Proximal Humerus Anatomy Quiz
39 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which structures are primarily responsible for the attachment of the pectoralis major and supraspinatus muscles?

  • Greater tubercle (correct)
  • Coracoid process
  • Lesser tubercle
  • Deltoid tuberosity

    • What is the term for the deep groove located between the lesser and greater tubercles of the humerus?

  • Infraglenoid notch
  • Surgical neck
  • Epicondylar groove
  • Intertubercular groove (correct)

    • What is the anatomical position directly below the anatomic neck of the humerus called?

  • Capitulum
  • Radial groove
  • Surgical neck (correct)
  • Deltoid tuberosity

    • Which fat pad is located posteriorly at the elbow joint?

    <p>Posterior fat pad</p> Signup and view all the answers

    Which joint connects the scapula to the clavicle?

    <p>Acromio-clavicular joint</p> Signup and view all the answers

    What is the largest and longest bone in the upper extremity?

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

    What is the name of the cavity on the scapula where the head of the humerus fits?

    <p>Glenoid cavity</p> Signup and view all the answers

    Which structure is primarily identified as the rough elevation on the body of the humerus?

    <p>Deltoid tuberosity</p> Signup and view all the answers

    What are the names of the two tubercles found on the proximal humerus?

    <p>Lesser and greater tubercles</p> Signup and view all the answers

    Which muscle attaches at the greater tubercle of the humerus?

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

    What is the anatomical landmark located directly below the head of the humerus called?

    <p>Anatomical neck</p> Signup and view all the answers

    Which projection of the shoulder is primarily requested to evaluate the scapula?

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

    Which of the following is one of the angles of the scapula?

    <p>Inferior angle</p> Signup and view all the answers

    What is the recommended CR direction for the AP projection of the scapula?

    <p>Perpendicular to the midscapula</p> Signup and view all the answers

    Which action is necessary when performing the lateral projection of the scapula?

    <p>Have the patient grasp the opposite shoulder</p> Signup and view all the answers

    For optimal exposure factors during scapular imaging, which consideration is essential?

    <p>Include the entire scapula in the image</p> Signup and view all the answers

    What is the position of the patient when performing a lateral scapula projection in the recumbent position?

    <p>Supine and rotated until the scapula is parallel to IR</p> Signup and view all the answers

    Which projection is most effective for demonstrating coracoacromial arch?

    <p>Neer method</p> Signup and view all the answers

    What is the recommended body rotation for the posterior oblique position using the Grashey method?

    <p>10° to 15°</p> Signup and view all the answers

    Which structure of the humerus is located the farthest distally?

    <p>Surgical neck</p> Signup and view all the answers

    What is another term for the mid area of the costal surface of the scapula?

    <p>Subscapular fossa</p> Signup and view all the answers

    What is the primary function of the clavicle and scapula in the shoulder girdle?

    <p>To connect the upper limb to the trunk</p> Signup and view all the answers

    Which part of the scapula is referred to as the glenoid cavity?

    <p>Lateral angle (head)</p> Signup and view all the answers

    Which border of the scapula is nearest to the vertebrae?

    <p>Medial (Vertebral) border</p> Signup and view all the answers

    What is the significance of the costal (ventral) surface of the scapula?

    <p>It is the anterior surface of the scapula.</p> Signup and view all the answers

    What is the term for the thickened ridge of the spine on the posterior surface of the scapula?

    <p>Crest of spine</p> Signup and view all the answers

    Which angle of the scapula is located at the high medial corner?

    <p>Superior angle</p> Signup and view all the answers

    How many borders does the scapula have?

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

    What does the term 'axillary border' refer to in terms of scapula anatomy?

    <p>Border nearest the axilla</p> Signup and view all the answers

    What is the location of the acromion in relation to the glenoid cavity?

    <p>Superior and posterior</p> Signup and view all the answers

    Which projection places the humerus in an AP position?

    <p>AP External Rotation</p> Signup and view all the answers

    What is the purpose of the 25-30˚ medial angle in the Inferosuperior Axial Projection?

