Which of the following joints is considered to have a ball and socket (spheroidal) type of movement?

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

a. Lesser tubercle
b. Glenoid process
c. Intertubercular sulcus
d. Anatomic neck

Glenoid process

Which term describes the medial end of the clavicle?
a. Acromial extremity
b. Acromion
c. Sternal extremity
d. Acromial tuberosity

Sternal extremity

The anterior surface of the scapula is referred to as the:
a. Scapular surface.
b. Dorsal surface.
c. Supraspinous and infraspinous fossa.
d. Costal surface.

Costal Surface

What is the name of the large fossa found within the anterior surface of the scapula?
a. Supraspinous fossa
b. Infraspinous fossa
c. Subscapular fossa
d. Glenoid fossa

Subscapular Fossa

Which of the following joints is considered to have a ball and socket (spheroidal) type of movement?
a. Acromioclavicular joints
b. Sternoclavicular joints
c. Bicipital joint
d. Scapulohumeral joint

Scapulohumeral joint

Which rotation of the humerus will result in a lateral position of the proximal humerus?
a. Internal rotation (epicondyles perpendicular to image receptor)
b. Neutral rotation (epicondyles 45° to the image receptor)
c. External rotation (epicondyles parallel to the image receptor)
d. None of the above

Internal rotation

Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh?
a. Internal rotation
b. Neutral rotation
c. External rotation
d. AP axial

Neutral rotation

Which of the following shoulder projections best demonstrates the glenoid cavity in profile?
a. Grashey method
b. Clements modification
c. Garth method
d. AP shoulder, neutral rotation

Grashey method

How much CR angulation should be used for a PA oblique (scapular Y) projection?
a. No CR angle is required.
b. 10° to 15°
c. 20° to 30°
d. 35° to 45°

No CR angle is required

Where is the CR centered for a transthoracic lateral projection for proximal humerus?
a. 1 inch (2.5 cm) inferior to the acromion
b. Level of the greater tubercle
c. Level of surgical neck
d. Midaxilla

Level of surgical neck

Which projection of the shoulder requires that the patient be rotated 45° to 60° toward the IR from a PA position?
a. Inferosuperior axiolateral projection
b. AP oblique projection
c. Lateral scapula projection
d. None of the above

Lateral scapula projection

What type of compensating filter is recommended for an AP shoulder projection?
a. Wedge
b. Boomerang
c. Trough
d. Gradient

Boomerang

How much CR angulation is required for an asthenic patient for an AP axial projection of the clavicle?
a. 15°
b. 30°
c. 45°
d. No CR angulation should be used for this projection.

30 degrees

The AP humerus requires that the humeral epicondyles are _____ to the IR.
a. set at a 45° angle
b. parallel
c. perpendicular
d. slightly oblique

parallel

Where is the CR centered for the AP oblique (Grashey method) position for the glenoid cavity?
a. Acromion
b. 2 inches (5 cm) medial and inferior to the superolateral border of shoulder
c. Coracoid process
d. 1 inch (2.5 cm) superior to the coracoid process

2 inches medial and inferior to the superolateral border of shoulder

An AP shoulder projection with accurate positioning demonstrates the

1. Glenoid fossa in profile.
2. Superior scapular body-centered within the collimated field.
3. Superolateral scapular border without thorax superimposition.
4. Superior scapular angle superior to the mid clavicle.

a. 1, 2, and 3 only
b. 2, 3, and 4 only
c. 2 and 3 only
d. 3 and 4 only

Superior scapular body-centered within the collimated field
Superolateral scapular border without thorax superimposition

2&3 only

An AP shoulder projection obtained with the humeral epicondyles positioned parallel with the IR demonstrates the

1. Greater tubercle in profile laterally.
2. Lesser tubercle in profile medially.
3. Humeral head in profile medially.
4. Greater tubercle superimposed over the humeral head.

a. 1 and 3 only
b. 1 and 2 only
c. 3 and 4 only
d. 2 and 4 only

Greater tubercle in profile laterally
Humeral head in profile medially

1&3 only

For an AP shoulder projection, the

1. Shoulders are positioned at equal distances from the IR.
2. Central ray is centered 1 inch (2.5 cm) inferior to the coracoid.
3. Imaginary line connecting the humeral epicondyles is positioned at a 45-degree angle to the IR.
4. Central ray is angled cephalically when a kyphotic patient is imaged.

