Humerus Shaft X-ray Positioning Quiz
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Questions and Answers

What is the clinical indication for an Antero-posterior – supine X-ray of the humerus?

  • To immobilize the arm for a true lateral projection
  • To assess restricted movement of the patient's arm (correct)
  • To visualize the elbow joint in lateral position
  • To examine the shoulder joint in a standing position

    • How should the patient be positioned for an Antero-posterior – erect X-ray of the humerus?

  • Lying down with the affected limb immobilized by a sandbag
  • Rotated towards the unaffected side to bring the anterior aspect into contact with the cassette
  • Lying supine on the X-ray table with fully extended arms
  • Sitting or standing with back in contact with the cassette (correct)

    • Where should the central ray be directed for a Lateral – erect X-ray of the humerus?

  • Toward the elbow joint at a 45-degree angle
  • At an angle to visualize the shoulder joint
  • Centred midway between the shoulder and wrist joints
  • At right-angles to the shaft of the humerus (correct)

    • What is essential for an Antero-posterior – supine X-ray of the humerus to capture?

    <p>Both shoulder and elbow joints</p> Signup and view all the answers

    What is used to immobilize the forearm for an Antero-posterior – supine X-ray of the humerus?

    <p>Sandbag</p> Signup and view all the answers

    What is indicated if an arm needs to be immobilized for a true lateral projection?

    <p>Lateral – erect X-ray</p> Signup and view all the answers

    What is the purpose of the lateral projection for imaging the shoulder region?

    <p>To evaluate the glenohumeral joint space and the lateral aspect of the scapula</p> Signup and view all the answers

    How is the patient positioned for an antero-posterior (AP) projection when examined in an erect position?

    <p>With the affected shoulder against the cassette and rotated approximately 30 degrees</p> Signup and view all the answers

    When is a lateral oblique ‘Y’ projection used for imaging the shoulder region?

    <p>When arm immobilization prevents abduction of the arm</p> Signup and view all the answers

    Which part of the clavicle articulates with the acromion to form a joint?

    <p>The lateral part</p> Signup and view all the answers

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

    <p>40 inches</p> Signup and view all the answers

    How should the patient be positioned for the radiograph?

    <p>Erect or supine position</p> Signup and view all the answers

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

    <p>1 inch inferior to coracoid process</p> Signup and view all the answers

    What does full external rotation evidence in the radiograph?

    <p>Greater tubercle visualized in full profile on the lateral aspect of the proximal humerus</p> Signup and view all the answers

    What should be visible in an optimal exposure of AP projection—external rotation shoulder?

    <p>Clear, sharp bony trabecular markings with soft tissue detail visible for possible calcium deposits</p> Signup and view all the answers

    What is shielded outside the region of interest during the procedure?

    <p>Radiosensitive tissues</p> Signup and view all the answers

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

    <p>40 inches (102 cm)</p> Signup and view all the answers

    Which muscles are included in the Rotator cuff muscles?

    <p>Supraspinatus, Infraspinatus, Subscapularis</p> Signup and view all the answers

    What is the patient position for an AP projection—internal rotation shoulder?

    <p>Erect or supine position</p> Signup and view all the answers

    What is the purpose of shielding in radiography?

    <p>To protect radiosensitive tissues outside the region of interest</p> Signup and view all the answers

    What is the recommended collimation for an AP projection—internal rotation shoulder?

    <p>Collimate on four sides, with lateral and upper borders adjusted to soft tissue margins</p> Signup and view all the answers

    What is the recommended respiration status during exposure for an AP projection—internal rotation shoulder?

    <p>Suspend respiration during exposure</p> Signup and view all the answers

    Which part of the clavicle articulates with the acromion to form a joint?

    <p>Lateral part</p> Signup and view all the answers

    Where is the glenoid cavity located?

    <p>Superior anterior aspect of the scapula</p> Signup and view all the answers

    What projects from the upper margin of the scapula?

