Unit 6 Chapter 5

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Which of the following structures is considered the most posterior? a. Scapular notch b. Coracoid process c. Acromion d. Glenoid process

c. acromion

Match each of the following projections with its corresponding method name. Methods names can be used more than once. A. Neer method B. Grashey method C. Bernageau method D. Fisk modification E. Garth method Inferosuperior axial

c. bernageau method

What is an alternative CR centering technique for an AP shoulder projection on an obese patient if unable to palpate the coracoid process? a. Center at level of jugular notch b. Center 2 inches below level of vertebral prominens c. Center 2 inches below AC joint d. Center at level of xiphoid process

c. center 2 inches below AC joints

Which of the following projections requires the CR to be centered 2 inches inferior and medial from the superolateral border of the shoulder? a. Tangential projection (Fisk modification) b. Inferosuperior axial (clements projection) c. Anterior oblique (Grashey method) d. Posterior oblique (Scapula Y lateral projection)

c. grashey method

Which position of the shoulder and proximal humerus projects the lesser tubercle in profile medially? a. External rotation b. Neutral rotation c. Internal rotation d. Exaggerated rotation

c. internal rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Humeral epicondyle angled 45° to IR

c. neutral rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Palm of hand against thigh

c. neutral rotation

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

What is most common clinical indication to perform the alexander method for the AC joints? a. Possible fracture of distal clavicle b. Possible fracture of coracoid process c. suspected AC joint separation d. Suspected subacromial spurs

c. suspected AC joint separation

The anterior surface of the scapula is referred to as the _____________ surface.

costal

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Condylar process

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Coronoid process

Which of the following devices permits good visualization of soft-tissue and bony anatomy for adult shoulder radiography? a. Wedge compensating filter b. Aluminum added filtration c. Trough compensating filter d. Boomerang compensating filter

Which of the following projections is best for demonstrating a possible dislocation of the proximal humerus? a. Anterior oblique (Grashey method) b. Fisk modification c. Inferosuperior axial (clements modification) process d. Posterior oblique (Scapular Y) projection

How much is the body rotation for a posterior oblique position (Grashey method)? A. 5° to 8° B. 10° to 15° C. 20° to 25° D. 35° to 45°

How much should the CR be angled for an AP axial projection of the clavicle on an asthenic patient? A. 5° B. 10° C. 20° D. 30°

What CR angle is required for the AP axial projection (zanca method) acromioclavicular (AC) joints? a. 25 degrees cephalad b. 45 degrees caudad c. 5 to 10 degrees caudad d. 10 to 15 degrees cephalad

d. 10 to 15 degrees cephalad

Select the term(s) that correctly describe(s) the shoulder joint. a. Humeroscapular b. Scapulohumeral c. Glenohumeral d. B and C

d. B and C

What type of CR angle is required for the lateral scapula position? Why? a. 10 to 15 degrees cephalad b. 5 to 15 degrees caudad c. 10 to 15 degrees caudad d. None

d. None because the CR is perpendicular to IR

The supine version of the tangential projections for the intertubercular sulcus requires that the CR be angled __________________ posteriorly from the horizontal plane.

10 to 15 degrees

Which special projection of the shoulder requires that the affected side be rotated 45 degrees toward the cassette and uses a 45 degrees caudad CR angle?

AP apical oblique axial projection

What two shoulder projections are taken routinely for a shoulder (with no traumatic injury) and proximal humerus?

AP external and internal rotation

Which specific joint is found on the lateral end of the clavicle? a. Scapulohumeral b. Sternoclavicular c. Acromioclavicular d. Glenohumeral

C. Acromioclavicular

Specifically, where is the central ray placed for an AP projection of the shoulder?

CR is 1-inch inferior to the coracoid process

Where is the CR centered for the AP scapula projection?

CR is 2 inches inferior to coracoid process or level at the axilla.

T/F The affected arm must be placed into external rotation for the transthoracic lateral projection

False

T/F The lateral scapula and posterior oblique (Scapular Y) projections are the same projection.

False

T/F The scapular Y lateral (posterior oblique) position requires the body to be rotated 25 to 30 degrees anteriorly toward the affected side.

False

T/F A central ray angle of 10 to 15 degrees caudad may be used for the transthoracic lateral shoulder projection if the patient is unable to elevate the uninjured arm and shoulder sufficiently and why.

False because CR is angled 10 to 15 degrees cephalad

T/F The PA axial transaxillary projection (Bernageau method) requires no CR angles, why.

False because CR is suppose to be angled 30 degrees caudad

What must be ruled out before performing the weight-bearing study for AC joints?

Fracture of clavicle

The three angles of the scapula includes the

Lateral, superior, and inferior

The __________ (Male or Female) clavicle tends to be thicker and more curved in shape.

Male

The ___________________________ projection is the special projection of the shoulder that best demonstrates the acromiohumeral space for possible subacromial spurs, which creates shoulder impingement symptoms (more than one answer possible).

Neer and Apical AP axial projection

Which two landmarks are placed perpendicular to the IR for the scapular Y lateral projection?

Superior angle of scapula and the AC joint articulation

Which lateral projection can be performed to demonstrate the entire humerus for a patient with a midhumeral fracture?

Transthoracic lateral projection for humerus

T/F Orthostatic (breathing) technique is recommended for the transthoracic lateral projection.

True

T/F The use of breathing technique can be performed for the transthoracic lateral humerus projection

True

T/F the transthoracic lateral projection can be performed for possible fractures or dislocations of the proximal humerus.

True

T/F: The greatest technical concern during a pediatric shoulder study is voluntary motion.

True

T/F It is recommended to perform shoulder positions on obese patients in the erect position when possible and why?

True because to reduce OID and part distortion

Which anatomy of the shoulder is best demonstrated with a PA axial (Bernageau method)? a. Scapulohumeral joint space b. Coracoacromial arch c. Coracoid process d. Intertubercular (bicipital) sulcus

a. scapulohumeral joint space

What is another term for the mid area of the costal surface of the scapula? A. Subscapular fossa B. Infraspinous fossa C. Supraspinous fossa D. Scapulohumeral surface

a. subscapular fossa

The use of automatic exposure control (AEC) is not recommended for the AP projection of the scapula. A. True B. False

a. true

The three aspects of the clavicle are the

acrominal end, body of clavicle, and sternal end

The _________ ___________ projection of the shoulder produces an image of the glenoid process in profile.

anterior oblique

What is the anatomic name for armpit?

axilla

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Acromial extremity

What type of CR angle should be used for the inferosuperior axial projection for the scapulohumeral joint space? a. 15 degrees medially b. 25 to 30 degrees medially c. 25 degrees anteriorly and medially d. 35 to 45 degree medially

b. 25 to 30 degrees medially

What type of CR angle is required for the apical AP axial shoulder projection? a. 10 to 15 degrees caudad b. 30 degrees caudad c. 45 degrees caudad d. 5 to 10 degrees cephalad

b. 30 degrees cauded

What is the minimal 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 lbs b. 8 to 10 lbs c. 12 to 15 lbs d. 20 to 30 lbs

b. 8 to 10 lbs

To best demonstrate a possible Hill-Sachs defect, which additional positioning technique can be added to the inferosuperior axial (Lawrence method) projection? a. Angle CR 10 to 15 degrees caudad b. Rotate affected arm externally approximately 45 degrees c. Angle CR 3 to 5 degrees caudad d. Place humeral epicondyles parallel to IR

b. rotate affected arm externally approximately 45 degrees

Which two positioning landmarks are aligned perpendicularly to the IR for the lateral scapula projection? a. Scapular spine and greater tubercle b. Superior angle and AC Joint c. AC Joint and greater tubercle d. Acromion and coracoid process

b. superior angle and ac joint

With which of the following projections can an orthostatic (breathing) technique be used? a. Grashey method b. Transthoracic lateral for humerus c. Scapular Y lateral d. Garth method

b. transthoracic lateral for humerus

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Greater Tubercle

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Intertubercular groove

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Surgical neck

Where is the CR centered for an AP projection-external rotation of the shoulder? a. Acromion b. 1 inch superior to coracoid process c. 1 inch inferior to coracoid process d. 2 inches inferior to acromioclavicular joint

c. 1 inch inferior to coracoid process

For the erect version of the tangential projection for the intertuberular sulcus, the patient leans forward ______________ from vertical. a. 5 to 7 degrees b. 20 to 25 degrees c. 10 to 15 degrees d. 35 to 45 degrees

c. 10 to 15 degrees

What type of CR angle is required for the apical AP axial shoulder (Garth method) projection? a. 15 degree cephalad b. 10 to 15 caudad c. 30 degrees caudad d. 45 degrees caudad

c. 30 degrees caudad

Which of the following kVp ranges should be used for a shoulder series on an average adult using a grid? a. 100 to 120 kVp b. 55 to 60 kVp c. 80 to 90 kVp d. 65 to 70 kVp

c. 80 to 90 kvp

An asthenic patient requires ___________ (more or less) CR angle for an AP axial clavicle projection than a hypersthenic patient.

A posterior dislocation of the humerus projects the humeral head _________________ (superior or inferior) to the glenoid cavity with the special projection described in the previous question.

superior

What are the three borders of the scapula?

superior, medial, lateral

All of the joints of the shoulder girdle are classified as being

synovial

T/F A 72-inch SID is recommended for adult AC joint studies.

true

T/F Shoulder projections are best performed erect when possible.

true

T/F The use of contact shields overs the breast, lungs, and thyroid regions is recommended for most shoulder projection.

true

T/F The use of the grid is not required for shoulder studies that measure less than 10cm.

true

Scapulohumeral is what type of movement joint?

Ball and socket

Acromioclavicular is what type of movement joint?

Plane

Sternoclavicular is what type of movement joint?

Plane

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Coracoid process

Name the anatomic structures with its correct location: A. Scapula B. Clavicle C. Proximal humerus D. Not part of the shoulder girdle Crest of spine

What CR angulation is required for the tangential projection-supraspinatus outlet (Neer method)? a. 10 to 15 degrees caudad b. 45 degrees caudad c. 25 degrees anteriorly and medially d. None; CR is perpendicular

a. 10 to 15 degrees caudad

What type of CR angulation is required for the inferosuperior axial projection for the shoulder? a. 25 to 30 degrees medially b. 35 to 45 degrees medially c. 25 degrees anterior and 25 degrees medially d. CR perpendicular to IR

a. 25 to 30 degrees medially

If the patient cannot fully abduct the affected arm 90° for the inferosuperior axial transaxillary projection (clements modification), the technologist can angle the CR __________________ degrees towards the axilla. a. 5 to 15 degrees b. 20 to 25 degrees c. 25 to 30 degrees d. 45 degrees

a. 5 to 15 degrees

If physical immobilization is required, which individual should be asked to restrain a child for a shoulder series? a. Parent or guardian b. Radiologic technologist c. Radiology student d. Nurse aide

a. parent or guardian

Which bony structure seperates the supraspinous and infraspinous fossae? a. Scapular spine b. Glenoid cavity c. Acromion d. superior border of scapula

a. Scapular spine

Which of the following projections best demonstrates the supraspinatous outlet regions? a. Tangential projection (Neer method) b. Fisk method c. Inferosuperior axial projection d. PA axial transaxillary projection (Bernageau method)

a. Tangential projection

What type of compensating filter is recommended for use on an AP shoulder projection for hypersthentic patient? a. Boomerang b. Trough c. Wedge d. Gradient

a. boomerang

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Epicondyles parallel to IR

a. external rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Greater tubercle profiled laterally

a. external rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Proximal humerus in position for an AP projection

a. external rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Supination of hand

a. external rotation

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. Anterior oblique (grashey method)

a. external rotation

Which of the following projections produces a tangential projection of the intertubercular sulcus (grooves) a. Fisk modification b. Grashey method c. Hobbs modification d. Lawrence method

a. fisk modification

a. neer method

Which following is not an angle found on the scapula? a. Inferior angle b. Medial angle c. Lateral angle d. superior angle

b. Medial angle

What is the type of joint movement for the scapulohumeral joint? a. Plane b. Ball and socket c. Ellipsoidal d. Pivot (trochoidal)

b. ball and socket

Which type of injury must be ruled out before the weight-bearing phase an AC joint study? a. Shoulder separation b. Fractured clavicle c. Bursitis of the scapulohumeral joint d. Bankart lesion

b. fractured clavicle

b. grashey method

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Epicondyles perpendicular to IR

b. internal rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Lesser tubercle profiled medially

b. internal rotation

Identify the correct proximal humerus rotation for the each of the following: A. External rotation B. Internal rotation C. Neutral rotation Proximal humerus in a lateral position

b. internal rotation

How are the humeral epicondyles aligned for a rotational lateromedial projection of the humerus? a. 45 degrees to IR b. Perpendicular to IR c. Parallel to IR d. 20 degrees angle to IR

b. perpendicular to IR

What is the major advantage of the supine, tangential version of the intertubercular, sulcus projection over the erect version? a. Less radiation exposure b. Reduced object-IR distance (OID) c. Less risk for motion d. Ability to use automatic exposure

b. reduced OID

Which of the following AP proximal shoulder projections will demonstrate the lesser tubercle in profile? A. External rotation B. Neutral rotation C. Internal rotation D. None of the above

c. Internal rotation

Which of the following nontrauma projections can be performed erect to provide. a lateral perspective of the proximal humerus in relationship to the scapulohumeral joint? a. Tangential projection (Fisk modification) b. AP projection-neutral rotation c. PA axial transaxillary projection (Bernageau method) d. Anterior oblique position (Grashey Method)

c. PA axial transaxillary projection

Which anatomy is best demonstrated by the Alexander method? a. Scapulohumeral joint b. Coracoid process c. Proximal humerus d. AC Joints

d. ac joints

Which of the following scapular structures is most posterior? A. Coracoid process B. Glenoid cavity C. Scapular notch D. Acromion

d. acromion

Which of the following structures of the scapula extends most anteriorly? a. glenoid cavity b. Acromion c. Scapular spine d. coracoid process

d. coracoid process

d. fisk modification

Which special projection of the shoulder places the glenoid cavity in profile for an "open" scapulohumeral joint? a. Garth method b. Transthoracic lateral (lawrence method) c. Fisk modification d. Grashey method

d. fisk modification

What type of CR angle is required for the pearson method for AC joints? a. 20 degrees cephalad b. 10 degrees cauded c. 25 to 30 degrees cephalad d. No CR angle

d. no CR angle

Which of the following humeral structures is most distal? A. Anatomic neck B. Greater tubercle C. Lesser tubercle D. Surgical neck

d. surgical neck

e. garth method

T/F A 72-inch SID is recommended for most shoulder girdle studies.

false

T/F A PA axial projection of the clavicle requires a 35° to 45° caudal CR angle.

false

T/F Large focal spot setting should be selected for most adult shoulder studies.

false

T/F Low mA with long exposure times should be used for adult shoulder studies.

false

T/F The kVp range for adult shoulder projection is between 100 to 110 kVp.

false

T/F The male clavicle is shorter and less curved than the female clavicle.

false

The anterior oblique projections is also referred to as ____________ method.

grashey method

The shoulder girdle consist of

humerus, scapular, and clavicle

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