Humerus/Shoulder Test

Question 1

What should be in profile on the internal rotation of the shoulder?

a.) lesser tubercle
b.) greater tubercle
c.) clavicle
d.) humerus

Answer 1

a.) lesser tubercle

Question 2

Which of the following breathing techniques should be used for an AP projection of the humerus?

a.) shallow breathing
b.) full expiration
c.) full inspiration
d.) suspended respiration

Answer 2

d.) suspended respiration

Question 3

What is the correct part position for the PA ulnar deviation projection of the wrist?

a.) hand should be left straight
b.) move hand toward ulnar side as much as possible
c.) move hand away from ulnar side as much as possible
d.) rotate hand upward toward ulnar side

Answer 3

b.) move hand toward ulnar side as much as possible

Question 4

What is the purpose of using a small focal spot when performing bone work?

a.) to obtain open joint spaces
b.) to reduce magnification
c.) to reduce scatter production
d.) to increase sharpness

Answer 4

d.) to increase sharpness

Question 5

Where is the central ray directed on the internal and external projections of the shoulder?

a.) 2’’ inferior to caracoid process
b.) 1 1/2’’ inferior to coracoid process
c.) 1’’ inferior to coracoid process
d.) 3’’ inferior to coracoid process

Answer 5

c.) 1’’ inferior to coracoid process

Question 6

What are the three parts of the proximal radius that should be demonstrated on the forearm projections? Choose all that apply.

a.) head
b.) neck
c.) tuberosity
d.) styloid process

Answer 6

a.) head
b.) neck
c.) tuberosity

Question 7

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

a.) 0 degrees
b.) 5 degrees
c.) 15 degrees
d.) 10 degrees

Answer 7

a.) 0 degrees

Question 8

Where should the CR be directed on the transthoracic lateral humerus projections?

a.) surgical neck
b.) distal humerus
c.) mid diaphysis/shaft
d.) mid shoulder

Answer 8

c.) mid diaphysis/shaft

Question 9

Situation: A patient enters the ED with multiple injuries including a possible fracture of the left proximal humerus. Which positioning rotation should be performed to determine the extent of the humerus injury?

a.) AP neutral shoulder rotation and carefully rotated internally poximal humerus
b.) AP should as is, show radiograph to ED physician before attempting a rotational projection
c.) AP and horizontal beam transthoracic lateral shoulder
d.) AP and oblique shoulder without arm rotation

Answer 9

c.) AP and horizontal beam transthoracic lateral shoulder

Question 10

Which of the following is shown in profile on a lateral projection of the humerus?

a.) glenoid cavity
b.) greater tubercle
c.) capitulum
d.) lesser tubercle

Answer 10

d.) lesser tubercle

Question 11

Which projections demonstrate an open glenohumeral joint space?

1.) inferosuperior axial shoulder projection
2.) transthoracic lateral shoulder projection
3.) AP oblique shoulder projection (grashey method)
4.) PA oblique scapular Y shoulder projection

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

Answer 11

a.) 1 and 3 only

Question 12

A radiograph of a transthoracic lateral projection reveals that it is difficult to visualize the proximal humerus due to the ribs and lung markings.The following exposuer factors were used, 75 KVP, 30 MAS, 40 inch SID, grip, suspended respiration. Which of the following changes will improve the quality of the image?

a.) use a compression band to prevent patient movement
b.) make the exposure on second inspiration
c.) use a breathing technique
d.) use a 72 inch SID

Answer 12

c.) use a breathing technqiue

Question 13

What is the correct obliquity for the mediolateral projection of the humerus?

a.) 5 degrees
b.) 15 degrees
c.) 20 to 30 degrees
d.) 45 degrees

Answer 13

c.) 20 to 30 degrees

Question 14

Which of the following carpal bones are located on the proximal row? Choose all that apply.

a.) scaphoid
b.) lunate
c.) triquetrum
d.) pisiform
e.) trapezium
f.) trapezoid
g.) capitate
h.) hamate

Answer 14

a.) scaphoid
b.) lunate
c.) triquetrum
d.) pisiform

Question 15

For the lateral projection of the forearm, the elbow should be flexed:

a.) 80 degrees
b.) 90 degrees
c.) 45 degrees
d.) 90 to 120 degrees

Answer 15

b.) 90 degrees

Question 16

On the inferosuperior axial shoulder if the arm is abducted less that 90 degrres the CR medial angle should be decreased to?

a.) 3 to 5 degrees
b.) 5 to 10 degrees
c.) 15 to 20 degrees
d.) 30 degrees

Answer 16

c.) 15 to 20 degrees

Question 17

A general positioning rule is to place the long axis of the part _________ the long axis of the image receptor.

