Ch 5 - Humerus and Shoulder Girdle

Shoulder girdle

clavicle and scapula

Shoulder Girdle

consists of two bones: the clavicle and the scapula

Grashey Method

Glenoid Cavity (Non-Trauma) AP Oblique Projection Proximal Humerus fractures or dislocations Glenoid Cavity fractures PT: rotate 35* - 45* toward affected side

Tip of the coracoid process of the scapula

Inferosuperior Axial projection Identify A

Glenoid cavity

Inferosuperior Axial projection Identify B

Spine of the scapula

Inferosuperior Axial projection Identify C

Acromion of the scapula

Inferosuperior Axial projection Identify D

A. Acromion (PA)

PA oblique (scapular Y position) Identify A

B. Coracoid process

PA oblique (scapular Y position) Identify B

C. Inferior angle

PA oblique (scapular Y position) Identify C

D. Spine of scapula

PA oblique (scapular Y position) Identify D

E. Body of scapula

PA oblique (scapular Y position) Identify D

Clements Modification

Shoulder (Non-Trauma) ISA Axial Projection Degenerative conditions Hill-Sachs defect anterior humerus PT: Supine or recumbent PT: abduct arm 90* / vertical CR: 5* - 15* if not 90*

Fisk Modification

Shoulder (Non-Trauma) Tangential Projection-Intertubercular Sulcus Pathologies in the intertubercular suclus of the promixial humerus PT: leaning over table holding IR / shot thru posterior humerus head PT: Supine arm at side CR: 10* to 15* from vertical to humeral head

Lawrence Method (Non-trauma)

Shoulder Non-trauma ISA Projection external rotation CR: medially 25* - 30* Degenerative conditions Hill-Sachs defect anterior humerus

Hobbs Modification

Shoulder Non-trauma PA Transaxillary Projection Proximal Humerus fractures or dislocations PT: 5* - 10* rotation obl PT: arm raised superiorly Bursitis, shoulder impingement, osteoporosis, osteoarthritis, and tendonitis

Garth Method

Shoulder Trauma AP Apical Oblique Axial Projection Scapulohumeral Dislocations Anterior dislocation - humeral head inferior Posterior dislocation - humeral head superior PT: affected side toward IR CR: 45* caudad

Lawrence Method (Trauma)

Shoulder Trauma Proximal Humerus Transthoracic Lateral projection Proximal fractures to the Humerus PT: LAT with SOI on IR PT: Neutral rotation with opposite arm placed over the head to prevent superimposition

Neer Method

Shoulder Trauma Tangential Projection Supraspinatus Outlet Proximal fractures to Humerus Demonstrates coracoacromial arch for supraspinatus outlet Possible shoulder impingment PT: Rotated 45* -60* CR: 10* - 15* caudal angle

scapulohumeral joint (glenohumeral joint or shoulder joint)

The humeral head articulates with the glenoid cavity of the scapula to form the

scapula

The humerus articulates with the ________________ at the shoulder joint

sternoclavicular joint, acromioclavicular joint, and scapulohumeral joint (glenohumeral or shoulder joint)

Three joints or articulations are involved in the shoulder girdle are:

Inferosuperior Axial projection (Lawrence Method Non-Trauma)

Which projection results in a lateral view of the head and neck of the humerus and demonstrates the relationship of the humerus to the glenoid cavity

Not to superimpose the scapula in the radiograph

Why is the AP projection of the scapula is taken with the arm abducted?

Idiopathic chronic adhesive capsulitis (frozen shoulder)

is a disability of the shoulder joint that is caused by chronic inflammation in and around the joint. It is characterized by pain and limitation of motion

Osteoarthritis, also called degenerative joint disease (DJD)

is a noninflammatory joint disease characterized by gradual deterioration of the articular cartilage with hypertrophic bone formation. DJD is the most common type of arthritis and is considered part of the normal aging process.

Bursitis

is an inflammation of the bursae, or fluid-filled sacs enclosing the joints

Tendonitis

is an inflammatory condition of the tendon that usually results from a strain

Bankart lesion

is an injury of the anteroinferior aspect of the glenoid labrum. This type of injury often is caused by anterior dislocation of the proximal humerus

Impingement syndrome

is impingement of the greater tuberosity and soft tissues on the coracoacromial ligamentous and osseous arch, generally during abduction of the arm.

Shoulder dislocation

is traumatic removal of humeral head from the glenoid cavity

Rotator cuff

pathology is acute or chronic, traumatic injury to one or more of the rotator cuff muscles: teres minor, supraspinatus, infraspinatus, and subscapularis

Acromioclavicular (AC) dislocation

refers to an injury in which the distal clavicle usually is displaced superiorly

AC joint separation

refers to trauma to the upper shoulder region resulting in a partial or complete tear of the acromioclavicular (AC) or coracoclavicular (CC) ligament or both ligaments

F. Inferior angle of the scapula

identify F

F. Surgical neck of humerus

identify F

G. Body of humerus

identify G

G. Lateral (axillary) border of the scapula

identify G

H. Glenoid cavity (fossa) or scapulohumeral joint of the scapula

identify H

Rheumatoid (ru′-ma-toyd) arthritis (RA)

is a chronic systemic disease characterized by inflammatory changes that occur throughout the connective tissues of the body. The inflammation begins in synovial membranes and can later involve the articular cartilage and bony cortex

Pearson Method

AC Joint separation AP projection Bilateral with & without 8-10 lbs weights 72" SID both ACJ

AP acromioclavicular joints with and without weights

Identify projection

AP humerus projection

Identify projection

AP oblique projection (Grashey method)

Identify projection

AP projection—neutral rotation

Identify projection

AP scapula

Identify projection

AP scapula (radiograph)

Identify projection

AP shoulder—external rotation

Identify projection

Erect mediolateral humerus projection

Identify projection

Fracture of proximal humerus, neutral rotation

Identify projection

Inferosuperior axial projection

Identify projection

Inferosuperior axial projection (Clements modification)

Identify projection

Lateromedical projection of mid-to-distal humerus

Identify projection

PA oblique (scapular Y lateral) with anterior dislocation

Identify projection

PA oblique (scapular Y lateral) with no dislocation

Identify projection

PA transaxillary projection

Identify projection

Recumbent transthoracic lateral projection of humerus

Identify projection

Shoulder Internal rotation—lateral

Identify projection

Shoulder Non-trauma AP - External rotation

Identify projection

Inferosuperior Axial projection (pic)

Identify this projection

Hill-Sachs defect

is a compression fracture of the articular surface of the posterolateral aspect of the humeral head that often is associated with an anterior dislocation of the humeral head.

E. Anatomic neck of humerus

identify E

E. Medial (vertebral) border of the scapula

identify E

Osteoporosis

due to a reduction in the quantity of bone or atrophy of skeletal tissue

A. Acromion of the scapula

identify A

A. Head of humerus

identify A

A. Sternoclavicular joint (articulation of the sternal extremity (medial) end and the upper part of the sternum)

identify A

B. Greater tubercle of humerus

identify B

B. Neck of scapula (approximately 1 inch below coracoid process)

identify B

B. Sternal extremity (medial) of the clavicle

identify B

C. Body of the clavicle

identify C

C. Intertubercular sulcus of humerus

identify C

C. Suprascapular notch of the scapula

identify C

D. Acromial extremity (lateral) of the clavicle

identify D

D. Lesser tubercle of humerus

identify D

D. Superior angle of the scapula

identify D

E. Acromioclavicular joint (articulation of the acromial extremity of the clavicle and the acromion of the scapula)

identify E