Question 1

An AP clavicle projection with accurate positioning demonstrates
1)the medial clavicular end next to the lateral edge of the vertebral column.
2)the superior scapular angle superior to the clavicle.
3)inferosuperior foreshortening on the kyphotic patient unless the central ray is angled cephalically.
4)an overexposed medial clavicle unless a compensating filter is used.
A) 2 only
B) 1 and 3 only
C) 1, 3, and 4 only
D) 1, 2, and 3 only

Accepted Answer

Option 1 is correct as the medial clavicular end should be adjacent to the lateral edge of the vertebral column. Option 3 is correct as there may be inferosuperior foreshortening on a kyphotic patient unless the central ray is angled cephalically. However, option 4 is incorrect as a compensating filter is used to even out the density of the image, and it would not result in overexposure of the medial clavicle. Option 2 is incorrect as the superior scapular angle should be inferior to the clavicle. Therefore, choices 1 and 3 are the correct options.

Question 2

A PA oblique scapular Y shoulder projection that was obtained with the patient overrotated demonstrates the
1)glenoid fossa medially.
2)medial scapular border closer to the ribs than the lateral scapular border.
3)superior scapular angle superior to the clavicle.
4)lateral scapular border closer to the ribs than the medial scapular border.
A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Accepted Answer

When a PA oblique scapular Y shoulder projection is obtained with the patient overrotated, it will demonstrate the glenoid fossa medially (1) and the lateral scapular border closer to the ribs than the medial scapular border (4). Option 2 is incorrect, as the medial scapular border will be closer to the ribs than the lateral scapular border due to the overrotation. Option 3 is also incorrect, as the superior scapular angle will be inferior to the clavicle due to the overrotation. Therefore, the correct answer is B, which includes options 1 and 4.

Question 3

An imaginary line connecting the humeral epicondyles is positioned perpendicular to the IR for a(n)
1)internally rotated AP shoulder projection.
2)AP oblique shoulder projection (Grashey method).
3)lateral humeral projection.
4)PA oblique scapular Y shoulder projection.
A) 1 and 3 only
B) 2 and 4 only
C) 3 only
D) 1, 3, and 4 only

Accepted Answer

For an internally rotated AP shoulder projection and a lateral humeral projection, positioning the imaginary line connecting the humeral epicondyles perpendicular to the image receptor (IR) is correct. This ensures proper orientation and visualization of the anatomical structures.

Question 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 supraspinatus fossa and 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

Accepted Answer

The AP scapular projection with accurate positioning should demonstrate almost superimposed anterior and posterior glenoid fossa margins (1), the humeral shaft at a 90-degree angle with the body (3), and the supraspinatus fossa and superior scapular angle without clavicular superimposition (4). However, the vertebral scapular border may have some thoracic cavity superimposition (2) and is not a crucial criterion for accurate positioning. Therefore, the correct choice is B, which includes options 1, 3, and 4.

Question 5

An AP axial shoulder projection (Stryker method) with accurate positioning demonstrates the
1)coracoid process situated directly lateral to the conoid tubercle of the clavicle.
2)posterolateral aspect of the humeral head in profile laterally.
3)greater and lesser tubercles in partial profile.
4)coracoid process superimposed over the lateral clavicle.
A) 1 and 2 only
B) 2 and 3 only
C) 3 and 4 only
D) 1, 2, 3, and 4

Accepted Answer

The answer of An AP axial shoulder projection (Stryker method)...

Question 6

An AP clavicle projection obtained with the patient rotated away from the affected shoulder demonstrates the
1)medial clavicular end superimposed over the vertebral column.
2)medial clavicular end shifted away from the vertebral column.
3)scapular body with increased thoracic superimposition.
4)scapular body with decreased thoracic superimposition.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only

Accepted Answer

In an AP clavicle projection with the patient rotated away from the affected shoulder, the medial clavicular end should be shifted away from the vertebral column (2) and the scapular body should have decreased thoracic superimposition (4). This positioning allows for better visualization of the clavicle without overlap from other structures. The other choices, (1) medial clavicular end superimposed over the vertebral column and (3) scapular body with increased thoracic superimposition, would result from incorrect positioning and would hinder proper visualization of the clavicle.