a. 1 and 2 only
b. 3 and 4 only
c. 1, 2, and 3 only
d. 1, 2, 3, and 4

Shoulders are positioned at equal distances from the IR
Central ray is centered 1 inch inferior to coracoid
Imaginary line connecting humeral epicondyles is positioned at a 45 degree angle to IR
Central ray is angled cephalically when a kyphotic patient is imaged

1,2,3&4 - all of the above

For an AP oblique shoulder projection (Grashey method), the

1. Patient's midcoronal plane is rotated to a 35- to 45-degree angle with the IR.
2. Central ray is centered to the coracoid process.
3. Patient is rotated toward the affected shoulder.
4. Image is obtained with the patient in an upright position.

a. 1 and 3 only
b. 2 and 4 only
c. 2, 3, and 4 only
d. 1, 2, 3, and 4

Patient's midcoronal plane is rotated to a 35 to 45 degree angle with the IR
Central ray is centered to the coracoid process
Patient is rotated toward the affected shoulder
Image is obtained with the patient in an upright position

1,2,3&4 - all of the above

For an AP oblique shoulder projection (Grashey method), the patient is rotated more than 45 degrees when the patient is

1. Recumbent.
2. Kyphotic.
3. Seated.
4. Upright and leaning against the upright IR holder.

a. 1 and 2 only
b. 3 and 4 only
c. 1, 2, and 4 only
d. 1, 2, 3, and 4

Recumbent
Kyphotic
Upright and leaning against the upright IR holder

1,2 &4

An AP oblique shoulder projection (Grashey method) with accurate positioning demonstrates

1. The glenoid fossa in profile and facing superiorly.
2. An open glenohumeral joint space.
3. A longitudinally foreshortened clavicle.
4. The glenohumeral joint in the center of the collimated field.

a. 1 and 3 only
b. 1, 2, and 4 only
c. 2, 3, and 4 only
d. 1, 2, 3, and 4

An open glenohumeral joint space
A longitudinally foreshortened clavicle
The glenohumeral joint in the center of the collimated field

2,3&4

The arms of the Y on a PA oblique scapular Y shoulder projection are formed by the

1. Coracoid.
2. Scapular body.
3. Acromion.
4. Glenoid fossa.

a. 1 and 2 only
b. 2 and 3 only
c. 3 and 4 only
d. 1 and 3 only

Coracoid and Acromion

1&3

For a PA oblique scapular Y shoulder projection, the patient's

1. Humerus is elevated until the hand is placed on the hip.
2. Body is rotated toward the unaffected shoulder.
3. Body is rotated until an imaginary line connecting the acromion angle and coracoid processes is aligned parallel with the IR.
4. Midcoronal plane is vertical.

a. 2 and 3 only
b. 3 and 4 only
c. 2, 3, and 4 only
d. 1, 2, 3, and 4

Body is rotated until an imaginary line connecting the acromion angle and coracoid processes is aligned parallel with the IR
Midcoronal plane is vertical

3&4

A PA oblique scapular Y shoulder projection with accurate positioning demonstrates

1. The superior angle of the scapula at the same transverse level as the clavicle.
2. Superimposed scapular borders.
3. A laterally situated glenoid fossa.
4. The coracoid, acromion, and humerus creating the arms and leg of the Y formation.

a. 1 and 2 only
b. 2 and 4 only
c. 1 and 3 only
d. 1, 2, and 4 only

The superior angle of the scapula at the same transverse level as the clavicle
Superimposed scapular borders

1&2

An AP axial clavicle projection with accurate positioning demonstrates the

1. Medial clavicular end superimposed over the first and second ribs.
2. Middle and lateral thirds of the clavicle superior to the acromion.
3. Clavicle bowing upward.
4. Medial clavicular end superimposed over the vertebral column.

a. 1 and 2 only
b. 2 and 3 only
c. 1, 2, and 3 only
d. 1, 2, 3, and 4

Medial clavicular end superimposed over the first and second ribs
Middle and lateral thirds of the clavicle superior to the acromion
Clavicle bowing upward

1,2&3

For an AP axial clavicle projection,

1. The patient's shoulders are positioned at equal distances from the IR.
2. The central ray is angled 15 to 30 degrees cephalad.
3. A compensating filter is positioned over or under the lateral clavicle.
4. The central ray is centered halfway between the medial and lateral clavicular ends.

