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Questions and Answers
What is the name of the structure directly below the anatomic neck on the anterior surface of the proximal humerus?
What is the name of the structure directly below the anatomic neck on the anterior surface of the proximal humerus?
- Deltoid tuberosity
- Surgical neck
- Lesser tubercle (correct)
- Greater tubercle
Which of the following structures is not part of the proximal humerus anatomy?
Which of the following structures is not part of the proximal humerus anatomy?
- Deltoid tuberosity
- Capitulum
- Trochlea
- Coronoid process (correct)
Which joint connects the scapula to the humerus?
Which joint connects the scapula to the humerus?
- Elbow joint
- Acromioclavicular joint
- Radioulnar joint
- Scapulohumeral joint (correct)
What is the term for the rough raised elevation along the anterolateral surface of the humerus body where the deltoid muscle attaches?
What is the term for the rough raised elevation along the anterolateral surface of the humerus body where the deltoid muscle attaches?
Which fat pad is located posteriorly in relation to the humerus?
Which fat pad is located posteriorly in relation to the humerus?
Which part of the humerus is located at the uppermost end and articulates with the glenoid cavity?
Which part of the humerus is located at the uppermost end and articulates with the glenoid cavity?
What is the function of the olecranon fossa?
What is the function of the olecranon fossa?
Which two epicondyles on the distal humerus provide muscle attachment?
Which two epicondyles on the distal humerus provide muscle attachment?
What structure on the humerus serves as a groove for the biceps tendon?
What structure on the humerus serves as a groove for the biceps tendon?
The trochlea of the humerus articulates with which bone?
The trochlea of the humerus articulates with which bone?
In an AP (anterior) view of the distal humerus, which feature is NOT typically visible?
In an AP (anterior) view of the distal humerus, which feature is NOT typically visible?
Which projection is primarily used to visualize the lateral condyle of the humerus?
Which projection is primarily used to visualize the lateral condyle of the humerus?
Which part of the humerus is located between the head and the greater tubercle?
Which part of the humerus is located between the head and the greater tubercle?
Which bones make up the shoulder girdle?
Which bones make up the shoulder girdle?
What term refers to the lateral border of the scapula?
What term refers to the lateral border of the scapula?
What is the name of the shallow depression at the end of the lateral angle of the scapula?
What is the name of the shallow depression at the end of the lateral angle of the scapula?
What is the primary function of the shoulder girdle?
What is the primary function of the shoulder girdle?
What is the recommended arm position for the AP projection of the scapula?
What is the recommended arm position for the AP projection of the scapula?
Which of the following structures is located on the anterior surface of the scapula?
Which of the following structures is located on the anterior surface of the scapula?
Which projection is best suited to demonstrate the coracoacromial arch?
Which projection is best suited to demonstrate the coracoacromial arch?
What does the term 'axilla' refer to in relation to the shoulder anatomy?
What does the term 'axilla' refer to in relation to the shoulder anatomy?
In the lateral projection of the scapula, how should the patient position their arm?
In the lateral projection of the scapula, how should the patient position their arm?
Which of the following describes the position of the inferior angle of the scapula?
Which of the following describes the position of the inferior angle of the scapula?
What is the central ray orientation for the lateral scapula projection?
What is the central ray orientation for the lateral scapula projection?
The spine of the scapula separates the posterior surface into which two fossae?
The spine of the scapula separates the posterior surface into which two fossae?
Which factor does NOT contribute to optimal exposure in scapula projections?
Which factor does NOT contribute to optimal exposure in scapula projections?
What is another term for the mid area of the costal surface of the scapula?
What is another term for the mid area of the costal surface of the scapula?
Which of these options indicates the proper degree of body rotation for a posterior oblique position (Grashey method)?
Which of these options indicates the proper degree of body rotation for a posterior oblique position (Grashey method)?
Which part of the humerus is positioned most distally?
Which part of the humerus is positioned most distally?
What is the position of the proximal humerus during external rotation?
What is the position of the proximal humerus during external rotation?
Which positioning consideration is recommended when the measurement is greater than 10 cm?
Which positioning consideration is recommended when the measurement is greater than 10 cm?
