Humerus Lateral X-ray Positioning and Anatomy Quiz

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Questions and Answers

What is the recommended minimum SID for the AP projection—external rotation shoulder?

30 cm

40 inches (correct)

75 kV range

24 × 30 cm

In what position should the patient be for the radiograph?

Sitting

Erect or supine (correct)

Prone

Lateral

How should the arm be positioned for the AP projection—external rotation shoulder?

Fully extend the arm; keep hand pronated

Abduct extended arm slightly; externally rotate arm (supinate hand) (correct)

Keep arm close to the body; internally rotate arm

Flex the arm at 90 degrees; keep hand neutral

Where should the CR be directed for the AP projection—external rotation shoulder?

1 inch (2.5 cm) inferior to coracoid process Signup and view all the answers

What anatomy is demonstrated in the AP projection of proximal humerus?

Proximal humerus and lateral two-thirds of clavicle and upper scapula Signup and view all the answers

What is evidenced by greater tubercle visualized in full profile on the lateral aspect of the proximal humerus in the AP projection?

Full external rotation Signup and view all the answers

In an antero-posterior X-ray of the humerus shaft, how should the arm be positioned?

Slightly abducted with the elbow joint fully extended Signup and view all the answers

Where should the central ray be directed for a lateral X-ray of the humerus shaft?

Right-angles to the shaft of the humerus Signup and view all the answers

What is the essential image characteristic for an antero-posterior X-ray of the humerus shaft?

Both shoulder and elbow joints should be seen Signup and view all the answers

How should the patient be positioned for an antero-posterior X-ray of the humerus shaft?

Supine on the X-ray table Signup and view all the answers

What is the clinical indication for a lateral X-ray of the humerus shaft?

To obtain a true lateral projection when arm is immobilized Signup and view all the answers

Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?

Underneath the affected limb Signup and view all the answers

How should the forearm be immobilized for an antero-posterior X-ray of the humerus shaft?

With the elbow joint flexed and wrist in neutral position Signup and view all the answers

What is the purpose of the lateral X-ray projection for the shoulder?

To evaluate the glenohumeral joint space and the lateral aspect of the scapula Signup and view all the answers

How is the AP projection different when taken with the patient lying supine on the trolley?

The patient's position is supine instead of standing Signup and view all the answers

When is a lateral oblique 'Y' projection used?

When arm abduction is not possible Signup and view all the answers

What does the antero-posterior (modified) – Stryker’s projection demonstrate?

Deformity of the humeral head Signup and view all the answers

What forms the acromioclavicular joint?

The lateral part of clavicle and acromion Signup and view all the answers

Where is the scapula bone located?

Posterior to the chest wall Signup and view all the answers

What are the main parts of the scapula bone?

Acromion, glenoid cavity, and coracoid process Signup and view all the answers

What consists of the humerus bone?

Head, neck, greater tubercle, and lesser tubercle Signup and view all the answers

What does lateral projection evaluate?

Glenohumeral joint space and lateral aspect of scapula Signup and view all the answers

What does AP projection demonstrate when taken with patient lying supine on trolley?

The patient's position is supine instead of standing Signup and view all the answers

What is the clinical indication for the AP projection—internal rotation shoulder (nontrauma)?

Fractures or dislocations of proximal humerus and shoulder girdle Signup and view all the answers

Where should the central ray (CR) be directed for the AP projection—internal rotation shoulder?

1 inch (2.5 cm) inferior to coracoid process Signup and view all the answers

What is evidenced by full internal rotation position in the AP projection—internal rotation shoulder?

Greater tubercle visualized in full profile on the medial aspect of the humeral head Signup and view all the answers

What is the recommended minimum Source-to-Image Distance (SID) for the AP projection—internal rotation shoulder?

40 inches (102 cm) Signup and view all the answers

What does the lateral view of proximal humerus and lateral two-thirds of clavicle demonstrate in the AP projection—internal rotation shoulder?

Anatomy Demonstrated: Lateral view of proximal humerus and lateral two-thirds of clavicle and upper scapula is demonstrated, including the relationship of the humeral head to the glenoid cavity. Signup and view all the answers

What should be done with respiration during exposure for the AP projection—internal rotation shoulder?

Suspend respiration during exposure. Signup and view all the answers

How should the patient's arm be positioned for the AP projection—internal rotation shoulder?

Abduct extended arm slightly; internally rotate arm (pronate hand) until epicondyles of distal humerus are perpendicular to IR. Signup and view all the answers

What forms an outline visualized superimposed over the humeral head in full internal rotation position in AP projection—internal rotation shoulder?

An outline of the greater tubercle Signup and view all the answers

What is shielded outside region of interest for AP projection—internal rotation shoulder?

All radiosensitive tissues outside region of interest. Signup and view all the answers

Where should patient be positioned for radiograph during AP projection—internal rotation shoulder?