    <p>To profile the humeral head</p> Signup and view all the answers

    Which structure is profiled medially during the AP Internal Rotation?

    <p>Lesser tubercle</p> Signup and view all the answers

    What positioning consideration is recommended when performing shoulder radiography?

    <p>Use a grid for all projections</p> Signup and view all the answers

    During the Grashey method, what is the angle of body rotation required?

    <p>35-45˚</p> Signup and view all the answers

    What is the correct evaluation criterion for the Inferosuperior Axial Projection?

    <p>Lesser tubercle profiled anteriorly</p> Signup and view all the answers

    Which projection requires the patient to be in a 45-60˚ anterior oblique position?

    <p>PA Oblique (Scapular Y)</p> Signup and view all the answers

    What is the primary indication for performing a Supraspinatus Outlet projection?

    <p>To visualize the coracoacromial arch</p> Signup and view all the answers

    In the AP Neutral rotation, how is the arm positioned?

    <p>At the side in 'as is' position</p> Signup and view all the answers

    Study Notes

    Proximal Humerus Anatomy

    • Largest and longest bone in the upper extremity
    • Approximately 1/5 of an adult's height
    • Articulates with the scapula at the shoulder joint
    • '
    • The most proximal part of the humerus is a rounded portion called the head '
    • ' Slightly constricted portion below the head is the anatomic neck
    • The process directly below the anatomic neck on the anterior surface is the lesser tubercle
    • Larger lateral process is the greater tubercle where the pectoralis major and supraspinatus muscles attach
    • Deep groove between the two tubercles is the intertubercular groove (bicipital groove)
    • The area below the head and tubercles is the surgical neck
    • Distal to the surgical neck is the body (shaft)
    • Deltoid tuberosity is a rough raised elevation along the anterolateral surface of the body where the deltoid muscle attaches

    Joints

    • Scapulohumeral joint (glenohumeral or shoulder joint) 'h
    • Elbow joint '

    Learning Outcomes

    • Identify the following joints on an image of the upper extremity:
      • Acromioclavicular joint
      • Shoulder joint
      • Sternoclavicular joint
    • Identify the following parts and prominences on an image or skeleton:
      • Scapula
        • Head
        • Neck
        • Body
        • Glenoid cavity
        • Spine
        • Acromion
        • Coracoid process
        • Angles: Medial, Superior, and Inferior
        • Borders: Superior, Axillary, and Vertebral
        • Scapular Notch

    Let's Review – Proximal Humerus

    • The two neck names and where they are located are:
      • Anatomical neck: Located below the head
      • Surgical neck: Located below the lesser and greater tubercle
    • Lesser tubercle is the smaller more medial tubercule
    • Greater tubercle is the larger more lateral tubercule
    • Intertubercular sulcus/groove (bicipital groove) is the groove that separates the tubercules
    • Deltoid tuberosity is the name of the rough elevation on the body of the humerus
    • Deltoid muscle attaches to the deltoid tuberosity
    • Pectoralis major and supraspinatus muscles attach to the greater tubercle
    • The other two names that refer to the shoulder joint are glenohumeral joint and scapulohumeral joint

    Shoulder Girdle

    • Consists of 2 bones:
      • Clavicle
      • Scapula
    • Function of the two bones is to connect the upper limb to the trunk (axial skeleton)

    Scapula Anatomy - Borders

    • Forms the posterior part of the shoulder girdle
    • Flat, triangular bone
    • The scapula has 3 borders:
      • Superior border: Uppermost margin
      • Lateral (Axillary) border: Border nearest axilla
      • Medial (Vertebral) border: Border near the vertebrae

    Scapula Anatomy - Angles

    • The three corners of the scapula are called angles:
      • Superior angle: High - medial corner of the scapula
      • Inferior angle: Most inferior portion of the scapula
      • Lateral angle (head): Sometimes called head of the scapula, thickest part, ends laterally in a shallow depression called the glenoid cavity (fossa)

