TEST 3 Flashcards

1
Q

A hand is displaced correctly in supination or pronation? which position?

A

pronation - PA

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2
Q

Among all 5 digits, which digit have 2 phalanges?

A

thumb - 1st digit

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3
Q

Which digit has 3 phalanges?

A

2 to 5th

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4
Q

A sesamoid bone is located near which digit?

A

1st digit

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5
Q

What is the movement for 1st CMC joint?

A

Saddle

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6
Q

List the 3 joints for 1st digit from proximal to distal

A

CMC - MCP - IP

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7
Q

The head of the metacarpal articulates with the proximal phalanx makes up which joint

A

MCP

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8
Q

The head of proximal phalanx articulates with the base of distal phalanx make up which joint?

A

1st IP joint

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9
Q

The base of distal phalanx articulates with the head of middle phalanx make up which joint?

A

DIP joint (2-5)

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10
Q

The base of the middle phalanx articulates with the head of the proximal phalanx make up which joint?

A

PIP ( 2- 5)

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11
Q

Give the movement for the following joints:
1. IP
2. MCP
3. CMC

A
  1. ginglymus
  2. ellipsoidal
  3. sellar
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12
Q

Is the movement for CMC joint different in each digit? If so, determine the movement for each of them.

A

YES

CMC in thumb: saddle (sellar)
CMC in 2-5: plane (gliding)

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13
Q

List the techniques (SID, kVp, CR, patient position, collimation includes which anatomy) for PA HAND

A

SID: 40”
kVp: 50-60
CR: 3rd MCP
Pt position: pronate hand, slightly abduct digits
Collimate: include wrist + 1” of distal forearm

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14
Q

When you are doing a PA for an AFFECTED DIGIT (2-5), where is the CR?

A

CR at PIP (2-5)

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15
Q

Can you do a PA for 1st digit? If not, what is the alternative?

A

NO due to increased OID

AP

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16
Q

Where is the CR for 1st digit

A

CR: MCP joint

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17
Q

What anatomy you should include when collimating the digits?

A

distal metacarpal

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18
Q

Which digits are taken in the Mediolateral projection?

A

2

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19
Q

Which digit/s are taken in the Lateromedial PA Oblique projection?

A

3-5

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20
Q

4 & 5th digits are taken in which projection

A

Lateromedial

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21
Q

How do you distinguish normal PA from Oblique PA for HAND ?

A

Look at head and space of/between MCP joint

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22
Q

What are the position for 1st digit

A

AP & Lateral

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23
Q

List the techniques (SID, kVp, CR, IR size, patient position, collimation includes which anatomy) for 1st DIGIT

A

SID: 40
50-60 kVp
CR: MCP
IR: 8 x 10
position:
-internally rotate & place dorsal aspect on IR (AP)
-pronate hand & rotate till lateral (L)
Collimation: 1st metacarpal & trapezium

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24
Q

What anatomy do you need to include when taking image for 1st digit

A

1st metacarpal & trapezium

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25
Q

What are 3 positions for HAND

A

PA
Oblique
Lateral

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26
Q

Where is the CR for Lateral Hand

A

2nd MCP Joint

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27
Q

Where is the CR when taking Oblique Hand

A

3rd MCP joint

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28
Q

2 positions for LATERAL HAND

A

OK SIGN
KARATE CHOP

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29
Q

List the carpals in the proximal row (from lateral to medial)

A

Scaphoid - Lunate - Triquetrum - Pisiform

Navicular - Semilunar - Triangular - Pisiform

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30
Q

List the carpals in the distal row (from lateral to medial)

A

Trapezium - Trapezoid - Capitate - Hamate

G Multangular - L Multangular - Os Magnum - Unciform

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31
Q

Which carpal bone is biggest?

A

Capitate

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32
Q

Which carpal/s articulate with the radius? ( name it from lateral to medial)

A

Scaphoid - Lunate

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33
Q

List the techniques (SID, kVp, IR size, CR) for wrist

A

SID: 40”
50 kVp
IR: 8 x 10
CR: mid carpals

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34
Q

Why CR for wrist is at mid-carpal

A

to see distal ulna & radius - identifying fracture of forearm

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35
Q

What are the positions for wrist ?

