receptor?
Long axis of part parallel to long axis of IR
131
Can you change the orientation for each projection when using multiple on one IR?
No- keep the same direction when multiple projections are on one IR
132
What are the CR rules for upper limb?
Multiple images can be performed on 1 IR and should be performed if less than 30% of the IR will be exposed
133
How should IR be prepped for exposure when multiple are being done on the same IR?
IR should be masked and a clear collimated border should be present between exposed areas
134
How should the central ray be in relation to the part and IR?
90 degrees or perpendicular
135
Should the central ray be centered to the part or IR?
BOTH
136
What is a fracture and dislocation of the posterior lip of the distal radius?
Barton's fracture
137
What is a fracture of the base of the first metacarpal with subluxation and posterior displacement?
Bennett's fracture
138
What is a fracture is a transverse fracture through the metacarpal neck, most commonly the 5th metacarpal?
Boxer's fracture
139
What is a fracture is a transverse fracture of the distal radius, displaced posteriorly, often a second fracture at the ulnar styloid also occurs
Colle's fracture
140
What is a fracture is a transverse fracture of the distal radius displaced anteriorly?
Smith's fracture
141
What fractures are reverse of each other?
Colle's and Smith's
142
What is it called when there is accumulated fluid, synovial or hemorrhagic, in the joint cavity?
Joint effusion
143
What is joint effusion an indication of?
Fracture, dislocation, soft-tissue damage or inflammation
144
What might we see on a requisition for osteoarthritis?
DJD or degenerative joint disease
145
What is osteoarthritis?
Gradual deterioration of articular cartilage
146
Is osteoarthritis normal?
Yes, considered a normal part of the aging process
147
What is the routine for: thumb
AP
Medial oblique
Lateral
148
What is the routine for: fingers (2-5)
PA
Oblique
Lateral
149
How should the fingers 2-5 oblique?
2&3 medial or lateral
4&5 lateral
150
What is the routine for: hand
PA
Lateral oblique
Fan lateral
151
What is the routine for: forearm
AP
Lateral
152
What is the routine for: elbow
AP
Medial (or lateral) oblique
90 degree lateral
153
How are phalanges positioned for the oblique hand?
Parallel to the IR
154
Can the phalanges touch the IR for oblique hand?
Only if the metacarpals are the specific area of interest
155
When might an extension lateral be required as opposed to the fan lateral hand?
If displacement in the metacarpal region is the specific area of interest or if the image is to demonstrate foreign body location
156
What is the Ball Catcher's position AKA?
Norgaard method
157
What type of projection is the ball catchers?
Bilateral AP oblique
158
What IR is used for ball catchers?
One 10x12 cassette
159
Describe ball catcher's position?
Both hands are placed on the ulnar surface and rotated 45 degrees
160
Where is the CR for ball catcher's position?
Center of the cassette at the level of the 5th metacarpal
161
Purpose of ball catcher's projection?
Eval rheumatoid arthritis
162
What is a special position used to demonstrate the scaphoid?
Ulnar deviation (or Navicular)
163
Describe ulnar deviation position?
Hand pronated with fingers rotated towards ulnar side of wrist
164
Central ray position ulnar deviation?
Directed to scaphoid
165
Any angle for ulnar deviation?
May require 10-15 degree tube angle with the long axis of the forearm
166
What type of projection is the Carpal Canal (tunnel)?
Tangential
167
Describe carpal canal position?
Patient hyperextends wrist to 90 degrees and holds fingers back with the other hand. Entire hand is rotated internally 10 degrees to prevent superimposition of the pisiform and hamate
168
How should the tube be angled for carpal canal?
Angle 25-30 degrees to the long axis of the hand
169
Where is the CR for carpal canal?
Enters 1.5" distal to the base of the 3rd metacarpal
170
Carpal canal criteria
Carpal sulcus open
Pisiform and hamate separated
Rounded scaphoid in profile
171
What should you do for an AP elbow if the elbow cannot be fully extended?
Take 2 projections, one with the humerus parallel to the IR, one with the forearm parallel
172
Where is the central ray directed for AP elbow (even when taking 2 projections)
Mid-elbow joint
173
What is a trauma axial lateral elbow example?
Coyle method
174
What projections are done for the Coyle method?
One to demonstrate the radial head, another to demonstrate the coronoid process
175
How does technique change for the Coyle method?
