Chapter 5 Holly

Select the term that correctly describes the shoulder joint

Scapulohumeral & glenohumeral

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

acromioclavicular

Which of the following is not an angle found on the scapula

medial angle

Which of the following structures of the scapular extends most anterior

Coracoid process

True or false, the male clavicle shorter, and less curved than the female clavicle

False

Which bony structure separates the superspinous and infraspinous fossae

Scapular spine

Which of the following structures is considered the most posterior?

acromion

What is type of joint movement for the scapular humoral joint?

Ball and socket

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

Nongrid

True or false if a virtual grid is used a critical grid is not needed

True

True or false the greater technical concern during a pediatric shoulder study is voluntary motion

True

Which of the following imaging modalities or procedures assesses physiologic aspects instead of anatomic

nuclear medicine

Which of the following imaging modalities and procedures provides a functional and dynamic study of the shoulder joint

DMS

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 pathological conditions often produces narrowing of the joint space

osteoarthritis

Which of the following pathological conditions results in systemic inflammatory changes to connective issues

Rheumatoid arthritis

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

Center 2 inches (5cm) below AC joint

What type of compensating filter is recommended for the use of an AP shoulder projection for a hypersthenic patient

boomerang

Which projection of the shoulder requires that the humoral epicondyles be parallel to the IR

External rotation

Where is the central race center for an AP projection, external rotation of the shoulder?

1 in(2.5cm) inferior to coracoid process

Which position of the shoulder and proximal humorous projects, the lesser tubercle in profile mediall

Internal rotation

What type of central ray angle should be used for the infer superior axial projections for the scapular humoral joint space

25-30 degrees medially

To best demonstrate the hill sachs defect on the inferosuperior axial projections, which additional positioning maneuvers must be used

Use exaggerated external rotation(msp)

How are the humoral epicondyles aligned for a rotational lateral medial projection of the humerus

Perpendicular to IR

Which special objection of the shoulder places the Glenoid cavity in profile for an open scapulohumeral joint

Grashey method

What type of CR angle is required for the apical AP axial shoulder projection(Garth method)

45* caudad

For the erect version of the tangential projection for the intertubercular sulcus, the patient leans forward_____ from vertical

10°-15°

What is the major advantage of the supply tangential version of the intertubercular sulcus projection over the erect version

Reduced oid

Which of the following projections best demonstrates the supraspinatus outlet region

Tangential projection (Neer method)

With which of the following projections can an orthostatic technique be used?

Transthoracic lateral for humerus

What central rate angulation is required for the tangential projection supraspinatus outlet(neer method)

10-15* caudad

Which clinical indication is best demonstrated with the Garth method

Scapulohumeral dislocations

Which anatomy of the shoulder is best demonstrated with Supero inferior transaxillary projection

Coracoid process of the scapula on the end

If the patient cannot fully abduct the affected arm 90° for the inferosuperior axial transaxillary projection(Clement's modification), the technologist can angle the CR____ degrees towards the axilla

5-15* toward axilla

Which of the following projections requires a CR to be centered 2 inches inferior and medial from the supero lateral border of the shoulder

Anterior oblique(grashey method)

Which anatomy is best demonstrated by the Alexander method

AC joints

Which type of injury must be ruled out before the weight-bearing phase of an AC joint study

Fractured clavicle

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

8-10 lbs(3-4kg)

True or false a PA axial projection of the clavicle requires a 35 to 45° caudal central ray angle

False

True or false, a 72 inch SID is recommended for adult AC joint studies

True

Which two positioning landmarks are aligned perpendicularly to the IR for the lateral scapular projection

superior angle and AC joint

A radiograph of an anterior oblique(grashey method) shows that the anterior and posterior glenoid rims are not super imposed. The following positioning factors were used.: erect position, body rotated 2530° toward the affected side, central ray perpendicular to scapular, humoral joint space, and affected arm, slightly abducted in neutral rotation. Which of the following modifications will superimpose the Glenoid rims during the repeat exposure

Rotate body more toward affected side

A patient with a possible shoulder dislocation enters the emergency room. A neutral AP projection of the shoulder has been taken, confirming a dislocation. Which additional projection should be taken.

AP apical oblique axial (Garth method)

A radiograph of an AP axial clavicle taken on an asthenic patient shows that the clavicle is projected in the lung field below the top of the shoulder. The following positioning factors were used: erect position, central ray angled 15° cephalad, 40 inch SID, and respiration suspended at end of expiration. Which of the following modifications should be made during the repeat exposure.

