Shoulder Anatomy and Radiography (Ch 4-5)

What two terms correctly describe the shoulder joint?

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

All of the joints of the shoulder girdle are diarthrodial.

The specific joint at the lateral end of the clavicle is the ______ joint.

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

Which structure of the scapula extends most anteriorly?

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

The female clavicle is shorter, less curved, and ______ than the male clavicle.

Which bony structure separates the supraspinous and infraspinous fossae?

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

Which is the most posterior structure of the scapula?

True or False: A non-grid technique applies for adult shoulder radiography.

The use of a grid during shoulder radiography will result in higher patient dose over nongrid procedures.

A grid is generally used when the anatomical part thickness exceeds ______.

What is the primary purpose of using a grid for a shoulder projection?

Improper grid alignment can cause grid ______.

What image receptor speed is used for adult shoulder radiography with analog technique?

What SID is used for adult shoulder radiography with analog technique?

What kVp range is used for adult shoulder radiography?

True or False: Gonadal shielding should be used for children and adults of childbearing age even though shoulder exposure is minimal.

True or False: The greatest technical concern during a pediatric shoulder study is voluntary motion.

Which modality best demonstrates osteomyelitis?

Local or generalized infection of bone or bone marrow caused by bacteria introduced by trauma or surgery is a condition termed:

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

What is the common term for idiopathic chronic adhesive capsulitis?

An injury to the anterior inferior glenoid labrum is called a ______ lesion.

Which chronic systemic disease causes arthritic inflammatory changes throughout the body?

Rheumatoid arthritis is three times more common in men than women.

In advanced destructive stages of rheumatoid arthritis, manual exposure factors should be ______.

One of the early signs of rheumatoid arthritis is soft tissue swelling near the ulnar styloid process.

Superior displacement of the distal clavicle describes which condition?

The Hill-Sachs defect is a fracture of the articular surface of the glenoid cavity.

A traumatic injury to one or more muscles of the shoulder joint is called a ______.

A reduction in the quantity of bone is called ______.

Which position best demonstrates signs of impingement syndrome in the acromiohumeral space?

Which pathologic condition often produces narrowing of the joint space?

What is the alternative CR centering for an AP shoulder on an obese patient if the coracoid process cannot be palpated?

Which compensating filter balances density between the thin acromion and the dense joint on an AP shoulder?

Which routine shoulder projection requires the humeral epicondyles parallel to the IR?

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?

Where is the CR centered for an AP external rotation projection of the shoulder?

Which of the following AP shoulder projections demonstrates the lesser tubercle in profile medially?

In an AP internal rotation shoulder projection, the humeral epicondyles are ______ to the IR.

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

In an AP neutral rotation shoulder projection, the epicondyles form what angle with the IR?

Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh?

What medial central ray (CR) angle is required for the inferosuperior axial shoulder (Lawrence method)?

The inferosuperior axial shoulder projection is also called the ______ method.

The inferosuperior axial projection requires the affected arm to be abducted ______ from the trunk.

Which shoulder projection is excellent for imaging dislocations and also shows Hill-Sachs and Bankart lesions?

A radiograph of the inferosuperior axial projection (Lawrence method) demonstrates the acromion process of the shoulder to be located most superiorly (anteriorly).

Which maneuver best demonstrates a Hill-Sachs defect on the inferosuperior axial projection?

For a Hill-Sachs defect, exaggerated external rotation has the thumb turned down at ______.

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

The AP humerus requires that the humeral epicondyles are _____ (insert answer) to the IR.

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

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

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

How many degrees is the patient rotated toward the affected side for the Grashey method?

Where is the CR centered for the posterior oblique position for the glenoid cavity?

For a Grashey method projection of the shoulder, the CR is centered to the acromion.

A radiograph of an AP oblique 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?

The primary diagnostic goal of the Grashey method is to profile the glenoid cavity and show an open ______ joint space.

What CR angle is required for the apical AP axial shoulder projection?

The apical AP axial projection is centered ______ superior to the coracoid process.

For the erect tangential projection of the intertubercular sulcus, how far is the humerus angled from vertical?