A

PA
Lateral
Oblique
Ulnar deviation
Carpal Tunnel

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36
Q

How do you tell if its a True PA for WRIST

A

separation of radius & ulna
equal space between proximal metacarpal

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37
Q

What anatomy do you need to include when collimating wrist

A

Distal radius & ulna
Mid metacarpals

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38
Q

How do you tell if its a TRUE 45 degree OBLIQUE for WRIST

A

distal radius partially superimpose ulna head

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39
Q

How do you tell if its a TRUE LATERAL for WRIST

A

Ulna head superimpose distal radius

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40
Q

What 3 carpals you can see in TRUE LATERAL

A

Capitate Trapezium Scaphoid

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41
Q

How is hand positioned for ulnar deviation?

A

evert hand toward ulna

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42
Q

What is the tube angled for ulnar deviation? Why?

A

10 - 15 proximal
elongate scaphoid

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43
Q

When patient cant perform ulnar deviation, what is the alternative?

A

PA Axial (Stecher)

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44
Q

How to position patient for PA Axial

A

elevate hand 20 degree
Place IR & hand on angled sponge
ulnar deviate (if possible)

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45
Q

For PA axial (Stecher), do we angle the tube or the patient hand ? by how much?

A

patient hand angled at 20 degree

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46
Q

For PA axial (Stecher), why do we angle the hand 20 degree?

A

so scaphoid is parallel to IR

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47
Q

PA axial (Stecher) is used for taking _____

A

WRIST

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48
Q

How do you position patient for Carpal Tunnel

A

dorsiflex hand 90 degree
rotate hand & wrist 10 degree internally (tw radial side)

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49
Q

Why do we need to rotate hand & wrist 10 degree internally for Carpal Tunnel

A

prevent superimposition of pisiform and hamate

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50
Q

Carpal Tunnel is used to see which carpals

A

hamate, pisiform, trapezium

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51
Q

For carpal tunnel, do we angle the tube or the patient hand? how much?

A

Tube
25-30 proximal tube angle

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52
Q

Where is the CR for Gaynor-Hart

A

1” distal to base of 3rd metacarpal (center of palm)

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53
Q

Radioulnar joint is distal when ____

A

closest to the wrist

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54
Q

Radioulnar joint is proximal when ____

A

closest to elbow

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55
Q

What make up the distal radioulnar joint?

A

head of ulna & ulna notch (on radius)

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56
Q

What make up the proximal radioulnar joint?

A

Head of radius + ulna at radial notch

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57
Q

List the anatomy of Distal Radius?

A

styloid process
ulnar notch
body

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58
Q

List the anatomy of Proximal Radius?

A

Head
Neck
Radial Tuberosity

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59
Q

Bicep tendon attached to which anatomy part of forearm?

A

radial tuberosity

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60
Q

Why is it important to know the position of forearm joint?

A

to make sure elbow and wrist are included for AP & Lateral

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61
Q

Ulna notch is on ___ aspect of distal radius

A

medial

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62
Q

Head of radius is ____
Head of ulna is ___

A

proximal
distal

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63
Q

Styloid process is more prominent on ____ than ___

A

ulna - radius

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64
Q

List the anatomy of Distal ulna

A

styloid process
head
body

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65
Q

List the anatomy of Proximal ulna

A

radial notch
coronoid process
coronoid tubercle
trochlear notch
olecranon process

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66
Q

Which 2 anatomic structures allow the elbow to flex & extend

A

trochlea of humerus & trochlear notch of ulna

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67
Q

During pronation, rotation of forearm include which joints?

A

distal and proximal radioulnar joint

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68
Q

What are routines/positions for forearm

A

AP & Lateral

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69
Q

kVp for forearm

A

60+

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70
Q

Why do we supinate hand for AP Forearm

A

so humeral epicondyles are parallel to IR to avoid crossing of radius and ulna

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71
Q

What anatomy should be include when collimating forearm

A

wrist & elbow

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72
Q

Why is it important that arm extended and level with table for AP Forearm

A

decreased OID

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73
Q

supination and pronation of hand is what type of movement

A

pivot

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74
Q

Describe movement of forearm when hand pronated

A

radius cross over ulna

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75
Q

how do radius and ulna look in AP Forearm with NO rotation

A

radius & ulna partially superimposed

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76
Q

how do radius and ulna look in AP Forearm with lateral rotation

A

radius & ulna are separated

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77
Q

how do radius and ulna look in AP Forearm with medial rotation

A

radius & ulna are superimposed

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78
Q

How to position patient for Lateral Forearm

A

Flex elbow 90 degree, level with table
rotate wrist into lateral

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79
Q

Why do we do Lateral Forearm

A

to make wrist & elbow lateral so we can see all bones

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80
Q

what are the articulating surface of distal humerus called

A

epicondyles

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81
Q

What are the condyles of distal humerus? give its anatomic position

A

trochlea (medial)
capitulum (lateral)

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82
Q

capitulum articulates with _____
trochlea articulate with_____
give which type of joint/movement

A

radius
ulna
ginglymus

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83
Q

What are 3 fossa of distal humerus

A

radial fossa
coronoid fossa
olecranon fossa

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84
Q

Which elbow fossa are anterior

A

radial & coronoid

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85
Q

Olecranon fossa is located posteriorly or anteriorly

A

posterior

86
Q

Describe mechanism of flexion of elbow

A

radial head +coronoid process slide into their fossa and rotate at trochlear notch

87
Q

Describe mechanism of extending of elbow

A

olecranon process slide into olecranon fossa

88
Q

What are fat pads

A

extrasynovial pads of fat, cushion between muscle and bone

89
Q

the scaphoid fat stripe is best seen on which position of the wrist

A

PA & Oblique

90
Q

what is the location of the scaphoid fat stripe for wrist

A

lateral to scaphoid and superior to radius

91
Q

the pronator fat stripe is best seen on which position of the wrist

A

Lateral

92
Q

what is the location of pronator fat stripe for wrist

A

anterior to radius

93
Q

How can the fat pads indicate pathology?

A

if there are swelling/ edema fluid within joint, the normal position is altered

94
Q

the anterior elbow fat pad is best seen on which position?
location?

A

lateral
anterior to distal humerus

95
Q

the posterior elbow fat pad is best seen on which position?
location?

A

lateral on POSITIVE image
not seen on NEGATIVE image

within olecranon fossa

96
Q

the supinator elbow fat pad is best seen on which position?
location?

A

lateral
anterior to radius

97
Q

the Sail Sign corresponds to which fat pad

A

Anterior & posterior elbow fat pad

98
Q

What happened to POSTERIOR elbow fat pad when there is trauma?

A

tricep push post fat pad out of olecranon fossa

99
Q

4 positions for Elbow

A

AP
Lateral
Internal Oblique
External Oblique

100
Q

kVp elbow

A

65+

101
Q

how to position pt for AP ELBOW

A

arm extend, level with table
supinate hand ( epi parallel w IR)

102
Q

what anatomy need to be included when collimating AP elbow

A

proximal forearm
distal humerus

103
Q

If pt cant extend their arm for a regular AP, what 2 alternate AP positions to do instead to get the elbow?

A

AP proximal forearm (forearm // IR)
AP distal humerus (humerus // IR)

104
Q

when patient cant extend their elbow fully for oblique position, what is the alternative ?

A

Coyle (Lateromedial & Mediolateral)

105
Q

Why do we do axial lateromedial for elbow

A

to see radial head

106
Q

How to position pt in axial lateromedial for elbow

A

flex elbow 90
pronate hand

107
Q

What is the tube angle for axial lateromedial (elbow)

A

45 degree toward shoulder

108
Q

What is the tube angle for axial mediolateral (elbow)

A

45 degree from shoulder

109
Q

How to position pt in axial mediolateral for elbow

A

flex elbow 80
pronate hand

110
Q

why do we do Coyle?

A

when pt cant extend elbow fully for M/L oblique

111
Q

why do we do 45 degree tube angle

A

distort distal humerus to see radial head better (?)

112
Q

which one replaced external oblique for elbow

A

mediolateral (Coyle)

113
Q

Why do we do axial mediolateral for elbow

A

to see coronoid process

114
Q

What anatomy should be seen for ELBOW internal oblique

A

trochlea & coronoid process

115
Q

What anatomy should be seen for ELBOW external oblique

A

capitulum & radial head/neck w/o superimpose

116
Q

when we are in anatomic position, which position is the elbow

A

internal oblique

117
Q

What happened to epicondyles when we pronate hand for internal oblique

A

epicondyles 45 degree to IR

118
Q

To see medial aspect of elbow, which position should the patient be in

A

internal oblique

119
Q

[Ex OB] TRUE lateral 45 degree of elbow is when ____

A

radial head/neck/tuberosity are seen
no superimposition of ulna
proximal radioulnar joint is open

