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Chapter 5

Bontrager's Upper Extremities

QuestionAnswer
The shoulder girdle consists of? Proximal Humerus, Scapula, and Clavicle
The 3 aspects of the clavicle are the? Sternal extremity, Body (shaft), and Acromial extremity
The ________ (male or female) clavicle tends to be thicker and more curved in shape. male
The 3 angles of the scapula include? Lateral angle, superior angle, and inferior angle
The anterior surface of the scapula is referred to as the _________ surface. costal surface
What is the anatomic name for the armpit? axilla
What are the names of the 2 fossae located on the posterior scapula? Infraspinous fossa and supraspinous fossa
All of the joints of the shoulder girdle are classified as being? Synovial (diarthrodial) - freely movable
What is the movement type for the scapulohumeral joint? spheroidal
What is the movement type for the sternoclavicular joint? plane
What is the movement type for the acromioclavicular joint? plane
T/F. The use of a grid is not required for shoulder studies that measure less than 10cm. True
T/F. The kV range for adult shoulder projections is between 80 and 90 kV for analog and 100 to 110 kV for digital imaging systems. False
T/F. Low mA with short exposure times should be used for adult shoulder studies. False
T/F. Large focal spot setting should be selected for most adult shoulder studies. False
T/F. A high-speed screen-IR system is recommended for analog shoulder studies when using a grid. True
T/F. A 72-inch (183-cm) source-image distance (SID) is recommended for most shoulder girdle studies. False
T/F. The use of contact shields over the breast, lung, and thyroid regions is recommended for most shoulder girdle studies. True
Which one of the following kV ranges (analog) should be used for a shoulder series on an average adult? A. 70 to 80 kV B. 55 to 60 kV C. 80 to 90 kV D. 65 to 75 kV A. 70 to 80 kV
If physical immobilization is required, which individual should be asked to restrain a child for a shoulder series? A. Parent or guardian B. Radiologic technologist C. Radiography student D. Nurse aide A. Parent or guardian
T/F. CT arthrography of the shoulder joint often requires the use of iodinated contrast media injected into the joint space. True
T/F. Magnetic resonance imaging (MRI) is an excellent modality for demonstrating bony injuries of the shoulder girdle. False
T/F. Nuclear medicine bone scans can demonstrate signs of osteomyelitis and cellulitis. True
T/F. Radiography is more sensitive than nuclear medicine for demonstrating physiologic aspects of the shoulder girdle. False
T/F. Sonography (ultrasound) can provide a functional (dynamic) evaluation of joint movement that MRI cannot. True
Which one of the following clinical indications requires a decrease in manual exposure factors? A. Impingement syndrome B. Bursitis C. Bankart lesion D. Osteoporosis D. Osteoporosis
Which 2 routine shoulder projections are routinely taken for a shoulder (with no traumatic injury) and proximal humerus? AP, external rotation & AP, internal rotation
Specifically, where is the central ray placed for an AP projection of the shoulder? CR perpendicular to IR, directed to 1 inch (2.5 cm) inferior to coracoid process.
Which lateral projection can be performed to demonstrate the entire humerus for a patient with a midhumeral fracture? Transthoracic lateral projection for humerus.
To best demonstrate a possible Hill-Sachs defect, which additional positioning technique can be added to the inferosuperior axial projection? Rotate affected arm externally approximately 45 degrees
What type of central ray angulation is required for the inferosuperior axial projection for the shoulder? 25 degrees to 30 degrees medially
The __________ projection of the shoulder produces an image of the glenoid process in profile. This projection is also referred to as the ____________ method. posterior oblique projection; grashey method
Which one of the following projections produces a tangential projection of the intertubercular groove? A. Fisk modification B. Grashey method C. Hobbs modification D. Lawrence method A. Fisk modification
The supine version of the tangential projection for the intertubercular groove requires that the central ray be angled _________ posteriorly from the horizontal plane. 10 degrees to 15 degrees
What projection best demonstrates a possible dislocation of the proximal humerus? Scapular Y projection
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. tangential projection-supraspinatus outlet; neer method
What nontrauma projection can be performed erect to provide a lateral view of the proximal humerus in relationship to the glenohumeral joint? PA transaxillary projection (Hobbs modification)
How much is the CR angled for the inferosuperior axial projection (Clements modification) if the patient cannot fully abduct the arm 90 degrees? A. 5 degrees to 15 degrees B. 45 degrees C. 25 degrees to 30 degrees D. 20 degrees A. 5 degrees to 15 degrees
What CR angle is required for the AP axial projection (Alexander method) for AC joints? A. 25 degrees cephalad B. 45 degrees caudad C. 5 degrees to 10 degrees caudad D. 15 degrees cephalad D. 15 degrees cephalad
T/F. The PA transaxillary projection (Hobbs modification) requires no CR angle. True
T/F. The transthoracic lateral projection can be performed for possible fractures or dislocations of the proximal humerus. True
T/F. The use of a breathing technique can be performed for the transthoracic lateral humerus projections. True
T/F. The affected arm must be placed into external rotation for the transthoracic lateral projection. False
T/F. A central ray angle of 10 degrees to 15 degrees caudad may be used for transthoracic lateral projections if the patient is unable to elevate the uninjured arm and shoulder sufficiently. False. 10 degrees to 15 degrees cephalad
T/F. The scapular Y lateral (anterior oblique) position requires the body to be rotated 30 degrees to 40 degrees anteriorly toward the affected side. False
Which 2 landmarks are placed perpendicular to the IR for the scapular Y lateral projection? superior angle of the scapula & the AC joint articulation
Which special projection of the shoulder requires that the affected side be rotated 45 degrees toward the cassette and use a 45 degree caudad central ray angle? AP apical oblique axial projection
A posterior dislocation of the humerus projects the humeral near _________ (superior or inferior) to the glenoid cavity with the special projection described in the previous question. superior
A thin-shouldered patient requires ________ (more or less) CR angle for an AP axial clavicle projection than a large-shouldered patient. more
What must be ruled out before performing the weight-bearing study for acromioclavicular joints? fracture of clavicle
Where is the CR centered for the AP scapula projection? CR perpendicular to midscapula, 2 inches inferior to coracoid process, or to level of axilla, & approximately 2 inches medial from lateral border of patient
What type of CR angle is required for the lateral scapula position? A. 10 degrees to 15 degrees cephalad B. 5 degrees to 15 degrees caudad C. 10 degrees to 15 degrees caudad D. None D. none (CR perpendicular to the IR)
A radiograph of an AP axial clavicle projection reveals that the clavicle is projected below the superior border of the scapula. What can the technologist do to correct this problem during the repeat exposure? Increase central ray cephalad angle.
A radiograph of an AP scapula reveals that the scapula is within the lung field and difficult to see. Which 2 things can the radiologist do to improve the visibility of the scapula during the repeat exposure? Ensure that the affected arm is abducted 90 degrees and use a breathing technique.
A radiograph of an AP projection (with external rotation) of a shoulder (with no traumatic injury) reveals that neither the greater nor lesser tubercles are profiled. What must be done to correct this during the repeat exposure? Supinate the hand and ensure that the epicondyles are parallel to the IR for a true AP.
Created by: calliecrouse