Humerus & Shoulder Girdle Exam Questions

What are the three borders of the scapula?

Medial border, superior border, lateral border

What are the 3 angles of the scapula?

Lateral angle, superior angle, inferior angle

What are the 2 surfaces of the scapula?

Costal surface, dorsal surface

AP Proximal Humerus (External Rotation)

• Epicondyles parallel to IR

• Greater Tubercle lateral

• Lesser Tubercle anteriorly

• CR 1 inch below coracoid process

Lateral Proximal Humerus (Internal Rotation)

• Epicondyles are perpendicular to IR

• Greater Tubercle anterior

• Lesser Tubercle in profile medially

• CR 1 inch below coracoid process

Inferosuperior Axial is also known as

Lawrence Method

Inferosuperior Axial (Lawrence Method)

• IR against neck

• “shooting through the armpit”

• Palm up

• CR 25-30 degrees medial to axilla (rotation of tube)

• Arm supinated, abducted 90 degrees

Superior Inferior (Axillary View)

Pt is seated at the end of the table, and you shoot from the top to the bottom with a small tube angle, about 5-10

AP oblique- Glenoid Cavity (Grashey Method)

• CR perpendicular

• 45 degrees oblique

Scapular Y lateral

(Shoulder Y lateral)

• For lateral shoulder and proximal humerus

• CR to proximal humerus

Transthoracic Lateral

• CR perpendicular to surgical neck

• Has breathing technique

AP clavicle

• CR perpendicular

• CR to mid clavicle

AP Axial Clavicle

• CR 15-30 degrees cephalad

• CR to mid clavicle

AC joints

• CR to midpoint between AC joints

• with and without weights

• 72 inch SID

AP Scapula

• Breathing technique

• CR to mid scapula

Lateral Scapula

• For body of scapula

• CR to mid vertebral border

Select the term that best describes the shoulder joint

Scapulohumeral and Glenohumeral

Which specific joint is found on the lateral end of the clavicle?

Acromioclavicular

Which of the following structures of the scapula extends most anteriorly?

Coracoid process

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

false

Which bony structure separates the supraspinous and infraspinous fossae?

scapular spine

Which of the following structures is considered the most posterior?

acromion

Which of the following technical considerations does not apply for adult shoulder radiography?

Nongrid

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

true

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

true

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

Idiopathic Chronic Adhesive Capsulitis

Injury to the anteroinferior glenoid labrum

Bankart lesion

Chronic systemic disease with arthritic inflammatory changes throughout the body

Rheumatoid arthritis

Superior displacement of distal clavicle

AC joint dislocation

Compression fracture of humeral head

Hill-Sachs defect

Traumatic injury to one or more muscles of the shoulder joint

Rotator cuff tear

Reduction in the quantity of bone

Osteoporosis

Which of the following projections and/or positions best demonstrates signs of impingement syndrome in the acromiohumeral space?

Apical AP axial projection

Which of the following pathologic conditions often produces narrowing of the joint space?

Osteoarthritis

Which of the following pathologic conditions may require a reduction in manual exposure factors?

Rheumatoid arthritis

What is an alternative CR centering technique for an AP shoulder projection on an obese patient if unable to palpate the coracoid process?

Center 2 inches below AC joint

Which routine projection of the shoulder requires that the humeral epicondyles be parallel to the IR?

External Rotation

Where is the central ray centered for an AP projection— external rotation of the shoulder?

1 inch inferior to coracoid process

Which position of the shoulder and proximal humerus projects the lesser tubercle in profile medially?

Internal rotation

How are the humeral epicondyles aligned for a rotational lateromedial projection of the humerus?

Perpendicular to IR

Which special projection of the shoulder places the glenoid cavity in profile for an “open” scapulohumeral joint?

Grashey method

Which of the following projection best demonstrates the supraspinatus outlet region?

Tangential Projection (Neer method)

What central ray angulation is required for the tangential projection-supraspinatus outlet (Neer method)?

10 to 15 degrees caudad

Which anatomy of the shoulder is best demonstrated with a PA axial?

Scapulohumeral joint space

True/False: A 72 inch SID is recommended for adult AC joint studies

true

A patient with a possible right-shoulder separation enters the emergency room. which of the following routine should be performed?

AC joint series: non-weight bearing and weight-bearing projection

What does the humerus articulate with?

Scapula

Anatomic neck

Slightly constricted area below and lateral to the head

Lesser tubercle

Process directly below the anatomical neck on the anterior surface

Greater tubercle

Large lateral process

Intertubecular groove

Deep groove between the two tubercles

Surgical neck

Area below the head and tubercles

Why is the surgical neck named that?

It is a common fracture site

Deltoid tuberosity

Roughened raised triangular area along the anterolateral surface of the body

Where is the lesser tubercle located?

Anteriorly

Where is the greater tubercle located?

Laterally

What does the shoulder girdle consist of?

Clavicle and scapula

Whta is the clavicle commonly called?

Collarbone

What makes up the clavicle?

Two ends and a long central portion

Acromial extremity

Articulates with the acromion and scapula

Sternal extremity

Articulates with the manubrium of the sternum

Body of the clavicle

Elongated portion between the two extremities

Whose clavicle is typically shorter and less curved?

Female

What is the scapula commonly called?

Shoulder blade

Scapula

Flat triangular bone with three boarders, three angles, and two surfaces

Medial (vertebral) boarder of scapula

Long edge near the vertebrae

Superior boarder of scapula

Uppermost margin of the scapula

Lateral (axillary) boarder of scapula

Boarder nearest to the axilla (armpit)

Lateral angle of scapula

Thickest part and ends laterally in a shallow depression called the glenoid cavity

The lateral angle is also sometimes called?

Head of scapula

Scapulohumeral joint

Where the humeral head articulates with the glenoid cavity of the scapula

Neck of scapula

Area between the head and the body of the scapula

Superior and inferior angles of the scapula

Upper and lower ends of the medial or vertebral boarder

Costal surface

Anterior surface of the scapula

Subscapular fossa

Middle area of the costal surface with a large depression

Acromion

Large curved process that extends laterally over the head of the humerus

Coracoid process

Thick beaklike process that projects anteriorly beneath the clavicle

Suprascapular notch

Notch on the superior boarder that is partially formed by the base of the coracoid process

Spine of scapula

Prominent structure on the dorsal, posterior surface of the scapula. Starts at vertebral boarder and continues laterally to end at the acromion

Crest of the spine of the scapula

Posterior boarder of the spine that is thick

Supraspinous fossa

On the posterior surface located above the spine

Infraspinous fossa

On the posterior surface located below the spine

Where is the acromion?

Extends superiorly and posteriorly to the glenoid cavity

Where is the coracoid process?

Anteriorly in relationship to the glenoid cavity

What is the classification of the shoulder girdle?

Synovial joint

What is the mobility type of the shoulder girdle?

Diarthrodial

What is the movement type of the shoulder (scapulohumeral) joint?

Ball and socket joint

What is the movement type of the sternoclavicular joint?

Plane or gliding

What is the movement type of the acromioclavicular joint?

Plane or gliding

Hill-Sachs defect

Fracture of the articular surface of the posterolateral aspect of the humeral head and is associated with anterior dislocation of the humeral head

Where are common fracture sites on a shoulder x-ray (clavicle, humerus, scapula)?

• clavicle: middle third and distal third

• humerus: surgical neck

• scapula: neck, body, spine