Question 7

A lateral scapular projection obtained with the patient underrotated and the arm placed at a 90-degree angle with the patient demonstrates
1)superimposed lateral and vertebra scapular borders.
2)the lateral scapular border medial to the vertebral border.
3)the superior scapular angle inferior to the coracoid.
4)the vertebral scapular border medial to the lateral border.
A) 1 and 3 only
B) 2 only
C) 2 and 3 only
D) 4 only

Accepted Answer

When the patient is underrotated in a lateral scapular projection, the vertebral scapular border will be closer to the image receptor and thus appear medial to the lateral border. The superior scapular angle should be superior to the coracoid process, and the two borders should be separate without significant superimposition. Option 2 is incorrect because it describes the opposite scenario, with the vertebral border medial to the lateral border. Option 1 is incorrect because significant superimposition would not allow for the borders to be distinguished. Option 3 is incorrect because the superior scapular angle should be superior to the coracoid process, not inferior.

Question 8

A PA oblique scapular Y shoulder projection obtained with the patient's upper midcoronal plane tilted toward the IR demonstrates
1)the glenoid cavity on end.
2)the superior scapular angle superior to the clavicle.
3)a longitudinally foreshortened scapular body.
4)the superior scapular angle inferior to the clavicle.
A) 2 and 4 only
B) 3 only
C) 2 and 3 only
D) 1, 2, and 3 only

Accepted Answer

The PA oblique scapular Y projection with the upper midcoronal plane tilted towards the IR demonstrates the superior scapular angle above the clavicle (2), and a longitudinally foreshortened scapular body (3), but does not visualize the glenoid cavity on end (1) or the superior scapular angle below the clavicle (4). Therefore, options 1 and 4 can be eliminated, and the correct answer is C.

Question 9

A tangential supraspinatus outlet projection (Neer method) with accurate positioning is obtained when
1)the arm is abducted and the midcoronal plane is at a 60-degree angle with the IR.
2)a 10- to 15-degree caudal central ray angulation is used.
3)the central ray is centered to the superior aspect of the humeral head.
4)the midcoronal plane is vertical.
A) 1 and 2 only
B) 1 and 3 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

The tangential supraspinatus outlet projection (Neer method) requires the arm to be abducted with the midcoronal plane at a 60-degree angle to the image receptor (IR), a 10- to 15-degree caudal central ray angulation, the central ray centered to the superior aspect of the humeral head, and the midcoronal plane to be vertical for accurate positioning.

Question 10

An AP axial shoulder projection (Stryker method) with poor positioning that demonstrates the lesser tubercle in profile
1)also demonstrates an obscured greater tubercle.
2)was obtained because the humerus was elevated beyond vertical.
3)demonstrates the Hill-Sachs defect.
4)was obtained because the distal humerus was tilted laterally.
A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Accepted Answer

A poorly positioned AP axial shoulder projection with the humerus elevated beyond vertical may result in the lesser tubercle being seen in profile, while the greater tubercle is obscured. Tilt of the distal humerus laterally may result in an AP projection with both the greater and lesser tubercles superimposed upon one another, making it difficult to discern lateral structures. Hill-Sachs defect is best demonstrated using an oblique view of the humerus.

Question 11

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

Accepted Answer

The answer of For an AP scapular projection, the
1)patient's arm...

Question 12

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

Accepted Answer

For an AP axial clavicle projection, ensuring the patient's shoulders are equidistant from the image receptor (IR) helps maintain symmetry and proper alignment. Angling the central ray 15 to 30 degrees cephalad helps project the clavicle above the ribs and scapulae for a clearer view. Centering the central ray halfway between the medial and lateral ends of the clavicle ensures that the entire clavicle is captured in the image. A compensating filter is not typically used for this projection, as it's not mentioned in standard radiographic procedures for the clavicle.

Question 13

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

Accepted Answer

An AP axial clavicle projection with accurate positioning will show the medial clavicular end superimposed over the first and second ribs, the middle and lateral thirds of the clavicle superior to the acromion, and the clavicle bowing upward. The medial clavicular end should not be superimposed over the vertebral column in a correctly positioned AP axial clavicle projection.

Question 14

A tangential supraspinatus outlet projection (Neer method) that was obtained with the patient underrotated demonstrates the
1)glenoid fossa medially.
2)medial scapular border closer to the ribs than the lateral scapular border.
3)superior scapular angle 0.5 inch inferior to the clavicle.
4)lateral scapular border closer to the ribs than the medial scapular border.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Accepted Answer

The answer of A tangential supraspinatus outlet projection (Neer method)...

Question 15

The AP axial shoulder projection (Stryker method)
1)is performed to demonstrate the Hill-Sachs defect.
2)is obtained with the affected humerus vertical and the palm of the hand placed on top of the head.
3)uses a 10-degree caudal central ray angle.
4)is obtained with the patient in a supine position.
A) 3 and 4 only
B) 2, 3, and 4 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

The Stryker method is used to demonstrate the Hill-Sachs defect, involves positioning the affected humerus vertically with the palm on the head, and is performed with the patient supine.

Question 16

A tangential supraspinatus outlet projection (Neer method) with accurate positioning demonstrates
1)the superior scapular spine inferior to the clavicle.
2)superimposed scapular borders.
3)the glenoid cavity on end.
4)the coracoid, acromion, and scapular body creating the arms and leg of the Y formation.
A) 1 and 2 only
B) 3 and 4 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

The tangential supraspinatus outlet projection (Neer method) is designed to demonstrate the supraspinatus outlet and adjacent structures. This positioning accurately shows the superior scapular spine positioned inferior to the clavicle (1), superimposed scapular borders (2), the glenoid cavity viewed on end (3), and the coracoid, acromion, and scapular body forming the Y shape (4). These features are key in assessing the shoulder joint, particularly for impingement syndromes.

Question 17

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

Accepted Answer

The answer of A lateral scapular projection with accurate positioning...

Question 18

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

Accepted Answer

The lesser tubercle is best demonstrated in profile on a lateral humeral projection, a transthoracic lateral proximal humeral projection, and an inferosuperior axial shoulder projection. These views position the lesser tubercle in such a way that it is clearly visible, unlike the neutral AP shoulder projection which does not specifically profile the lesser tubercle.

Question 19

For an AP AC joint projection without weights,
1)the central ray is centered to the AC joint.
2)the midcoronal plane is positioned parallel with the IR.
3)a grid is used if the patient's AP measurement is 6 inches (15 cm).
4)the patient's shoulders are positioned at equal distances from the IR.
A) 1 and 4 only
B) 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

The answer of For an AP AC joint projection without...

Question 20

A nondislocated AP oblique scapular Y shoulder projection demonstrates
1)the humeral head superimposed over the glenoid fossa.
2)the glenoid fossa on end.
3)the medial scapular border closer to the ribs than the lateral scapular border.
4)magnification of the scapula and humerus.
A) 1 and 3 only
B) 2 and 4 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

A nondislocated AP oblique scapular Y shoulder projection should show the humeral head superimposed over the glenoid fossa and the glenoid fossa on end. Magnification of the scapula and humerus can occur due to the positioning. However, the medial scapular border should not be closer to the ribs than the lateral scapular border in a properly positioned Y view.

Quiz 5: Image Analysis of the Shoulder

An imaginary line connecting the humeral epicondyles is positioned perpendicular to the IR for a(n) 1) internally rotated AP shoulder projection. 2) AP oblique shoulder projection (Grashey method) . 3) lateral humeral projection. 4) PA oblique scapular Y shoulder projection.

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.

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.

For an AP AC joint projection without weights, 1) the central ray is centered to the AC joint. 2) the midcoronal plane is positioned parallel with the IR. 3) a grid is used if the patient's AP measurement is 6 inches (15 cm) . 4) the patient's shoulders are positioned at equal distances from the IR.

A nondislocated AP oblique scapular Y shoulder projection demonstrates 1) the humeral head superimposed over the glenoid fossa. 2) the glenoid fossa on end. 3) the medial scapular border closer to the ribs than the lateral scapular border. 4) magnification of the scapula and humerus.