Patient in an erect or supine position. Signup and view all the answers

What is the main purpose of the lateral X-ray projection for the shoulder?

To evaluate the proximal humerus and shoulder joint Signup and view all the answers

Where is the acromion located in relation to the scapula bone?

Superior anterior aspect Signup and view all the answers

Which joint does the lateral part of the clavicle articulate with?

Acromioclavicular joint Signup and view all the answers

What is the function of the coracoid process of the scapula bone?

Attachment site for muscles and ligaments Signup and view all the answers

Which part of the scapula bone is located at the superior anterior aspect?

Acromion Signup and view all the answers

What bones make up the elbow joint?

Humerus, radius, ulna Signup and view all the answers

How should the arm be positioned for an antero-posterior X-ray of the humerus shaft?

Extended fully with the palm facing upwards Signup and view all the answers

Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?

Under the elbow joint Signup and view all the answers

What is the essential image for an antero-posterior X-ray of the humerus shaft supposed to demonstrate?

Distal third of humerus and proximal third of radius and ulna Signup and view all the answers

What position should the patient be in for a lateral projection of elbow?

Seated alongside the table with affected side nearest to table Signup and view all the answers

How should the elbow be positioned for a lateral projection of elbow?

Flexed to 90 degrees with palm rotated to face upwards Signup and view all the answers

Where should the central ray be centered for antero-posterior X-ray of elbow joint?

Through joint space 2.5 cm distal to midway between medial and lateral epicondyles of humerus Signup and view all the answers

How is the limb immobilized during antero-posterior X-ray of elbow joint?

Using sandbags Signup and view all the answers

What does lateral projection of elbow demonstrate?

Proximal third of radius and ulna bone Signup and view all the answers

Where should the central ray be directed for lateral projection of elbow?

Through radial head and neck at mid-elbow joint level Signup and view all the answers

What is the anatomical position?

Standing with head, eyes, and toes pointing forward, feet together, and arms by the side Signup and view all the answers

What type of plane divides the body into right and left sides?

Sagittal plane Signup and view all the answers

What movement term describes 'away from the midline of the body or body part'?

Abduction Signup and view all the answers

Which term means 'closer to the origin of the body part or the point of attachment of a limb to the trunk'?

Proximal Signup and view all the answers

'Hyperextension' refers to:

Increase in the angle of joint or straightening of a joint Signup and view all the answers

What is the term for 'movement toward the midline of the body or body part'?

Adduction Signup and view all the answers

Which term means 'towards or at front of the body'?

Anterior (ventral) Signup and view all the answers

What does 'superficial' mean in anatomical terms?

Towards or at the body surface Signup and view all the answers

What is 'transverse plane' also known as?

Horizontal plane (axial plane) Signup and view all the answers

'Lateral' refers to being:

Away from the midline of the body (on the outer side) Signup and view all the answers

'Axial plane' divides the body into:

Anterior and posterior portions Signup and view all the answers

Study Notes

The text describes various X-ray projection techniques for imaging the shoulder region, including the lateral, antero-posterior (AP), and oblique projections.
The lateral projection is used to evaluate the glenohumeral joint space, the head of the humerus, the greater and lesser tuberosities, and the lateral aspect of the scapula. The patient stands with the affected shoulder against an erect cassette, the arm is abducted and rotated outwards, and the cassette is positioned to include the superior border of the scapula. The horizontal central ray is directed towards the medial border of the scapula and centred to the head of the humerus.
The AP projection is used to demonstrate the glenoid cavity and joint space when the body of the scapula is parallel to the cassette. In the erect position, the patient stands with the affected shoulder against the cassette and is rotated approximately 30 degrees to bring the plane of the glenoid fossa perpendicular to the cassette. The cassette is positioned so that its upper border is at least 5 cm above the shoulder. The horizontal central ray is centred to the palpable coracoid process of the scapula and collimated to an 18-24 cm cassette. The image should clearly show the joint space between the head of the humerus and the glenoid cavity, and the head, greater and lesser tuberosities, lateral aspect of the scapula, and the distal end of the clavicle.
In cases where the patient cannot be examined in the erect position due to multiple trauma or immobility, the AP projection is taken with the patient lying supine on the trolley. The upper border of the cassette is positioned at least 5 cm above the shoulder, and the vertical central ray is centred to the palpable coracoid process of the scapula. The subacromial space should be visible and the proximal end of the humerus, the lateral aspect of the scapula, and the whole of the clavicle need to be included.
A lateral oblique ‘Y’ projection is taken when the arm is immobilized and no abduction of the arm is possible. The patient stands or sits with the lateral aspect of the injured arm against an erect cassette, and the horizontal central ray is directed towards the medial border of the scapula and centred to the head of the humerus. This projection is used in recurrent dislocation, along with the antero-posterior with the humerus lateral, antero-posterior with the humerus oblique, and infero-superior projections.
The antero-posterior (modified) – Stryker’s projection is used to demonstrate a deformity of the humeral head. The patient lies supine on the X-ray table, and the arm of the affected side is extended fully and the elbow then flexed to allow the hand to rest on the patient’s head. The line joining the epicondyles of the humerus remains parallel to the tabletop, and the centre of the cassette is positioned 2.5 cm superior to the head of the humerus. The central ray is angled 10 degrees cranially and directed through the centre of the axilla to the head of the humerus and the centre of the cassette. This projection is used in the diagnosis of various shoulder conditions.
The text also mentions the simple anatomical structure of the shoulder region, including the clavicle, scapula, and humerus bones, and their respective joints. The lateral part of the clavicle articulates with the acromion, forming the acromioclavicular joint, while the medial third articulates with the sternum, forming the sternoclavicular joint. The scapula bone has a triangular shape and is located posterior to the chest wall. Its main parts include the acromion, glenoid cavity, and coracoid process. The humerus bone consists of the head, neck, greater tubercle, and lesser tubercle.

