1. Victoria Clague, MD

2. Imaging Orientation CT imaging based on different body densities. Bone is the most dense Air is least dense Muscle intermediate density Fat is less dense than fluid, more dense than air Vessels are intermediate density unless intravenous contrast is administered (in which case they are very dense) LeftRight Air Front Back Left Right

4. Ascending aorta Left ventricle Right Atrium Pulmonary artery Ao RALV PA

5. Aortic valve (AV) Trachea (T) Superior Vena Cava (SVC) Right Atrium AV T SVC RA LV AO

6. Name this structure \ A.Left atrium B.Left ventricle C.Right atrium D.Right ventricle X

7. Name this structure \ A.Left atrium B.Left ventricle C.Right atrium D.Right ventricle X

8. Vasculature Arteries Brachiocephalic Common carotid Internal External Subclavian Vertebral

9. Arteries Internal carotid External carotid Vertebral Common carotid Subclavian Brachiocephalic

10. Vasculature Branches of the subclavian artery Vertebral Internal thoracic Thyrocervical trunk Thoracoacromial V IT TC TA

11. Name this structure A. Left subclavian artery B. Right subclavian artery C. Left Vertebral artery D. Left common carotid artery

12. Name this structure A. Left subclavian artery B. Right subclavian artery C. Left Vertebral artery D. Left common carotid artery

13. Shoulder Greater mobility of joint compared to hip as it is not weight bearing Mobility can leads to problems of dislocation and impingement Scapular shape belies its role as scaffold for muscular attachments

14. Anterior Y view Axillary view

15. Scapula Scaffolding for Muscle attachments Spine to scapula Trapezius Rhomboids Scapula to humerus Deltoid Supraspinatus Scapula to chest wall Serratus anterior

16.  A. acromion  B. angle of the scapula  C. scapular wing  D. corocoid process X

17.  A. acromion  B. angle of the scapula  C. scapular wing  D. corocoid process X

19. Orientation MR imaging – based on proton spins of water. On this T1 sequence: Fat is bright Soft tissue density is medium Cortical bone is very dark Tendons are very dark

20. T1 routine T2 with fat saturation T1 with fat saturation In all sequences fluid in the joint is bright

22. Shoulder MRI Humeral head Glenoid Supraspinatus tendon Hum GL ST

23. Top to bottom Bones Scapula (Sc) Glenoid labrum Humeral head (Hum) Muscles Deltoid (D) Infraspinatus (Infr) Subscapularis (Sub) Biceps Tendon (Bic) Sc Hum D D Sub Infr Bic

24. Normal

26.  Shoulder most commonly dislocated joint  Anterior dislocation most common  Usually caused by trauma  Rotator cuff tears and prior dislocations are a risk factor

27. Stability of the glenohumeral joint is dependent on  Glenohumeral ligaments  Capsule  Muscles of the rotator cuff

28. NORMAL

30.  Small opening between acromioclavicular joint and humeral head predisposes supraspinatus to tears more than other rotator cuff muscles  Degenerative spurs or osteophytes at the acromioclavicular joint are a risk factor, further irritating the tendon