a.) parallel with
b.) axial to
c.) adjacent to
d.) perpendicular to

Answer 17

a.) parallel with

Question 18

For external rotation of the shoulder the hand should be placed in the ________ the long axis of the image recptor.

a.) internal, elbow
b.) external, hand
c.) palm on hip, shoulder
d.) supine, epicondyles

Answer 18

d.) supine, epicondyles

Question 19

The top of the Y on a PA/AP 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

Answer 19

d.) 1 and 3 only

Question 20

What makes up the scapular Y projection?

a.) acromion and coracoid make up the top of the scapular Y
b.) body of the scapula forms the vertical component of the Y
c.) coracoid only
d.) humeral head

Answer 20

a.) acromion and coracoid make up the top of the scapular Y
b.) body of the scapula forms the vertical component of the Y

Question 21

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

a.) internal rotation (epicondyles perpendicular to image receptor)
b.) neutral rotation (epicondyles 45 degrees to image receptor)
c.) external rotation ( epicondyles parallel to image receptor)
d.) none of the above

Answer 21

a.) internal rotation (epicondyles perpendicular to image receptor)

Question 22

Where is the central directed on the PA wrist projection?

a.) mid metacarpal area
b.) midcarpal area
c.) mid CMC joint
d.) scaphoid area

Answer 22

b.) midcarpal area

Question 23

For a transthoracic lateral projection the proximal humerus should be projected:

a.) directly over the opposite humerus
b.) over the vertebral column
c.) over the sternum
d.) between the vertebral column and sternum

Answer 23

d.) between the vertebral column and sternum

Question 24

What evaluation criteria should be demonstrated on the grashey method of the shoulder? Choose all that apply.

a.) glenoid cavity superimposed
b.) glenoid cavity free of superimposition
c.) scapulohumeral joint closed by the humerus
d.) scapulohumeral joint open

Answer 24

b.) glenoid cavity free of superimpositon
d.) scapulohumeral joint open

Question 25

How much should the body be rotated for the grashey method?

a.) 10 to 20 degrees
b.) 25 to 35 degrees
c.) 35 to 45 degrees toward affected side
d.) 35 to 45 degrees away from affected side

Answer 25

c.) 35 to 45 degrees toward affected side

Question 26

Which arm should be raised for the transthoracic lateral projection?

a.) affected arm
b.) unaffected arm

Answer 26

b.) unaffected arm

Question 27

Where is the CR centered for the transthoracic lateral projection?

a.) level of surgical neck
b.) 1 inch inferior to the acromion
c.) level of the greater tubercle
d.) midaxilla

Answer 27

a.) level of surgical neck

Question 28

Evaluation Criteria:

What should be demonstrated on the grashey method?

a.) open joint space between humeral head and glenoid cavity
b.) glenoid cavity in profile
c.) glenoid cavity not in profile
d.) glenoid cavity in profile only

Answer 28

b.) glenoid cavity in profile

Question 29

A patient enters the ER 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 due to the extent of the trauma. What other projection should be taken for this patient?

a.) apical oblique projection
b.) horizontal beam transthoracic lateral projection for humerus
c.) rotational lateral projection for humerus
d.) scapular Y lateral - AP oblique projection

Answer 29

b.) horizontal beam transthoracic lateral projection for humerus

Question 30

For internal rotation of the shoulder the hand should be placed in the ________ postion and the epicondyles should be ________ to the plane of the IR.

a.) internal, elbow
b.) external, hand
c.) palm on hip, shoulder
d.) pronated, perpendicular

Answer 30

d.) pronated, perpendicular

Question 31

Which of the following carpal bones are located on the distal row? Choose all that apply.

a.) scaphoid
b.) trapezium
c.) lunate
d.) trapezoid
e.) triquetrum
f.) capitate
g.) pisiform
h.) hamate

Answer 31

b.) trapezium
d.) trapizoid
f.) capitate
h.) hamate

Question 32

Evaluation Criteria:

Neutral rotation of shoulder which of the following should be demonstrated?
1.) proximal one third of the humerus
2.) upper scapula
3.) lateral two thirds of clavicle
4.) humeral head partial profile
5.) greater and lesser tubercles superimposed by humeral head

Answer 32

1, 2, 3, and 5

Question 33

The acromial end of the clavicle articulates with the:

a.) acromion process of the scapula
b.) sternal extremity of the clavicle
c.) glenoid cavity
d.) coracoid process

Answer 33

a.) acromion process of the scapula

Question 34

What should be in profile on the external rotation of the shoulder?

a.) lesser tubercle
b.) greater tubercle
c.) clavicle
d.) humerus

Answer 34

b.) greater tubercle

Question 35

How should the arm be palced for the glenoid cavity projection of the shoulder?

