M Ch 5

A

The large, rounded, elevated process prominently located on the lateral surface of the proximal humerus is the: a. greater tubercle. b. lesser tubercle. c. medial epicondyle. d. lateral epicondyle.

B

A Hill-Sachs defect is a: a. fracture due to posterior dislocation of the humeral head. b. wedge-shaped compression fracture of the articular surface of the humeral head. c. congenital deformity of the humeral head. d. congenital deformity of the glenoid cavity.

C

A Hill-Sachs defect may be demonstrated using which of the following projections? 1. Inferosuperior axial (Lawrence) 2. Inferosuperior axial (Rafert modification) 3. AP axial (Stryker notch) a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

D

A lateral projection of the shoulder and proximal humerus can be obtained with which of the following? a. PA oblique (scapular Y) b. Inferosuperior axial (Lawrence) c. Inferosuperior axial (West Point) d. Transthoracic lateral (Lawrence)

A

All of the joints of the shoulder girdle are: a. synovial, freely movable. b. fibrous, slightly movable. c. fibrous, immovable. d. cartilaginous, immovable.

C

For a transthoracic lateral projection of the shoulder, lung detail may be blurred to better visualize the shoulder area. Which exposure time is recommended to blur the lung structures? a. Minimum of 1 second b. Minimum of 2 seconds c. Minimum of 3 seconds d. Minimum of 5 seconds

B

For an AP projection of the scapula, the IR size and its position should be: a. 8 × 10 inches (18 × 24 cm) lengthwise. b. 10 × 12 inches (24 × 30 cm) lengthwise. c. 8 × 10 inches (18 × 24 cm) crosswise. d. 10 × 12 inches (24 × 30 cm) crosswise.

C

For an AP projection of the shoulder with the arm in a neutral position, the epicondyles of the humerus should be _____ with the plane of the IR. a. parallel b. perpendicular c. 45 degrees d. 60 degrees

A

For an AP projection of the shoulder with the humerus in internal rotation, the epicondyles of the humerus should be _____ with the plane of the IR. a. perpendicular b. parallel c. 45 degrees d. 60 degrees

D

For an AP projection of the shoulder, the central ray should be directed: a. 15 degrees. b. 30 degrees. c. 15 to 30 degrees. d. perpendicular to the IR.

A

For an AP projection of the shoulder, the central ray should enter _____ inch(es) inferior to the _____. a. 1; coracoid process b. 1; acromion c. 2; coracoid process d. 2; acromion

B

For delineation of the acromion and coracoid processes of the scapula in the lateral projection, how is the arm positioned? a. Flex the elbow and place the hand on the anterior abdomen. b. Flex the elbow and place the hand on the posterior thorax. c. Extend the arm upward and rest the forearm on the head. d. Extend the arm straight down at the side in the anatomic position.

D

For delineation of the body of the scapula for the lateral projection, how is the arm positioned? a. Flex the elbow and place the hand on the anterior abdomen. b. Flex the elbow and place the hand on the posterior thorax. c. Extend the arm straight down at the side. d. Extend the arm upward and rest the forearm on the head.

C

For the PA oblique projection (scapular Y) of the shoulder, the body is rotated so that the midcoronal plane is how many degrees from the IR? a. 25 b. 45 c. 45 to 60 d. 25 to 60

C

For the lateral projection of the scapula, the body is placed in which position? a. True lateral b. 15 degrees oblique c. RAO or LAO d. RPO or RAO

D

How far should the arm be abducted for an inferosuperior projection of the shoulder joint? a. 15 degrees b. 30 degrees c. 45 degrees d. 90 degrees

B

How far should the head, shoulders, and elbow be elevated for the inferosuperior axial projection of the shoulder? a. 2 to 3 inches b. 3 to 4 inches c. 4 to 5 inches d. 5 to 6 inches

A

How is the arm positioned for an AP scapula? a. Abducted 90 degrees, forearm flexed b. Abducted 90 degrees, forearm extended c. Adducted, lateral rotation d. Adducted, medial rotation

B

How is the central ray directed for an inferosuperior axial projection of the shoulder joint? a. 5 degrees horizontally b. 15 to 30 degrees horizontally c. 5 degrees cephalad d. 15 to 30 degrees cephalad

D

How many degrees is the body rotated for the AP oblique projection (Grashey method) of the shoulder joint? a. 20 degrees toward the affected side b. 20 degrees away from the affected side c. 35 to 45 degrees away from the affected side d. 35 to 45 degrees toward the affected side

