Chapter 5

Humerus & Shoulder

Proximal Humerus

• _____________– Rounded portion.

• Anatomic neck – Inferior to head slightly constricted area

• __________ tubercle – Small process inferior to anatomic neck

• __________ tubercle – Large lateral process

Proximal Humerus

• _______________ groove – Space between tubercles.

• Surgical neck

– Tapered area inferior to head & tubercles

• ____________ tuberosity– Rough area on anteriolateral surface

• Body

– Long portion of humerus

Humerus Imaging

Routine• AP• Lateral• 40” SID• 70 kVp

AP Humerus

• _________ hand (if possible)• Epicondyles are __________ to IR• Include shoulder and elbow• Center at mid-shaft• Rotate collimator to _________of humerus• Collimate to skin

Lateral Humerus

• ____________ hand (If possible) • Epicondyles are ______________ to IR• Include shoulder and elbow• Center to mid-shaft• Rotate collimator to _________of humerus• Collimate to skin

Questionable Fracture

• _________________________

• Erect _____________

• X-table Lateral

• Transthoracic

Erect Mediolateral

• Pt upright in _____________ oblique• Elbow _____________• Move arm ________, away from the body• Align epicondyles __________ to the IR• CR to mid shaft• Shoulder may not be on the image

X-table Lateral

• Pt. Supine• Elevate ___________ arm with positioning

sponge• Place IR between the __________and

arm• CR to mid shaft• Shoulder may not be on the image

Transthoracic

• Position _____________with affected side closest to IR

• Raise ____________ arm

• Center to ______________of humerus

• Use a breathing technique

Shoulder Girdle

• Clavicle & Scapula

– _____________connection to axial skeleton at sternum (______________joint)

– ______________ connection by muscles off of _________

Scapula

• Posterior aspect of shoulder girdle

• Triangular Flat bone with: – 3 _________– 3 angles– 2 ___________

Scapula Borders

• ___________ Border – Uppermost aspect

• ___________(Axillary) Border – Border closest to Arm pit (Axilla)

• ____________ (Vertebral) Border – Border closest to vertebral column

Scapula Angles

• __________ Angle – Head of scapula forms glenoid fossa.

• ____________ Angle – Lowest point on vertebral border.

• ___________ Angle – Highest point on vertebral border.

Scapula Surfaces

• _________ Surface – Anterior Surface

• ___________Surface – Posterior Surface

Scapula AnatomyCostal Surface

• ______________Process – Projection off of superior border.

• _____________ notch – Depression between superior border and

coracoid.

Scapular AnatomyDorsal Surface

• ____________ Spine – Elevated projection across posterior scapula

• ______________ – Large projection off of spine

• Supraspinous _________ – Depression superior to spine

• Infraspinous fossa – Depression inferior to spine

Shoulder Joint

• Scapulohumeral

• Spheroidal (Ball and Socket)

• ________________– “Socket” where humeral head sits

Shoulder Imaging

Routine• AP Internal Rotation• AP External Rotation• Scapular ‘Y’• Glenoid Fossa• Axial• Transthoracic Lateral (Trauma)• 40” SID• 75 kVp

AP External Rotation

• Erect or Supine• Supinate hand so _______________are parallel

to cassette• Center _____________coracoid process• Suspend ____________• Shows Greater tubercle in profile• Include shoulder girdle• ___________rotate if fx or dislocation present

AP Internal Rotation

• Erect or Supine• Pronate hand so ______________ are

perpendicular to cassette• Center ___________coracoid process• Suspend respiration• Shows ____________in profile• __________rotate if fx or dislocation is present

Glenoid Fossa

• Erect or Supine• Position into __________posterior oblique

with affected side toward IR.• __________ arm slightly• Center at shoulder joint• Suspend respiration• Shows ___________in profile without

humerus obstructing

Scapular ‘Y’

• Try to position erect• Position into ___________oblique with

affected side closest to IR.• Palpate ________________to determine

true lateral• Slightly ________ arm• Center to joint space _________top of

shoulder• Suspend respiration

AxialInferiosuperior

• Supine• Place the cassette ___________ to the table

against the ____________ and close the neck.• Abduct arm _________, with external rotation.• Direct the CR through ___________• Suspend respiration• Shows coracoid process, lesser tubercle,

scapular spine, and humeral head glenoid fossa

Transthoracic LateralTrauma

• Position true lateral with __________ side closest to IR

• Raise ___________ arm• Center to ___________of Humerus• Use a breathing technique