120
Q

[Int OB] TRUE medial 45 degree of elbow is when ___

A

radial head superimpose proximal ulna
trochlear notch partially opens

121
Q

What are the anatomy for proximal humerus (8)

A

Head
Anatomic Neck
Greater & Lesser Tubercle
Surgical Neck
Intertubercular groove
deltoid tuberosity
body

122
Q

What is the groove between greater and lesser tubercle

A

intertubercular groove

123
Q

which part of the upper arm that articulate with the scapula to make up the shoulder joint

A

proximal humerus

124
Q

Where is lesser tubercle located

A

directly below the anatomic neck on the anterior surface

125
Q

A humerus is in a true AP when taken with ___ rotation

A

external

126
Q

in a true AP projection, the greater tubercle is located ____

A

laterally

127
Q

2 positions for humerus

A

AP & lateral

128
Q

SID & kVP for humerus

A

40
70-85

129
Q

What do we need to include when taking humerus imaging

A

Shoulder & elbow

130
Q

when epicondyles are parallel to IR, elbow is in which position

A

AP

131
Q

when epicondyles are perpendicular, elbow is in which position

A

Lateral

132
Q

Condyle of distal humerus that articulate with the radius ?

A

capitulum

133
Q

If patient have possible fractures of the arm, which 3 lateral positions would you do?

A

Erect Mediolateral
X-table lateral
Transthoracic

134
Q

in a neutral rotation, where are the G & L tubercles located

A

both are anterior

135
Q

In an internal rotation, where are the G & L tubercles located

A

G: lateral
L: medial

136
Q

In an external rotation, where are the G & L tubercles located

A

G: lateral
L: just medial to greater tubercle

137
Q

Patient is in _____ oblique for erect mediolateral position

A

anterior

138
Q

A true erect mediolateral would show the lesser tubercle ____

A

medially

139
Q

Why do we do X-table lateral

A

to see mid to distal humerus

140
Q

When do we do X-table lateral

A

when patient cant stand

141
Q

Cons of X-table lateral

A

cant get the whole humerus

142
Q

Where is the IR for X-table lateral

A

between body & arm (fig 5.34)

143
Q

Do you use a grid for X-table lateral

A

NO

144
Q

kVp for humerus

A

70-85

145
Q

Why do we do transthoracic lateral

A

to see proximal humerus

146
Q

How do you position patient for transthoracic?

A

affected side against IR
raise unaffected arm across thorax
can be either erect or supine

147
Q

Where is the CR for transthoracic

A

surgical neck

148
Q

Which lateral position MAINLY required the breathing technique

A

Transthoracic

149
Q

Why is it important to do breathing technique for Transthoracic

A

short, shallow breaths to blur out ribs & pulmonary markings

150
Q

how do you position patient for X-table lateral

A

supine
elbow flexed 90 degree

151
Q

what is the projection for X-table lateral

A

lateromedial

152
Q

What are the two bones of shoulder girdle

A

clavicle & scapula

153
Q

What is the function of clavicle & scapula

A

connect upper limb to axial skeleton

154
Q

if you do transthoracic, you got ____ of humerus

A

AP

155
Q

A scapula has
____ borders
____ angles
____ surfaces

A

3
3
2

156
Q

[scapula] The vertebral border is _

A

medial

157
Q

[scapula] The superior border is _

A

uppermost margin of scapula

158
Q

[scapula] The axillary border is _

A

lateral

159
Q

[scapula]
The costal surface is ____
The dorsal surface is ____

A

anterior
posterior

160
Q

The head of the scapula sometimes called___

A

lateral angle

161
Q

The humeral head articulates with ___

A

glenoid cavity of scapula

162
Q

What is the notch that formed by the base of coracoid process

A

suprascapular notch

163
Q

What 2 fossa served as an attachment for shoulder muscle

A

infraspinous & supraspinous fossa

164
Q

What is the movement type for SC & AC joint

A

gliding

165
Q

What 4 structures you can see in dorsal scapula

A

scapular spine
acromion
supraspinous fossa
infraspinous fossa

166
Q

What 2 structures you can see in costal scapula

A

coracoid process
scapular notch

167
Q

What make up the scapulohumeral joint

A

scapula and proximal end of humerus

168
Q

What make up the Ball & Socket for shoulder

A

Ball: head of humerus
Socket: glenoid fossa of scapula

169
Q

Majority of dislocation for shoulder happened _____

A

anteriorly

170
Q

What are the main 3 positions for shoulder & 3 alternative position

A

AP internal rotation
AP external rotation
Scapular Y

Axial
Glenoid Fossa
Transthoracic Lateral

171
Q

SID & kVp for shoulder

A

40
75 kV

172
Q

Epicondyle parallel to IR, you will see ____

A

AP of entire upper extremity ( humerus, elbow, shoulder)