D

How many pounds of weight should be affixed to each wrist for the AP projection of the AC joint? a. 2 lb b. 5 lb c. 2 to 4 lb d. 5 to 8 lb

D

How much is the body rotated for a PA oblique projection of the shoulder? a. 30 degrees b. 45 degrees c. 60 degrees d. 45 to 60 degrees

A

How should the central ray be angled for the AP projection (Pearson method) of the AC joints? a. 0 degrees b. 5 degrees cephalad c. 7 degrees cephalad d. 5 to 7 degrees cephalad

B

How should the humerus be positioned for an inferosuperior axial projection of the shoulder joint? 1. Internal rotation 2. External rotation 3. Neutral rotation a. 1 only b. 2 only c. 3 only d. 1, 2, and 3

B

If a breathing technique cannot be used for the transthoracic lateral projection of the shoulder, the exposure should be made using: a. full expiration. b. full inspiration. c. partial inspiration. d. partial expiration.

A

If the patient can be positioned properly, the central-ray angle for the transthoracic lateral projection of the shoulder is: a. 0 degrees. b. 5 degrees cephalad. c. 10 degrees cephalad. d. 15 degrees cephalad.

C

If the patient cannot elevate the unaffected shoulder for a transthoracic lateral projection of the shoulder, the central ray should be angled _____ degrees. a. 0 to 5 b. 5 to 10 c. 10 to 15 d. 15 to 25

B

If the patient places the back of the hand against the hip, the humerus will be in: a. external rotation. b. internal rotation. c. abduction. d. adduction.

D

If the patient places the palm of the hand against the thigh, the humerus will be in: a. lateral position. b. external rotation. c. internal rotation. d. neutral position.

B

In an image of an AP axial projection of the clavicle, the clavicle should be demonstrated with: 1. most of the clavicle projected above the ribs. 2. only the lateral end superimposing the coracoid process. 3. only the medial end superimposing the first or second ribs. a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

C

Letter A in the image below labels the: a. acromion. b. coracoid process. c. clavicle. d. first rib.

A

Letter B in the image below labels the: a. acromion. b. coracoid process. c. clavicle. d. glenoid.

B

Letter C in the image below labels the: a. acromion. b. coracoid process. c. clavicle. d. glenoid.

C

PA oblique projection of the shoulder (scapular Y) is performed to evaluate: a. carcinoma. b. fractures. c. dislocations. d. soft tissue swelling.

B

Patients often arrive in the radiology department with trauma to the shoulder. Which of the following positions is recommended for x-ray examination of the shoulder on these patients? a. Supine b. Upright c. Lateral recumbent d. Lateral decubitus

C

The AP projection of the AC joints places the joints at an increased OID. Which of the following is the recommended SID to compensate for this distance? a. 40 inches b. 48 inches c. 72 inches d. 120 inches

B

The IR size commonly used for an AP projection of the shoulder is: a. 8 × 10 inches (18 × 24 cm). b. 10 × 12 inches (24 × 30 cm). c. 11 × 14 inches (30 × 35 cm). d. 7 × 17 inches (18 × 43 cm).

C

The PA oblique projection of the shoulder joint (scapular Y) is performed in which of the following positions? a. AP b. Lateral c. RAO or LAO d. RPO or LPO

D

The Pearson method is an AP projection of the: a. shoulder joint. b. proximal humerus. c. scapulohumeral joint. d. acromioclavicular articulation.

B

The SC articulation is formed by the sternal extremity of the clavicle and the: 1. manubrium. 2. sternum. 3. first rib cartilage. a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

D

The acromial extremity of the clavicle articulates with the: a. glenoid cavity. b. coracoid process. c. sternal extremity of the clavicle. d. acromion process of the scapula.

B

The anatomy labeled in the image below by the arrowhead is the: a. acromion. b. coracoid process. c. glenoid. d. lesser tubercle.

B

The area of the proximal humerus located directly below the tubercles, which is the site of many fractures, is called the: a. anatomic neck. b. surgical neck. c. coracoid process. d. intertubercular groove.

D

The articulation between the glenoid cavity and head of the humerus is called the _____ joint. a. synovial b. spheroidal c. acromioclavicular d. scapulohumeral

C

The bone part identified in the figure above is the: a. acromion. b. costal surface. c. coracoid process. d. glenoid cavity.

