10). We do them AP here, but feel for the medial border of the scapula. 300. the arm is placed in this position for a AP scapula. Let's take a look! PA Oblique Shoulder "Scapular Y View" RAO or LAO Technique. Arm internally rotated 40 to 60 degrees and C-arm back 30 to 60 degrees for AP view. Position of Part: Center the scapula to the middle of the table or to the middle of the upright stand, flex the elbow, abduct the arm and place the arm near the head (stop sign). Methods: Following laboratory experimentation on dry bone specimens, a small pilot study was conducted in . AP neutral trauma 4. How much do you know about the way your body operates? It also positions the acromion and coracoid process in profile. Align your finger at the medial border of scapula to where you touched the upper humerus, ensure that imaginary line is perpendicular to the Bucky. AP radiography is important for evaluating fractures or dislocations in trauma cases and evaluating calcific tendonitis or bursitis and AC joint arthritis in the cases of chronic shoulder pain and provides complete visualization . (C) with the arm at the side in the anatomic position. • AP • Medial and lateral obliques • Cross table lateral 3. Figure 1. Routine radiographic projections for imaging of the acute shoulder include the AP with an additional projection; either a lateral of the scapula and proximal humerus (LS) or an axial projection of the shoulder.2, 3, 4 The AP projection is a key component of the routine trauma shoulder series. Ap scapular y view positioning keyword after analyzing the system lists the list of keywords related and the list of websites with related content, in addition you can see which keywords most interested customers on the this website Definition. True Anteroposterior Views. Shoulder; Scapular "Y" view: FFD: 40", kVp: 70, mA:100 Sec/mAs: Dependant on measurement of part. Positioning of shoulder, scapula and clavicle for Beasley scapular pa oblique projection rao or lao position 10 12 lw ir, sid, grid kvp evaluate suspected anatomy as seen in the AP view in the plane of the scapula and the true axillary view. X-ray Beam - Directed perpendicular to the scapula and x-ray cassette, i.e., angled 45-degrees to frontal plane of thorax.. Its submitted by dealing out in the best field. Most used view for the AC articulation? Radiographs AP radiographs are taken in a standardized manner with the patient supine and rolled 30 to the side to be imaged . Grashey View. Exposure. AP projection: What bones make up the Y view? 4 RADT-1400: Radiographic Positioning 5. AP in external rotation for visualization of the greater tuberosity; Scapula Y or axillary view in place of true lateral. PA or AP 14" x 17" GRID, portrait / lengthwise to PT. Helpful for: Shoulder Dislocation, Proximal Humerus Fracture, Scapula Fracture . Occasionally an axillary view is added to assess for dislocations and glenohumeral instability. 1. glenoid fossa in profile. Objective: To determine whether new positioning landmarks can help radiographers position the lateral scapula and Y projections more accurately. The current AP view takes the Scapula image in raise the arms to minimize overlap of the lungs and ribs. For simplicity, we focus on the standard AP view. The scapula Y x-ray can sometimes be a difficult x-ray to perfect; especially if the patient is more gracious in size. The skull anteroposterior (AP) view is a non-angled radiograph of the skull. The muscles that move the scapulae are extrinsic muscles - they attach from the neck and/or shoulder to the limb (Figures 11(a) and 11(b)).The trapezius is a large flat muscle that covers much of the upper back. Term. All of the joints of the shoulder girdle are: Definition. Follow the cortex of every bone in each view. The patient should be asked to sit with the side to be imaged nearest to the . The scapula, a triangular bone, articulates solidly only with the small clavicle.Because the scapula is not held firmly in place, it is free to move in several directions. 1. This can be accomplished via an AP oblique, scapular Y (PA oblique position), axillary, or transthoracic projection. Position of patient Sitting erect (left or right) with the horizontal beam angled at 15 degrees.. Scapular Y trauma 5. SCAPULAR Y VIEW The scapular "Y" view can be taken in the erect or supine position, in the PA direction, with the affected shoulder rotated anteriorly 45°. Position of part: Internally rotate the arm and then flex elbow to about 90 degrees. The humeral head does not appear displaced from the glenoid . Shoulder X-ray views. Top of IR 2" above shoulder. Put your finger there. This view controlled screw placement in the coronal plane. Place the hand's palm over the hip unless contraindicated due to pain (e.g. CR: 2" inferior to the coracoid. AP: "Light bulb on a stick" - often the only sign of a posterior dislocation. AP View of the Shoulder "Transthoracic," or "Routine" AP View - AP