a.) externally
b.) internally
c.) neutral
d.) arm straight up in the air

Answer 35

c.) neutral

Question 36

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

a.) supine
b.) back of the hand against the thigh
c.) palm against the thigh
d.) prone

Answer 36

b.) back of the hand against the thigh

Question 37

Evaluation Criteria:
Which of the following should be clearly demonstrated on the scapular Y projection?

a.) humeral head and glenoid cavity superimposed
b.) humeral head in profile
c.) no superimposition of scapular body over bony thorax
d.) humeral shaft and scapular body superimposed
e.) acromion projected laterally and free of superimposition
f.) coracoid superimposed or projected below the clavicle
g.) scapula in lateral profile with lateral and vertebral borders superimposed

Answer 37

a.) humeral head and glenoid cavity superimposed
c.) no superimposition of scapular body over the bony thorax
d.) humeral shaft and scapular body superimposed
e.) acromion projected laterally and free of superimposition
f.) coracoid superimposed or projected below the clavicle
g.) scapula in lateral profile with lateral and vertebral borders superimposed

Question 38

Which of the following arm positions demonstrates the lesser tubercle in profile medially?

a.) external rotation
b.) internal rotation
c.) neutral rotation
d.) none of the above

Answer 38

b.) internal rotation

Question 39

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

a.) back of hand against the thigh
b.) prone
c.) palm against the thigh
d.) supine

Answer 39

c.) palm against the thigh

Question 40

In what position should the hand be for an AP elbow projection?

a.) pronated
b.) oblique
c.) supinated
d.) lateral

Answer 40

c.) supinated

Question 41

Which of the following is shown in profile on the AP projection of the humerus?

a.) greater tubercle
b.) glenoid cavity
c.) capitulum
d.) lesser tubercle

Answer 41

a.) greater tubercle

Question 42

For the exaggerated external rotation, what rotation and hand placement is for this projection?

a.) internal rotation, thumb downward 45 degrees
b.) externally rotated, thumb pointed upward
c.) externally rotated, thumb up, 30 degrees
d.) internally rotated, thumb downward, 45 degrees

Answer 42

a.) internal rotation, thumb downward 45 degrees

Question 43

The capitulum of the humerus articulates with the:

a.) ulnar coranoid process
b.) trochlea
c.) radial head
d.) lateral epicondyle

Answer 43

c.) radial head

Question 44

How should the epicondyles be placed for the lateral position of the shoulder?

a.) 30 degrees
b.) 45 degrees
c.) parallel
d.) perpendicular

Answer 44

d.) perpendicular

Question 45

Where is the central ray directed for the inferiosuperior axial projection?

a.) horizontally through humerus
b.) horizontally through axilla and humeral head

Answer 45

b.) horizontally through axilla and humeral head

Question 46

Grids are generally not required unless the anatomy measures greater than:

a.) 14 cm
b.) 8 cm
c.) 5 cm
d.) 10 cm

Answer 46

d.) 10 cm

Question 47

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

a.) 20 degrees away from the affected side
b.) 20 degrees toward the affected side
c.) 35 to 45 degrees away from the affected side
d.) 35 to 45 degrees toward the affected side

Answer 47

d.) 35 to 45 degrees toward the affected side

Question 48

On the lateromedial projection of the humerus how should the patient and part be positioned? Choose all that apply.

a.) elbow partially flexed
b.) body rotated toward affected side to place humerus and shoulder in contact with IR
c.) epicondyles perpendicular
d.) epicondyles parallel

Answer 48

a.) elbow partially flexed
b.) body rotated toward affected side to place humerus and shoulder in contact with IR
c.) epicondyles perpendicular

Question 49

On the PA oblique scapular Y shoulder projection accurate positioning of a patient demonstrates:
1.) true lateral view of scapula
2.) thin body of scapula seen on end without superimposition
3.) acromion and caracoid appear symmertric
4.) humeral head superimposed over the scapular body

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

Answer 49

c.) 1, 2, 3 and 4

Question 50

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

a.) glenoid cavity
b.) lateral angle
c.) acromion
d.) neck

Answer 50

a.) glenoid cavity

Question 51

Correct positioning for lateral projection of the humerus. Which of the following should be demonstrated?
Choose all that apply.
1.) elbow to shoulder
2.) epicondyles without rotation
3.) lesser tubercle in profile on medial side
4.) humeral head and greater tubercle in profile
5.) lesser tubercle located between humeral head and greater tubercle
6.) epicondyles superimposed
7.) greater tubercle superimposed over humeral head

a.) 1, 2 and 4
b.) 1, 2, 4 and 5
c.) 1, 3, 6 and 7
d.) 1 only

Answer 51

c.) 1, 3, 6 and 7

Question 52

Which of the following is the best position to place the patient in for a transthoracic lateral projection of the humerus?

