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Questions and Answers
What is the clinical indication for an Antero-posterior – supine X-ray of the humerus?
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?
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?
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?
What is essential for an Antero-posterior – supine X-ray of the humerus to capture?
What is used to immobilize the forearm for an Antero-posterior – supine X-ray of the humerus?
What is used to immobilize the forearm for an Antero-posterior – supine X-ray of the humerus?
What is indicated if an arm needs to be immobilized for a true lateral projection?
What is indicated if an arm needs to be immobilized for a true lateral projection?
What is the purpose of the lateral projection for imaging the shoulder region?
What is the purpose of the lateral projection for imaging the shoulder region?
How is the patient positioned for an antero-posterior (AP) projection when examined in an erect position?
How is the patient positioned for an antero-posterior (AP) projection when examined in an erect position?
When is a lateral oblique ‘Y’ projection used for imaging the shoulder region?
When is a lateral oblique ‘Y’ projection used for imaging the shoulder region?
Which part of the clavicle articulates with the acromion to form a joint?
Which part of the clavicle articulates with the acromion to form a joint?
What is the recommended minimum SID for the AP projection—external rotation shoulder?
What is the recommended minimum SID for the AP projection—external rotation shoulder?
How should the patient be positioned for the radiograph?
How should the patient be positioned for the radiograph?
Where should the CR be directed for the AP projection—external rotation shoulder?
Where should the CR be directed for the AP projection—external rotation shoulder?
What does full external rotation evidence in the radiograph?
What does full external rotation evidence in the radiograph?
What should be visible in an optimal exposure of AP projection—external rotation shoulder?
What should be visible in an optimal exposure of AP projection—external rotation shoulder?
What is shielded outside the region of interest during the procedure?
What is shielded outside the region of interest during the procedure?
What is the recommended minimum SID for the AP projection—internal rotation shoulder?
What is the recommended minimum SID for the AP projection—internal rotation shoulder?
Which muscles are included in the Rotator cuff muscles?
Which muscles are included in the Rotator cuff muscles?
What is the patient position for an AP projection—internal rotation shoulder?
What is the patient position for an AP projection—internal rotation shoulder?
What is the purpose of shielding in radiography?
What is the purpose of shielding in radiography?
What is the recommended collimation for an AP projection—internal rotation shoulder?
What is the recommended collimation for an AP projection—internal rotation shoulder?
What is the recommended respiration status during exposure for an AP projection—internal rotation shoulder?
What is the recommended respiration status during exposure for an AP projection—internal rotation shoulder?
Which part of the clavicle articulates with the acromion to form a joint?
Which part of the clavicle articulates with the acromion to form a joint?
Where is the glenoid cavity located?
Where is the glenoid cavity located?
What projects from the upper margin of the scapula?
What projects from the upper margin of the scapula?
Which bone consists of head, neck, greater tubercle, and lesser tubercle?
Which bone consists of head, neck, greater tubercle, and lesser tubercle?
What is essential for an Antero-posterior – supine X-ray of the humerus to capture?
What is essential for an Antero-posterior – supine X-ray of the humerus to capture?
What is used to immobilize the forearm for an Antero-posterior – supine X-ray of the humerus?
What is used to immobilize the forearm for an Antero-posterior – supine X-ray of the humerus?
What is indicated if an arm needs to be immobilized for a true lateral projection?
What is indicated if an arm needs to be immobilized for a true lateral projection?
What does full external rotation evidence in a radiograph indicate?
What does full external rotation evidence in a radiograph indicate?
When is a lateral oblique ‘Y’ projection used for imaging the shoulder region?
When is a lateral oblique ‘Y’ projection used for imaging the shoulder region?
What should be visible in an optimal exposure of AP projection—external rotation shoulder?
What should be visible in an optimal exposure of AP projection—external rotation shoulder?
What is the anatomical position?
What is the anatomical position?
What is the sagittal plane?
What is the sagittal plane?
What does 'abduction' refer to?
What does 'abduction' refer to?
Which term describes movement toward the midline of the body or body part?
Which term describes movement toward the midline of the body or body part?
What is 'proximal' in anatomical terms?
What is 'proximal' in anatomical terms?
'Superficial' in anatomical terms means:
'Superficial' in anatomical terms means:
What is 'extension' in terms of joint movement?
What is 'extension' in terms of joint movement?
What does 'coronal plane' divide?
What does 'coronal plane' divide?
What does 'deep' refer to in anatomical terms?
What does 'deep' refer to in anatomical terms?
Which bone articulates with the capitulum at the lateral aspect of the lower humerus?
Which bone articulates with the capitulum at the lateral aspect of the lower humerus?
What is the recommended position of the arm for an antero-posterior X-ray of the elbow joint?
What is the recommended position of the arm for an antero-posterior X-ray of the elbow joint?
Where should the cassette be positioned for an antero-posterior X-ray of the elbow joint?
Where should the cassette be positioned for an antero-posterior X-ray of the elbow joint?
What should be visible in an optimal image of lateral projection of the elbow?
What should be visible in an optimal image of lateral projection of the elbow?
What is the recommended direction of the vertical central ray for an AP X-ray of the elbow joint?
What is the recommended direction of the vertical central ray for an AP X-ray of the elbow joint?
Where should the CR be directed for the lateral projection of the elbow?
Where should the CR be directed for the lateral projection of the elbow?
What is essential for an optimal image in lateral projection of elbow?
What is essential for an optimal image in lateral projection of elbow?
What is the recommended position of the patient's arm for lateral projection of the elbow?
What is the recommended position of the patient's arm for lateral projection of the elbow?
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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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