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Test your knowledge of the anatomy and X-ray positioning of the humerus shaft with this quiz. Learn about the clinical indications and techniques for capturing X-rays of the humerus shaft.

Humerus Shaft Anatomy and X-ray Positioning Quiz

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Questions and Answers

What is the recommended minimum SID for the AP projection—external rotation shoulder?

In what position should the patient be for the radiograph?

How should the arm be positioned for the AP projection—external rotation shoulder?

Where should the CR be directed for the AP projection—external rotation shoulder?

What anatomy is demonstrated in the AP projection of proximal humerus?

What is evidenced by greater tubercle visualized in full profile on the lateral aspect of the proximal humerus in the AP projection?

In an antero-posterior X-ray of the humerus shaft, how should the arm be positioned?

Where should the central ray be directed for a lateral X-ray of the humerus shaft?

What is the essential image characteristic for an antero-posterior X-ray of the humerus shaft?

How should the patient be positioned for an antero-posterior X-ray of the humerus shaft?

What is the clinical indication for a lateral X-ray of the humerus shaft?

Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?

How should the forearm be immobilized for an antero-posterior X-ray of the humerus shaft?

What is the purpose of the lateral X-ray projection for the shoulder?

How is the AP projection different when taken with the patient lying supine on the trolley?

When is a lateral oblique 'Y' projection used?

What does the antero-posterior (modified) – Stryker’s projection demonstrate?

What forms the acromioclavicular joint?

Where is the scapula bone located?

What are the main parts of the scapula bone?

What consists of the humerus bone?

What does lateral projection evaluate?

What does AP projection demonstrate when taken with patient lying supine on trolley?

What is the clinical indication for the AP projection—internal rotation shoulder (nontrauma)?

Where should the central ray (CR) be directed for the AP projection—internal rotation shoulder?

What is evidenced by full internal rotation position in the AP projection—internal rotation shoulder?

What is the recommended minimum Source-to-Image Distance (SID) for the AP projection—internal rotation shoulder?

What does the lateral view of proximal humerus and lateral two-thirds of clavicle demonstrate in the AP projection—internal rotation shoulder?

What should be done with respiration during exposure for the AP projection—internal rotation shoulder?

How should the patient's arm be positioned for the AP projection—internal rotation shoulder?

What forms an outline visualized superimposed over the humeral head in full internal rotation position in AP projection—internal rotation shoulder?

What is shielded outside region of interest for AP projection—internal rotation shoulder?

Where should patient be positioned for radiograph during AP projection—internal rotation shoulder?

What is the main purpose of the lateral X-ray projection for the shoulder?

Where is the acromion located in relation to the scapula bone?

Which joint does the lateral part of the clavicle articulate with?

What is the function of the coracoid process of the scapula bone?

Which part of the scapula bone is located at the superior anterior aspect?

What bones make up the elbow joint?

How should the arm be positioned for an antero-posterior X-ray of the humerus shaft?

Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?

What is the essential image for an antero-posterior X-ray of the humerus shaft supposed to demonstrate?

What position should the patient be in for a lateral projection of elbow?

How should the elbow be positioned for a lateral projection of elbow?

Where should the central ray be centered for antero-posterior X-ray of elbow joint?

How is the limb immobilized during antero-posterior X-ray of elbow joint?

What does lateral projection of elbow demonstrate?

Where should the central ray be directed for lateral projection of elbow?

What is the anatomical position?

What type of plane divides the body into right and left sides?

What movement term describes 'away from the midline of the body or body part'?

Which term means 'closer to the origin of the body part or the point of attachment of a limb to the trunk'?

'Hyperextension' refers to:

What is the term for 'movement toward the midline of the body or body part'?

Which term means 'towards or at front of the body'?

What does 'superficial' mean in anatomical terms?

What is 'transverse plane' also known as?

'Lateral' refers to being:

'Axial plane' divides the body into:

Study Notes

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