The transthoracic lateral projection may be performed with the patient positioned upright or

What patient position would be required if the patient's right shoulder is to be examined (AP Oblique Projection - Grashey Method)?

The ___ should be parallel with the plane of the IR (AP Oblique Projection - Grashey Method)

Plane of the superior angle and acromion.

What is the proper arm position for the Grashey method?

Abducted in slight internal rotation.

A properly positioned AP oblique (Grashey) image will demonstrate the ___ in profile.

AP Oblique Glenoid Cavity (Grashey Method) Identify the letter A.

AP Oblique Glenoid Cavity (Grashey Method) Identify the letter B.

AP Oblique Glenoid Cavity (Grashey Method) Identify the letter C.

AP Oblique Glenoid Cavity (Grashey Method) Identify the letter D.

The transthoracic Lateral Projection may be performed with the patient positioned upright or:

To what specific area of the Humerus should the IR be centered for the transthoracic Lateral Projection (Lawrence Method)?

How many degrees and in which direction should the central ray be directed if it cannot be directed perpendicular to the IR because the patient is unable to elevate the unaffected shoulder (Transthoracic Lateral Projection - Lawrence Method)?

10 to 15 degrees Cephalad.

Which change to radiographic exposure factors should be used to aid effectively the blurring of lung detail by the action of the heart when the patient is able to hold his or her breath for a sustained period (Transthoracic Lateral Projection- Lawrence Method)?

Use a low mA/long exposure time combination with the usual mAs factor.

Transthoracic Lateral shoulder (Lawrence Method) Identify the letter A.

Scapula (superior border)

Transthoracic Lateral shoulder (Lawrence Method) Identify the letter B.

Transthoracic Lateral shoulder (Lawrence Method) Identify the letter C.

Transthoracic Lateral shoulder (Lawrence Method) Identify the letter D.

Transthoracic Lateral shoulder (Lawrence Method) Identify the letter E.

Transthoracic Lateral shoulder (Lawrence Method) Identify the letter F.

Lateral border of Scapula.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter A.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter B.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter C.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter D.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter E.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter F.

Inferosuperior Axial Projection (Lawrence Method) Identify the letter G.

True or false. When the patient is recumbent, the head and upper torso should be elevated 3 inches (Inferosuperior Axial Projection- Lawrence Method)

True or false. When using a horizontally directed central ray, the patient should be placed in the supine body position (Inferosuperior Axial Projection- Lawrence Method)

(Inferosuperior Axial Projection - Lawrence Method) With reference to the long axis of the body, how should the affected arm be positioned?

As close as possible to a right angle.

(Inferosuperior Axial Projection - Lawrence Method) Into which rotational position should the Humerus be placed?

(Inferosuperior Axial Projection - Lawrence Method) Which area of the body should the central ray enter?

Axilla of the affected arm.

(Inferosuperior Axial Projection - Lawrence Method) What positioning factor determines how many degrees the central ray should be directed medically?

The degree of abduction of the affected arm.

(PA Oblique Scapular Y) True or False. In an image of a normal shoulder, the humeral head should be directly superimposed over the junction of the Scapular Y.

(PA Oblique Projection- Scapular Y) what breathing instructions should be given to the patient?

Stop breathing for the exposure.

(PA Oblique Projection- Scapular Y) What position would be used to examine a patient's injured left shoulder?

(PA Oblique Projection- Scapular Y) with reference from the thorax, where should the Scapular body be demonstrated in the image of the PA Oblique Projection?

Along the Lateral aspect but not superimposed.

PA Oblique shoulder Joint - Identify the letter A.

PA Oblique shoulder Joint - Identify the letter B.

PA Oblique shoulder Joint- Identify the letter C.

PA Oblique shoulder Joint- Identify the letter D.

PA Oblique shoulder Joint- Identify the letter E.

For the Fisk modification, the IR is supported on the patient's:

For the Fisk modification, a standing patient should lean forward or backward to place the vertical Humerus at an angle of ___ to ___ degrees.

For the Fisk modification, how should the central ray be directed?

Supine Tangential intertubercular (bicipital) groove. Identify the letter A.

Supine Tangential Intertubercular (bicipital) Groove. Identify the letter B.

Supine Tangential Intertubercular (bicipital) Groove. Identify the letter C.

Supine Tangential Intertubercular (bicipital) Groove. Identify the letter D.

Acromioclavicular (AC) Articulations. True or False. The patient may be positioned either upright or supine to demonstrate AC joints.

False. To demonstrate AC joints best, the patient should be in the upright position because dislocations of the AC Joint tend to reduce themselves in the recumbent position.

Acromioclavicular (AC) Articulations. True or False. The central Ray should be directed perpendicularly to the affected AC Joint for each image.

False. The central Ray should be directed to the midline of the body at the level of the AC joints.

Acromioclavicular (AC) Articulations. What procedure should be performed to demonstrate both AC joints on a patient who has wide shoulders?

Two IRs should be used and exposed simultaneously.

