Chapter 05: Shoulder Girdle

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1

Which of the following bones connect the upper limb to the trunk?

1. Clavicle

2. Scapula

3. Humerus

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1 and 2

2

Which of the following bones make up the shoulder girdle? 1. Humerus

2. Scapula

3. Clavicle

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

2 and 3

3

The area of the proximal humerus located directly below the tubercles, which is the site of many fractures, is called the:

a. anatomic neck.

b. surgical neck.

c. coracoid process.

d. intertubercular groove

surgical neck.

4

The depression identified in the figure above is called the:

a. infraspinous fossa.

b. supraspinous fossa.

c. intertubercular groove.

d. surgical neck.

intertubercular groove.

5

The large, rounded, elevated process prominently located on the lateral surface of the proximal humerus is the:

a. greater tubercle.

b. lesser tubercle.

c. medial epicondyle.

d. lateral epicondyle

greater tubercle.

6

The small, synovial fluid–filled sacs, which relieve pressure and reduce friction in joint tissues, are called:

a. bursae.

b. ligaments.

c. tendons.

d. cartilage.

bursae.

7

The articulation between the glenoid cavity and head of the humerus is called the _____ joint.

a. synovial

b. spheroidal

c. acromioclavicular

d. scapulohumeral

scapulohumeral

8

The scapulohumeral articulation is classified as a _____ joint, _____ type.

a. cartilaginous; gliding

b. fibrous; gliding

c. synovial; ball and socket

d. synovial; condyloid

synovial; ball and socket

9

Patients often arrive in the radiology department with trauma to the shoulder. Which of the following positions is recommended for x-ray examination of the shoulder on these patients?

a. Supine

b. Upright

c. Lateral recumbent

d. Lateral decubitus

Upright

10

Which of the following positions of the humerus are commonly used when performing an AP projection of the shoulder?

1. External rotation

2. Neutral rotation

3. Internal rotation

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1, 2, and 3

11

To demonstrate the greater tubercle of the humerus on an AP projection of the shoulder, the epicondyles must be:

a. in a neutral position.

b. at a 45-degree angle with the plane of the IR.

c. parallel with the plane of the IR.

d. perpendicular with the plane of the IR

parallel with the plane of the IR.

12

The IR size commonly used for an AP projection of the shoulder is:

a. 8 × 10 inches (18 × 24 cm).

b. 10 × 12 inches (24 × 30 cm).

c. 11 × 14 inches (30 × 35 cm).

d. 7 × 17 inches (18 × 43 cm).

10 × 12 inches (24 × 30 cm).

13

The respiration phase for an AP projection of the shoulder should be:

a. inspiration.

b. expiration.

c. suspended.

d. shallow breathing.

suspended.

14

For an AP projection of the shoulder, the central ray should be directed:

a. 15 degrees.

b. 30 degrees.

c. 15 to 30 degrees.

d. perpendicular to the IR

perpendicular to the IR

15

For an AP projection of the shoulder, the central ray should enter _____ inch(es) inferior to the _____.

a. 1; coracoid process

b. 1; acromion

c. 2; coracoid process

d. 2; acromion

1; coracoid process

16

Which of the following is prominently shown in profile on an AP projection of the shoulder with the humerus in external rotation?

a. Lesser tubercle

b. Greater tubercle

c. Scapulohumeral joint

d. Acromioclavicular joint

Greater tubercle

17

The greater tubercle will be partially superimposed over the humeral head on which of the following projections and positions?

a. AP, external rotation

b. AP, neutral rotation

c. AP, internal rotation

d. PA oblique, scapular Y

AP, neutral rotation

18

For an AP projection of the shoulder with the arm in a neutral position, the epicondyles of the humerus should be _____ with the plane of the IR.

a. parallel

b. perpendicular

c. 45 degrees

d. 60 degrees

45 degrees

19

If the patient places the palm of the hand against the thigh, the humerus will be in:

a. lateral position.

b. external rotation.

c. internal rotation.

d. neutral position.

neutral position.

20

For an AP projection of the shoulder with the humerus in internal rotation, the epicondyles of the humerus should be _____ with the plane of the IR.

a. perpendicular

b. parallel

c. 45 degrees

d. 60 degrees

perpendicular

21

Which of the following is prominently shown in profile on an AP projection of the shoulder with the humerus in internal rotation?

a. Lesser tubercle

b. Greater tubercle

c. Glenoid cavity

d. Acromioclavicular joint

Lesser tubercle

22

If the patient places the back of the hand against the hip, the humerus will be in:

a. external rotation.

b. internal rotation.

c. abduction.

d. adduction.

internal rotation.

23

The use of compensating filters is particularly useful when using:

a. small focal spot.

b. digital radiography systems.

c. detail film/screen IR.

d. less collimation

digital radiography systems.

24

When the arm cannot be rotated or abducted due to injury, which of the following can be used to perform a lateral projection of the shoulder?

a. Tangential projection, Settegast method

b. PA axial projection, Holmblad method

c. Transthoracic lateral projection, Lawrence method

d. AP projection, Pearson method

Transthoracic lateral projection, Lawrence method

25

Where should the center of the IR be positioned for a lateral projection of the shoulder?

a. Acromion process

b. Anatomical neck

c. Surgical neck

d. Greater tubercle

Surgical neck

26

For a transthoracic lateral projection of the shoulder, lung detail may be blurred to better visualize the shoulder area. Which exposure time is recommended to blur the lung structures?

a. Minimum of 1 second

b. Minimum of 2 seconds

c. Minimum of 3 seconds

d. Minimum of 5 seconds

Minimum of 3 seconds

27

If a breathing technique cannot be used for the transthoracic lateral projection of the shoulder, the exposure should be made using:

a. full expiration.

b. full inspiration.

c. partial inspiration.

d. partial expiration.

full inspiration.

28

Which of the following are achieved when the transthoracic lateral projection of the shoulder is done on full inspiration?

1. Wide latitude

2. Higher contrast

3. Decrease in exposure

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

2 and 3

29

If the patient can be positioned properly, the central-ray angle for the transthoracic lateral projection of the shoulder is:

a. 0 degrees.

b. 5 degrees cephalad.

c. 10 degrees cephalad.

d. 15 degrees cephalad.

0 degrees.

30

If the patient cannot elevate the unaffected shoulder for a transthoracic lateral projection of the shoulder, the central ray should be angled _____ degrees.

a. 0 to 5

b. 5 to 10

c. 10 to 15

d. 15 to 25

10 to 15

31

How far should the head, shoulders, and elbow be elevated for the inferosuperior axial projection of the shoulder?

a. 2 to 3 inches

b. 3 to 4 inches

c. 4 to 5 inches

d. 5 to 6 inches

3 to 4 inches

32

How far should the arm be abducted for an inferosuperior projection of the shoulder joint?

a. 15 degrees

b. 30 degrees

c. 45 degrees

d. 90 degrees

90 degrees

33

How should the humerus be positioned for an inferosuperior axial projection of the shoulder joint?

1. Internal rotation

2. External rotation

3. Neutral rotation

a. 1 only

b. 2 only

c. 3 only

d. 1, 2, and 3

2 only

34

How is the central ray directed for an inferosuperior axial projection of the shoulder joint?

a. 5 degrees horizontally

b. 15 to 30 degrees horizontally

c. 5 degrees cephalad

d. 15 to 30 degrees cephalad

15 to 30 degrees horizontally

35

Which of the following are clearly demonstrated on the inferosuperior axial projection of the shoulder joint?

1. Proximal humerus

2. Scapulohumeral joint

3. Acromioclavicular articulation

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1, 2, and 3

36

The PA oblique projection of the shoulder joint (scapular Y) is performed in which of the following positions?

a. AP

b. Lateral

c. RAO or LAO

d. RPO or LPO

RAO or LAO

37

PA oblique projection of the shoulder (scapular Y) is performed to evaluate:

a. carcinoma.

b. fractures.

c. dislocations.

d. soft tissue swelling

dislocations.

38

For the PA oblique projection (scapular Y) of the shoulder, the body is rotated so that the midcoronal plane is how many degrees from the IR?

a. 25

b. 45

c. 45 to 60

d. 25 to 60

45 to 60

39

What is the central-ray angle for the PA oblique projection (scapular Y) of the shoulder joint?

a. 0 degrees

b. 5 degrees caudad

c. 10 degrees caudad

d. 15 degrees caudad

0 degrees

40

Which of the following will be directly superimposed over the junction of the Y on the PA oblique (scapular Y) projection?

a. Humerus

b. Humeral head

c. Coracoid process

d. Acromion process

Humeral head

41

Which of the following structures is projected in lateral profile on a PA oblique (scapular Y) projection?

a. Humerus

b. Scapula

c. Clavicle

d. Acromion

Scapula

42

Which of the following projections clearly demonstrates the glenoid cavity?

a. AP

b. PA oblique (scapular Y)

c. AP oblique (Grashey)

d. Transthoracic lateral (Lawrence)

AP oblique (Grashey)

43

How many degrees is the body rotated for the AP oblique projection (Grashey method) of the shoulder joint?

a. 20 degrees toward the affected side

b. 20 degrees away from the affected side

c. 35 to 45 degrees away from the affected side

d. 35 to 45 degrees toward the affected side

35 to 45 degrees toward the affected side

44

The Pearson method is an AP projection of the:

a. shoulder joint.

b. proximal humerus.

c. scapulohumeral joint.

d. acromioclavicular articulation

acromioclavicular articulation

45

How many pounds of weight should be affixed to each wrist for the AP projection of the AC joint?

a. 2 lb

b. 5 lb

c. 2 to 4 lb

d. 5 to 8 lb

5 to 8 lb

46

Two exposures are commonly made of the AC joints—one without weights and one with weights. How are the weights applied? a. Affixed to the elbows

b. Affixed to the wrists

c. Held in the hands

d. Held by the fingers

Affixed to the wrists

47

How should the central ray be angled for the AP projection (Pearson method) of the AC joints?

a. 0 degrees

b. 5 degrees cephalad

c. 7 degrees cephalad

d. 5 to 7 degrees cephalad

0 degrees

48

The AP projection of the AC joints places the joints at an increased OID. Which of the following is the recommended SID to compensate for this distance?

a. 40 inches

b. 48 inches

c. 72 inches

d. 120 inches

72 inches

49

In an image of an AP axial projection of the clavicle, the clavicle should be demonstrated with:

1. most of the clavicle projected above the ribs.

2. only the lateral end superimposing the coracoid process.

3. only the medial end superimposing the first or second ribs.

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1 and 3

50

To obtain a more uniform image density, the respiration phase for the AP projection of the clavicle should be:

a. inspiration.

b. expiration.

c. shallow breathing.

d. suspended respiration

expiration.

51

Which of the following projections can be used to demonstrate the clavicle?

1. AP or PA

2. AP axial

3. PA axial

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1, 2, and 3

52

The central-ray angle for an AP axial projection of the clavicle when performed on a patient in the supine position is _____ degrees.

a. 15

b. 25

c. 15 to 25

d. 15 to 30

15 to 30

53

To elevate the clavicle above the ribs and scapula for the AP axial projection, the phase of respiration should be:

a. full inspiration.

b. full expiration.

c. shallow breathing.

d. suspended respiration

full inspiration.

54

For an AP projection of the scapula, the IR size and its position should be:

a. 8 × 10 inches (18 × 24 cm) lengthwise.

b. 10 × 12 inches (24 × 30 cm) lengthwise.

c. 8 × 10 inches (18 × 24 cm) crosswise.

d. 10 × 12 inches (24 × 30 cm) crosswise.

10 × 12 inches (24 × 30 cm) lengthwise.

55

The respiration phase for an AP projection of the scapula is:

a. inspiration.

b. expiration.

c. suspended respiration.

d. shallow breathing.

shallow breathing.

56

How is the arm positioned for an AP scapula?

a. Abducted 90 degrees, forearm flexed

b. Abducted 90 degrees, forearm extended

c. Adducted, lateral rotation

d. Adducted, medial rotation

Abducted 90 degrees, forearm flexed

57

For the lateral projection of the scapula, the body is placed in which position?

a. True lateral

b. 15 degrees oblique

c. RAO or LAO

d. RPO or RAO

RAO or LAO

58

For delineation of the acromion and coracoid processes of the scapula in the lateral projection, how is the arm positioned?

a. Flex the elbow and place the hand on the anterior abdomen.

b. Flex the elbow and place the hand on the posterior thorax.

c. Extend the arm upward and rest the forearm on the head.

d. Extend the arm straight down at the side in the anatomic position

Flex the elbow and place the hand on the posterior thorax.

59

When the patient is positioned properly for a lateral projection of the scapula, the body of the scapula will be _____ the plane of the IR.

a. perpendicular to

b. parallel with

c. at a 30-degree angle to

d. at a 60-degree angle to

perpendicular to

60

The central-ray angulation for a lateral scapula is:

a. 0 degrees.

b. 5 degrees caudad.

c. 10 degrees cephalad.

d. 5 to 10 degrees cephalad

0 degrees.

61

How much is the body rotated for a PA oblique projection of the shoulder?

a. 30 degrees

b. 45 degrees

c. 60 degrees

d. 45 to 60 degrees

45 to 60 degrees

62

The clavicle is classified as a(n) _____ bone.

a. short

b. long

c. flat

d. irregular

long

63

The scapula is classified as a(n) _____ bone.

a. flat

b. short

c. long

d. irregular

flat

64

The rounded head of the humerus fits into an oval depression on the lateral aspect of the scapula called the:

a. neck.

b. acromion.

c. lateral angle.

d. glenoid cavity.

glenoid cavity.

65

The lesser tubercle is situated on which surface of the humerus?

a. Medial

b. Lateral

c. Anterior

d. Posterior

Anterior

66

The SC articulation is formed by the sternal extremity of the clavicle and the:

1. manubrium.

2. sternum.

3. first rib cartilage.

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1 and 3

67

All of the joints of the shoulder girdle are:

a. synovial, freely movable.

b. fibrous, slightly movable.

c. fibrous, immovable.

d. cartilaginous, immovable.

synovial, freely movable.

68

Which position of the hand will place the humerus in external rotation?

a. Prone

b. Supine

c. Palm against the thigh

d. Back of the hand against the thigh

Supine

69

Which position of the hand will place the humerus in neutral position?

a. Prone

b. Supine

c. Palm against the thigh

d. Back of the hand against the thigh

Palm against the thigh

70

Which position of the hand will place the humerus in internal rotation?

a. Prone

b. Supine

c. Palm against the thigh

d. Back of the hand against the thigh

Back of the hand against the thigh

71

What is the central-ray angulation for the AP oblique projection (Grashey method) of the shoulder joint?

a. 0 degrees

b. 5 degrees

c. 0 to 5 degrees

d. 5 to 10 degrees

0 degrees

72

A lateral projection of the shoulder and proximal humerus can be obtained with which of the following?

a. PA oblique (scapular Y)

b. Inferosuperior axial (Lawrence)

c. Inferosuperior axial (West Point)

d. Transthoracic lateral (Lawrence)

Transthoracic lateral (Lawrence)

73

A Hill-Sachs defect may be demonstrated using which of the following projections?

1. Inferosuperior axial (Lawrence)

2. Inferosuperior axial (Rafert modification)

3. AP axial (Stryker notch)

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

2 and 3

74

A Hill-Sachs defect is a:

a. fracture due to posterior dislocation of the humeral head.

b. wedge-shaped compression fracture of the articular surface of the humeral head.

c. congenital deformity of the humeral head.

d. congenital deformity of the glenoid cavity.

wedge-shaped compression fracture of the articular surface of the humeral head.

75

Which of the following methods best demonstrates the supraspinatus outlet (coracoacromial arch)?

a. Neer

b. Alexander

c. West Point

d. Stryker notch

Neer

76

For delineation of the body of the scapula for the lateral projection, how is the arm positioned?

a. Flex the elbow and place the hand on the anterior abdomen.

b. Flex the elbow and place the hand on the posterior thorax.

c. Extend the arm straight down at the side.

d. Extend the arm upward and rest the forearm on the head

Extend the arm upward and rest the forearm on the head

77

When the tangential projection of the intertubercular groove is performed with the patient supine, the position of the hand is:

a. supinated.

b. pronated.

c. lateral.

d. neutral.

supinated.

78

When the Fisk modification is used for the tangential projection of the intertubercular groove, the patient is:

a. prone.

b. supine.

c. sitting.

d. standing

standing

79

When the Fisk modification is used for the tangential projection of the intertubercular groove, the vertical humerus is placed at an angle of _____ degrees.

a. 0

b. 5

c. 5 to 10

d. 10 to 15

10 to 15

80

Which of the following projections are improved significantly with the use of a compensating filter?

1. AP shoulder

2. Lateral scapula

3. PA oblique (scapular Y)

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

1, 2, and 3