Increase central ray angulation

A patient with a possible right shoulder separation enters the emergency room which of the following routines should be performed

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

A patient comes to the radiology department with a history of tendinitis of the bicep tendon, which of the following projections will best demonstrate calcification of the tendon within the intertubercular sulcus

Tangential projection (Fisk modification)

An AP apical oblique axial (Garth method) radiographic image demonstrates poor visibility of the shoulder joint. The technologist use the following factors: patient erect, facing the x-ray tube, 45° of rotation of affected shoulder toward the IR, 45° cephalad angle, and the CR centered to the scapular humoral joint. Which of the following factors would have contributed to the substandard Garth position

Wrong direction of CR angle

A patient is referred to radiology for an AC joint series. The routine calls for an AP axial projection(zanca method) to be included. How is this projection performed?

Perform the ap position erect with a 10 to 15° cephalic angle

A patient enters the ER with a proximal and mid humeral fracture. The patient is an extreme pain which of the following positioning routine routines would demonstrate the entire humorous without excessive movement of the limb.

AP and transthoracic lateral of the humerus

An AP external rotation shoulder position demonstrates the

Greater tubercle/tuberosity

Which method is used to demonstrate the glenohumeral joint?

-grashey

An AP internal rotation of the shoulder position best demonstrates the

-lesser tubercle

The bicipital (intertubercular) groove is demonstrated using this projection.

-tangential(axial)

The inferosuperior axial position (Lawrence method) demonstrates the

-glenohumeral joint

The AP internal rotation of the shoulder places the humerus in the position.

-lateral

The landmark that is used for correct centering of the AP external and AP internal rotation of the shoulder is the

-coracoid process

The correct scapular Y shoulder position requires this amount of obliquity.

-45 to 60°

The hand is for an AP projection of the humerus.

-supinated

Radiographs of the AC joints should be performed

-bilaterally, weight-bearing and non-weight-bearing, and erect

In evaluating a true lateral scapula, the two structures that should be exactly superimposed are and

-vertebral and axillary borders

Which of the following projections would be best for demonstrating a possible anterior dislocation of the proximal humerus?

-scapular Y

Which lateral projection of the shoulder should be taken for possible fracture of the proximal third of the humerus?

-transthoracic lateral

The recommended breathing instructions of the AP projection of the scapula is

-orthostatic breathing technique

In the lateral position of the humerus (non-trauma), the arm is

-abducted and internally rotated

On the scapular Y radiograph, the superior part of the Y is formed by

acromion and coracoid process

For the AP axial projection of the clavicle, the CR is directed

-15 to 20° cephalad

Which of the following projections delivers the greatest skin dose to the patient?

-transthoracic lateral

The most distal portion of the scapula

-inferior angle of scapula

The most anteriorly located process of the upper scapula

coracoid process

The common name for the arm pit.

-axilla

The position which the AC joins need to be done

-erect bilateral

The rotation of the shoulder (in a trauma patient)

neutrally

Greater tubercle in profile

-external rotation

Humeral epicondyles are at a 45-degree angle to film

-neutral rotation

Epicondyles are perpendicular to film

-internal rotation

Supination of the hand

-external rotation

Palm of the hand is against the thigh

-neutral rotation

Epicondyles are parallel to the film

-external rotation

Lesser tubercle profiled medially

-internal rotation

The proximal humerus is in a lateral position

-internal rotation

The proximal humerus is in position for an AP projection.

-external rotation

What separates the head of the humerus from the body (shaft) of the humerus?

-anatomical neck

Which of the following articulates with the clavicle?

-scapula and sternum

The scapula is classified as what type of bone?

-flat bone

Which of the following is the largest bone in the upper extremity?

-humerus

The acromion is located on which of the following bones?

-scapula

Which of the following is used to determine if there is any separation of the AC joint?

-patient erect, holding weights

A lateral position of the scapula requires which of the following?

-affected arm raised

What angle joins the medial and lateral border of the scapula?

-inferior angle

What is another name for the lateral border of the scapula?

-axillary

Where is the scapular notch located?

-superior to the scapular spine

Which of the following will place the humerus in a true lateral position?

-AP internal rotation

Where is the anatomical neck of the humerus located in relation to the surgical neck?

-superior

Which two positions/projections are taken of a shoulder that has NOT been injured?

-AP internal and AP external rotation

What is the name of the projection that can be palpated on the medial aspect of the humerus?

-medial epicondyle

The head of the humerus articulates with which part of the scapula?

glenoid cavity

Which of the following positions will best demonstrate the greater tubercle of the humerus?

-AP lateral rotation

What is the name of the groove between the lesser and greater tubercles of the humerus?

intertubercular

Which of the following is the most likely location for a fracture of the humerus?

-surgical neck

What is the correct term for the armpit?

-axilla