Increase kvP by 5 to compensate for the central ray angle
176
What is the position for Coyle method radial head?
Elbow flexed 90 degrees, hand pronated
177
What is the position for Coyle method coronoid process?
Elbow flexed 80 degrees, hand pronated
178
Where is the central ray for the Coyle method radial head?
Directed 45 degrees towards shoulder and centered to the radial head
179
Where is the central ray for the Coyle method coronoid process?
Directed 45 degrees from the shoulder and centered into the mid-elbow joint
180
When are radial head lateral projections done?
For occult fracture of the radial head and neck
181
What are the four separate lateral positions for radial head laterals?
Hand supinated
Hand lateral
Hand pronated
Hand with maximum internal rotation
182
What's the mnemonic for carpal bones?
(Lateral to medial)
Proximal row:
Some - Scaphoid
Lovers - Lunate
Try - Triquetrum
Positions - Pisiform
Distal row:
That - Trapezium
They - Trapezoid
Can't - Capitate
Handle - Hamate
183
Carpals involved in ulnar deviation
Scaphoid
184
Carpals involved in radial deviation
Lunate, triquetrum, pisiform, hamate
185
How to remember where the triquetrum vs trapezium vs trapezoid bones are?
Triquetrum- Some Lovers TRY Positions, meaning the TRI is next to lunate and pisiform
TrapeziUM is below the thUMb
186
Which bone of the forearm crosses over when you pronate your hand?
The radius crosses over the ulna
187
What SID to use for upper limb?
40"
188
What are the 3 positioning principles?
1. Part parallel to the IR
2. CR 90 degrees to part & IR
3. Correct CR positioning
189
What is the cast conversion for small-medium dry plaster cast?
Increase mAs 50-60% or increase kVp 5-7
190
What is the cast conversion for large or wet plaster cast?
Increase mAs 100% or kVp 8-10
191
What is the cast conversion for fiberglass cast?
Increase mAs 25-30% or kVp 3-4
192
What is displacement from a joint?
Dislocation
193
What is a partial dislocation?
Subluxation
194
What is a rupture or tearing of connective tissues?
Sprain
195
What is a bruise without fracture?
Contusion
196
What is a simple fx?
Closed
197
What is a compound fx?
Open- breaks through skin
198
What is a comminuted fx?
Splintered or crushed
199
What is an impacted fx?
Fragments driven into each other
200
What is an incomplete fx?
Does not transverse through entire bone
201
What is an Barton's fx?
Fx and dislocation of posterior lip of distal radius
202
What is a Boxer's fx?
Fx of metacarpal neck (5th)
203
What is a Colle's fx?
Fx of distal radius with posterior displacement
204
What is a nursemaid's (jerked) elbow?
AKA as radial head subluxation, it's a common injury in young children caused by a sudden pull on the hand or arm, which partially dislocates the radius from the elbow joint
205
What is a Smith's fx?
AKA Reverse Colles, distal radius fracture with anterior displacement
206
What's an Epiphyseal fx?
Growth plate fracture that occurs at the epiphysis, the part of a long bone near the joint that is responsible for growth and development
207
CR for all finger (digits 2-5) positions?
PIP
208
Finger criteria
Entire finger and min 1/3 of MCP demonstrated
No rotation/true position
209
CR for all thumb positions?
First MCP joint
210
Thumb criteria
Entire thumb demonstrated including first CMC joint
No rotation
211
CR for PA and oblique hand?
3rd MCP joint
212
Criteria for hand
Entire hand and carpals
No rotation of phalanges or metacarpals
Adequate/equal separation of phalanges and metacarpals on oblique
213
CR for fan lateral hand?
2nd MCP joint
214
What do you do if the PT cannot do a fan lateral hand?
Extension and/or flexion hand lateral
215
Proper PA wrist position
Arch hand, palm side down
216
PA wrist CR
Mid-carpal
217
How do you make the beam parallel to carpal-intercarpal spaces?
An AP wrist (alternative projection)
218
Where is the CR for oblique wrist?
Still mid-carpal
219
Criteria for wrist?
Distal radius, ulna, carpals demonstrated
Trapezium seen in entirety
Center of field at midcarpals
220
Position for lateral wrist
Hand and wrist in true lateral (hand may be slightly tweaked externally to allow radius and ulna to be superimposed)
221
How are epicondyles in relation to IR for AP forearm?