Acromioclavicular (AC) Articulations. What is the purpose of the weight-bearing projections for the AC joints?

The weights enable better demonstration of a separation of an AC Joint.

Acromioclavicular (AC) Articulations. What is the proper method to attach the weights? Why?

Weights should be affixed to the patient's wrists. Attaching weights to the Wrist prevents the patient from tensing muscles, making demonstration of a small dislocation more difficult.

The recommended SID for radiography of the AC joints is:

AP and PA Projections of the Clavicle. What breathing instructions should be given to the patient?

Suspend respiration after expiration.

The AP and PA Projections of the Clavicle produce similar images. Identify which Projection (AP or PA) produces the best spacial resolution and explain why.

PA (Because of decreased OID)

AP and PA Projections of the Clavicle. True or False. The entire clavicle should be demonstrated with either AP or PA Projection.

AP and PA Clavicle Projections. True or False. The AP and PA projections should demonstrate the entire clavicle free from superimposition with other bony structures.

False. Although the entire clavicle should be imaged, the Medial half of the Clavicle should be demonstrated superimposed over the thorax.

AP Clavicle. Identify the letter A.

AP Clavicle Projection. Identify the letter B.

AP Clavicle Projection. Identify the letter C.

AP Clavicle Projection. Identify the letter D.

AP Clavicle Projection. Identify the letter E.

How many degrees and in which direction should the central ray be directed for the following projections?

A. AP Axial Clavicle, with patient supine:

B. PA Axial Clavicle, with patient prone:

A. 15 to 30 degrees cephalad
B. 15 to 30 degrees caudad

How does the appearance of the Clavicle differ in the Axial projections compared with the AP/PA Projections?

The Clavicle is more horizontal and projected free of bony superimposition in the Axial projections.

What positioning consideration determines how much the X-ray tube should be angled for AP Axial and PA Axial Projections of the Clavicle?

The size of the patient (thickness of the thorax)

How many degrees and in which direction should the central ray be directed for the AP Axial Projection (Clavicle) with the patient upright in the lordotic position?

What criterion is used to determine if the CR angle was sufficient for the Axial projections of the Clavicle?

CR angle is sufficient if the Medial and of the Clavicle is at the level of the first or second ribs.

True or False. For the AP Axial Projection of the Clavicle, the exposure should occur after the patient has been instructed to suspend respiration following full expiration.

False. Respiration should be suspended after full inspiration.

What is the purpose of abducting the upper limb for the AP Projection of the Scapula?

To pull the Scapula laterally from the thorax

Which type of respiration should the patient use to obliterate lung detail (AP Projection of the Scapula)?

Which Scapular border should be demonstrated free from superimposition with the ribs for the AP Projection of the Scapula?

True or False. AP Projection images of the Scapula should demonstrate the area of the Scapula, including the Glenoid Cavity and Coracoid Process, without superimposition with the ribs.

True or False. AP Scapula Projection images should demonstrate the acromion and the inferior angle.

True or False. For the AP Projection of the Scapula, the patient should be rotated toward the affected side for best placement of the Scapula parallel with the IR.

False. Rotation of the patient toward the affected side offsets the effect of drawing the Scapula Lateral.

AP Scapula Projection. Identify the letter A.

AP Scapula Projection. Identify the letter B.

AP Scapula Projection. Identify the letter C.

AP Scapula Projection. Identify the letter D.

AP Scapula Projection. Identify the letter E.

AP Scapula Projection. Identify the letter F.

For the Lateral Projection of the Scapula, what is the significance of arm placement?

It determines what part of the Scapula is demonstrated in superimposition with the Humerus.

For the Lateral Projection of the Scapula, how should the affected arm be placed for best demonstration of the acromion and Coracoid processes?

Instruct the patient to flex the elbow and place the hand on the posterior thorax.

True or False. The lateral Scapula Projection image should demonstrate the Lateral and Medial borders superimposed.

True or False. The lateral Scapula Projection image should demonstrate the Scapular body free from superimposition with the ribs.

True or False. The acromion and the inferior angle should be demonstrated in the Lateral Projection.

Lateral Scapula Projection. Identify the letter A.

Lateral Scapula Projection. Identify the letter B.

Lateral Scapula Projection. Identify the letter C.

Lateral Scapula Projection. Identify the letter D.

Lateral Scapula Projection. Identify the letter E.

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

PA Oblique Shoulder (Scapular Y)

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

AP Shoulder, external rotation position.

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

AP Oblique shoulder (Grashey Method)

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

Inferosuperior Axial Projection (Lawrence Method)

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

Tangential Intertubercular Groove (Fisk Modification)

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

AP Projection AC joints (Pearson Method)

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

Transthoracic Lateral shoulder (Lawrence Method)

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

Identify the projection by name, as well as the position and method name, if applicable, and the part of the Shoulder Girdle that is demonstrated.

AP Shoulder, internal rotation.

Which classification of bone is the Scapula?

Which classification of bone is the Clavicle?

What is the name of the fossa on the anterior surface of the Scapula?

