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Total questions: 73
Worksheet time: 55mins
Which of the following structures is not part of the proximal humerus?
Lesser tubercle
Glenoid process
Intertubercular sulcus
Anatomic neck
Which term describes the medial end of the clavicle?
Acromical extremity
Acromion
Sternal extremity
Acromial tuberosity
The anterior surface of the scapula is referred to as the
scapular surface
dorsal surface
supraspinous and infraspinoious fossa
costal surface
What is the name of the large fossa found within the anterior surface of the scapula?
Supraspinious fossa
Infraspinous fossa
Subscapular fossa
Glenoid fossa
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 sulcus
Which of the following joints is considered to have a ball and socket ( spheroidal) type of movement?
Acromioclavicular joints
Sernoclavicular joints
Bicipital joint
Scapulohumeral joint
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)
None of of the above
Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh?
Internal rotation
Neutral rotation
External rotation
AP axial
Which of the following shoulder positions is considered a trauma projection ( can be performed safely for a possible fracture or dislocated of the proximal humerus)?
AP apical oblique axial ( Garth method ) projection
Inferosuperior axial ( Clements modifications ) projection
AP projection - internal rotation
None of the above
What medial central ray (CR ) angle is required for the inferosuperior axial shoulder ( Lawrence method)?
5 -10
40 -45
25 -30
10 - 15
What additional maneuver must be added to the inferosuperior axial shoulder ( Lawrence method ) projection to best demonstrate a possible hill-Sachs defects?
Increase medial CR angulation
Angle the CR 10 - 15 downward or posteriorly in addition to the medial angle
Perform exaggerated external rotation of the affected upper limb
Increase abduction of the affected upper limb
Which of the following shoulder projections best demonstrate the glenoid cavity in profile?
Grashey method
Clements modification
Garth method
AP shoulder, neutral rotation
How much posterior CR angulation is required for the supine version of the tangential projection ( Fisk modification ) for the inter tubercular ( bicipital ) sulcus?
20 -30
30 -40
10 -15
no angle is used for this projection
Which ionization chamber(s) for the AEC should be activated for a tangential projection (Fisk Modification ) for an intertubercular sulcus?
Center chambers
Both outside chambers
Left chamber
Cannot use AEC with this projection
Which of the following projections can be performed using an orthostatic ( breathing ) technique?
Scapular Y lateral projection
Inferosuperior axiolateral projection
AP clavicle
AP scapula
How much CR angulation should be used for a PA oblique ( scapular Y ) projection?
No CR angle is required
10 -15
20 - 30
35 -45
Where is the CR centered for a transthoracic lateral projection for proximal humerus?
1 inch (2.5 cm ) inferior to the acromion
Level of the greater tubercle
Level of surgical neck
Midaxilla
An AP apical oblique ( Garth method ) projection for an anteriorly dislocated scapulohumeral joint will project the humerus ___________ to the glenoid cavity.
superior
inferior
lateral
medial
Which projection of the shoulder requires that the pt be rotated 45 - 60 towards the IR from a PA position?
Inferosuperior axiolateral projection
AP oblique projection
Lateral scapula projection
None of the above
Which of the following projections will best demonstrate the acromiohumeral space to detect possible spurring?
AP oblique projection - Gashey method
Inferosuperior axial projection - Clements method
PA transaxillary projection - Hobbs modification
Apical AP axial projection
What type of CR angle is required for the apical AP axial projection?
30 caudad
15 - 20 cephalad
45 caudad
10 - 15 caudad
Which alternative landmark can be palpated if unable to locate the coracoid process for the shoulder projection for the obese shoulder?
Inferior angle of scapula
Greater tubercle of humerus
AC joint
Lesser tubercle of humerus
What rtpe of compensating filter is recommended for a AP shoulder projection?
Wedge
Boomerang
Trough
Gradient
Which of the following modalities best demonstrates shoulder joint pathology such as a rotator cuff tear using dynamic evaluation techniques during joint movements?
Ultrasound
Magnetic resonance imaging ( MRI )
Computed tomography ( CT )
Arthrography
Which of the following best demonstrates the coracoacromial arch?
Neer method
West Point method
Fisk method
Garth method
The inferosuperior axial projection ( clements modification ) requires a CR angle of ___ toward the axilla if a pt cannot fully abduct extremity 90 degrees.
35
none
40 -45
5 - 15
How much CR angulation is required for an asthenic pt for an AP axial projection of the clavicle?
15
30
45
No CR angulation should be used for this projection
Where is the CR centered for the bilateral acromioclavicular ( AC) joint projection on a single 35- x 43-cm (14x17) Image receptor?