Parallel
222
CR for forearm
Mid-forearm
223
Forearm criteria
Carpals to distal humerus included (both joints)
Humeral epicondyles in profile
Only SLIGHT superimposition of distal radioulnar joint
224
Do we want the radius and ulna superimposed for an AP forearm?
NO. This is why forearm is done AP with the hand supinated. If we pronated, the radius would cross over
225
Lateral forearm position
Arm flexed 90 degrees
Wrist in true lateral
CR to midforearm
226
Lateral forearm criteria
Head of ulna is superimposed over radius
227
What do you do if the elbow cannot be fully extended?
Two partially flexed AP projections (one with humerus parallel to IR, one with forearm parallel to IR)
228
What degrees should an oblique be?
45
229
What are in profile for a lateral oblique elbow?
Radial head, neck, and tuberosity
Lateral epicondyle and capitulum
230
What are in profile for a medial oblique elbow?
Coronoid process
Trochlea and medial epicondyle
231
Lateral elbow position?
Elbow flexed 90 degrees
Humerus and forearm parallel to IR
232
Criteria for lateral elbow
Three concentric arcs visible
Olecranon process in profile
233
What is the modified Robert's method special projection?
AP thumb with CR 15 degrees proximal to 1st CMC joint
The base of the first metacarpal and trapezium must be visualized
234
What is the PA stress "Skier's thumb" special projection?
Bilateral stress projection for possible ulnar collateral ligament injury.
Both thumbs hold a rubber band taught
235
What is the AP oblique bilateral (Norgaard method) special projection?
AKA "Ballcatchers"
Bilat hands 45 degrees oblique
MCP joints opened
Midshafts of 2nd-5th metacarpals and base of phalanges not overlapped
Used to eval rheumatoid arthritis
236
What is the carpal canal AKA?
Gaynor Hart method
237
What is the carpal bridge tangential projection?
Hand is hyperFLEXED (opposite of canal)
CR 45 degrees to forearm
Dorsal surface parallel to IR
238
Carpal bridge criteria
Tangential view of dorsal aspect
Center of field at proximal 3rd metacarpal
239
What are the two options for ulnar deviation?
Modified Stecher (deviate hand/wrist externally)
or
Hand elevated 20 degrees (no ulnar deviation)
240
What is radial deviation?
Hand/wrist deviated internally to radius
Better visualize carpals on ulnar side (Lunate, triquetrum, pisiform, hamate)
241
What is the acute flexion (Jones method) special projection?
Tangential AP elbow projection
Acute flexion view of the elbow, which uses a highly flexed elbow to view structures like the olecranon, trochlea, and radial head for fractures and other intra-articular issues
CR perp to humerus
CR perp to forearm
242
What is the trauma axial lateromedial projection (Coyle method)
2 views:
CR 45 deg
90 deg elbow flexion for radial head
CR 45 deg
80 flexion for coronoid process
243
Can you do lateral elbows supine?
Yes- put the IR in between their elbow and torso and shoot CTL
244
What are radial head lateromedial projections?
Lateral views of elbow with the hand either supinated (maximum external rotation), lateral, or pronated (maximum internal rotation)
245
What is the largest and longest bone of the upper limb?
The humerus.
246
With what bone does the humerus articulate at the shoulder joint?
The scapula.
247
What is the most proximal rounded portion of the humerus?
The humeral head.
248
What is the anatomic neck of the humerus?
A constricted area below and lateral to the head.
249
How does the anatomic neck appear radiographically?
As a line between the greater and lesser tubercles.
250
Where is the lesser tubercle located?
Directly below the anatomic neck, on the anterior surface.
251
What is the greater tubercle?
The larger lateral process of the humerus.
252
What is found between the greater and lesser tubercles?
The intertubercular (bicipital) groove.
253
What is the intertubercular groove?
A deep groove between the greater and lesser tubercles.
254
What is the surgical neck of the humerus?
The tapered area below the head and tubercles.
255
Why is the surgical neck a common fracture site?
It is thinner and often impacted during falls; fractures here frequently require surgery.
256
What is the body (shaft) of the humerus?
The long mid-portion of the humerus.
257
What is the shoulder girdle made up of?