D

The bony area identified in the figure above is the: a. acromion. b. costal surface. c. coracoid process. d. glenoid cavity.

D

The central-ray angle for an AP axial projection of the clavicle when performed on a patient in the supine position is _____ degrees. a. 15 b. 25 c. 15 to 25 d. 15 to 30

A

The central-ray angulation for a lateral scapula is: a. 0 degrees. b. 5 degrees caudad. c. 10 degrees cephalad. d. 5 to 10 degrees cephalad.

B

The clavicle is classified as a(n) _____ bone. a. short b. long c. flat d. irregular

C

The depression identified in the figure above is called the: a. infraspinous fossa. b. supraspinous fossa. c. intertubercular groove. d. surgical neck.

C

The glenoid of the scapula in the image below is labeled as letter: a. B. b. C. c. D. d. E.

B

The greater tubercle will be partially superimposed over the humeral head on which of the following projections and positions? a. AP, external rotation b. AP, neutral rotation c. AP, internal rotation d. PA oblique, scapular Y

C

The lesser tubercle is situated on which surface of the humerus? a. Medial b. Lateral c. Anterior d. Posterior

A

The part identified in the figure above is the: a. acromion. b. coracoid process. c. glenoid cavity. d. superior border.

B

The part identified in the figure above is the: a. superior angle. b. inferior angle. c. coracoid process. d. lateral border.

B

The part identified on the clavicle in the figure above is the: a. sternal extremity. b. acromial extremity. c. inferior angle. d. subscapular fossa.

B

The projection in the image below was obtained with the arm positioned in: a. neutral position. b. external rotation. c. internal rotation. d. oblique rotation.

B

The projection of the shoulder demonstrated in the figure above is the: a. axiolateral. b. inferosuperior axial (Lawrence). c. transthoracic lateral (Lawrence). d. acromioclavicular (Pearson).

D

The respiration phase for an AP projection of the scapula is: a. inspiration. b. expiration. c. suspended respiration. d. shallow breathing.

C

The respiration phase for an AP projection of the shoulder should be: a. inspiration. b. expiration. c. suspended. d. shallow breathing.

D

The rounded head of the humerus fits into an oval depression on the lateral aspect of the scapula called the: a. neck. b. acromion. c. lateral angle. d. glenoid cavity.

A

The scapula is classified as a(n) _____ bone. a. flat b. short c. long d. irregular

C

The scapulohumeral articulation is classified as a _____ joint, _____ type. a. cartilaginous; gliding b. fibrous; gliding c. synovial; ball and socket d. synovial; condyloid

D

The small, rounded, elevated process identified in the figure above is the: a. acromion. b. anatomic neck. c. greater tubercle. d. lesser tubercle.

A

The small, synovial fluid-filled sacs, which relieve pressure and reduce friction in joint tissues, are called: a. bursae. b. ligaments. c. tendons. d. cartilage.

B

The use of compensating filters is particularly useful when using: a. small focal spot. b. digital radiography systems. c. detail film/screen IR. d. less collimation.

B

The white arrow in the image below points to the: a. acromion. b. coracoid process. c. greater tubercle. d. lesser tubercle.

C

To demonstrate the greater tubercle of the humerus on an AP projection of the shoulder, the epicondyles must be: a. in a neutral position. b. at a 45-degree angle with the plane of the IR. c. parallel with the plane of the IR. d. perpendicular with the plane of the IR.

A

To elevate the clavicle above the ribs and scapula for the AP axial projection, the phase of respiration should be: a. full inspiration. b. full expiration. c. shallow breathing. d. suspended respiration.

B

To obtain a more uniform image density, the respiration phase for the AP projection of the clavicle should be: a. inspiration. b. expiration. c. shallow breathing. d. suspended respiration.

B

Two exposures are commonly made of the AC joints—one without weights and one with weights. How are the weights applied? a. Affixed to the elbows b. Affixed to the wrists c. Held in the hands d. Held by the fingers

B

What anatomy is labeled as letter A in the image below? a. Greater tubercle b. Lesser tubercle c. Acromion d. Coracoid process

D

What anatomy is labeled as letter C in the image below? a. Greater tubercle b. Lesser tubercle c. Acromion d. Coracoid process

A

What anatomy is labeled as letter D in the image below? a. Glenoid b. Lesser tubercle c. Acromion d. Coracoid process

A

What is the central-ray angle for the PA oblique projection (scapular Y) of the shoulder joint? a. 0 degrees b. 5 degrees caudad c. 10 degrees caudad d. 15 degrees caudad

A

What is the central-ray angulation for the AP oblique projection (Grashey method) of the shoulder joint? a. 0 degrees b. 5 degrees c. 0 to 5 degrees d. 5 to 10 degrees

D

What projection (method) is demonstrated in the image below? a. AP oblique (Grashey) b. PA oblique (Scapular Y) c. Transthoracic (Lawrence) d. Inferosuperior axial (Lawrence)

B

What projection, position, and anatomy of interest in the image below is demonstrated? a. AP projection of the shoulder in external rotation b. AP projection of the shoulder in internal rotation c. AP projection of the shoulder in neutral position d. AP oblique projection of the shoulder (Grashey)

D

When the Fisk modification is used for the tangential projection of the intertubercular groove, the patient is: a. prone. b. supine. c. sitting. d. standing.

D

When the Fisk modification is used for the tangential projection of the intertubercular groove, the vertical humerus is placed at an angle of _____ degrees. a. 0 b. 5 c. 5 to 10 d. 10 to 15

C

When the arm cannot be rotated or abducted due to injury, which of the following can be used to perform a lateral projection of the shoulder? a. Tangential projection, Settegast method b. PA axial projection, Holmblad method c. Transthoracic lateral projection, Lawrence method d. AP projection, Pearson method

A

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. a. perpendicular to b. parallel with c. at a 30-degree angle to d. at a 60-degree angle to

A

When the tangential projection of the intertubercular groove is performed with the patient supine, the position of the hand is: a. supinated. b. pronated. c. lateral. d. neutral.

C

Where should the center of the IR be positioned for a lateral projection of the shoulder? a. Acromion process b. Anatomical neck c. Surgical neck d. Greater tubercle

C

Which of the following are achieved when the transthoracic lateral projection of the shoulder is done on full inspiration? 1. Wide latitude 2. Higher contrast 3. Decrease in exposure a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

D

Which of the following are clearly demonstrated on the inferosuperior axial projection of the shoulder joint? 1. Proximal humerus 2. Scapulohumeral joint 3. Acromioclavicular articulation a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

A

Which of the following bones connect the upper limb to the trunk? 1. Clavicle 2. Scapula 3. Humerus a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

C

Which of the following bones make up the shoulder girdle? 1. Humerus 2. Scapula 3. Clavicle a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

B

Which of the following is prominently shown in profile on an AP projection of the shoulder with the humerus in external rotation? a. Lesser tubercle b. Greater tubercle c. Scapulohumeral joint d. Acromioclavicular joint

A

Which of the following is prominently shown in profile on an AP projection of the shoulder with the humerus in internal rotation? a. Lesser tubercle b. Greater tubercle c. Glenoid cavity d. Acromioclavicular joint

A

Which of the following methods best demonstrates the supraspinatus outlet (coracoacromial arch)? a. Neer b. Alexander c. West Point d. Stryker notch

D

Which of the following positions of the humerus are commonly used when performing an AP projection of the shoulder? 1. External rotation 2. Neutral rotation 3. Internal rotation a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

D

Which of the following projections are improved significantly with the use of a compensating filter? 1. AP shoulder 2. Lateral scapula 3. PA oblique (scapular Y) a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

D

Which of the following projections can be used to demonstrate the clavicle? 1. AP or PA 2. AP axial 3. PA axial a. 1 and 2 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3

C

Which of the following projections clearly demonstrates the glenoid cavity? a. AP b. PA oblique (scapular Y) c. AP oblique (Grashey) d. Transthoracic lateral (Lawrence)

B

Which of the following structures is projected in lateral profile on a PA oblique (scapular Y) projection? a. Humerus b. Scapula c. Clavicle d. Acromion

B

Which of the following will be directly superimposed over the junction of the Y on the PA oblique (scapular Y) projection? a. Humerus b. Humeral head c. Coracoid process d. Acromion process

B

Which position of the hand will place the humerus in external rotation? a. Prone b. Supine c. Palm against the thigh d. Back of the hand against the thigh

D

Which position of the hand will place the humerus in internal rotation? a. Prone b. Supine c. Palm against the thigh d. Back of the hand against the thigh

C

Which position of the hand will place the humerus in neutral position? a. Prone b. Supine c. Palm against the thigh d. Back of the hand against the thigh