During the AP projection of the humerus, where should the epicondyles be positioned relative to the IR?
During the AP projection of the humerus, where should the epicondyles be positioned relative to the IR?
For a true lateral projection of the humerus, which structure should be seen in profile medially?
For a true lateral projection of the humerus, which structure should be seen in profile medially?
What is recommended when performing a horizontal beam lateral projection for trauma?
What is recommended when performing a horizontal beam lateral projection for trauma?
In the lateral projection of the humerus, how should the arm be positioned?
In the lateral projection of the humerus, how should the arm be positioned?
What is the purpose of the orthostatic breathing technique in transthoracic lateral projection of the humerus?
What is the purpose of the orthostatic breathing technique in transthoracic lateral projection of the humerus?
What should be avoided if a fracture or dislocation is suspected during an imaging procedure?
What should be avoided if a fracture or dislocation is suspected during an imaging procedure?
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Study Notes
Humerus Anatomy and Imaging
- The humerus is the longest and largest bone in the upper extremity, approximately 1/5 of an adult's height.
- It articulates with the scapula at the shoulder joint and with the radius and ulna at the elbow joint.
- Proximal humerus features include the head, anatomical neck, surgical neck, greater tubercle, lesser tubercle, and intertubercular groove.
- Distal humerus features include the medial epicondyle, lateral epicondyle, olecranon fossa, coronoid fossa, radial fossa, capitulum, and trochlea.
- Routine humerus projections include AP and lateral views. Special trauma projections include horizontal beam lateral and transthoracic lateral views.
- AP projection demonstrates greater tubercle in profile laterally, humeral head partially in profile medially, and minimal glenoid cavity superimposition.
- Lateral projection shows epicondyles superimposed and lesser tubercle in profile medially. Three concentric arcs (trochlear sulcus, capitulum & trochlea ridges, trochlear notch of ulna) indicate a good lateral view. Two fat pads (anterior and posterior) and the supinator fat stripe are also visible.
- Neutral rotation of the humerus places the proximal humerus in an oblique position; external rotation results in a true AP position; internal rotation yields a lateral position.
Proximal Humerus Positioning Considerations
- Use a 40 SID with or without a grid (use grid for thicknesses exceeding 10cm).
- Accurate centering and collimation are crucial.
- Clinical indications for humerus imaging include fractures, dislocations, and pathologies like osteoporosis.
Distal Humerus Review
- The ulna is located on the medial (5th digit) side; the radius is on the lateral (1st digit) side.
- The three fossae of the distal humerus are the olecranon fossa, coronoid fossa, and radial fossa.
- The trochlea articulates with the ulna; the capitulum articulates with the radius.
Scapula Anatomy and Imaging
- The scapula (shoulder blade) has three borders (superior, lateral/axillary, medial/vertebral) and three angles (superior, inferior, lateral/head).
- The glenoid cavity (fossa) of the scapula forms the shoulder joint with the head of the humerus.
- Anterior features include the neck, body (with costal/ventral surface and subscapular fossa), acromion, coracoid process, and suprascapular notch.
- Posterior features include the spine (with crest), supraspinous fossa, and infraspinous fossa.
- Routine scapula projections are AP and lateral (erect or recumbent). The lateral scapular view shows the body in profile and may demonstrate the coracoacromial arch (Scapular Y).
- AP scapula projection requires 90° arm abduction and hand supination. The lateral borders of the scapula should be free of ribs and lungs.
- Lateral scapula projection (erect method) requires the patient to cross their arms to fully visualize the body of the scapula; a recumbent method uses rotation to position the AC joint and superior border perpendicular to the IR.
Clavicle and AC Joints
- Further information on the clavicle and acromioclavicular (AC) joints is found in the continued chapter 5.
Quiz Questions and Answers (implied from the provided text):
- A Hill-Sachs defect is best demonstrated through an Inferosuperior axial projection with exaggerated external rotation.
- The body rotation for a posterior oblique (Grashey) method is 35° to 45°.
- The most distal humeral structure is the surgical neck.
- Another term for the mid area of the costal surface of the scapula is the subscapular fossa.
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