    <p>Coracoid process</p> Signup and view all the answers

    Which bone consists of head, neck, greater tubercle, and lesser tubercle?

    <p>Humerus</p> Signup and view all the answers

    What is essential for an Antero-posterior – supine X-ray of the humerus to capture?

    <p>The entire length of the humerus</p> Signup and view all the answers

    What is used to immobilize the forearm for an Antero-posterior – supine X-ray of the humerus?

    <p>Immobilizer cuff</p> Signup and view all the answers

    What is indicated if an arm needs to be immobilized for a true lateral projection?

    <p>Sandbags</p> Signup and view all the answers

    What does full external rotation evidence in a radiograph indicate?

    <p>Proper patient positioning</p> Signup and view all the answers

    When is a lateral oblique ‘Y’ projection used for imaging the shoulder region?

    <p>To visualize both shoulder dislocations and fractures</p> Signup and view all the answers

    What should be visible in an optimal exposure of AP projection—external rotation shoulder?

    <p>All three bones - clavicle, scapula, and humerus</p> Signup and view all the answers

    What is the anatomical position?

    <p>Standing erect with head, eyes, and toes pointing forward, feet together, and arms by the side</p> Signup and view all the answers

    What is the sagittal plane?

    <p>A vertical plane dividing the body into right and left sides</p> Signup and view all the answers

    What does 'abduction' refer to?

    <p>Movement away from the midline of the body or body part</p> Signup and view all the answers

    Which term describes movement toward the midline of the body or body part?

    <p>Adduction</p> Signup and view all the answers

    What is 'proximal' in anatomical terms?

    <p>Close to the origin of the body part or attachment of a limb to the trunk</p> Signup and view all the answers

    'Superficial' in anatomical terms means:

    <p>'Towards or at' the body surface</p> Signup and view all the answers

    What is 'extension' in terms of joint movement?

    <p>Increase in angle of joint or straightening of a joint</p> Signup and view all the answers

    What does 'coronal plane' divide?

    <p>The body into anterior and posterior portions</p> Signup and view all the answers

    What does 'deep' refer to in anatomical terms?

    <p>'Away from' the body surface</p> Signup and view all the answers

    Which bone articulates with the capitulum at the lateral aspect of the lower humerus?

    <p>Radius</p> Signup and view all the answers

    What is the recommended position of the arm for an antero-posterior X-ray of the elbow joint?

    <p>Fully extended with palm facing upwards</p> Signup and view all the answers

    Where should the cassette be positioned for an antero-posterior X-ray of the elbow joint?

    <p>Under the elbow joint</p> Signup and view all the answers

    What should be visible in an optimal image of lateral projection of the elbow?

    <p>Distal third of humerus and proximal third of radius and ulna</p> Signup and view all the answers

    What is the recommended direction of the vertical central ray for an AP X-ray of the elbow joint?

    <p>Centred through the joint space, 2.5cm distal to the point, midway between medial and lateral epicondyles of humerus.</p> Signup and view all the answers

    Where should the CR be directed for the lateral projection of the elbow?

    <p>Centred through olecranon fossa.</p> Signup and view all the answers

    What is essential for an optimal image in lateral projection of elbow?

    <p>Distal third of humerus and proximal third of radius and ulna.</p> Signup and view all the answers

    What is the recommended position of the patient's arm for lateral projection of the elbow?

    <p>Flexed to 90 degrees with palm rotated 90 degrees to the tabletop.</p> 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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    Related Documents

    X-Ray of the Humerus - PDF
    X-Ray of Shoulder (Non-Trauma) - Al-Kitab University 2012 PDF
    Elbow Joint X-Ray PDF

    Description

    Test your knowledge of the positioning and clinical indications for X-ray imaging of the shaft of the humerus. This quiz covers the technique for taking an antero-posterior supine view and the clinical scenarios where this imaging is necessary.

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