The clavicle and scapula
258
What does the clavicle and scapula function as
To connect each upper limb to the axial skeleton
259
At what level of the spine is the upper and lower margin of the scapula?
T2 upper
T7 lower
260
What is the clavicle AKA?
Collar bone
261
What is the clavicle?
Long bone with double curvature
262
What is the lateral end of the clavicle called? What does it articulate with?
Acromial extremity
Articulates with acromion of scapula
263
What does the clavicle and acromion form?
Acromioclavicular (AC) joint
264
What is the medial end of the clavicle called? What does it articulate with?
Sternal extremity
Articulates with manubrium of the sternum
265
What does the clavicle and sternum form?
Sternoclavicular (SC) joint
266
What is the main elongated portion of the clavicle called that?
Body/shaft
267
Are female clavicles shorter or longer than males?
Females have shorter and less curved clavicles
268
What is the scapula AKA?
Shoulder blade
269
What is the scapula?
Flat triangular bone that forms the posterior part of the shoulder girdle
270
What are the 3 borders of the scapula?
Medial (vertebral)
Superior
Lateral (axillary)
271
Which scapular border is closest to the vertebrae?
Medial (vertebral)
272
Which scapular border is closest to the axilla/armpit?
Lateral (axillary)
273
Which scapular border is the uppermost?
Superior
274
What are the three angles of the scapula?
Lateral
Superior
Inferior
275
Which scapular angle is where the head of the scapula (thickest part) meets the glenoid cavity (fossa)?
Lateral angle
276
Which scapular angle is where the superior border and medial border meet?
Superior angle
277
Which scapular angle is where the medial and lateral borders meet?
Inferior angle
278
What is the joint where the head of the humerus articulates with the glenoid cavity of the scapula?
Scapulohumeral (shoulder or glenohumeral) joint
279
What is the constricted area between the head and body of the scapula?
Neck
280
What is the body (blade) of the scapula?
The mid-portion of the scapula.
281
What is the costal surface of the scapula?
The anterior (ventral) surface.
282
What is the subscapular fossa?
A large concavity or depression on the costal surface.
283
What is the acromion?
A long curved process extending laterally over the head of the humerus.
284
What is the coracoid process?
A thick, beak-like process projecting anteriorly beneath the clavicle.
285
What is the scapular notch?
A notch on the superior border formed by the base of the coracoid process.
286
What is the spine of the scapula?
A prominent structure on the posterior surface, starting at the vertebral border and ending at the acromion.
287
What is the crest of the scapula?
A thickened ridge on the spine separating the posterior surface into the infraspinous fossa and supraspinous fossa.
288
What forms the upper part of the “Y” in the lateral scapula view?
Coracoid process anteriorly and acromion process posteriorly.
289
What forms the bottom leg of the “Y”?
The body of the scapula.
290
When is the scapular “Y” performed?
When dislocation of the humerus is suspected.
291
What indicates anterior shoulder dislocation?
Humeral head is inferior to the coracoid process.
292
What indicates posterior shoulder dislocation?
Humeral head is inferior to the acromion process.
293
What type of joint is the scapulohumeral (glenohumeral) joint?
Spheroidal (ball-and-socket), diarthrodial, synovial, freely movable.
294
What movements does the scapulohumeral joint allow?
Flexion, extension, abduction, adduction, circumduction, medial/lateral rotation.
295
Which joint dislocates most often in the body?
The shoulder (scapulohumeral joint).
296
What type of joint is the sternoclavicular (SC) joint?
Gliding or double plane joint; diarthrodial, synovial, freely movable.
297
What type of joint is the acromioclavicular (AC) joint?
Gliding or plane joint; diarthrodial, synovial, freely movable.
298
Should a trauma patient be asked to rotate their arm?
No, not if trauma or fracture is suspected.
299
What are routine non-trauma humerus views?
AP External and AP Internal rotation.
300
Which places the humerus AP in anatomic position- external or internal rotation?
External rotation of shoulder
301
Which places the humerus in a true lateral position- external or internal rotation?
Internal rotation of shoulder
302
What does external rotation of the humerus demonstrate?
Greater tubercle in profile laterally
303
How does external rotation of the should shoulder place humeral epicondyles in relation to the IR?
Epicondyles parallel to IR
304
What does internal rotation of the humerus demonstrate?
Lesser tubercle in profile medially
305
How does internal rotation of the should shoulder place humeral epicondyles in relation to the IR?
Epicondyles perpendicular to IR
306
What is a neutral rotation of shoulder orient the humerus as?
Oblique
307
What is neutral rotation used for?
Trauma cases where the arm cannot be rotated
308
How does neutral shoulder place humeral epicondyles in relation to the IR?
45 degrees
309
What is an AC dislocation?
Distal clavicle displaced, usually from a fall.
310
What is bursitis?
Inflammation of the bursa, causing pain and limited movement.
311
What is a rotator cuff tear?
Traumatic injury to rotator cuff muscles, causing limited range of motion.
312
Basic shoulder routine
AP External, AP Internal
313
Trauma shoulder projections
AP Neutral, Scapular Y
314
Basic clavicle routine
AP, AP Axial (15–30°)
315
Basic scapula routine
AP, Anterior Oblique Lateral Y
316
Basic acromioclavicular (AC) joint routine
AP Bilateral, with & without weights
317
What should we do after taking pics without weights for AC joints?
Check with rad before adding weights in case of fx
318
What is the IR size for AC joints?
14x17 crosswise (to get both joints in 1 pic)
319
SID for AC joints
72"
320
Where is the CR for AC joints
1" above jugular notch
321
Why weights for AC joints
Demonstrates acromioclavicular joint separation
322
IR size for AP and lateral scapula
10x12 lengthwise
323
SID for scapula
40"
324
AP Scapula position
Erect or supine
Arm abducted 90 deg
Hand supinated + salute
325
Is there a breathing technique for scapula?
Yes
326
Position lateral scapula for body
Erect (non trauma)
Anterior oblique position like "Y"
Affected arm brought across to unaffected shoulder
327
Position lateral scapula for acromion and coracoid processes
Erect (non trauma)
Anterior oblique position like "Y"
Flex elbow and place arm behind back
328
IR size for clavicle
10x12 lengthwise
329
SID for clavicle
40"
330
Position for clavicle
Erect or supine, arms at sides, chin raised
331
CR for AP clavicle
Perpendicular to mid clavicle
332
CR for AP axial clavicle
CR angled 15-30 deg cephalad/cephalic and directed to mid-clavicle (15 for hypersthenic, 30 for hyposthenic)
333
Why axial projection clavicle?
Throws clavicles above lung field. Allows for 90 degree different projection from AP
334
What is the patient’s position for the inferosuperior axial projection?
Supine, with head turned away from the side of interest.
335
How is the arm positioned for the inferosuperior axial projection?
Abducted 90°.
336
Where is the IR placed for the inferosuperior axial projection?
On top of the patient’s shoulder, against the neck.
337
How is the CR directed for the inferosuperior axial projection?
Horizontal, angled medially 25–30°, entering the axilla.
338
What anatomy is demonstrated in the inferosuperior axial projection?
Lateral view of the proximal humerus in relation to the glenoid cavity.
339
How much is the patient rotated in the Grashey method?
35–45° posterior oblique.
340
Which side is closest to the IR in the Grashey method?
The affected side.
341
What is the arm position in the Grashey method?
Neutral.
342
What anatomy does the Grashey method demonstrate?
The glenoid cavity.
343
Which side of the patient is placed against the bucky in the Lawrence method?
The affected side.
344
What should the patient do with the unaffected arm in the Lawrence method?
Lift it above the head and rotate it anteriorly.
345
Where is the CR directed in the Lawrence method?
To the surgical neck of the affected humerus.
346
What is the arm position of the affected side in the Lawrence method?
Neutral.
347
What technique should be used for exposure in the Lawrence method?
Breathing technique (inspiration).
348
What anatomy does the Lawrence method demonstrate?
Lateral view of the proximal humerus through the thorax.
349
How much is the patient rotated for the scapular 'Y' view?
45–60° anterior oblique.
350
Which side is closest to the IR in the scapular 'Y' view?
The affected side.
351
How do you find the correct patient rotation for the scapular 'Y'?
Palpate the medial border of the scapula and rotate until scapula is lateral.
352
Where is the CR directed in the scapular 'Y' view?
To the shoulder joint.
353
What condition is the scapular 'Y' most often used to evaluate?
Shoulder dislocations.
