Chapter 10,11,12,13,14

At approximately what age does the xiphoid process become totally ossified? A) 12 years old B) 21 years old C) 40 years old D) The xiphoid process never becomes ossified.

C) 40 years old pg. 356: the xiphoid process is composed of cartilage during infancy and youth, and usually does not become totally ossified until about the age of 40 years old.

How much CR angulation is required for the AP axial projection? A) 10° to 15° B) 20° to 25° C) 30° to 40° D) 45°

C) 30° to 40° pg. 523: angle CR 30° to 40° cephalad

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Narrowing and wormlike appearance of distal esophagus a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

g. Esophageal varices pg. 467: advanced esophageal varices manifest with narrowing of the distal third of the esophagus and "wormlike" or "cobblestone" appearances caused by enlarged veins during an esophagram.

How much obliquity is required for the RAO position for the esophagus? A) 10° to 15° B) 20° to 30° C) 35° to 40° D) 45° to 60°

C) 35° to 40° pg. 478: rotate 35° to 40° from prone position, with right anterior body against IR.

The recommended digital systems kV range for the superoinferior tangential (axial) projection of the nasal bones is: A) 40 to 50. B) 50 to 60. C) 70 to 80. D) 75 to 85.

C) 70 to 80. pg. 424: digital systems = 70 to 80 kV, analog = 60 to 70 kV

Part 3 is part of which bone? A) Palatine B) Sphenoid C) Lacrimal D) Ethmoid

D) Ethmoid pg. 398

How much rotation and which oblique position are required to best demonstrate the left sternoclavicular joints? A) 10° to 15° LAO B) 35° to 45° LAO C) 10° to 15° RAO D) 5° to 10° RAO

A) 10° to 15° LAO pg. 367: anterior oblique positions (RAO, LAO) - best visualizes the sternoclvicular joint on the downside. A 10° to 15° rotation in an anterior oblique position will rotate the SC joint across the spine to the opposite side; thus, and RAO will best demonstrate the right or downside SC joint. The LAO position will best demonstrate the left SC joint. LAO: patient prone, the left side is down touching the IR, and right side is rotated up 10° to 15°. RAO: patient prone, the right side is down touching the IR, and left side is rotated up 10° to 15°.

The axiolateral oblique projection (modified Law method) for TMJs requires a ____ rotation of the skull and a ____ angle of the CR. A) 15°; 15° B) 10°; 15° C) 5°; 0° D) 0°; 25° to 30°

A) 15°; 15° pg. 435: from a lateral position rotate the face toward IR 15° (with MSP of head rotated 15° from plane of IR). Angle the CR 15° caudad, centered 1.5" superior to upside EAM.

What type of contrast media is ideal for demonstrating a diverticulum within the stomach? A) Double-contrast barium/negative contrast agent B) Single-contrast barium sulfate C) Water soluble D) Radiolucent

A) Double-contrast barium/negative contrast agent pg. 462: potential polyps, diverticula, and ulcers are better demonstrated with a double-contrast technique.

During an upper GI series, the "halo" sign appears in the duodenum. Which of the following conditions will produce this radiographic sign? A) Ulcer B) Bezoar C) Diverticulum D) Tumor

A) Ulcer pg. 473: During an upper GI study, the ulcer appears as a punctate barium collection that may be surrounded by a "lucent-halo" appearance.

The posterior aspect of the orbit is termed the: A) apex. B) base. C) sphenoid strut. D) crown.

A) apex pg. 398: each orbit is cone-shaped ... the rim of the orbit, which corresponds to the outer circular portion of the cone is called the base. The posterior portion of the cone, the apex, corresponds to the optic foramen, through which the optic nerve passes.

The incus auditory ossicle is labeled: A) iii. B) i. C) iv. D) ii. E) vii.

A) iii. pg. 387

Multiple myeloma is seen often in the flat bones of the bony thorax. A. True B. False

A. True

The degree of rotation for the right anterior oblique (RAO) projection of the sternum is dependent on the size of the thoracic cavity. A. True B. False

A. True pg. 359: The patient is rotated into a 15° to 20° right anterior oblique (RAO) position to shift the sternum just to the left of the thoracic vertebrae and into the homogeneous heart shadow. The degree of obliquity required is dependent on the size of the thoracic cavity. Large deep chested thorax (hypersthenic = 15°) requires less rotation than a thin patient (hyposthenic/asthenic = 20°). Hypersthenic patient = distance between the spine and sternum is already great to begin with because of their body habitus and size, so we don't have to rotate them as far. Asthenic patient = distance between the spine and sternum is much less and we have to rotate them more to get them offset from each other.