relative to thorax - Suboptimal view of Glenohumeral joint - Good view of AC joint "Scapular," "Grashey," or "Glenohumeral" AP View - Better visualize bony relationships incl GH joint - Suboptimal view of AC joint Both have been called "True" AP . AP Scapula breathing technique is: Definition. A postmortem analysis illustrates the variability of notching appearance according to the orientation of the beam, the same case being possibly graded notching 1 to 4 depending of the position of the scapula (Fig. Supine or AP Upright, scapula in direct contact w/ table w/o rotation of thorax, center to mid-scapular area, abduct arm 90 degrees and supinate hand Position (Patient/Part/Plane): Lateral PA erect, face patient towards IR in anterior oblique position w/ affected side closest to IR, place arm of affected side across chest for Y-View, plane of . 1.5 to 2 inches above shoulders CR - inferior border of scapula (T7) or 3" below jugular notch - Pleural effusion: affected side down, - Free air/pneumothorax: unaffected side down - Divers position *JMWC - 15 degrees trendelenberg Breathing - Second inhalation and hold AP view Lateral view Y view B - Bones Go through the bones one at a time. Acromion process, coracoid process and body of scapula. •Align humerus with long axis of IR, unless diagonal placement is needed to include both shoulder and elbow joints. Helps bring the scapular away from the ribcage. These alterations are theorized to be the result of adaptations due to the demands of repetitive throwing. A.2,3, and 4 only. Center scapulohumeral joint to CR and to center of IR. Positioning For the orthogonal view, the scapula is imaged in a caudal to cranial direction. AP Humerus Rotate body toward affected side as needed to bring shoulder and proximal humerus in contact with cassette. Average patient will be in 45degree to 60degree anterior oblique position. (B) away from the affected side. For the delineation of the acromion and coracoid processes of the scapula in the lateral projection the arm is positioned as follows: Definition. Lateral Scapula RAO or LAO IR Size. AP v PA - Scapular edges. To achieve a lateral scapula in a supine patient, the patient is rolled affected side up and a triangular positioning sponge inserted. This view is used to assess possible or known dislocations, scapular fractures or degeneration. Because the axillary view is often difficult to obtain due to pain [2], we will focus on Scapula "Y" but will discuss the axillary view in the "one more view" section . Then touch the upper most tip of the patients humerus. 2. glenohumeral joint centered within the collimated field. Evaluation was by the following criteria: accuracy of diagnosis; patient preference; ease of technique; and diagnosis of associated pathology. Lateral, mid and distal, trauma vii. ©Ken L Schreibman, PhD/MD 11/17/15 www.schreibman.info Upper Extremity Trauma: page 1 of 10 Shoulder Bones a) Radiographs AP & Obl Ax & WP Y & ACJ AC Injury Because the scapula lies on the posterolateral aspect of the thoracic cage, the true anteroposterior view of the glenohumeral joint is obtained by angling the x-ray beam 45 degrees from medial to lateral (Fig. Adjust cassette to center to CR. Collimate to about the width of the humerus, then shoot. The thing that makes the Y view particularly tricky is that its a much more 3-dimensional structure than most other projections. CR for a lateral scapula? Caudocranial Image. It is also useful in seeing both the coracoid and acromion process in profile. synovial, freely moveable. Part Position: Position patient so midscapula area is centered to CR. perpendicular to the mid-medial border of the protruding scapula: Term. The C-arm should rotate in an arc of 90 degrees between the AP image and scapula "Y" lateral image to confirm orthogonal views. 70 kVp @ 10 mA @2 seconds "breathing technique" (20 mAs), 40". Inferosuperior axial, non-trauma 3. The scapular spine is off from the lateral body of the scapular by about 5 degrees. The collimation is opened dorsal and ventral to include the entire scapula. AP partial flexion 6. slow breathing: Term. Video Credit : RadPositioning Mandible Oblique Lateral Sitting. The typical views are AP (external rotation) and the scapular Y view. The arm of the patient. This projection is a true anterior-posterior (AP) view of the shoulder. For control of the screw position in the parasagittal plane, a classic scapular Y view could be used . In order to demonstrate a profile view of the glenoid fossa, the patient is AP recumbent and obliqued 45º (A) toward the affected side. Positioning for an AP projection of the shoulder joint Have the patient upright or in the supine position. For the AP view, the arm is slightly abducted, and the thorax can be rotated to place the posterior shoulder against the image receptor. Gently abduct arm 90 degree and supinate hand. Term. Second best: the scapula Y lateral (see p. 77). Technical factors Image receptor (IR): 8 x 10 inch (18 x 24 cm). AP non-trauma 2. We identified it from trustworthy source. Posterior . Demonstrates - Glenohumeral joint with glenoid seen in profile separate from the humeral head. • The scapular Y view is also used to evaluate the contour of the undersurface of the acromion process when "typing" the acromion. Position - Patient is erect or sitting with arm in sling or shoulder internally rotated. However, comparisons between the throwing and nonthrowing . 