RAD111 Ch5 Humerus and Shoulder Girdle TXTBK Review

What does the shoulder girdle consist of?

clavicle and scapula humerus

What is the longest bone in the upper limb

Humerus

The lengths of the humerus is ________ of body height

1/5th

The humerus articulates with which bone at the shoulder joint

Scapula

Which process of the proximal humerus is lateral

Greater tubercle

Which process do the pectoralis major and supraspinatus muscle attach to on the proximal humerus

Greater tubercle

What's another name for the intertubercular sulcus

Bicipital groove

What's another name for the body of the humerus

Shaft

Which tubersoity is the roughed raised triangular elevation along the anterolateral surface of the body to which the deltoid muscle is attached

Deltoid tuberosity

Which rotation places the humerus in a true AP or anatomical position

External rotation

Which tubercle (greater or lesser) is located anteriorly and the (greater or lesser) is located laterally in a true AP projection

Lesser tubercle is located anteriorly

Greater tubercle is located laterally

The shoulder girdle consists of which 2 bones

clavicle and scapula

What is the function of the clavicle and scapula

connect each upper limb to the trunk or axial skeleton

Anteriorly, the shoulder girdle connects to the trunk at the upper ______________

Sternum

Posterirly, the connection of the shoulder girdle to the trunk is (complete or incomplete)

Incomplete because the scapula is connected to the trunk by muscles only

Each shoulder girdle and each upper limb connect at the shoulder joint between the __________ and __________

scapula and humerus

The upper margin of the scapula is at the level of the __________ posterior rib

Second

The lower margin of the scapula is at the level of the ________ posterior rib

seventh (T7)

What are the three main parts to the clavicle

acromial extremity, sternal extremity, body

The acromical extremity of the clavicle articulates with the

Acromion of the scapula AKA acromioclavicular joint

Which joint is readily palpatable in the scapula

Acromioclavicular joint (AC)

The medial or sternal extremity articulates with the

Manubrium, upper part of the sternum; AKA sternoclavicular joint

Which joint is also readily palpatable and forms the jugular notch

Sternoclavicular joint

What is the elongated portion of the clavicle between the 2 extremities

Body (shaft)

Which end of the clavicle has a flattened and downward curvature

Acromial end

Which end is more triangular in shape, broader, and directed downward

Sternal end

Males or females have a shorter and less curved clavicle

Females

Males or females have a longer, thicker, and more curved clavicle

Males

What bone forms the posterior part of the shoulder girdle, is flat triangular with three borders, three angles, and 2 surfaces

Scapula

What are the three borders of the scapula

Superior border

Medial (vertebral border)

Lateral (axillary) border

What are the three corners/angles of the scapula

Superior angle

Inferior angle

Lateral (head) angle

Which angle is the thickest and referred to as the head of the scapula. It ends laterally with the glenoid cavity

Lateral angle (head)

What articulates with the glenoid cavity of the scapula

Humeral head

The humeral head and the glenoid cavity make up the ____ joint

Scapulohumeral joint

What's another name for Scapulohumeral joint

Glenohumeral joint or shoulder joint

What are the upper and lower ends of the medial or vertebral borders of the scapula

Superior and inferior angles

What is another name for the body of the scapula

Blade

Wing

Ala

The anterior surface of the scapula is termed as the ________ because of its proximity with the ribs

Costal surface

Costa =

Rib

What is the middle area of the costal surface that presents a large concavity or depression

subscapular fossa

The acromion extends laterally or medially over the humeral head

Laterally

What is the thick beak like process that projects anteriorly under the clavicle

Coracoid process

The ____________ is a notch on the superior border that's partially formed by the base of the coracoid process

Suprascapular notch

What is the prominent structure, On the dorsal, or posterior, surface of the scapula. It starts at the vertebral border as a smooth triangular area and continues laterally to end at the acromion

Spine

What process overhangs the shoulder joint posteriorly on the scapula

Acromion

The posterior border or ridge of the spine is thickened and is termed the

Crest of spine

The crest of spine separates the posterior fossa, known as the

Infraspinous fossa (inferior)

Supraspinous fossa (superior)

The infraspinous and supraspinatus fossa serve as a attachment point for

Shoulder muscles

In the lateral view, the scapula forms the letter

Y

The lateral (axillary) border is the thicker edge or border that extends from the _____ cavity to the _______ angle

Glenoid cavity ; inferior angle

An AP projection of the scapula is taken with the arm ________________ so as to not to superimpose the scapula

Abducted

In a PA oblique scapular Y lateral projection the scapula is taken with the patient in an _____________ oblique projection

Anterior

In a PA oblique scapula Y lateral projection, The upper body is rotated until the scapula is separated from the

Rib cage

The Inferiosuperior axial projection shows the relationship of what

Humeral head and glenoid cavity (Scapulohumeral joint)

What are the three joints/articulations in the shoulder girdle

Sternocalvicular joint

Acromioclavicular joint

Scapulohumeral joint

The three shoulder girdle joints are classified as which type of joint

Synovial

Synovial joints are joints that are characterized by a ________ capsule that contains ________ fluid

Fibrous capsule; synovial fluid

The mobility type of all three joints is freely moveable, or

Diarthoridal

The Scapulohumeral/shoulder joint movement type is the

Ball-and-socket / spheroidal joint.

