RAD111 CH5 Projections angles

How should the hand be rotated for routine AP humerus projection

Supinated/external rotation

What is the breathing technique for AP humerus routine

Suspend respiration

How should the hand be rotation for routine AP rotational lateral of humerus projection

Back of hand against the hip/ internally rotated

What is the breathing technique for routine AP rotational lateral

Suspend during respiration

Distal humerus angle and pt position

Pt recumbent, Horizontal beam, elbow at 90 degrees

What is the breathing technique for distal humerus

Suspend respiration

What is the angle for transthoracic lateral humerus

0

What is the breathing technique for transthoracic lateral humerus

Orthostatic. Minimum of 3 seconds exposure but 4-5 seconds is preferred

What position is the patients affected arm in transthoracic lateral humerus

Neutral rotation, shoulder dropped and opposite arm raised above head

What do you center to for a transthoracic lateral humerus

Midiaphysis

If the patient is too weak or in too much pain to elevate uninjured arm and what angle should you use for the CR for transthoracic lateral projection of humerus

10-15 degrees CEPHALAD

How should the hand be rotated for shoulder AP external rotation

Hand should be in anatomical position

What should you center to for a routine shoulder AP external rotation

1 inch inferior to Coracoid process

OR

2 inches below the lateral portion of the AC joint

How should the hand be rotated for a shoulder internal rotoation for the lateral view

Back of hand should be against the hip

What should you center to for a routine shoulder internal rotation AP lateral view

1 inch inferior to coracoid process

OR 2inches below AC joint

What's another name for the Lawerence method of the shoulder

Inferiosuperior axial projection

What pathology is determined in the Lawerence method

Hill-Sachs's defect with exaggerated rotation of affected limb

Osteoarthritis

What angle do you use for the Lawerence method

Medially 25-30 degrees, centered horizontally to axilla and humeral head

If the abduction of the arm is less than 90 degrees how should you angle the CR for Lawerence method

CR angle should be decreased to 15-20 degrees

What is the PT position for the Lawrence method

Supine, with shoulder at 90 degrees abducted, hand externally rotated

What's the alternative method for the Lawerence method

Exaggerated external rotation. The thumb is pointed down posteriorly 45 degrees

What's the breathing technique for the Lawerence method

Suspend respiration

What is clinical indication for the Clement's method

Hill-Sachs's defect

Osteoarthritis

What is another name for Clement's method

Inferiosuperior axial shoulder

What angles are used for Clement's modification

Arm abducted 90 degrees

CR perpendicular to IR (btw shoulder and neck)

If the pT can't reach 90 degrees for the Clement's modification, what angle should you use

5-15 degrees toward axilla

What's the breathing technique for Clement's method

Suspend respiration

What's another name for the modificed bernageau method

PA axial transaxillary shoulder

What clinical indications for modified berngeau method

Fractures or dislocations of prox humerus

Bursitis, shoulder impingement

What is the PT position for modified berngeau method

Erect with arm raised 160-180 degrees, head turned away

What angles are used in the modified berngeau method

Body positioned 70 degrees from PA toward affected side

CR is 30 degrees caudadly centered at creases of arm

What is the superoinferior transaxillary shoulder used for

Fractures and dislocations of proximal humerus

Bursitis and shoulder impingement

PT position for superoinferior transaxillary shoulder

Seated at end of table, elbow flexed 90 degrees, leaning laterally, head turned opposite away

What angles are used for the superoinferior transaxillary shoulder

Perpendicular to glenoid fossa

OR

5-15 degrees toward elbow

What is respiration for superoinferior transaxillary shoulder

Suspend

What's another name for the grashey method

AP oblique shoulder

What does the grashey method show

glenoid cavity + fractures of glenoid labrum or brim

Bankart lesion, erosion of glenoid rim

What angles are used for the grashey method

35-45 degrees body rotated toward affected side.

Clinical indications for apical AP axial

Acromiohumeral space and spurring of anteroinferior aspect of acromion. Shoulder impingement

PT position for apical AP axial shoulder

Pt erect

Part position for apical AP axial shoulder

Extend arm

Hand in neutral position

CR for Apical AP axial shoulder

30 degrees caudal angle

Anatomy demonstrated for Apical AP axial shoulder

Acromion process and acromiohumeral joint space

Another name for the Fisk modification

Tangential intertubular (bicpital) sulcus shoulder

Clinical indications for disk modification

Intertubuluar sulcus groove of bony spurs of humeral tubercles

PT position for erect (Fisk modification)

Pt standing leaning over table

Elbow flexed

Hand supinated holding onto IR

Head turned away from affected side

PT leaning forward placing humerus 10-15 degrees from vertical

PT position for supine Fisk

PT supine

Arm at side

Hand supinated

Vertical IR on table against top of shoulder and against neck (head turned against top of shoulder

CR for supine FIsk

10 to 15 degrees posterior from horizontal directed at groove

Why is a neutral rotation used for an AP shoulder

When the PT is too injured or in pain to move the shoulder

What does the transthoracic lateral (proximal humerus) Lawerence method show

Fractures or dislocations of proximal humerus

What breathing method should you used for transthoracic lateral shoulder

Orthostatic

what is the projection for the scapular Y lateral shoulder

PA oblique

Clinical indications for scapular Y lateral

Humeral head shown inferior to coracoid process w anterior dislocation for less common posterior dislocation humeral head demonstrated inferior to acromion process

Another name for the neer method

Tangential supraspinatus outlet shoulder

Clinical indications for neer method

Demonstrates coracoacromial arch for supraspinatus outlet region for possible shoulder impingement

Angle for neer method

10-15 degrees caudal angle

Another name for the Garth method

AP apical oblique axial projection

Clinical indications for Garth method

Scapulohumeral dislocation especially posterior dislocations,

Glenoid process fractures,

Hill-Sachs lesions

Angles for Garth Method

45 degree caudad of CR

Body rotated 45 degrees toward affected side (posterior surface against board)

What is the angle for the AP axial clavicle

15-30 cephalic angle

What is the angle for the zanca method (Ac joints)

10-15 degree cephalic angle

The zanca method uses 50% less _______ than a standard glenohumeral exposure to better visualize soft tissue

Kilovtalage kvetch

What is the CR for AP scapula

2" inferior to coracoid process

2" medial from lateral border of patient

What breathing technique does the AP scapula use

Orthostatic breathing or suspend breathing

In lateral scapula, how should the PT position their arm to see the scapular body in view

Arm should reach for the non affected shoulder on the opposite side

In lateral scapula, how should the PT position their arm to see the acromion and coracoid process

Arm placed on their back