Procedures Shoulder

Front 1

The three aspects of the clavicle are the

Back 1

sternal extremity, body (shaft),and acromial extremity

Front 2

The three angles of the scapula include the

Back 2

lateral angle, superior angle, and inferior angle

Front 3

The anterior surface of the scapula is referred to as the

Back 3

costal surface

Front 4

What are the names of the two fossae located on the posterior scapula?

Back 4

Infraspinous fossa

Supraspinous fossa

Front 5

All of the joints of the shoulder girdle are classified as being

Back 5

synovial (diarthrodial)

Front 6

Joint movement type:

Scapulohumeral

Back 6

spheroidal

Front 7

Joint movement type:

Sternoclavicular

Back 7

Plane

Front 8

Joint movement type:

Acromioclavicular

Back 8

Plane

Front 9

What rotation demonstrates the greater tubercle profiled laterally?

Back 9

External rotation

Front 10

What rotation demonstrates the humeral epicondyles angled 45 degrees to image receptor?

Back 10

Neutral rotation

Front 11

What rotation demonstrates the epidondyles perpendicular to IR

Back 11

internal rotation

Front 12

What rotation demonstrates the supination of the hand

Back 12

external rotation

Front 13

What rotation demonstrates the palm of the hand against thigh

Back 13

neutral rotation

Front 14

What rotation demonstrates the epicondyles parallel to IR

Back 14

external rotation

Front 15

What rotation demonstrates the lesser tubercle profiled medially

Back 15

internal rotation

Front 16

What rotation demonstrates the proximal humerus in a lateral position

Back 16

internal rotation

Front 17

What rotation demonstrates the proximal humerus in position for an AP projection?

Back 17

external rotation

Front 18

How much (at what angle) should the affected arm be abducted from the body for the Inferosuperior Axiolateral projection?

Back 18

90 degrees

Front 19

The kV range for adult should projections is

Back 19

between 70 +/- 5 kV

Front 20

____ focal spot setting should be selected for most adult shoulder studies.

Back 20

Small Focal Spot

Front 21

T/F: Low mA with short exposure times should be used for adult shoulder studies.

Back 21

False.

High mA

Front 22

T/F: The use of contact shields over the breast, lung, and thyroid regions is recommended for most shoulder projections.

Back 22

True

Front 23

T/F: CT arthrography of the shoulder joint requires the use of iodinated contrast media injected into the joint space.

Back 23

True

Front 24

T/F: MRI is an excellent modality for demonstrating nondisplaced fractures of the shoulder girdle.

Back 24

FALSE

Front 25

T/F: Nuclear medicine bone scans can demonstrate signs of osteomyelitis and cellulitis.

Back 25

True

Front 26

Compression between the greater tuberosity and soft tissues on the coracoacromial ligamentous and osseous arch

Back 26

Impingement syndrome

Front 27

Injury of the anteroinferior glenoid labrum

Back 27

Bankart lesion

Front 28

Inflammatory condition of the tendon

Back 28

Tendonitis

Front 29

Superior displacement of the distal clavicle

Back 29

Acromioclavicular joint

Front 30

Compression fracture of the articular surface of the humeral head

Back 30

Hill-Sachs defect

Front 31

Traumatic injury to one or more of the supportive muscles of the shoulder girdle

Back 31

Rotator Cuff Tear

Front 32

Atrophy of skeletal tissue

Back 32

Osteoporosis

Front 33

Subacromial spurs

Back 33

Impingement syndrome

Front 34

Fluid-filled joint space

Back 34

Bursitis

Front 35

Thin bony cortex

Back 35

Osteoporosis

Front 36

Abnormal widening of acromioclavicular joint space

Back 36

Acromioclavicular joint separation

Front 37

Calcified tendons

Back 37

Rheumatoid arthritis

Front 38

Avulsion fracture of the glenoid rim

Back 38

Bankart lesion

Front 39

Narrowing of joint space

Back 39

Osteoarthritis

Front 40

Closed joint space

Back 40

Rheumatoid arthritis

Front 41

Compression fx of humeral head

Back 41

Hill-Sachs defect

Front 42

Which two basic shoulder projections are routinely taken for a shoulder (with no traumatic injury) and proximal humerus?

Back 42

AP external

AP internal

Front 43

Specifically, where is the central ray placed for an AP projection of the shoulder?

Back 43

Perpendicular to IR, to midscapulohumeral joint; 3/4" inferior and lateral to coracoid process

Front 44

Which lateral projection can be performed to demonstrate the entire humerus for a patient with a midhumeral fx?

Back 44

Transthoracic lateral

Front 45

To best demonstrate a possible Hill-Sachs defect, which additional positioning technique can be added to the infero-superior axial projection?

Back 45

Rotated affected arm externally approximately 45 degrees

Front 46

What type of central ray angulation is required for the inferosuperior axial projection for the shoulder?

Back 46

25 - 30 degrees medially

Front 47

The ___ projection of the shoulder produces an image of the glenoid process in profile. This projection is also referred to as the ___ method.

Back 47

AP oblique

Grashey method

Front 48

Which projection produces a tangential projection of the intertubercular groove?

Back 48

Tangential projection
(Fisk modification)

Front 49

The supine version of the tangential projection for the intertubercular groove requires that the central ray be angled ___ from the horizontal plane.

Back 49

10 - 15 degrees posteriorly

Front 50

What projection would demonstrate a possible dislocation of the proximal humerus?

Back 50

Scapular Y

Front 51

The ___ projection is the special projection of the shoulder that best demonstrates the acromiohumeral space for possible subacromial spurs, which create shoulder impingement symptoms.

This projection is also referred to as the ___ method.

Back 51

Supraspinous outlet tangential projection

Neer method

Front 52

What projection can be performed erect to provide a lateral view of the proximal humerus in relationship to the glenohumeral joint?

Back 52

Superoinferior axial projection
(Hobbs modification)

Front 53

How much is the CR angled for the inferosuperior axial projection (Clements modification) if the patient cannot fully abduct the arm 90 degrees?

Back 53

5 - 15 degrees toward axilla

Front 54

What CR angle is required for the AP axial projection (Alexander method) for AC joints?

Back 54

15 degrees cephalad

Front 55

T/F: The superoinferior axial projection (Hobbs modification) requires no CR angle.

Back 55

True

Front 56

T/F: The transthoracic lateral projection can be performed for possible fractures or dislocations of the proximal humerus.

Back 56

True

Front 57

T/F: The affected arm must be placed into external rotation for the transthoracic lateral projection.

Back 57

FALSE

Neutral rotation

Front 58

A CR angle of ____ may be used for the transthoracic lateral projections if the patient is unable to elevate the injured arm and shoulder sufficiently.

Back 58

10-15 degrees cephalad

Front 59

T/F: The scapular Y lateral (anterior oblique) position requires the body to be rotated 45-60 degrees anteriorly toward the affected side.

Back 59

True

Front 60

What shoulder projection delivers the greatest skin dose to the patient?

Back 60

Transthoracic lateral

Skin dose - 1005

Front 61

What shoulder projection requires the smallest thyroid dose?

Back 61

Scapular Y lateral

Skin dose - 1

Front 62

Which special projection of the shoulder requires that the affected side be rotated 45 degrees toward the cassette and uses a 45 degree caudad central ray angle?

Back 62

Garth method
(AP apical oblique axial projection)

Front 63

A posterior dislocation of the humerus projects the humeral head (superior/inferior) to the glenoid cavity with the Garth method.

Back 63

Superior

Front 64

A thin-shouldered patient requires ___ CR angle for an AP axial clavicle projection than a large-shouldered patient.

Back 64

10 - 15 degrees MORE

Front 65

Inferosuperior axial

Back 65

Lawrence method

Front 66

AP oblique for glenoid cavity

Back 66

Grashey method

Front 67

Tangential for intertubercular (bicipital) groove

Back 67

Fisk modification

Front 68

Supraspinatus outlet tangential

Back 68

Neer method

Front 69

Transthoracic lateral

Back 69

Lawrence method

Front 70

AP apical oblique axial

Back 70

Garth method

Front 71

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

Back 71

25-30 degrees

inferosuperior axial shoulder (Lawrence method) is laying down - CR into axilla

Front 72

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

Back 72

to the scapulohumeral joint.

Front 73

T/F: AP scapula is performed using a breathing technique.

Back 73

True

Front 74

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

Back 74

Lateral scapula position

Front 75

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

Back 75

30 degrees

Front 76

Where is the CR centered for an AC joint projection on a single 14x17" image receptor?

Back 76

1 inch above the jugular notch

Front 77

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

Back 77

Increase rotation of thorax

(PA projection)

Front 78

Situation: A pt comes for tx of an arthritic condition o fthe right shoulder. The radiologist orders AP internal/external rotation projections as well as an inferosuperior axiolateral projection o fthe scapulohumeral joint. However, pt can't abduct the arm for this projection. What other projection will best demonstrate the scapulohumeral joint space?

Back 78

AP oblique

Front 79

Situation: A pt enters the ED w a possible AC joint separation. The pt is paraplegic; therefore, the study can't be done erect. What routine would be performed to diagnose this condition?

Back 79

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

Front 80

Situation: A pt enters the ED w a possible bony defect or fx of the midwing area of scapula. Pt can stand. In addition to the routine AP scapula projection with arm abducted, what would best demonstrate the involved area?

Back 80

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

Front 81

T/F: A posterior dislocation of the shoulder occurs more frequently than an anterior dislocation.

Back 81

FALSE.

Anterior dislocation occurs more frequently.

Front 82

What position demonstrates the greater tubercle in profile medially?

Back 82

None of the above

Front 83

Supraspinatus outlet projection

Back 83

Neer method

Front 84

Inferosuperior axial (patient supine) projection

Back 84

Lawrence method

Front 85

Posterior oblique, glenoid cavity projection

Back 85

Grashey method

Front 86

Where is the central ray directed for the Scapular Y lateral projection?

Back 86

Mid-scapula