173
Q

Epicondyles perpendicular to IR, you will see ____

A

Lateral view

174
Q

Epicondyles parallel to IR in AP ____ rotation

A

external

175
Q

Where is the CR for AP internal & external rotation of the shoulder

A

1” inferior to coracoid

176
Q

how do you position patient for AP external rotation

A

supinate hand
suspend respiration

177
Q

how do you position pt for AP internal rotation

A

pronate hand
suspend respiration

178
Q

AP external rotation will show ___ in profile

A

greater tubercle

179
Q

AP internal rotation will show ___ in profile

A

lesser tubercle

180
Q

If we put the epicondyles perpendicular to the IR, we will see _____ tubercle

A

lesser

181
Q

If we put the epicondyles parallel to the IR, we will see _____ tubercle

A

greater

182
Q

Where is the CR for scapula Y

A

throuh scapulohumeral joint

183
Q

What make up the two upper arm of the Y

A

lateral: acromion
medial. coracoid process

184
Q

[scapular Y] how do you know if there is no dislocation of the humerus

A

humeral head superimposed base of the Y

185
Q

Which projection start in Anterior Oblique Y

A

Tangential Projection - Supraspinatus outlet (Neer)

186
Q

[Neer] which structures are needed to be perpendicular to IR

A

superior scapular angle and AC joint

187
Q

[Neer] the superior scapular angle and AC joint need to be ____ to IR

A

perpendicualr

188
Q

Where is the. CR for Neer

A

through superior humeral head

1” superior to medial aspect of scapular spine

189
Q

What is the tube angle for Neer?

A

10 -15 caudal angle

190
Q

Why do we do Neer

A

to see the supraspinatus outlet without superimposition of humeral head

191
Q

What is the Grashey method

A

AP oblique to show glenoid cavity in profile w/o superimposition of humeral head

192
Q

How to position pt for Grashey

A

rotate body 30-45 degree posterior oblique
arm neutral with slight abduction

193
Q

Where is CR for Grashey

A

2” inferior & 2” medial from superiolateral border of shoulder

scapulohumeral join t

194
Q

Collimation of Grashey includes ___

A

upper & lateral soft tissue margins

195
Q

In neutral, you will have ____ oblique of elbow

A

internal

196
Q

WIth AP external rotation, epicodyles are ____ to IR

A

parallel

197
Q

with AP internal rotation, epicondyles are ____ to IR

A

perpendicular

198
Q

What can u see in Inferiosuperior axial projection

A

coracoid
lesser tubercle
scapular spine
humeral head

199
Q

where is the CR for Lawrence

A

through axilla

200
Q

how do you position pt for Lawrence

A

supine
abduct arm 90 degree with external rotation

201
Q

which projection is used to show the proximal humerus

A

transthoracic lateral

202
Q

2 positions for scapula imaging

A

AP & Lateral Y

203
Q

Where is the CR for AP Scapula

A

2” inferior to coracoid process

204
Q

how to position pt for AP Scapula

A

supinate hand
abduct arm 90
suspend respiration

“salute”

205
Q

2 positions for clavicle imaging

A

Ap & AP axial

206
Q

where is cr for ap clavicle

A

mid clavicle

207
Q

how is arm position in AP Clavicle

A

neutral

208
Q

where is cr for AP axial for clavicle

A

15-30 cephalad to midclavicle

209
Q

Suspended respiration for AP and AP Axial clavicle is ___

A

inspiration

210
Q

Why do we inhale for AP Clavicle

A

to elevate clavicle

211
Q

why is it important to abduct arm 90 degree for AP scapula

A

move scapula toward lateral margin
prevent superimposition of ribs & thorax

212
Q

kvp for clavicle

A

75