1. 1 RT 124 – week 2 SHOULDER Shoulder/Ribs Unit - #1 lecture rev 2010

2. 2 SHOULDER –ROUTINE –TRAUMA Week 3 CLAVICLE A/C JOINTS Scapula RIBS STERNUM Week 2 Week 4

3. 3 CLAVICLE AP LT CLAVICLE - UPRIGHT AXIAL LT CLAVICLE- UPRIGHT AP RT CLAVICLE - SUPINE AXIAL RT CLAVICLE- SUPINE A/C JOINTS A/C JTS – (BILATERAL) W/O WTS A/C JTS – (BILATERAL) WITH WTS LT - A/C JTS - W/O WTS LT - A/C JTS – WITH WTS SHOULDER (UPRIGHT OR SUPINE) NON- TRAUMA AP RT SHOULDER – INT ROT AP RT SHOULDER – EXT ROT LT SHOULDER – GRASHEY TRAUMA AP RT SHOULDER – NEUTRAL ROT LT SHOULDER – TRANSTHORACIC LAT RT SHOULDER – SCAPULAR Y SCAPULA (UPRIGHT OR SUPINE) AP, LAT – RT SCAPULA SC joints – Lecture only RIBS – (UPRIGHT OR SUPINE) UNILATERAL: AP RT UPPER & LOWER RIBS PA RT UPPER & LOWER RIBS OBLIQUE – FOR RT AXILLARY UPPER RIBS OBLIQUE – FOR RT AXILLARY LOWER RIBS OBLIQUE – FOR RT POSTERIOR UPPER RIBS OBLIQUE – FOR RT POSTERIOR LOWER RIBS BILATERAL: AP BILATERAL UPPER RIBS AP BILATERAL LOWER RIBS PA BILATERAL UPPER RIBS PA BILATERAL LOWER RIBS RPO - BILATERAL UPPER RIBS RPO BILATERAL LOWER RIBS LPO - BILATERAL UPPER RIBS LPO BILATERAL LOWER RIBS STERNUM “PA” - RAO LATERAL - UPRIGHT, RECUMBANT LATERAL SUPINE – XTABLE LATERAL SHOULDER & THORAX CH. 6 & 9

4. 4 Projections for Lab Demonstration & Practice This WEEK LAB SHOULDER – ROUTINE – AP : EXT & INT ROT – GRASHEY OBLIQUE GLENOID FOSSA – SHOULDER – TRAUMA – AP Neutral – Transthoracic Lateral – AP Oblique – Scapular Y

5. 5 SHOULDER GIRDLE Anterior Posterior view

6. 6

7. 7 LATERIAL VIEW

8. 8

9. 9

10. 10

11. 11 ARTICULATIONS

12. 12

13. 13 SHOULDER SERIES begin series notes….. REVIEW PAGES IN MERRILLS

14. 14

15. 15 ROUTINE SHOULDER AP – EXTERNAL ROTATION AP - INTERNAL ROTATION (NEUTRAL ROTATION) GRASHEY (OBLIQUE) AXILLARY (INFERIOR/SUPERIOR) –(Lecture only) Lab demo only Sup/Inf

16. 16

17. 17 EXTERNAL ROTATION

18. 18

19. 19

20. 20 INTERNAL ROTATION

21. 21

22. 22 NEUTRAL ROTATION

23. 23

24. 24

25. 25

26. 26

27. 27

28. 28

29. 29 GRASHEY OBLIQUE OF SHOULDER TO OPEN UP JOINT SPACE

30. 30

31. 31

32. 32

33. 33 Inferosuperior axial shoulder joint: Lawrence method / Axillary “view”

34. 34

35. 35

36. 36

37. 37

38. 38

39. 39

40. 40 Alternate positioning not in lab

41. 41 Alternate axillary Will demo in lab

42. 42 OUTLET VIEW NOT IN LAB

43. 43 “TRAUMA SERIES” SHOULDER AP – NEUTRAL “AS IT LAYS” TRANSTHORACIC LATERAL SCAPULAR Y - FOR SHOULDER

44. 44

45. 45

46. 46

47. 47 TRANSTHORACIC LATERAL

48. 48

49. 49 TransThroacic LAT – BREATHING TECH

50. 50 Scapular Y for shoulder PA OBLIQUE

51. 51

52. 52

53. 53

54. 54

55. 55

56. 56 ANTERIOR DISLOCATION PA oblique shoulder joint showing anterior dislocation (humeral head projected beneath coracoid process).

57. 57

58. 58

59. 59 Film Critque & Anatomy Review

60. 60

61. 61

62. 62

63. 63 Immobilization necessary Some PATHOLOGY

64. 64

65. 65 Position?

66. 66 Position? Path?

67. 67 Calcific tendonitis/ Position? Important to include soft tissue of shoulder

68. 68 Position? Pathology?

69. 69 Position? Pathology?

70. 70 ANTERIOR DISLOCATION PA oblique shoulder joint showing anterior dislocation (humeral head projected beneath coracoid process).

71. 71 Posterior dislocation

72. 72 Position? Pathology?

73. 73 Pseudoarthosis

74. 74 there is separation of humeral head from glenoid fossa caused by fluid in joint space.

75. 75 Osteolytic metastasis to humerus from carcinoma of kidney.

76. 76

77. 77 DISLOCATION OF SHOULDER Anterior Posterior

78. 78 Position? Pathology?

79. 79 Projections for Lab Demonstration & Practice This WEEK LAB SHOULDER – ROUTINE – AP : EXT & INT – GRASHEY OBLIQUE GLENOID FOSSA Practice in classroom during lab testing….. Then in lab

80. 80 Projections for Lab Demonstration & Practice THIS WEEK or Next SHOULDER – TRAUMA – AP Neutral – Transthoracic Lateral – AP Oblique – Scapular Y

81. 81 Shoulder & Bony Thorax 2010 Part 2 CLAVICLE AC JOINTS Part 3 SCAPULA STERNUM – Part 4 RIBS –