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Anatomy and Radiography of the Proximal Humerus, Exams of Nursing

Lancaster UniversityNursing

A detailed study of the structures of the proximal humerus, including the lesser tubercle, glenoid process, intertubercular groove, and anatomic neck. It also covers the insertion point for the deltoid muscle, the joints with spheroidal movement, and the rotation of the humerus. The document also explains various projections and maneuvers used in radiography to best demonstrate the proximal humerus, such as the garth method, clements modification, and neer method.

Typology: Exams

2023/2024

Available from 05/14/2024

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Chapter 05: Humerus and Shoulder Girdle
Test Bank
MULTIPLE CHOICE
1. Which of the following structures is not part of the proximal humerus?
a. Lesser tubercle
b. Glenoid process
c. Intertubercular groove
d. Anatomic neck
ANS: B REF: 174
2. Which term describes the medial end of the clavicle?
a. Acromial extremity
b. Acromion
c. Sternal extremity
d. Acromial tuberosity
ANS: C REF: 175
3. The female clavicle is usually shorter and less curved than that of the male.
a. True
b. False
ANS: A REF: 175
4. 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.
ANS: D REF: 176
5. 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
ANS: C REF: 176
6. What is the name of the insertion point for the deltoid muscle located on the anterolateral
surface of the humerus?
a. Surgical neck
b. Deltoid protuberance
c. Deltoid tuberosity
d. Intertubercular groove
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Download Anatomy and Radiography of the Proximal Humerus and more Exams Nursing in PDF only on Docsity!

Chapter 05: Humerus and Shoulder Girdle

Test Bank

MULTIPLE CHOICE

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

a. Lesser tubercle

b. Glenoid process

c. Intertubercular groove

d. Anatomic neck

ANS: B REF: 174

2. Which term describes the medial end of the clavicle?

a. Acromial extremity

b. Acromion

c. Sternal extremity

d. Acromial tuberosity

ANS: C REF: 175

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

a. True

b. False

ANS: A REF: 175

4. 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.

ANS: D REF: 176

5. 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

ANS: C REF: 176

6. What is the name of the insertion point for the deltoid muscle located on the anterolateral

surface of the humerus?

a. Surgical neck

b. Deltoid protuberance

c. Deltoid tuberosity

d. Intertubercular groove

ANS: C REF: 174

7. All of the joints of the shoulder girdle are diarthrodial.

a. True

b. False

ANS: A REF: 178

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

a. Acromioclavicular joints

b. Sternoclavicular joints

c. Bicipital joint

d. Scapulohumeral joint

ANS: D REF: 178

9. Which view and projection of the proximal humerus is represented in the figure?

a. External rotation, anteroposterior (AP) projection

b. Neutral rotation, AP projection

c. Internal rotation, AP projection

d. External rotation, lateral projection

ANS: A REF: 187

10. Part 5 refers to the:

a. coracoid process.

b. superior border of scapula.

c. lateral angle of scapula.

d. none of the above.

ANS: D REF: 175 | 176

11. Part 3 refers to the:

15. 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

ANS: B REF: 179

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

procedures.

a. True

b. False

ANS: A REF: 180

17. Which of the following shoulder positions is considered a trauma projection (can be

performed safely for a possible fracture or dislocation)?

a. AP apical oblique axial (Garth method) projection

b. Inferosuperior axial (Clements modification) projection

c. AP projection–internal rotation

d. None of the above

ANS: A REF: 198

18. What medial central ray (CR) angle is required for the inferosuperior axial shoulder

(Lawrence method)?

a. 5 ° to 10°

b. 40 ° to 45°

c. 25 ° to 30°

d. 10 ° to 15°

ANS: C REF: 189

19. What additional maneuver must be added to the inferosuperior axial shoulder (Lawrence

method) projection to best demonstrate a possible Hill-Sachs defect?

a. Increase medial CR angulation.

b. Angle the CR 10° to 15° downward or posteriorly in addition to the medial angle.

c. Perform exaggerated external rotation of the affected upper limb.

d. Increase abduction of the affected upper limb.

ANS: C REF: 191

20. 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

ANS: A REF: 192

21. A radiograph of the inferosuperior axial projection (Lawrence method) demonstrates the

acromion process of the shoulder to be located most superiorly (anteriorly).

a. True

b. False

ANS: B REF: 189

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

a. True

b. False

ANS: B REF: 192

23. How much posterior CR angulation is required for the supine version of the tangential

projection for the intertubercular (bicipital) groove?

a. 20 ° to 30°

b. 30 ° to 40°

c. 10 ° to 15°

d. No angle is used for this projection.

ANS: C REF: 193

24. Which ionization chamber(s) for the AEC should be used for a tangential projection for an

intertubercular groove?

a. Center chamber

b. Both outside chambers

c. Left chamber

d. Cannot use AEC with this projection

ANS: D REF: 197

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

a. Scapular Y lateral projection

b. Inferosuperior axiolateral projection

c. AP clavicle

d. AP scapula

ANS: D REF: 202

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

a. No CR angle should be used.

b. 10 ° to 15°

c. 20 ° to 30°

d. 35 ° to 45°

ANS: A REF: 194

27. 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

34. The inferosuperior axial projection (Clements modification) requires a CR angle of ____

toward axilla if a patient cannot fully abduct extremity 90°.

a. 35 °

b. none

c. 40 ° to 45°

d. 5 ° to 15°

ANS: D REF: 191

35. 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.

ANS: B REF: 199

36. Where is the CR centered for the bilateral acromioclavicular (AC) joint projection on a single

14- ´ 17-inch (35 ´ 43 cm) image receptor?

a. At the affected AC joint

b. 1 inch (2.5 cm) above jugular notch

c. At the level of the thyroid cartilage

d. At the sternal angle

ANS: B REF: 200

37. 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?

a. Angle CR 5° to 10° caudad.

b. Angle CR 5° to 10° cephalad.

c. Increase rotation of the body.

d. Abduct the arm slightly.