Which border of the Scapula extends from the Glenoid Cavity to the inferior angle?

Which border of the Scapula extends from the superior angle to the inferior angle?

Of which part of the Scapula is the acromion an extension?

Where is the Coracoid Process located in reference to the body of the Scapula?

Which borders of the Scapula unite to form the superior angle?

Which borders of the Scapula unite to form the inferior angle?

Where is the Scapular notch located?

Which joint is a ball and socket joint?

A. Acromioclavicular
B. Humeroulnar
C. Scapulohumeral
D. Sternoclavicular

Which portion of the Scapula articulates with the humeral head?

Which portion of the Scapula articulates with the Clavicle?

When performing AP Projections of the shoulder, where should the central ray be directed?

1 inch inferior to the Coracoid Process

With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP Projection of the shoulder with the shoulder in external rotation?

With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP Projection of the shoulder with the shoulder in internal rotation?

With reference to the plane of the IR, how should the humeral epicondyles be positioned for the AP Projection of the shoulder with the shoulder in Neutral rotation?

45 degrees medial Oblique

Which Projection of the Shoulder best demonstrates the greater tubercle of the Humerus in profile?

AP Projection with external rotation

Which Projection of the Shoulder best demonstrates the humeral head in profile?

AP Projection with external rotation

Which Projection of the Shoulder best demonstrates the lesser tubercle of the Humerus, in profile and pointing toward the Glenoid Cavity?

AP Projection with internal rotation

Which Projection of the Shoulder best demonstrates the lesser tubercle of the Humerus in profile and pointing toward the Glenoid Cavity?

AP Projection with internal rotation

Which Projection of the Shoulder is being performed when the patient is supine with the right shoulder centered on the IR, a vertical central ray is being directed perpendicular to the center of the IR, and the humeral epicondyles are parallel with the plane of the IR?

AP Projection with external rotation

What should be adjusted from the regular procedure for the Transthoracic Lateral projection (Lawrence Method) of the Humerus if the patient is unable to elevate the unaffected arm.

Which Projection of the upper limb should be performed to demonstrate a fracture of the proximal Humerus when that arm cannot be abducted?

Transthoracic Lateral Projection (Lawrence Method) of the Humerus

When performing the transthoracic Lateral Projection (Lawrence Method) of the Humerus, which breathing technique should be used to improve best the image contrast and decrease the exposure necessary to penetrate the body?

Which Projection of the Shoulder requires that a horizontal central ray be directed 15 to 30 degrees medially and enter the axilla of the affected arm?

Inferosuperior Axial Projection (Lawrence Method)

What is the proper position of the Humerus for the inferosuperior Axial Projection?

Abducted to a right angle and externally rotated.

How should the central ray be directed for the PA Oblique Projection (Scapular Y) of the Shoulder?

In which body position should the patient be placed to demonstrate the left shoulder with the PA Oblique Projection (Scapular Y)?

Which Projection of the Shoulder Joint requires the patient to be rotated until the midcoronal plane forms an angle of 45 to 60 degrees with the plane of the IR?

PA Oblique Projection (Scapular Y)

Where is the Humerus generally demonstrated on a PA Oblique shoulder (Scapular Y) image if the shoulder is normal?

Superimposed on the junction of the acromion and Coracoid Process

Where is the humeral head usually seen on a PA Oblique (Scapular Y) image if the Shoulder is anteriorly dislocated?

Beneath the Coracoid Process

Which Projection of the Shoulder Girdle is performed with the patient supine, an IR placed vertically against the superior surface of the shoulder, and the central ray angled 10 to 15 degrees posteriorly (downward from horizontal)?

Tangential for the Intertubercular (bicipital) Groove

Which Projection demonstrates the scapulohumeral joint space open and the Glenoid Cavity in profile?

AP Oblique Projection (Grashey Method)

What would be the required patient position to demonstrate the left shoulder using the AP Oblique Projection (Grashey Method)?

When demonstrating the Intertubercular (bicipital) Groove with the Fisk modification of the Tangential Projection, how should the affected Humerus be positioned?

The vertical Humerus should form an angle of 10 to 15 degrees

If the patient's condition permits, which joint should be demonstrated with the patient in an upright position?

How many degrees and in which direction should the central ray be directed for the PA Axial Projection of the Clavicle?

How many degrees and in which direction should the central ray be directed for the AP Axial Projection of the Clavicle with the patient Oblique?

15 to 30 degrees cephalad

When performing the AP Projection of the Scapula, the central ray should be directed toward a point 2 inches ___ to the Coracoid Process.

When performing a lateral Projection of the Scapula with the patient positioned RAO or LAO, approximately how much body rotation is necessary for the average patient?

Which patient position can be used to demonstrate the left scapula in a lateral perspective?

When the patient is positioned properly for a lateral projection of the scapula the body of the scapula will be the plane of the IR?

Which technique is best when imaging the transthoracic projection for humeral head?

When performing a lateral projection of the scapula with the patient positioned Rao or Lao approximately how much body rotation is necessary for the average patient?