Both bony and soft tissue anatomy may be evaluated by CT for pathology involving the sternum or the sternoclavicular joints. A. True B. False

A. True pg. 362: CT provides sectional images of the bony thorax. Skeletal detail and associated soft tissues may be evaluated with CT when clinically indicated. CT is useful for visualizing pathology involving the sternum and/or sternoclavicular joints without obstruction by overlying dense structures.

True/False: The liver performs more than 100 different functions. A.) True B.) False

A.) True pg. 446: The liver performs more than 100 different functions

True/False: Swallowed air can be used as a negative contrast medium during an upper GI series. A.) True B.) False

A.) True pg. 461: radiolucent, or negative, contrast media include swallowed air, CO2 gas crystals, and the normally present gas bubble in the stomach. Calcium and magnesium citrate carbonate crystals are frequently used to produce CO2.

True/False: No cassettes are required for imaging with a digital fluoroscopy system. A.) True B.) False

A.) True pg. 463: digital fluoroscopy is similar to conventional fluoroscopy with the addition of a flat panel detector and a computer for image manipulation and storage.

True/False: With digital fluoroscopy edge enhancement, brightness and contrast can be manipulated both during the procedure and also at a later time. A.) True B.) False

A.) True pg. 464: With the study saved on a hard disk, the technologist or radiologist has the ability to alter these imaging parameters at will.

True/False: Hypertrophic pyloric stenosis (HPS) is the most common form of intestinal obstruction found in infants. A.) True B.) False

A.) True pg. 472: HPS is the most common form of intestinal obstruction found in infants

True/False: Duodenal ulcers are rarely malignant. A.) True B.) False

A.) True pg. 473: Duodenal ulcers are rarely malignant.

True/False: Only 5% of all ulcers lead to bowel perforation. A.) True B.) False

A.) True pg. 473: Only 5% of all ulcers lead to perforation.

True/False: For an average adult, the amount of barium ingested is one 16-oz cup for a small-bowel-only series. A.) True B.) False

A.) True pg. 498: For the small bowel-only series, the patient generally ingests two cups (16 oz) of barium.

Which positioning line is placed perpendicular to the IR for the parieto-orbital oblique projection of the optic foramina? A) OML B) AML C) MML D) IOML

B) AML pg. 428: adjust flexion & extension so that AML is perpendicular to IR.

Protective aprons worn during fluoroscopy must possess at least ____ mm lead equivalency (Pb/Eq.). A) 0.25 B) 0.5 C) 0.75 D) 1

B) 0.5 pg. 465: protective aprons of 0.5 mm lead equivalency must always be worn during fluoroscopy.

How much skull tilt and rotation are required for the oblique inferosuperior (tangential) projection for zygomatic arches? A) 10° B) 15° C) 25° D) None

B) 15° pg. 426: rotate head 15° toward side to be examined; also tilt chin 15° toward side of interest.

What is the maximum CR angulation used for the axiolateral oblique projection of the mandible? A) 10° to 15° B) 25° C) 30° D) 45°

B) 25° pg. 429: Employ a combination of head tilt and CR angle not to exceed 25° cephalad (ex. angle the tube 10° cephalad and add 15° of head tilt toward IR).

What CR angle is required for the axiolateral (Schuller method) projection of the TMJs? A) None; the CR should be perpendicular to the film. B) 25° to 30° caudad C) 15° caudad D) 20° to 25° cephalad

B) 25° to 30° caudad pg. 436: angle CR 25° to 30° caudad, centered 1.5" anterior and 2" superior to upside EAM.

In the erect adult bony thorax, the posterior or vertebral end of a typical rib is ____ higher than or more superior to the anterior portion. A) 1 to 2 inches (2.5 to 5 cm) B) 3 to 5 inches (8 to 13 cm) C) 6 to 8 inches (15 to 20 cm) D) 10 to 12 inches (25 to 30 cm)

B) 3 to 5 inches (8 to 13 cm) pg. 357: The posterior or vertebral end of a typical rib is 3" to 5" higher than the anterior or sternal end.

What is the angle between the OML and the plane of the IR for the parietoacanthial (Waters) projection? A) 40° B) 37° C) 42° D) 15° to 20°

B) 37° pg. 420: adjust the head until MML line is perpendicular to the plane of the IR. OML forms a 37° angle with the table/upright imaging surface.

The ideal kV range for a double-contrast barium enema is: A) 70 to 80. B) 90 to 100. C) 100 to 125. D) 130 to 140.