At the affected AC joint
1 inch ( 2.5 cm) above jugular notch
At the level of the thyroid cartilage
At the sternal angle
A radiograph of an AP oblique ( Grashey method ) projection for the glenoid cavity reveals that the anterior and posterior rims of the glenoid process are not superimposed. Which of the following modifications should produce a more acceptable image?
Angle CR 5 - 10 caudad
Angle CR 5 - 10 cephalad
Increase rotation of the body toward the IR
Abduct the arm slightly
A radiograph of a transthoracic lateral projection reveals that it is difficult to visualize the proximal humerus due to ribs and lung markings. The following analog exposure factors were used : 75 kV, 30 mAs, 40-inch (102) SID, grid, and suspended respiration. Which of the following changes all improve the visibility of the proximal humerus?
Make the exposure on second inspiration
Use a compression band to prevent patient movement
Use a 72- inch (183 cm) SID
Use an orthostatic (breathing) technique
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 ?
Rotate epicondyles so they are perpendicular to the image receptor
Move the pt obliquely 10 -15 toward the affected area
Rotate the arm to place palm of the patients hand against the thigh
Positioning is acceptable : do not repeat it.
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 collimated
Make sure the sternal extremity is included on the AP axial projection
Only repeat it if the patients pain/symptoms involve the sternal extremity
Ask the radiologist whether he or she wants the projection repeated
A radiograph of a PA oblique ( 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?
Decrease rotation of thorax
Decrease CR angle
Increase rotation of thorax
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 in inferosuperior axial projection of the scapulohumeral joint. However, the pt cannot abduct the arm for this projection. Which other projection will best demonstrate the scapulohumeral joint space?
AP oblique ( Grashey method )
Scapular Y Lateral
Transthoraic lateral
AP projections - neutral rotatins
A pt comes to the emergency department ( ED ) with a possible AC joint seperation. Right clavicle and AC joints examinations are ordered. The clavicle is taken first, and the small linear fracture of the mid shaft of the clavicle is discovered. What should the technologist do in this situation.
Perform the weight - bearing phase as ordered
Reduce the amount of weight that would normally be given to a pt and perform the weight - bearing study.
Consult with the ED physician before continuing AC joint study
Slowly give the pt more weight to hold until he begins to complain and then the complete the AC joint study.
A pt enter the ED with mid shaft humeral fx. The AP projection taken on the cart demonstrates another fracture near the surgical neck of the humerus. The pt is unable to stand or rotate the humerus because of the extent of the trauma. What other projection should be taken for this pt?
Scapular Y lateral - AP oblique projection
Apical oblique projection
Horizontal beam transthoracic lateral projection for humerus
Rotational lateral projection for humerus
A referring physician suspects that a subacromial spur may be the cause for a pts shoulder impingement. She asks the technologist for projection that would best demonstrate any possible spurs in the suprasinatus outlet. Which of the following projections would accomplish this objective?
Tangential projection with 10 -15 caudad angle
Tangential projection with a 10 -15 cephalad angle
AP oblique shoulder with 45 caudad angle
AP shoulder with 10 - 15 caudad angle
A pt enter the ED with multiple injuries. The physician is concerned about a dislocation of the left proximal humerus. The pt is unable to stand. Which of the following routine is best advisable to best demonstrate this condition?
AP shoulder and inferiosuperior axial projection
AP shoulder and 35 -45 AP oblique ( Grashey method )
AP shoulder and Neer projection
AP shoulder and recumbent AP oblque ( Scapular Y ) projection
A pt enter the ED with a possible AC joint separation. This pt is paraplegic ; therefore , the study cannot be done erect. Which of the following routines would be preformed to diagnose this condition?
Non-weight-bearing and weight- bearing types of projections performed with the pt recumbent by pulling down on the shoulders
Recumbent AP and AP axial projection of the clavicles to include AC joints
AP projections if the shoulder with external and internal rotation performed recumbent
AP and AP apical oblique projection of the shoulder performed recumbent
A pt enters the ED with a possible boney defect of the mid wing area of the scapula. The pt 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 with best demonstrate the involved area?
Take an AP apical oblique projection of the shoulder.
Take a transthoracic lateral projection of the shoulder region.
Have the pt reach across the chest and grasp the opposite shoulder for a later scapula projection.
Have a pt drop the affected arm behind him/her and take the lateral scapula projection.
Which of the following projections/ positions should NOT be performed for a possible shoulder dislocation?
AP axial oblique ( Garth method)
Transthoracic lateral ( Lawerence method)
Inferiosuperior axial (clements modifications)
Scapular Y
Which of the following AP shoulder projections demonstrate the greater tubercle on profile medially?
External rotation
Internal rotation
Neutral rotation
None of the above
Which of the following AP shoulder projections demonstrate the lesser tubercle on profile medially?
External rotation
Internal rotation
Neutral roation
None of the above
A pt enters the ED with multiple injuries including a possible fx of the left proximal humerus. Which positioning rotation should be performed to determine the extent of the humerus injury?
AP neutral shoulder rotation and carefully rotated internally proximal humerus
AP shoulder as is ; showed radiographed to the ED physician before attempting a rotational lateral projection
AP and horizontal beam transthoracic lateral shoulder projection
AP and apical oblique should with out any arm rotation
The AP humerus requires that the humeral epicondyles are _____to the IR
Set at a 45 ange
Parallel
Perpendicular
Slightly oblique
A pt enters the ED with a dislocated shoulder. The technologist attempts to position the pt into the transthoracic lateral projection, but the pt is unable to raise the unaffected arm over the head completely. What can the technologist do to compensate for the pt's inability to raise his arm completely?
Perform the Grashey method instead.
Use a breathing technique.
Increase kV to penetrate through both shoulders
Angle the CR 10 - 15 cephalad.
A pt is scheduled for an arthrogram. During the course of the study, the radiologist requests a projection to demonstrate the inter tubercular sulcus. Which one of the following projections would best demonstrate this structure?
Fisk modification
Garth method
Grashey method
Pearson method
An inferosuperior axial projection (clements modification) is performed on a pt with a non traumatic shoulder injury. The pt cannot fully abduct the upper limb 90. Which of the following modifications of the position should be performed for this pt?
Angle CR 30 towards the axilla
Angle CR 5 - 15 toward the axilla
Angle CR 45 toward the elbow AC joint separation
Rotate shoulder slightly anterior to open joint space
A radiograph of an AP axial projection for the clavicle demonstrates that the clavicle is within the mid aspect of the lung apices. What should the technologist do to correct this error?
Do nothing : this is an acceptable AP axial clavicle projection.
Increase the caudad CR angle during repeat exposure.
Increase the cephalic CR angle during repeat exposure.
Make the exposure upon complete inspiration.
What is a possible radiographic sign for impingement syndrome of the shoulder?
Calcified tendons
Fluid- filled joint space
Fracture of the glenoid rim
Bone spurring in acromiohumeral space
What type of CR angle is required for the PA transaxillary projection (Hobbs modification) ?
CR is perpendicular to IR
5 -15 toward axilla
25 away from axilla
10 toward shoulder
Where is the CR centered for the AP oblique ( Grashey method) position for the glenoid cavity?
Acromion
2 inches (5 cm) medial and inferior to the super-lateral border of shoulder
Coracoid process
1 inch (2.5 cm ) superior to the coracoid process
What is the common term for idiopathic chronic adhesive capsulitis?
Bankart lesion
Tendinitis
Bursitis
Frozen shoulder
Another term for osteoarthritis?
rheumatoid arthritis
bursitis
degenerative joint disease
osteoporosis
Tangential, intertubercular sulcus projection
Fisk modification
Neer method
Garth method
Grashey method
Tangential, supraspinatus outlet projection
Garth method
Neer method
Hobbs modification
Fisk modification
AP apical oblique axial projection
Neer method
Garth method
Grashey method
Clements modification
Inferosuperior axial projection
Hobbs modification
Clements modification
Neer method
Fisk modification
Ap oblique, glénoïdaux cavity projection
Grashey method
Garth method
Neer method
Hobbs method
PA transaxiallary projection
Grashey method
Fisk modification
Garth method
Hobbs modification
The use of a grid shoulder radiography will result in higher pt dose over non grid procedures.
True
False
A radiograph of the inferosuperior axial projection ( Lawrence method ) demonstrates the acromion process of the shoulder to be located most superiorly ( anteriorly ).
False
True
For an AP oblique ( Grashey method ) projection of the shoulder , the CR is centered to the acromion.
True
False
The PA transaxillary projection ( Hobbs modification ) id performed to rule out possible shoulder dislocation.
True
False
PA transaxillary ( Hobbs modification ) requires 5 - 15 CR cephalic angle.
True
False
The recommended SID for APAC joint study is 72 inches ( 183 cm ).
True
False
The Hill-sachs defect is a fracture of the articular surface of the glenoid cavity.
True
False
The affected arm should not be abducted for an AP scapula projection.
False
True
An orthostatic ( breathing ) technique can be performed for the AP projection of the scapula.
True
False
A posterior dislocation of the shoulder occurs more frequently than an anterior dislocation.
True
False
The AP axial ( Alexander method ) for AC joint requires a 15 cephalic CR Ange.
False
True
For AC joint weight-bearing studies, patients should not be asked to hold on to the weights with their hands: rather, the weights should be attached to the wrists.
True
False
Sonography is effective in the dynamic evaluation of the shoulder joint.
True
False
