Chapter 6
Humerus & Shoulder
Proximal Humerus
• ____________
– Rounded portion.
• _________________
– Inferior to head slightly constricted area
• _________________
– Small process inferior to anatomic neck
• _________________
– Large lateral process
Proximal Humerus
• ____________________
– Space between tubercles.
• ___________________
– Tapered area inferior to head & tubercles
• Body
– Long portion of humerus
Humerus Imaging
Routine
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AP
Lateral
40” SID
70 kVp
AP Humerus
• __________ hand so ___________ are
parallel to cassette.
• Include _______________
• Center at mid-shaft
• Rotate _________ to long axis of humerus
• Collimate to skin
Lateral Humerus
• __________ hand so ____________ are
perpendicular to cassette
• Include __________________
• Center to mid-shaft
• Rotate collimator to long axis of humerus
• Collimate to skin
Questionable Fracture
• _________________!!!!!!!
• Erect Mediolateral
• X-table Lateral
• Transthoracic
Erect Mediolateral
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Pt upright in ___________
Elbow ______________
Move arm posterior, away from the body
Align __________________to the IR
CR to mid shaft
Shoulder may not be on the image
X-table Lateral
• Pt. Supine
• ______________________with
positioning sponge
• Place ______________________and arm
• CR to mid shaft
• Shoulder may not be on the image
Transthoracic Lateral
Trauma
• Position ____________with affected side
closest to IR
• Raise ________________
• Center to surgical neck of Humerus
• Use a breathing technique
Shoulder Girdle
• __________________
– _____________connection to axial skeleton
at sternum (Sternoclavicular joint)
– ______________ connection by muscles off
of scapula
Scapula
• Posterior aspect of shoulder girdle
• ________________bone with:
– 3 borders
– 3 angles
– 2 surfaces
Scapula Borders
• ________________ Border
– Uppermost aspect
• _________________Border
– Border closest to Arm pit (Axilla)
• _________________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 Anatomy
Costal Surface
• _______________Process
– Projection off of superior border.
• ______________ notch
– Depression between superior border and
coracoid.
Scapular Anatomy
Dorsal Surface
• _____________ Spine
– Elevated projection across posterior scapula
• ______________
– Large projection off of spine
• Supraspinous fossa
– Depression superior to spine
• Infraspinous fossa
– Depression inferior to spine
Shoulder Joint
• Scapulohumeral
• Spheroidal (Ball and Socket)
• ___________________
– “Socket” where humeral head sits
Shoulder Imaging
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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
• ____________ hand so ___________ are
parallel to cassette
• Center ________________process
• Suspend respiration
• Shows _____________in profile
• __________rotate if fx or dislocation present
AP Internal Rotation
• Erect or Supine
• __________ hand so _______________ are
perpendicular to cassette
• Center _______________process
• Suspend respiration
• Shows ________________in profile
• _____________rotate if fx or dislocation is
present
Glenoid Fossa
• Erect or Supine
• Position into _________________with
affected side toward IR.
• Abduct arm slightly
• Center at shoulder joint
• Suspend respiration
• Shows _________________ in profile
without humerus obstructing
Scapular ‘Y’
• Try to position erect
• Position into _______________with
affected side closest to IR.
• Palpate _________________to determine
true lateral
• Slightly abduct arm
• Center to joint space ________________
• Suspend respiration
Axial
Inferiosuperior
• Supine
• Place the cassette _____________ to the table
against the __________________the neck.
• ______________, with external rotation.
• Direct the CR through _______________
• Suspend respiration
• Shows coracoid process, lesser tubercle,
scapular spine, and humeral head glenoid fossa
Transthoracic Lateral
Trauma
• Position ________________with affected
side closest to IR
• Raise ________________
• Center to surgical neck of Humerus
• Use a breathing technique