ANS: C REF: 189

38. 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 analog exposure factors

were used: 75 kV, 30 mAs, 40-inch (102 cm) SID, grid, and suspended respiration. Which of

the following changes will improve the visibility of the proximal humerus?

a. Make the exposure on second inspiration.

b. Use a compression band to prevent patient movement.

c. Use a 72-inch (183 cm) SID.

d. Use an orthostatic (breathing) technique.

ANS: D REF: 195

39. 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?

a. Rotate epicondyles so they are perpendicular to the image receptor.

b. Move the patient obliquely 10° to 15° toward the affected side.

c. Rotate the arm to place palm of the patient’s hand against the thigh.

d. Positioning is acceptable; do not repeat it.

ANS: D REF: 183

40. A radiograph of an AP clavicle reveals that the sternal extremity is partially collimated off.

What should the technologist do?

a. Repeat the AP projection and correct collimation.

b. Make sure the sternal extremity is included on the AP axial projection.

c. Only repeat it if the patient’s pain/symptoms involve the sternal extremity.

d. Ask the radiologist whether he or she wants the projection repeated.

ANS: A REF: 199

41. 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?

a. Decrease rotation of thorax.

b. Decrease CR angle.

c. Increase rotation of thorax.

d. Abduct the arm more and flex it at the elbow.

ANS: A REF: 202

42. A patient comes to radiology for treatment of an arthritic condition of the right shoulder. The

radiologist orders AP internal/external rotation projections and an inferosuperior axiolateral

projection of the scapulohumeral joint. However, the patient cannot abduct the arm for this

projection. Which other projection will best demonstrate the scapulohumeral joint space?

a. Posterior oblique (Grashey method)

b. Scapular Y lateral

c. Transthoracic lateral

d. AP projection–neutral rotation

ANS: A REF: 192

43. A patient comes to the emergency department (ED) with a possible right AC joint separation.

Right clavicle and AC joint exams are ordered. The clavicle is taken first, and a small linear

fracture of the midshaft of the clavicle is discovered. What should the technologist do in this

situation?

a. Perform the weight-bearing phase as ordered.

b. Reduce the amount of weight that would normally be given to the patient and

perform the weight-bearing study.

c. Consult with the ED physician before continuing with the AC joint study.

d. Slowly give the patient more weight to hold until he begins to complain and then

48. 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?

a. Take an apical oblique projection of the shoulder.

b. Take a transthoracic lateral projection of the shoulder region.

c. Have the patient reach across the chest and grasp the opposite shoulder for a lateral

scapula projection.

d. Have the patient drop the affected arm behind him or her and take a lateral scapula

projection.

ANS: C REF: 204

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

a. True

b. False

ANS: A REF: 180

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

a. True

b. False

ANS: B REF: 181

51. The arm should be abducted about 45° for an AP scapula.

a. True

b. False

ANS: B REF: 202

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

a. True

b. False

ANS: A REF: 202

53. Which one of the following projections/positions should NOT be performed for a possible

shoulder dislocation?

a. AP axial oblique (Garth method)

b. Transthoracic lateral (Lawrence method)

c. Inferosuperior axial (Clements modification)

d. Scapular Y

ANS: C REF: 53

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

a. True

b. False

ANS: B REF: 196 | 198

55. The Alexander method for AC joints requires a 15° cephalic CR angle.

a. True

b. False

ANS: A REF: 200

56. For AC joint weight-bearing studies, patients should not be asked to hold on to the weights

with their hands; rather, the weights should be attached to the wrists.

a. True

b. False

ANS: A REF: 200

57. Which of the following AP shoulder projections demonstrates the greater tubercle in profile

medially?

a. External rotation

b. Internal rotation

c. Neutral rotation

d. None of the above

ANS: D REF: 179

58. Which of the following AP shoulder projections demonstrates the lesser tubercle in profile

medially?

a. External rotation

b. Internal rotation

c. Neutral rotation

d. None of the above

ANS: B REF: 179

59. 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 proximal humerus

b. AP shoulder as is; show radiograph to the ED physician before attempting a

rotational lateral projection

c. AP and horizontal beam transthoracic lateral shoulder projection

d. AP and apical oblique shoulder without any arm rotation

ANS: C REF: 184 | 185

60. 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

ANS: B REF: 187

a. CR is perpendicular to IR

b. 5 ° to 15° toward axilla

c. 25 ° away from axilla

d. 10 ° toward shoulder

ANS: A REF: 190

67. Sonography is an effective diagnostic tool in studying the shoulder joint.

a. True

b. False

ANS: A REF: 180

68. Where is the CR centered for the posterior oblique 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

ANS: B REF: 192

69. What is the common term for idiopathic chronic adhesive capsulitis?

a. Bankart lesion

b. Tendinitis

c. Bursitis

d. Frozen shoulder

ANS: D REF: 181

MATCHING

Select the correct method name to match each shoulder projection. (Use each choice only

once.)

a. Clements modification

b. Neer method

c. Fisk modification

d. Hobbs modification

e. Garth method

f. Grashey method

1. Tangential, intertubercular groove projection

2. Tangential, supraspinatus outlet projection

3. AP apical oblique axial projection

4. Inferosuperior axial projection

5. Posterior oblique, glenoid cavity projection

6. PA transaxillary projection

1. ANS: C REF: 193

2. ANS: B REF: 197

    1. ANS: E REF:
    1. ANS: A REF:
    1. ANS: F REF:
    1. ANS: D REF: