Bontrager Chapter 5 Self-test: Humerus & Shoulder Girdle (f)

What terms correctly describe the shoulder joint?

Scapulohumeral & glenohumeral

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

Acromionclavicular

What angles are found on the scapula?

Inferior, lateral, & superior

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

Glenoid cavity

Acromion

Scapulae spine

Coracoid process

Coracoid process

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

False

Which bony structure separates the supraspinous and infraspinous fossae?

Scapulae spine

Which of the following structures is considered most posterior?

Scapular notch

Coracoid process

Acromion

Superior border of scapula

Acromion

What type of movement is the scapulohumeral joint?

Spheroidal

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

A: Center and AEC chamber activated

B: High-speed IR

C: 40-44 in (100 to 110cm) SID

D: 70 to 80 kV (with grid)

A: Center and right automatic exposure control (AEC) chamber activated

T/F : even though the amount of radiation exposure is minimal for most shoulder projections, gonadal shielding should be used for children and adults of child bearing age

True

T/F: the greatest technical concern during a pediatric shoulder study is voluntary movement

True

Which one of the following imaging modalities or procedures best demonstrates osteomyelitis

Nuclear medicine

Which imaging modality or procedure provides a functional, or dynamic, study of the shoulder?

Ultrasound

Which Projection and/or position best demonstrates signs of impigement syndrome?

Scapulae Y (neer method)

Which Pathologic condition often produces narrowing of the joint space?

Osteoarthritis

Which Pathologic condition may require a reduction in manual exposure factors?

Rheumatoid arthritis

Which basic projection of the shoulder requires that the numeral epicondyles be parallel to the IR?

External rotation

Where is the central ray centered for a AP projection of the shoulder?

1" inferior to coracoid process

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

Internal rotation

What central ray angle should be used for the inferosuperior axial projection for the glenohumeral joint space?

25-30 degrees medially

To best demonstrate the hill-sachs defect on the inferosuperior axial projection, which additional positioning maneuver must be used?

Use exaggerated external rotation

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

Perpendular to the IR

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

Grashey Method

For the erect version of the tangential projection for the intertubercular groove, the patient lens forward ______ from vertical .

10-15 degrees

What is the major advantage of the supine, tangential version of the intertubercular groove projection over the erect version ?

Reduced OID

Which projection best demonstrates the supraspinatus outlet region?

Scapulae Y lateral (neer method)

With which of the following projections is a breathing technique recommended ?

Grashey method

Thansthoracic lateral

Fisk modification

Garth method

Thansthoracic lateral for humerus

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

10-15 degrees caudad

Which Pathologic feature is best demonstrated with the Garth method?

Scapulohumeral dislocations

Which anatomy of the shoulder is best demonstrated with a superoinferior axial projection (hobbs modification)?

Scapulohumeral joint spaces

If the patient cannot fully abduct the arm 90 for the inferosuperior axial projection (Clements modification), the technologist can angle the CR _____ degrees toward the axillary.

5 to 15 degrees

Which of the following projections requires the CR to be centered 2" inferior and medial from the superolateral border of the shoulder?

Tangential projection(Fisk modification)

Inferosuperior axial(Clements projection)

Posterior oblique(Grashey method)

Scapula Y lateral projection

Posterior oblique (Grashey method)

Which anatomy best demonstrated with the alexander method?

AC joints

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

Fractured clavicle

What is the minimum amoun of weight a large adult should have strapped to each wrist for the weight-bearing phase of an AC joint study?

8-10 lbs

T/F: a posteroanterior PA axial projection of the clavicle requires a 35-34 degree caudal central ray angle

false

T/F: a 72" SID is recommended for acromioclavicular joint study

True

A radiograph of a posterior oblique (Grashey method) reveals that the anterior and posterior glenoid rims are not superimposed. The following positioning factors were used: erect position, body rotated 35 degrees toward the affected side, central ray perpendicular to scapulohumeral joint space, and affected arm slightly abducted in neutral rotation. Which one of the following modification 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?

Garth method

A radiograph of an AP axial clavicle taken on an asthenic type patient reveals that the clavicle is projected in the lung field below the top of the shoulder. Patient was erect position, central ray angled 15 degree cephalad, 40" SID, and respiration suspended at the of expiration, What should be modified?

Increase central ray angulation

Patient has a history of tendonitis of the bicep tendon. Which projection will best demonstrate calcification of the tendon within the intertubercular groove?

Tangential projection- Fisk Modification

Patient with possible acromioclavicular separation enters the emergency room. Which routine should be used?

Acromioclavicular joint series: non-weight bearing projections

An AP apical oblique axial radiographic image shows poor visibility of the shoulder joint. Patient was erect, facing the x-ray tube, 45 degree of rotation of affected shoulder toward the IR, 45 degree cephalad angle, and the CR centered to the scapulohumeral joint. What would have contributed to the poor Garth position?

wrong direction of CR angle

Patient is referred to radiology for a nontrauma shoulder series. Routine calls for superoinferior axial projection (Hobbs modification). But the patient is unable to stand and is confined to a wheelchair. What should the technologist do?

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

A patient enters the ER with a proximal and mid-humeral fracture. The patient is in extreme pain. Which position routine would demonstrate the entire humerus without excessive movement of the limb.

AP and transthoracic lateral of humerus