a. 2 and 4 only
b. 1 and 3 only
c. 1, 2, and 4 only
d. 1, 2, 3, and 4

The patient's shoulders are positioned at equal distances from the IR
The central ray is angled 15 - 30 degrees cephalad
The central ray is centered halfway between the medial and lateral clavicular ends

1,2&4

An AP scapular projection with accurate positioning demonstrates

1. Almost superimposed anterior and posterior glenoid fossa margins.
2. The vertebral scapular border without thoracic cavity superimposition.
3. The humeral shaft at a 90-degree angle with the body.
4. The superior scapular angle without clavicular superimposition.

a. 1 and 3 only
b. 1, 3, and 4 only
c. 1 and 2 only
d. 3 and 4 only

Almost superimposed anterior and posterior glenoid fossa margins
The humeral shaft at a 90 degree angle with the body
The superior scapular angle without clavicular superimposition

1,3&4

For an AP scapular projection, the

1. Patient's arm is abducted 90 degrees to the body.
2. Image is exposed on expiration.
3. Patient's upper midcoronal plane leans slightly away from the IR.
4. Central ray is centered 2 inches (5 cm) inferior to the coracoid.

a. 1 and 4 only
b. 2 and 3 only
c. 1, 3, and 4 only
d. 1, 2, and 4 only

Patient's arm is abducted 90 degrees to the body
Image is exposed on expiration
Central ray is centered 2 inches inferior to the coracoid

1,2&4

A lateral scapular projection with accurate positioning obtained with the humerus abducted to a 90-degree angle with the body demonstrates

1. Superimposition of the lateral and vertebral scapular borders.
2. The scapula in a Y formation.
3. The superior scapular angle inferior to the coracoid.
4. The midscapular body in the center of the collimated field.

a. 1 and 4 only
b. 2 and 4 only
c. 1, 2, and 3 only
d. 1, 2, and 4 only

Superimposition of the lateral and vertebral scapular borders
The midscapular body in the center of the collimated field

1&4

The lesser tubercle is demonstrated in profile on a (n)

1. Neutral AP shoulder projection.
2. Lateral humeral projection.
3. Transthoracic lateral proximal humeral projection.
4. Inferosuperior axial shoulder projection.

a. 1 and 3 only
b. 2 and 4 only
c. 1, 3, and 4 only
d. 2, 3, and 4 only

Lateral humeral projection
Transthoracic lateral proximal humeral projection
Inferosuperior axial shoulder projection

2,3&4

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

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

All of the following positions of the humerus are commonly used when performing an AP projection of the shoulder, except:
a. Superior rotation.
b. External rotation.
c. Neutral rotation.
d. Internal rotation

Superior rotation

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

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

All of these projections can be used to demonstrate the clavicle, except:

a. AP.
b. AP axial.
c. PA axial.
d. Lateral.

Lateral

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

How is the upper extremity positioned for an AP scapula?

a. Abducted 90 degrees, with elbow flexed
b. Abducted 45 degrees, with elbow flexed
c. Adducted, lateral rotation
d. Adducted, medial rotation

Abducted 90 degrees, with elbow flexed

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

a. True lateral
b. 15- to 25-degree posterior oblique
c. 45- to 60-degree anterior oblique
d. Prone

45 - 60 degree anterior oblique

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

The clavicle is classified as a (n) _____ bone.
a. short
b. long
c. flat
d. irregular

long

The scapula is classified as a (n) _____ bone.
a. flat
b. short
c. long
d. irregular

flat

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

True

For an AP oblique (Grashey method) projection of the shoulder, the CR is centered to the acromion

False

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

Chapter 6.

Which of the following projections can be performed using an orthostatic technique?

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

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

The deltoid inserts into the deltoid tubercle/tuberosity around the middle of the surface. The lateral portion of the brachialis muscle originates from the distal part of this surface, as well as from the proximal two third of the lateral supracondylar ridge.

Which projection of the shoulder will demonstrate the lesser tubercle in profile?

Cards
Term Which classification of bone is the Scapula?
Definition Flat
Term Which projection of the shoulder best demonstrates the lesser tubercle of the humerus in profile and pointing toward the glenoid cavity?
Definition AP projection with internal rotation
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