When I insert an image inline with the text I can right click to add data such as long descriptions, alignment etc. When I use image option on the more complicated pages with image placeholders I can't figure out how to do the same level of formatting. It merely gives me the option to upload an alternative image. Right click doesn't do it. Did I miss a step?

The alignment of media in place on basic screen templates can only be adjusted by switching templates or changing the "media/text locations options" below the screen description field.  The text you enter for the description of your media becomes the alt text for that media.

The reason that images added into the text editor have more options is because they are only images as opposed to the media placeholders in the templates which allow for images, video and Flash.