    Shoulder Joint – Glenohumeral Joint

    • Formed by the:
      • Glenoid cavity (fossa) of the scapula
      • Head of the humerus

    Scapula Anatomy – Anterior View

    • Neck: Constricted area between the head and body of the scapula
    • Body (blade): Arched in shape for greater strength, thin flat lower portion of the body is referred to as the Wing or ala
    • Costal (Ventral) Surface: Anterior surface of the scapula
    • Subscapular fossa: Large depression on the anterior side

    Scapula Anatomy – Anterior View

    • Acromion: Long, curved process that extends laterally over the head of the humerus
    • Coracoid process: Thick, beaklike process that projects anteriorly beneath the clavicle
    • Suprascapular notch: Is on the superior border that is partially formed by the base of the coracoid process

    Scapula Anatomy – Posterior View

    • Posterior surface: Aka dorsal surface
    • Spine: Prominent structure on the dorsal surface, starts at the vertebral border as a smooth area and continues laterally to end at the acromion
    • Crest of spine: Thickened ridge of the spine
    • Spine separates the posterior surface into the:
      • Infraspinous fossa
      • Supraspinous fossa

    Scapula Anatomy

    • The lateral view of the scapula looks like the letter Y
    • The Y is formed by the acromion and coracoid:
      • Acromion extends superior and posteriorly in relation to the glenoid cavity
      • Coracoid is located anteriorly in relation to the joint or glenoid cavity
    • Lower portion of Y is the body

    Proximal Humerus Rotation

    • External Rotation
    • Internal Rotation
    • Neutral Rotation

    Positioning Considerations

    • 40 SID
    • Grid (greater than 10cm)
    • Remove anything that could cause artifacts
    • Suspend respiration

    Clinical Indications – Shoulder/Scapula

    • Degenerative conditions:
      • Osteoporosis
      • Osteoarthritis
    • Hill-Sachs defect
    • Fractures & Dislocations
    • Bursitis

    Routine ( Nontrauma) Projections

    • AP External Rotation (AP)
    • AP Internal Rotation (Lateral)

    AP Shoulder: External Rotation

    • 40 SID
    • GRID
    • Patient erect or supine
    • Abduct extended arm slightly
    • Externally rotate arm (supinate hand) until epicondyles are parallel to IR
    • CR – 1 inch inferior to coracoid process

    Evaluation Criteria (External Rotation)

    • Greater tubercle profiled laterally
    • Scapulohumeral joint centered
    • Proximal humerus, upper scapula, and clavicle visualized
    • Optimal exposure factors

    AP Shoulder – Internal Rotation

    • 40 SID
    • Grid
    • Patient erect or supine
    • Internally rotate arm (Pronate hand) until epicondyles are perpendicular to IR
    • CR – 1 in inferior to coracoid process

    Evaluation Criteria (Internal Rotation)

    • Lesser tubercle profiled medially
    • Scapulohumeral joint centered
    • Proximal humerus, upper scapula, and clavicle visualized
    • Optimal exposure factors

    Special (nontrauma) Projections

    • Inferosuperior Axial Projection (Lawrence Method)
    • AP oblique projection (Grashey method)

    Inferosuperior Axial Projection: Shoulder (Lawrence Method)

    • 40 SID
    • Position patient supine & shoulder raised about 2 inches from tabletop
    • Rotate head toward opposite side
    • Abduct arm 90 degrees from body
    • Externally rotate arm with palm up
    • CR – Directed medially 25-30˚, Centered to axilla & humeral head

    Evaluation Criteria (Inferosuperior Axial Projection)

    • Lesser tubercle profiled anteriorly
    • Humeral head and glenoid fossa profiled
    • Optimal exposure factors

    AP Oblique Projection: Grashey method

    • Glenoid Cavity should be visualized
    • 40 SID
    • Grid
    • Erect or Supine
    • Rotate body 35-45˚ toward affected side (posterior oblique)
    • CR – Centered to scapulohumeral joint

    Evaluation Criteria: Grashey Method (Posterior Oblique)