400. the triangular elevation on the anterolateral surface. About this Quiz. Arm of affected scapula above head , top of IR 2" above the shoulder. 10 X 12 Lengthwise. Standard shoulder radiographs: routine AP, true AP, scapular Y view, axillary lateral/modified AP Scapula pg 212. When postioning for a lateral scapula projection, what arm position(s) would be used to show delineation of the acromion and coracoid processes? 85 @ 16. RAO or LAO. An AP shoulder projection with accuraate positioning demonstrates the . View Ortho Ex1 Notes - Shoulder.docx from BIO 431 at Northern Virginia Community College. AP internal and external rotation 2. ORIF Humeral Shaft (Posterior Approach), Elbow Fractures (Lateral Decubitus Position) Radiolucent cantilever table reversed. 10 X 12 Lengthwise . The standard trauma series consists of chest radiograph, ap radiograph of injured shoulder girdle, ap and lateral radiographs of the scapula (Neer I and II views). (1) A true AP view of the scapula. This projection can be performed erect or supine, involving 90-degree abduction of the affected arm. The muscles that move the scapulae are extrinsic muscles - they attach from the neck and/or shoulder to the limb (Figures 11(a) and 11(b)).The trapezius is a large flat muscle that covers much of the upper back. Humerus 1. 3. superolateral scapular border without thorax superimposition. The lateral scapula shoulder or Y view is part of the standard shoulder series. The scapula, a triangular bone, articulates solidly only with the small clavicle.Because the scapula is not held firmly in place, it is free to move in several directions. Scapula . Acute Shoulder Series (fracture or dislocation suspected) • AP • Trans-scapular Y view • Axillary or Velpeau view 4. In 69 cases (92%), the scapular "Y" view and axillary view resulted in the same diagnosis. Indications Central Ray: Mid scapula, parallel to blade of scapula Measure: Through the central ray Lateral non-trauma 3. Chronic Shoulder Instability Series (recurrent shoulder instability) • True AP of glenohumeral joint • Stryker Notch View Positioning. Area Covered. In order to elevate the clavicle above the ribs and scapula for the AP axial projection, the phase of respiration should be _____. We recognize this kind of Chest X Ray Scapula graphic could possibly be the most trending subject taking into consideration we allowance it in google pro or facebook. PA Oblique Shoulder "Scapular Y View" RAO or LAO SID. There is a printable worksheet available for download here so you can take the quiz with pen and paper. (2) The axillary lateral view. The Supine AP Approach. It provides an overall impression of the . Transthoracic lateral trauma 6. According to our experience, the axillary view is not very helpful. AP Scapula: Breathing Instructions. The Grashey view involves angling the beam laterally or rotating the patient posteriorly(2). "Scapular Y View" RAO or LAO IR Size. AP Scapula Patient Position. AP view of the shoulder: It is the first-line and most useful imaging study in the evaluation of shoulder pathologies that may be taken in standing or supine position. abducted 90degrees and supinated. True AP View. The four important things about the AP projection for AC . These are the - Anterior-Posterior (AP) view, and the lateral or 'Y-view'. In the context of trauma there are 2 standard views used to assess this joint. The typical postoperative radiographic workup after a reverse TSA also includes an axillary view, which can be assessed for extension of the notch to the anterior and . The templates establish a scapular coordinate system for documentation of the humeral head center position relative to the scapula. If the patient can tolerate holding the arm in abduction, an 'axial' view is an alternative to the Y-view. Shoulder 1. We also speculated that reduction of a displaced coracoid base fracture by "joy-stick" manipulation would be facilitated by this view. The patient may be supine or erect, with the arm at the side or in the sling position. AP Scapula. (Not sure why then thisx meme may help). 1) Lateral view(=Scapular "Y" view, Trans-scapular view) Demonstrates: lateral projection of scapular body and humeral head overlapping the glenoid. Part Position: Rotate into an anterior oblique position as for a lateral scapula with patient facing IR. This view provides an overview of the entire skull rather than attempting to highlight any one region. Definition. Tips on correct positioning of the heel and . Affected scapula is flat against the x-ray cassette. 4. superior scapular angle superior to the midclavicle. Shoulder:A shoulder series typically includes at least two orthogonal views (for example, anterior-posterior and the lateral or scapular Y view) of the glenohumeral joint. In this quiz on human anatomy, we'll be focusing in on the shoulder, clavicle, scapula AC joints and their respective positions in the body. The authors use both radiographic and CT examination for diagnosing fractures of the scapula. Top of IR should be about 2 inches (5 cm) above shoulder, and lateral border of IR should be about 2 inches (5 cm) from lateral margin of rib cage. What position of the scapula demonstrates the coracoid process w/o superimposition with ribs? Personally, I use the scapular spine as my landmark. Source . Position: Erect with anterior aspect of affected shoulder against x-ray plate and rotating other shoulder out 40 . - downward stem of the Y is projected by body of the scapula; - upper forks are projected by the coracoid process anteriorly and by the spine and acromion posteriorly; - glenoid is located at the junction of the stem; Palpate scapular borders to determine correct rotation for a true lateral position of scapula. AP Scapula: Collimation. In addition to evaluating the inferior scapular neck for evidence of bony erosion, the AP view also allows for a review of glenosphere cranial-caudal positioning and tilt. Background: Currently used positioning landmarks for the lateral scapula and Y projections often yield inconsistent results and lead to repeats. If you are not sure then look at the medial edges of each scapula. Position of part Remove dentures, facial jewelry, earrings, and anything from the hair. extend the arm upward and rest the forearm on the head. Axial trauma (Coyle) vi. fracture) otherwise across the abdomen palm up. It's always great when you ace your scapula Y view on the first try. AP Scapula: CR location. 60 to 70 kVp range, mAs 6. Glenohumeral "True" AP (Grashey) View The "true" or Grashey AP view differs from the standard AP view in that the patient is rotated posteriorly approximately 35° to 45° so that the plane of the scapula rather than the bodyparallelsthecassette(Fig.1B).Thebeamisstilldirected perpendicular to the cassette and this eliminates the overlap 5.49. inferosuperior axial-Lawrence method. This is an online quiz called Fig 6 AP scapula radiograph. C.3 and 4 only. However this position can limit the movement of the Scapula so most of the time the Scapula can be viewed as overlap between the lungs and ribs. Questions and Answers. For the lateral projection of the scapula, the body is placed in what position? Indications This examination is able to assess for medial and la. G. Garnet Lux . A normal AP view 1. Position of Patient: AP erect or supine on the table. The beam is angled 458 or the patient rotates the body till the scapula is parallel to the X-ray cassette. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . •Abduct arm slightly and gently supinate hand so . shallow breathing. Minimum SID of 40 inches (100 cm). The 'shoulder' joint is more accurately termed the glenohumeral joint. The precise second view will vary. •Extend hand and forearm as far as patient can tolerate. Context: Differences in 3-dimensional (3D) scapular motion have been reported between healthy baseball position players and healthy nonoverhead athletic controls, as well as players diagnosed with shoulder impingement syndrome. The AP view is standard in all departments.. portably, this projection is done when the pa y view is not possible. 40. . These adjustments remove the view of the overlap between the humerus and the glenoid. We prefer the apical oblique projection (aka Modified Trauma Axial, MTA; see p. 76), because it allows gentle positioning of the patient, provides excellent demonstration of dislocations and shows fractures extremely well 1, 2. IMAGE FILESIZE LIMITED TO LOW-REZ DIGITAL USE normal lumbar spine oblique view sacroiliac joints spinous processes Scottie dog pars interarticularis transverse process superior facet inferior facet joint lamina pedicle back plain X-ray . 9). If the image is not labelled, it is usually fair to assume it is a standard PA view. Antero-posterior (AP) view; Lateral/scapula Y view (named due to the "Y" shape of the scapula in this view) An axial view can also be used as an alternative to the scapula Y view if the patient is unable to tolerate the positioning required to obtain this view. 5-1). Here are a number of highest rated Chest X Ray Scapula pictures upon internet. B.2 and 3 only. 400. identify the projection. Abstract. Indications Orthogonal to the AP shoulder (note: as is an axillary view); this view is a pertinent projection to assess suspected dislocations, scapula fractures, and degenerative changes.

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