Which view and projection of the proximal humerus is represented in the figure?

External rotation, anteroposterior (AP) projection

Neutral rotation, AP projection

Internal rotation, AP projection

External rotation, lateral projection

Which rotation of the humerus will result in a lateral position of the proximal humerus?

Internal rotation (epicondyles perpendicular to image receptor)

Neutral rotation (epicondyles 45° to the image receptor)

External rotation (epicondyles parallel to the image receptor)

Which of the following shoulder positions is considered a trauma projection (can be performed safely for a possible fracture or dislocation)?

AP apical oblique axial (Garth method) projection

Inferosuperior axial (Clements modification) projection

AP projection–internal rotation

What additional maneuver must be added to the inferosuperior axial shoulder (Lawrence method) projection to best demonstrate a possible Hill-Sachs defect?

Perform exaggerated external rotation of the affected upper limb.

Angle the CR 10° to 15° downward or posteriorly in addition to the medial angle.

Increase abduction of the affected upper limb.

How much posterior CR angulation is required for the supine version of the tangential projection for the intertubercular (bicipital) groove?

No angle is used for this projection.

Which ionization chamber(s) for the AEC should be used for a tangential projection for an intertubercular groove?

Cannot use AEC with this projection

Which of the following projections can be performed using a breathing technique?

Inferosuperior axiolateral projection

Where is the CR centered for a transthoracic lateral projection for proximal humerus?

1 inch (2.5 cm) inferior to the acromion

Which projection of the shoulder requires that the patient be rotated 45° to 60° toward the IR from a PA position?

Inferosuperior axialolateral projection

Which of the following modalities best demonstrates shoulder joint pathology such as rotator cuff tears using dynamic evaluation techniques during joint movements?

Magnetic resonance imaging (MRI)

How much CR angulation is required for an asthenic patient for an AP axial projection of the clavicle?

No CR angulation should be used for this projection.

Where is the CR centered for the bilateral acromioclavicular (AC) joint projection on a single 14- × 17-inch (35 × 43 cm) image receptor?

1 inch (2.5 cm) above jugular notch

At the level of the thyroid cartilage

A radiograph of a transthoracic lateral projection reveals that it is difficult to visualize the proximal humerus due to the ribs and lung markings. The following analog exposure factors were used: 75 kV, 30 mAs, 40-inch (102 cm) SID, grid, and suspended respiration. Which of the following changes will improve the visibility of the proximal humerus?

Use an orthostatic (breathing) technique.

Make the exposure on second inspiration.

Use a compression band to prevent patient movement.

A radiograph for an AP projection with external rotation of the proximal humerus reveals that the greater tubercle is profiled laterally. What should be changed to improve this image for a repeat exposure?

Positioning is acceptable; do not repeat it.

Rotate epicondyles so they are perpendicular to the image receptor.

Move the patient obliquely 10° to 15° toward the affected side.

Rotate the arm to place palm of the patient’s hand against the thigh.

A radiograph of an AP clavicle reveals that the sternal extremity is partially collimated off. What should the technologist do?

Repeat the AP projection and correct collimation.

Make sure the sternal extremity is included on the AP axial projection.

Only repeat it if the patient’s pain/symptoms involve the sternal extremity.

Ask the radiologist whether he or she wants the projection repeated.

A radiograph of a scapular Y lateral position reveals that the scapula is slightly rotated (the vertebral and axillary borders are not superimposed). The axillary border of the scapula is determined to be more lateral compared with the vertebral border. Which of the following modifications should be made for the repeat exposure?

Abduct the arm more and flex it at the elbow.

A patient comes to radiology for treatment of an arthritic condition of the right shoulder. The radiologist orders AP internal/external rotation projections and an inferosuperior axialolateral projection of the scapulohumeral joint. However, the patient cannot abduct the arm for this projection. Which other projection will best demonstrate the scapulohumeral joint space?

Posterior oblique (Grashey method)

AP projection–neutral rotation

A patient comes to the emergency department (ED) with a possible right AC joint separation. Right clavicle and AC joint exams are ordered. The clavicle is taken first, and a small linear fracture of the midshaft of the clavicle is discovered. What should the technologist do in this situation?

