Self-Test for Chapter 5 Humerus & Shoulder Girdle

Superior displacement of distal clavicle

Acromioclavicular joint dislocation

For the erect version of the tangential projection for the intertubercular groove, the patient leans forward ________________ from vertical. A. 5 to 7 degree C. 10 to 15 degree B. 20 to 25 degree D. 35 to 45 degree

C. 10 to 15 degree

Where is the CR centered for an AP projection-external rotation of the shoulder? A. Acromion C. 1in (2.5cm)inferior to coracoid process B. 1in(2.5cm) superior to coracoid process D. 2in (5cm) inferior to Acromioclavicular joint

C. 1in (2.5cm)inferior to coracoid process

Situation: A patient enters ER with proximal & midhumeral fracture. The patient is in extreme pain. Which positioning routines would demonstrate the entire humerus without excessive movement of limb? A. AP & mediolateral humerus B. AP & transthoracic lateral (Lawrence method) C. AP & transthoracic lateral of humerus D. AP & scapular Y lateral

C. AP & transthoracic lateral of humerus

Which specific joint is found on the lateral end of the clavicle? A. Scapulohumeral C. Acromioclavicular B. Sternoclavicular D. Glenohumeral

C. Acromioclavicular

Which one of the following structures is considered to be the most posterior? A. Scapular notch C. Acromion B. Coracoid process D. Glenoid process

C. Acromion

Situation: A patient with a possible shoulder dislocation enters the ER. A neutral AP projection of the shoulder has been taken, confirming a dislocation. Which additional projection should be taken? A. Inferosuperior axial (Clements modification) B. Alexander method C. Garth method D. AP; external rotation

C. Garth method

Which position of the shoulder & proximal humerus projects the lesser tubercle in profile medially? A. External rotation C. Internal rotation B. Neutral rotation D. Exaggerated rotation

C. Internal rotation

Which one of the following projections requires the CR to be centered 2in (5cm) inferior & medial from the superolateral border of the shoulder? A. Tangential projection (Fisk modification) B. Inferosuperior axial (Clements projection) C. Posterior oblique (Grashey method) D. Scapula Y lateral projection

C. Posterior oblique (Grashey method)

Which anatomy of the shoulder is best demonstrated with a PA transaxillary projection (Hobbs modification)? A. Scapulohumeral dislocations B. Coracoacromial arch C. Coracoid process D. Scapula in profile

C. Scapulohumeral dislocations

Which clinical indication is best demonstrated with the Garth method? A. Bursitis B. Rheumatoid arthritis C. Scapulohumeral dislocations D. Signs of shoulder impingement

C. Scapulohumeral dislocations

Which anatomy is best demonstrated with the Alexander method? A. Scapulohumeral joint B. Coracoid process C. Proximal humerus D. AC joints

D. AC joints

Which one of the following structures of the scapula extends most anteriorly? A. Glenoid cavity C. Scapular spine B. Acromion D. Coracoid process

D. Coracoid process

Which special projection of the shoulder places the glenoid cavity in profile for an "open" Scapulohumeral joint? A. Garth method B. Transthoracic lateral-Lawence method C. Fisk modification D. Grashey method

D. Grashey method

Which one of the following imaging modalities or procedures best demonstrate osteomyelitis? A. Ultrasound C. CT arthrography B. MRI D. Nuclear medicine

D. Nuclear medicine

A radiograph of posterior oblique (Grashey method) reveals that the anterior & posterior glenoid rims are not superimposed. Erect, body rotated 25 to 30 degree toward affected side, CR perpendicular to Scapulohumeral joint space, & affected arm slightly abducted in neutral rotation. Which one of the following modifications will superimpose the glenoid rims during the repeat exposure? A. Angle CR 10 to 15 degree caudad B. Rotate body less toward affected side C. Place affected arm in external rotation position D. Rotate body more toward affected side

D. Rotate body more toward affected side

Which one of the following projections and/or positions best demonstrates signs of impingement syndrome? A. AP & lateral shoulder external rotation B. Inferosuperior axial C. Inferosuperior axial with exaggerated rotation D. Tangential projection (Neer method)

D. Tangential projection (Neer method)

Situation: A patient comes to the radiology department with a history of tendonitis of biceps tendon. Which projection will best demonstrate calcification of tendon within the intertubercular groove? A. Garth method B. Grashey method C. PA transaxillary projection (Hobbs modification) D. Tangential projection-Fisk modification

D. Tangential projection-Fisk modification

True/False: A PA axial projection of the clavicle requires a 35 to 45 degree caudal CR angle

False

True/False: The male clavicle is shorter & less curved than the female clavicle.

False

Reduction in the quantity of bone

Osteoporosis

True/False: A 72in SID is recommended for Acromioclavicular joint studies.

True

True/False: Even though the amount of radiation exposure is minimal for most shoulder projections, gonadal shielding should be used for children & adults of childbearing age.

True

True/False: The greatest technical concern during a pediatric shoulder study is voluntary motion.

True

What CR angulation is required for the tangential projection-supraspinatus outlet (Neer method)? A. 10 to 15 degree caudad B. 45 degree caudad C. 25 degree anteriorly & medially D. None; CR is perpendicular

A. 10 to 15 degree caudad

If the patient cannot fully abduct the affected arm 90 degree for the Inferosuperior axial projection (Clements Modification), the technologist can angle the CR __________ toward the axilla. A. 5 to 15 degree B. 20 to 25 degree C. 25 to 30 degree D. 45 degree

A. 5 to 15 degree

Situation: A patient with a possible right shoulder separation enters the ER. Which one of the following routines should be used? A. Acromioclavicular joint series: Non-weight-bearing & weight-bearing projections B. AP neutral projection & Garth method C. AP neutral & transthoracic lateral projections D. AP internal & external projections

A. Acromioclavicular joint series: Non-weight-bearing & weight-bearing projections

Which routine projection of the shoulder requires that the humeral epicondyles be parallel to the IR? A. External rotation B. Neutral rotation C. Internal rotation D. Posterior oblique-Grashey method

A. External rotation

A radiograph of an AP axial clavicle taken on an asthenic type patient reveals the clavicle is projected in lung field below the top of shoulder. Erect, CR angled 15 degree cephalad, 40in SID, & respiration suspended at end of expiration. Which one of the following modification should be made during repeat exposure? A. Increase CR angulation B. Suspended respiration at end of inspiration C. Reverse CR angulation D. Use 72in SID

A. Increase CR angulation

Which one of the following analog techniques considerations does not apply for adult shoulder radiography? A. Non-grid B. High-speed IR C. 40 to 44-inch (102 to 113-cm) SID D. 70 to 80 kV

A. Non-grid

Which one of the following pathologic conditions often produces narrowing of the joint space? A. Osteoarthritis B. Bursitis C. Osteoporosis D. Idiopathic chronic adhesive capsulitis

A. Osteoarthritis

Which bony structure separates the supraspinous & infraspinous fossae? A. Scapular spine B. Coracoid process C. Acromion D. Superior border of scapula

A. Scapular spine

Which one of the following projections best demonstrates the supraspinatus outlet region? A. Tangential projection (Neer method) B. Fisk method C. Inferosuperior axial D. PA transaxillary projection (Hobbs modification)

A. Tangential projection (Neer method)

Which one of the following imaging modalities or procedures provides a functional, or dynamic, study of the shoulder joint? A. Ultrasound C. Nuclear medicine B. Radiography D. MRI

A. Ultrasound

An AP apical oblique axial (Garth method) radiographic image demonstrates poor visibility of the shoulder joint. The tech used factors like: patient erect, facing the x-ray tube, 45 degree rotation of affected shoulder toward the IR, 45 degree cephalad angle, & CR centered to Scapulohumeral joint. What factor contributed to this poor Garth position? A. Wrong direction of CR angle B. Incorrect CR centering C. Position must be performed recumbent D. Shoulder rotated wrong direction

A. Wrong direction of CR angle

What CR angle should be used for the Inferosuperior axial projection for the Scapulohumeral joint space? A. 15 degree medially B. 25 to 30 degree medially C. 25 degree anteriorly & medially D. 35 to 45 degree medially

B. 25 to 30 degree medially

What is the minimum amount of weight a large adult should have strapped to each wrist for the weight-bearing phase of an AC joint study? A. 5 to 7 lb C. 12 to 15 lb B. 8 to 10 lb D. 20 to 30 lb

B. 8 to 10 lb

Which type of injury must be ruled out before the weight-bearing phase of an AC joint study? A. Shoulder separation B. Fractured clavicle C. Bursitis of the Scapulohumeral joint D. Bankart lesion

B. Fractured clavicle

Which of the following in NOT an angle found on the scapula? A. Inferior angle C. Lateral angle B. Medial angle D. Superior angle

B. Medial angle

Situation: A patient is referred to radiography for nontrauma shoulder series. The routine calls for a PA transaxillary projection (Hobbs modification) be included. But the patient is unable to stand & is confined to a wheelchair. What should the tech do? A. Ask another tech to hold patient erect B. Perform the projection with patient's upper chest prone on the table C. Perform a recumbent posterior oblique D. Eliminate projection from routint

B. Perform the projection with patient's upper chest prone on the table

How are the humeral epicondyles aligned for a rotational lateromedial projection of the humerus? A. 45 degree to IR B. Perpendicular to IR C. Parallel to IR D. 20 degree angle to IR

B. Perpendicular to IR

What is the major advantage of the supine, tangential version of the intertubercular groove projection over the erect version? A. Less radiation exposure B. Reduced OID C. Less risk for motion D. Ability to use Automatic exposure control (AEC)

B. Reduced OID

Which one of the following pathologic conditions may require a reduction in manual exposure factors? A. Bursitis B. Rheumatoid arthritis C. Rotator cuff tear D. Bankart lesion

B. Rheumatoid arthritis

Select the term that correctly describes the shoulder joint. A. Humeroscapular C. Glenohumeral B. Scapulohumeral D. B & C

B. Scapulohumeral C. Glenohumeral

What is the type of joint movement for the Scapulohumeral joint? A. Plane C. Ellipsoidal B. Spheroidal D. Trochoidal

B. Spheroidal

Which two positioning landmarks are aligned perpendicularly to IR for the lateral scapula projection? A. Scapular spine & greater tubercle B. Superior angle & AC joint C. AC joint & greater tubercle D. Acromion & coracoid process

B. Superior angle & AC joint

Which one of the following projections can a breathing technique be employed? A. Grashey method B. Transthoracic lateral for humerus C. Scapular Y lateral D. Garth method

B. Transthoracic lateral for humerus

To best demonstrate the Hill-Sachs defect on the Inferosuperior axial projection, which additional positioning maneuver must be used? A. Angle CR 35 degree medially B. Use exaggerated external rotation C. Use exaggerated internal rotation D. Abduct arm 120 degree rotation from midsagittal plane

B. Use exaggerated external rotation

Injury to the anteroinferior glenoid labrum

Bankart lesion

Compression fracture of humeral head

Hill-Sachs defect

Disability of the shoulder joint caused by chronic inflammation in & around the joint

Idiopathic chronic adhesive capsulitis

Chronic systemic disease with arthritic inflammatory changes throughout the body

Rheumatoid arthritis

Traumatic injury to one or more muscles of the shoulder joint

Rotator cuff tear