Ball - and- socked involve what movements

Flexion

Extension

Abduction

Addiction

Circumspection

Medial(internal)

Lateral (external) rotation

Stretching the muscles and tendons of the shoulder joint can cause

Dislocation

Dislocations occur the most in which joint

Shoulder joint

The sternoclavicular joints is what type of movement joint

Plane or gliding joint. A limited amount of gliding occur in every direction

The acromioclavicular joint is what type of movement joint

Plane or gliding joint.

What is the primary movement of the claviclular joints

Gliding

Secondary rotary movements occur as the scapula moves _________ and ___________ with the clavicle

Forward and backward which allows the scapula to adjust its positoin and remain in close contact w the posterior wall.

In an external rotation, the epicondyles are _______ to the image receptor

Parallel

In an external rotation, the greater tubercle or lesser tubercle is seen laterally in profile

Greater tubercle is seen laterally in profile

The lesser tubercle is seen medially

In an internal rotation, how is the hand positioned

The back of the hand is against the thigh

In an internal rotation, the epicondyles are ________ to the image receptor

Perpendicular/superimposed, placing the humerus in a true lateral positoin

In an internal rotation, the greater or lesser tubercle is in profile medially

The lesser tubercle is in profile medially

The greater tubercle is in profile anteriorly and medial aspect of the proximal humerus

When is a neutral rotation appropriate when the rotation of the part is unacceptable

For a patient with trauma

How do the epicondyles appear in a neutral rotation

45 degrees angle to the IR

In a neutral rotation, where is the palm rotated

Palm is facing inward world the thigh

What do the greater and lesser tubercles look like when in a neutral rotation

Greater tubercle anteriorly but still lateral to the lesser tubercle, but really can't be seen all too well.

When should a grid be used

Used when the humerus projection is preformed erect with the use of a Bucky.

Shoulders of adults usually measure 4-6 inches and the use of a grid is required

When should a grid not be used

For children and thin asthenic adults whose shoulders is less than 4 inches

Do AC joints require grid

No bc they measure less than 4 inches and require less kVp

They are still used sometimes to reduce scatter radiation

Can use of grids add or reduce patient dose

Add patient dose bc of the required increase in exposure factors

What kVp should be used for shoulder thickness greater than 4

70-85

70-75 with no grid

Should you use high mA or low mA

High mA

Should you use short or long exposure times

Short exposure times

Small focal spot or large focal spot

Small

What cell for AEC is used

Center cell

What SID should be used

40in except for AC joints (72in SID)

What compensating filter can you use

Boomerang

For AP projections of the scapula and shoulder, what permits both soft tissues and bony anatomy to be seen clearly. It's especially efficient in shows the acromion and AC joints region while allowing for optimal visualization of the denser shoulder joint regions

Boomerang filer

What shielding should you use

Gonadal

What are the radiosenstive organs that may deliver significant doses doing a shoulder radiography

Thyroid

Lung

Breasts

How can you reduce exposure to radiosenstive organs

Collimate

contact shields

For pediatric patients, should you increase or decrease the exposure techniques

Decrease to compensate for the decrease in pediatric radiography

What is the most important role in pediatric radiography

Patient motion

What might you have to do for routine humerus and shoulder girdle exams for geriatric patients

Altered to accommodate the physical condition of the older patients

Should you reduce or increase the exposure techniques for geriatric patients

Reduce because of destructive pathologies seen in geriatrics

What are the alternative palpation potions for bariatric patients

The jugular notch and AC joints

To find the Scapulohumeral joint how many inches inferior do you go from the AC joints

2 inches and .5 an inch medial

Should you use a compensating boomerang filter for AP projections of the shoulder and scapula for bariatrics

Yes because of the increased shoulder thickness. It allows for better visualization of both soft tissues and bony anatomy

Should you preform projections erect or supine for bariatric patients

Erect to reduce OID and part distortion as a result of curved shoulders

What modality is used to image soft tissues pathologies like rotator cuff tears associated wit shoulder girdle and uses contrast medium injuected into the joint capsule

Arthography

What modalit(ities) are used n on the shoulder to evaluate soft tissue and skeletal involvement of lesions and soft tissue injuries.

CT and MRI