Consult with the ED physician before continuing with the AC joint study.

Perform the weight-bearing phase as ordered.

Reduce the amount of weight that would normally be given to the patient and perform the weight-bearing study.

Slowly give the patient more weight to hold until he begins to complain and then perform the weight-bearing study.

A patient enters the ED with a midshaft humeral fracture. The AP projection taken on the cart demonstrates another fracture near the surgical neck of the humerus. The patient is unable to stand or rotate the humerus because of the extent of the trauma. What other projection should be taken for this patient?

Horizontal beam transthoracic lateral projection for humerus

Scapular Y lateral-AP oblique projection

Rotational lateral projection for humerus

A referring physician suspects that a subacromial spur may be the cause for a patient’s arm numbness. She asks the technologist for a projection that would best demonstrate any possible spurs. Which of the following projections would accomplish this objective?

PA scapular Y lateral with 10° to 15° caudal angle

PA scapular Y lateral with 10° to 15° cephalad angle

AP oblique shoulder with 45° caudal angle

AP shoulder with 10° to 15° caudal angle

A patient enters the ED with multiple injuries. The physician is concerned about a dislocation of the left proximal humerus. The patient is unable to stand. Which of the following routines is advisable to best demonstrate this condition?

AP shoulder and recumbent AP oblique scapular Y projection

AP shoulder and inferosuperior axialolateral projection

AP shoulder and 35° to 45° LPO position (Grashey method)

AP shoulder and Neer projection

A patient enters the ED with a possible AC joint separation. The patient is paraplegic; therefore, the study cannot be done erect. Which of the following routines would be performed to diagnose this condition?

Non–weight-bearing and weight-bearing type of projections performed with the patient recumbent by pulling down on the shoulders

Recumbent AP and AP axial projection of the clavicles to include AC joints

AP projections of shoulders with external and internal rotation performed recumbent

AP and AP apical oblique projection of the shoulder performed recumbent

A patient enters the ED with a possible bony defect of the midwing area of the scapula. The patient is able to stand and move the upper limb freely. In addition to the routine AP scapula projection with the arm abducted, which of the following would best demonstrate the involved area?

Have the patient reach across the chest and grasp the opposite shoulder for a lateral scapula projection.

Take an apical oblique projection of the shoulder.

Take a transthoracic lateral projection of the shoulder region.

Have the patient drop the affected arm behind him or her and take a lateral scapula projection.

Chapter 05: Humerus and Shoulder Girdle

Authored by Andre Bell

Health Sciences

University

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MULTIPLE CHOICE QUESTION

45 sec • 1 pt

Which of the following structures is not part of the proximal humerus?

Lesser tubercle

Glenoid process

Intertubercular groove

Anatomic neck

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

Which term describes the medial end of the clavicle?

Acromial extremity

Acromion

Sternal extremity

Acromial tuberosity

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

The female clavicle is usually shorter and less curved than that of the male.

True

False

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

The anterior surface of the scapula is referred to as the:

scapular surface.

dorsal surface.

supraspinous and infraspinous fossa.

costal surface.

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

What is the name of the large fossa found within the anterior surface of the scapula?

Supraspinous fossa

Infraspinous fossa

Subscapular fossa

Glenoid fossa

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

What is the name of the insertion point for the deltoid muscle located on the anterolateral surface of the humerus?

Surgical neck

Deltoid protuberance

Deltoid tuberosity

Intertubercular groove

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

All of the joints of the shoulder girdle are diarthrodial.

True

False

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Chapter 05: Humerus and Shoulder Girdle

Which of the following structures is not part of the proximal humerus?

Which term describes the medial end of the clavicle?

The female clavicle is usually shorter and less curved than that of the male.

The anterior surface of the scapula is referred to as the:

What is the name of the large fossa found within the anterior surface of the scapula?

What is the name of the insertion point for the deltoid muscle located on the anterolateral surface of the humerus?

All of the joints of the shoulder girdle are diarthrodial.

Which of the following joints is considered to have a spheroidal type of movement?

Which view and projection of the proximal humerus is represented in the figure?

Part 5 refers to the:

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