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

A patient is scheduled for an arthrogram. During the course of the study, the radiologist requests a projection to demonstrate the intertubercular groove. Which one of the following projections would best demonstrate this structure?

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

Which tangential projection best demonstrates the supraspinatus outlet?

Which of the following best demonstrates the coracoacromial arch?

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?

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

An orthostatic (breathing) technique can be performed for the AP projection of the scapula.

Why is a slow, shallow breathing technique used for the transthoracic lateral?

The recommended breathing technique for the transthoracic lateral (Lawrence method) is the ______ technique.

The minimum recommended exposure time for orthostatic breathing technique is ______ seconds.

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

What CR angle is used for the transthoracic lateral if the patient cannot drop the unaffected shoulder?

Which routine positioning shows the entire humerus without excessive movement of the limb?

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?

Which projection best demonstrates scapulohumeral dislocations?

A neutral AP shoulder projection confirms a dislocation. What additional projection should be taken?

What CR angle is used for the Garth method?

The AP apical oblique axial (Garth method) requires the patient rotated ______ toward the affected side.

A Garth method radiograph shows poor visibility of the shoulder joint, with the CR angled 45° cephalad. What went wrong?

An AP apical oblique projection for an anteriorly dislocated scapulohumeral joint will project the humerus ______ (insert answer) to the glenoid cavity.

On the Garth method, a posterior dislocation is shown when the humeral head is projected ______ relative to the glenoid cavity.

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

Which anatomy is best demonstrated by the PA transaxillary projection (Hobbs modification)?

What type of CR angle is required for the superoinferior axial projection (Hobbs modification)?

PA transaxillary (Hobbs modification) requires a 5° to 15° CR cephalic angle.

The PA transaxillary projection (Hobbs modification) is performed to rule out possible shoulder dislocation.

When is the Hobbs modification used?

A patient cannot stand and a Hobbs modification is needed. What should be done?

How much is the patient rotated from the PA position toward the affected side in the PA transaxillary (Modified Bernageau) projection?

What is the CR angle for the PA transaxillary (Modified Bernageau) projection?

Which transaxillary modification places the patient in lateral recumbent with the affected arm elevated?

The inferosuperior axial projection (Clements modification) requires a CR angle of ____ (insert answer) toward axilla if a patient cannot fully abduct extremity 90°.

Which anatomy is best demonstrated by the Alexander method?

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

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

Where must weights be attached during a weighted bilateral AC joint study (Pearson method)?

Holding weights in the hands during an AC joint study is contraindicated because muscle contraction can prevent demonstration of ______.

Which routine should be used for a patient with a possible right shoulder separation?

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

The recommended SID for AC joints is 72 inches (183 cm).

Why is a 72-inch SID used for AC joint imaging?

What CR angulation range is used for an AP axial clavicle?

What CR angle range is used for an AP axial clavicle on an asthenic patient?

On an asthenic patient the clavicle projects in the lung field below the top of the shoulder with a 15° cephalad CR. What should be done on repeat?

What breathing instruction is given for an AP axial clavicle?

Which two positioning landmarks are aligned perpendicular to the IR for the lateral scapula projection?

How should the arm be positioned for an AP scapula to move the lateral border away from the thorax?

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?

How many bones are in each hand and wrist?

The upper limb consists of four groups. What are they?

How many phalanges are in each hand?

How many metacarpals are in each hand?

How many carpals are in each hand?

What are the most distal bones of the hand?

Each finger or thumb is called a ______.

True or False: Each digit has three phalanges, except the thumb, which has only proximal and distal phalanges.

Each phalanx has a rounded distal ______, a body (shaft), and an expanded proximal base.

The radiographic criteria for a true lateral finger indicate equal concavity of the anterior and posterior aspects of the phalanges.

A metacarpal shaft is ______ on its anterior surface and ______ on its posterior (dorsal) surface.

The thumb has only two phalanges, so the joint between them is the ______ joint.

Which joint of the thumb must be included in a thumb image?

The metacarpals articulate with the phalanges at their ______ ends and with the carpals at their ______ ends.

The joint found between the base of the third metacarpal and carpal bone is the:

The first metacarpal articulates with the ______ carpal.

The second metacarpal articulates with the ______ carpal.