    • Glenoid cavity profiled
    • Scapulohumeral joint centered
    • Optimal exposure factors

    Routine (trauma) Projections

    • AP Neutral rotation
    • PA Oblique (Scapular Y Lateral)

    AP Neutral: Shoulder (Trauma)

    • 40 SID
    • Grid
    • Erect or Supine
    • Arm at side in “as is” position
    • CR – Mid-scapulohumeral joint

    Evaluation Criteria (AP Neutral)

    • Greater tubercle superimposed
    • Scapulohumeral joint centered
    • Optimal exposure factors

    PA Oblique-Scapular Y Lateral: Shoulder (Trauma)

    • 40 SID
    • Grid
    • Erect or supine
    • Rotate patient into anterior oblique position 45-60˚
    • Palpate the superior angle of the scapula & AC joint articulation
    • Rotate patient until two points are perpendicular to IR

    Evaluation Criteria (Scapular Y Lateral)

    • Body of scapula superimposed on end
    • Acromion and coracoid processes in profile
    • Humeral head and glenoid cavity superimposed
    • Optimal exposure factors

    Special (Trauma) Projections

    • Supraspinatus outlet (Neer method)

    Supraspinatus Outlet: Shoulder (Trauma) ’

    • Neer Method
    • Specifically demonstrates coracoacromial arch for supraspinatus outlet region for possible shoulder impingement
    • 40 SID
    • Rotate patient into anterior oblique 45-60˚
    • CR – angle 10-15˚ caudal centered to pass through humeral head

    Evaluation Criteria (Neer Method vs. Scapular Y Lateral Projection:

    • Supraspinatus outlet (Neer method) open and in profile
    • Demonstrates coracoacromial arch
    • Optimal exposure factors

    Routine Scapula Projections

    • AP
    • Lateral

    AP Projection: Scapula

    • 40 SID
    • Erect or supine
    • Abduct arm 90˚ and supinate hand
    • CR – perpendicular to midscapula, (level of axilla and 2 inches medial from lateral border of patient)
    • Orthostatic breathing technique preferred

    Evaluation Criteria (AP Projection)

    • Entire scapula demonstrated
    • Lateral border of scapula free of ribs and lungs
    • Optimal exposure factors

    Lateral: Scapula - Erect

    • Have patient reach a crossed chest and grasp opposite shoulder to demonstrate body of scapula
    • Let arm hang by patients' side to demonstrate acromion and coracoid processes
    • Rotate patient 45-60˚
    • CR – Midvertebral border of scapula

    Lateral Scapula- Recumbent

    • Patient supine
    • Rotate patient till AC joint articulation and superior border of scapula are perpendicular to IR
    • CR- midscapula lateral border

    Body of Scapula in Profile (Lateral Scapula)

    • Borders of scapula superimposed
    • Free of superimposition by ribs
    • Arm elevated to demonstrate scapular body

    Quiz Me

    • The projection that would best demonstrate a possible Hill-Sachs defect is the A.Inferosuperior axial projection with exaggerated external rotation

    Quiz Me

    • The body rotation for a posterior oblique position (Grashey method) is D. 35° to 45°

    Quiz Me

    • The most distal humeral structure is D. Surgical neck

    Quiz Me 2

    • The mid area of the costal surface of the scapula is the A. Subscapular fossa

    Clavicle & AC Joints

    • Chapter 5 Continued

    Learning Objectives

    • Identify the following joints on an image of the upper extremity:
      • AC - Acromioclavicular Joint
      • SC - Sternoclavicular Joint
    • Describe the anatomy and positioning of the shoulder girdle and upper extremity
    • Identify the following parts and prominences on an image or skeleton:
      • Clavicle
        • Body
        • Sternal end
        • Acromial end

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Chapter 5 Humerus and Shoulder PDF

    Description

    Test your knowledge of the proximal humerus anatomy, including its structure and associated joints. This quiz covers important features such as the head, neck, tubercles, and major muscle attachments. Evaluate your understanding of this essential component of the upper extremity.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser