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