a.) recumbent
b.) upright
c.) supine
d.) prone

Answer 52

b.) upright

Question 53

Shoulder radiography produces signifigant dose to the breast and thyroid gland.

a.) true
b.) false

Answer 53

a.) true

Question 54

For an AP projection of the shoulder with the arm in a neutral position, the epicondyles of the humerus should be:

a.) 45 degrees with the plane of the IR
b.) parallel with the plane of the IR
c.) perpendicular with the plane of the IR
d.) 60 degrees with the plane of the IR

Answer 54

a.) 45 degrees with the plane of the IR

Question 55

For the AP projection of the elbow, the hand is:

a.) placed in the 45 degree oblique position
b.) pronated
c.) supinated
d.) placed in the lateral position

Answer 55

c.) supinated

Question 56

Which of the following evaluation criteria should be demonstrated on the AP humerus projection? Choose all that apply.

a.) greater tubercle in profile laterally
b.) humeral head partially seen in profile medially
c.) minimal superimposition of glenoid cavity
d.) humeral epicondyles 45 degrees to IR

Answer 56

a.) greater tubercle in profile lateally
b.) humeral head partially seen in profile medially
c.) minimal superimposition of glenoid cavity

Question 57

Accurate positioning on the AP oblique shoulder projection grashey method demonstrates:
1.) the glenoid cavity in profile
2.) an open scapulohuemral joint space
3.) anterior and posterior rims of the glenoid cavity superimposed
4.) body rotated 35 to 45 degrees

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

Answer 57

a.) 1, 2, 3 and 4

Question 58

Correct positioning for AP projection of the humerus. Which of the following should be demonstrated?
Choose all that apply.
1.) elbow to shoulder
2.) epicondyles parallel without rotation
3.) lesser tubercle in profile on medial side
4.) humeral head and greater tubercle in profile
5.) lesser tubercle located between humeral head and greater tubercle
6.) epicondyles superimposed
7.) greater tubercle superimposed over huemal head

Answer 58

1, 2 and 4

Question 59

Which of the following shoulder projections demonstrates the head of the humerus as a more rounded ball?

a.) external shoulder
b.) scapular Y
c.) grashey
d.) internal rotation

Answer 59

d.) internal rotation

Question 60

If the patient cannot elevate the unaffected shoulder for a transthoracic lateral projection of the proximal humerusthe central ray should be angled:

a.) 10 to 15 degrees cephalad
b.) 15 to 20 degrees cephalad
c.) 20 to 25 degrees caudad
d.) 5 to 10 degrees cephalad

Answer 60

a.) 10 to 15 degrees cephalad

Question 61

What is the correct part position on the AP external shoulder projection?

a.) internally rotate hand
b.) externally rotate hand, epicondyles parallel to IR
c.) epicondyles perpendicular
d.) elbow flexed 90 degrees

Answer 61

b.) externally rotate hand, epicondyles parallel to IR

Question 62

Where is the central ray directed for the scapular Y projection?

a.) perpendicular to scapulohumeral joint
b.) parallel to scapulohuemral joint
c.) CR angled 10 degrees toward the shoulder
d.) CR angled 10 degrees away from shoulder

Answer 62

a.) perpendicular to scapulohumeral joint

Question 63

Evaluation Criteria:
What structures should be demonstrated on the inferiosuperior axial projection?

a.) coracoid process pointing anteriorly
b.) lesser tubercle in profile and directed anteriorly
c.) scapular spine seen below scapulohumeral joint
d.) scapulohumeral joint with overlap
e.) greater tubercle in profile and directed anteriorly
f.) coracoid process pointing posteriorly

Answer 63

a.) coracoid process pointing anteriorly
b.) lesser tubercle in profile and directed anteriorly
c.) scapular spine seen below scapulohuemral joint
d.) scapulohumeral joint with overlap

Question 64

The ________ consists of the clavicle and the scapula

a.) shoulder girdle
b.) brachial plexius
c.) proximal humerus
d.) shoulder joint

Answer 64

a.) shoulder girdle

Question 65

For an AP projection of the shoulder the central ray should enter:

a.) 2 inches inferior to acromion
b.) 1 inch inferior to coracoid process
c.) 1 inch inferior to the acromion
d.) 2 inches inferior to the coraccoid process

Answer 65

b.) 1 inch inferior to the coracoid process

Question 66

Breathing technique can be used on the transthoracic lateral projection. What is the exposure time that should be used? Choose all that apply.

a.) 3 seconds
b.) 4 to 5 seconds desirable
c.) low MA
d.) 2 seconds

Answer 66

a.) 3 seconds
b.) 4 to 5 seconds desirable
c.) low MA