The third metacarpal articulates with the ______ carpal.

Which carpal articulates with both the fourth and fifth metacarpals?

List the four proximal row carpals from lateral to medial.

List the four distal row carpals from lateral to medial.

The boat-shaped carpal, largest in the proximal row, that articulates with the radius is the ______.

Which carpal bone is most frequently fractured?

Which of the following carpals articulates with the radius?

The moon-shaped carpal with a deep concavity on its distal side where it articulates with the capitate is the ______.

Which carpal has a pyramidal shape, three articular surfaces, and anterior articulation with the pisiform?

Which carpal bone is the smallest?

The pisiform articulates only with the ______.

Name all eight carpal bones in order.

What mnemonic helps recall the eight carpal bones?

Which of the carpal bones is considered to be the largest?

The hooklike process projecting from the palmar surface of the hamate is the ______.

Which carpals are best demonstrated on the carpal sulcus view?

The scaphoid articulates with which five bones?

The lunate articulates with which five bones?

The head of the radius is located at the ______ end near the elbow joint.

The head of the ulna is located at the ______ end near the wrist.

The ______ is the shorter forearm bone and the only one directly involved with the wrist joint.

The styloid processes of the radius and ulna are located at their ______ ends.

Which of the following structures is considered to be most distal?

Which of the following structures is considered to be most proximal?

Which of the following structures is considered to be most lateral?

Which one of the following structures is not part of the ulna?

Which two structures form the distal radioulnar joint?

Which two parts make up the articular portion of the distal humeral condyle?

The trochlea is located medially and articulates with the ______.

The capitulum is located laterally and articulates with the ______.

What are the two small depressions on the anterior aspect of the distal humerus?

Which two structures primarily form the hinge-like structure and movement of the elbow joint?

The olecranon process is the projection at the upper end of the ulna that forms the ______.

The interphalangeal joints have a(n) ____ (insert answer) type of joint movement.

The second through fifth metacarpophalangeal (MCP) joints are classified as ______ joints.

An ellipsoidal joint allows movement in ____ (insert answer) directions.

The first carpometacarpal (CMC) joint of the thumb is classified as a ______ joint.

The second through fifth CMC joints and the intercarpal joints are classified as ______ joints.

The radiocarpal (wrist) joint possesses a(n) ____ (insert answer) type of joint movement.

The proximal radioulnar joint is classified as a ______ joint.

Why is the wrist joint called the radiocarpal joint?

Which structure fans out from the ulnar styloid process to attach to the triquetrum and pisiform?

The radial collateral ligament extends from the radial styloid process primarily to the ______ side of the scaphoid.

Which wrist deviation best shows the scaphoid?

Which special projection of the wrist will open up the interspaces on the ulnar side of the wrist?

The forearm should be imaged in an AP (supinated) projection because in pronation the radius and ulna ______.

In pronation (PA forearm), the radius crosses over the ulna at which part of the ulna?

In AP elbow projections, lateral rotation ______ the radius and ulna, while medial rotation ______ them.

Which AP elbow position shows the radial head, neck, and tuberosity free of ulnar superimposition?

What does the medial (internal rotation) oblique elbow best demonstrate?

A radiograph of the elbow demonstrates the radius directly superimposed over the ulna and the coronoid process in profile. Which projection of the elbow has been performed?

How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the elbow?

A radiograph of an AP oblique elbow with medial rotation reveals that the radial head is superimposed over part of the coronoid process. What positioning error has been committed?

What does the lateral (external rotation) oblique elbow best demonstrate?

Which routine projection of the elbow best demonstrates the olecranon process in profile?

Which basic projection of the elbow best demonstrates the trochlear notch in profile?

How should the humeral epicondyles be aligned for a lateral projection of the elbow?

On a true lateral elbow flexed at 90°, which structure forms the smallest (innermost) of the three concentric arcs?

The smooth, depressed, center portion of the trochlea used for evaluating rotation on a lateral elbow is termed the trochlear:

On a true lateral elbow, the intermediate concentric arc is formed by the double ridge of the ______ and ______.

On a true lateral elbow, which structure forms the outermost concentric arc?

Which two views are obtained in the Jones method for an elbow locked in acute flexion?

What is the proper name for the acute flexion elbow projection?

What is the purpose of performing the AP partially flexed projections of the elbow?

A patient enters the ED in severe pain with a possible dislocation of the elbow. The patient has the elbow flexed more than 90°. Which one of the following routines should be performed to confirm the diagnosis?

The trauma axial lateral elbow technique is called the ______ method.

With the radial head projections, what is the only difference between the four projections?

In the Coyle method for the radial head, the elbow is flexed ______ and the CR is angled 45° ______.

In the Coyle method for the coronoid process, the elbow is flexed ______ and the CR is angled 45° ______.

A young child comes to radiology with an elbow injury. The basic elbow projections demonstrate a possible nondisplaced fracture of the coronoid process. Beyond the medial oblique projection, what additional projection(s) can be performed to demonstrate the coronoid process in profile?

Which fat pads are in the elbow?

Which fat stripes are in the wrist?

True or False: Displacement or absence of a fat pad may be the only indicator of a fracture or injury within a joint.

The scaphoid fat stripe is seen on the ______ images.

Displacement or obliteration of the scaphoid fat stripe indicates a fracture of the ______.

The pronator fat stripe is seen on the ______ view, about 1/4 inch (1 cm) anterior to the distal radius.

The three elbow fat pads can only be seen on which view?

An elevated, teardrop-shaped anterior fat pad on a lateral elbow is called the ______ sign.

Visualization of the posterior fat pad on a 90° lateral elbow is a reliable indicator of ______.

A nonvisible posterior fat pad on a well-exposed, correctly positioned lateral elbow radiograph generally suggests:

Extending the elbow past 90° on a lateral can cause false visualization of which fat pad?

Displacement or blurring of the supinator fat stripe suggests an occult fracture of the ______.

How much should kVp or mA be increased for a small to medium plaster cast?

How much should kVp or mA be increased for a large plaster cast?

How much should kVp or mA be increased for a fiberglass cast?

True or False: Arthrography requires contrast.

Nuclear medicine assesses the ______ aspect instead of the anatomic aspect.

A fracture and dislocation of the posterior lip of the distal radius involving the wrist joint is a ______ fracture.

A fracture of the base of the first metacarpal extending into the CMC joint with posterior displacement is a ______ fracture.

A patient enters the ED with a possible Bennett's fracture. Which of the following routines should be performed to confirm this diagnosis?

A transverse fracture through the metacarpal neck, most commonly the fifth, is a ______ fracture.

A transverse fracture of the distal radius with the distal fragment displaced posteriorly is a ______ fracture.

A transverse fracture of the distal radius with the distal fragment displaced anteriorly is a ______ fracture.

What is the difference between a Colles fracture and a Smith fracture?

A "skier's thumb" is an injury of the:

A patient comes to radiology with a possible tear of the ulnar collateral ligament of the wrist. The patient complains of discomfort near the thumb region. Basic thumb projections do not demonstrate any type of fracture or dislocation. Which one of the following projections can be performed to confirm an injury to the ulnar collateral ligament?

The Folio method requires a bilateral projection of the thumbs be taken with one single exposure.

In the Folio method, the stress view of the thumbs is taken in which projection?

On a bilateral clenched-fist PA wrist, scapholunate interspace widening of ______ indicates a ligament tear.

Which projection is used for suspected rheumatoid arthritis with soft tissue swelling near the ulnar styloid?

How much rotation of the hands is required for the AP oblique bilateral (Norgaard method) hand projection?

Where is the CR centered for the Norgaard method?

Which projection is used for early detection of rheumatoid arthritis erosions at the metacarpal heads?

In the Brewerton method, the hand dorsum is elevated ______ from the IR and the CR is angled ______ proximally.

Where is the CR centered for the Brewerton method?

A chronic disorder of bone remodeling producing enlarged, weakened, misshapen bones is called ______ disease.

What is the radiographic appearance of Paget disease?

What exposure adjustment is required during the sclerotic repair stage of Paget disease?

Degenerative joint disease with articular cartilage breakdown, osteophytes, and joint-space narrowing is ______.

A bacterial infection of the skin and subcutaneous soft tissues causing redness, swelling, warmth, and tenderness is ______.

Which modality can demonstrate cellulitis?

Which one of the following is the most common primary malignant bone tumor?

Multiple "punched-out" radiolucent osteolytic lesions on a skeletal survey are characteristic of ______.

Osteopetrosis ("marble bone") requires what change in manual exposure factors?

An osteochondroma is a benign bone tumor that points ______ the adjacent joint.

Which benign cartilaginous tumor appears as a well-demarcated radiolucent lesion with a thin cortex in the small bones of the hands or feet?

A general positioning rule is to place the long axis of the part ____ (insert answer) to the long axis of the image receptor.

Where is the CR centered for a PA projection of the hand?

A radiograph of a PA projection of the hand reveals that the distal radius and ulna and the carpals were cut off. What should the technologist do to correct this problem?

Where is the central ray (CR) placed for a PA projection of the third digit?

From a pronated position, which of the following is required for a PA oblique projection of the fourth digit of the hand?

Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?

A radiograph of a PA oblique of the hand reveals that the midaspect of the fourth and fifth metacarpals is superimposed. What specific positioning error has been committed?

Where is the CR directed for AP, PA oblique, and lateral projections of the thumb?

Which lateral hand projection is preferred for evaluating phalanges without superimposition?

Where is the CR centered for the "fan" lateral hand projection?

Which lateral hand projection shows anterior or posterior metacarpal fracture displacement and foreign body localization?

Which projection best demonstrates pathology involving the first carpometacarpal joint?

What CR angle is required with the modified Robert's method?

Where is the CR centered for the Modified Robert method?

In the Modified Robert method the ______ aspect of the thumb rests on the IR with the arm rotated internally.

The Modified Robert method is used to show which fracture?

What CR angle and centering are used for the PA axial wrist with ulnar deviation?

Why is a PA wrist with ulnar deviation performed?

A patient enters the ED with a possible scaphoid fracture. The patient is unable to assume the ulnar deviation position. Which of the following positions should be performed to confirm the diagnosis?

The Modified Stecher method elevates the hand and wrist on a ______ angle sponge to elongate and isolate the scaphoid.

A radiograph of the PA scaphoid projection reveals extensive superimposition of the scaphoid and adjacent carpals. Which of the following factors can lead to this problem?

The tangential inferosuperior carpal canal projection is also called the ______ method.

How much CR angulation to the long axis of the hand is required for the tangential, inferosuperior projection to demonstrate the carpal sulcus (canal)?

For the Gaynor-Hart method, the CR is centered 1 inch distal to the ______.

A patient with a history of carpal tunnel syndrome comes to radiology. The physician wants to rule out abnormal calcifications in the carpal sulcus. Which of the following projections would best demonstrate this region?

A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamate is superimposed over the pisiform. Which of the following measures will correct this problem?

Carpal tunnel syndrome is more common in middle-aged women than in middle-aged men.

The tangential carpal bridge projection directs the CR ______ distally to the forearm axis.

The tangential carpal bridge CR is centered ______ proximal to the wrist joint.

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces if the patient can assume this position?

Which structural classification applies to the scapula?

The inferior angle of the scapula is at the level of which vertebra?

Which area of the proximal humerus is a frequent fracture site requiring surgery?

What is the most common cause of axillary nerve injury?

Which joint is the only true bony union between the trunk and the upper extremity?

What is the movement classification of the acromioclavicular (AC) joint?

Where is the clavicle most commonly fractured?

What is the passageway for the suprascapular nerve?

A posterior dislocation of the shoulder occurs more frequently than an anterior dislocation.

Approximately ______ percent of shoulder joint dislocations occur anteriorly.

What is the purpose of the scapular Y projection?

How much is the patient rotated from the IR for the PA oblique (scapular Y lateral) projection?

How much CR angulation should be used for a scapular Y projection?

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?

On a scapular Y lateral, an anterior dislocation shows the humeral head inferior to the ______.

On a scapular Y lateral, a humeral head inferior to the acromion process indicates a ______ dislocation.

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?

What are the three views for shoulder trauma?

What three AP rotation projections are listed in the routine shoulder exam?

What two projections make up the routine humerus?