B) 90 to 100. pg. 515: analog & digital Double contrast = 90 to 100 kV Single contrast = 110 to 125 kV Iodinated, water-soluble contrast = 80 to 90 kV

Which part of the stomach is labeled 9? A) Cardiac notch B) Angular notch C) Pyloric orifice D) Incisura cardiaca

B) Angular notch pg. 454: Fig. 12.23

Which costocartilage attaches to the sternum at the level of the sternal angle? A) First B) Second C) Third D) Fourth and fifth

B) Second pg. 357: the second costocartilage connects to the sternum at the level of the sternal angle.

The aortic arch and the _____ create a normal indentation seen along the lateral border of the esophagus. A) pulmonary artery B) left primary bronchus C) pulmonary veins D) superior vena cava

B) left primary bronchus pg. 452: as the esophagus descends within the posterior aspect of the mediastinum, two indentations are present. One indentation occurs at the aortic arch, and the second is found where the esophagus crosses the left primary bronchus.

An axiolateral oblique projection (Law method) for the temporomandibular joints on a brachycephalic type of skull would require ____ rotation as compared with an average-shaped skull. A) more B) less C) the same D) Rotation depends on the patient's age.

B) less pg. 405: The positioning descriptions, including CR angles and head rotations, as described in this text are based on the average-shaped mesocephalic skull. For example, the axiolateral oblique projection (Law method) for TMJs requires 15° of head rotation. A long, narrow, dolichocephalic head requires slightly more than 15° of rotation, and a short, broad, brachycephalic type requires less than 15°.

The mastoid air cells communicate with the: A) inner ear. B) middle ear. C) external ear. D) base of the brain.

B) middle ear. pg. 386: A second direct communication into the middle ear occurs posteriorly to the mastoid air cells.

The pathway of communication between the frontal, maxillary, and ethmoid sinuses that provides drainage between them is termed: A) paranasal meatus. B) osteomeatal complex. C) labyrinths. D) lateral chambers.

B) osteomeatal complex. pg. 396: the drainage pathways of the frontal, maxillary, and ethmoid inuses make up the osteomeatal complex

The esophagus is located ____ to the larynx. A) anterior B) posterior C) inferior D) proximal

B) posterior pg. 452: the esophagus is located posterior to the larynx and trachea.

Gastric emptying studies are performed using: A) intraesophageal sonography. B) radionuclides. C) MRI. D) CT.

B) radionuclides. pg. 477: with the use of radionuclides, nuclear medicine scans demonstrate cirrhosis of the live, splenic tumors, gastrointestinal bleeding, and gastric emptying studies.

Part vii refers to the: A) esophagus. B) trachea. C) spinal cord. D) larynx.

B) trachea. pg. 451: figure 12.15

The left anterior oblique (LAO) position of the sternum provides the best frontal image of the sternum with it superimposed over the heart. A. True B. False

B. False pg. 359: RAO The patient is rotated into a 15° to 20° right anterior oblique (RAO) position to shift the sternum just to the left of the thoracic vertebrae and into the homogeneous heart shadow.

A recommended practice is to decrease the SID to less than 40 inches (102 cm) for the oblique sternum projection to increase the magnification and resultant unsharpness of overlying ribs. A. True B. False

B. False pg. 359: a minimum SID for sternum radiography is 40" In the past a common practice was to lower the SID to create magnification of the overlying posterior ribs and sternum with resultant unsharpness (blurring). Although this produced a more visible but distorted image of the sternum, it also resulted in an increase in radiation exposure to the patient. Therefore this practice is not recommended.

It is a safe practice to decrease the SID to 30 inches (77 cm) for the oblique sternum projection. A. True B. False

B. False pg. 359: a minimum SID for sternum radiography is 40" In the past a common practice was to lower the SID to create magnification of the overlying posterior ribs and sternum with resultant unsharpness (blurring). Although this produced a more visible but distorted image of the sternum, it also resulted in an increase in radiation exposure to the patient. Therefore, this practice is not recommended.

The use of 125 kV is recommended for AP and PA projections of the ribs to reduce skin dose. A. True B. False

B. False pg. 360: Uppers = select a medium, kV range (analog: 70-80; digital 80 ± 5) because the upper ribs are surrounded by lung tissue, and a lower kV will preserve radiographic contrast and will allow visualization of the ribs through the air-filled lungs. Lowers = select a medium, kV range (analog: 70-80; digital 80 ± 5) because the lower ribs are surrounded by the muscular diaphragm and dense abdominal structures, a medium kV will ensure proper penetration of these tissues.

A right or left marker may be taped over the area of interest to indicate the location of the trauma to the ribs. A. True B. False

B. False pg. 361: some departments protocols request the technologist tape a small metallic BB or some other small type of radiopaque marker over the site of injury before obtaining the images. This ensure the radiologist is away of the location of the trauma or pathology as indicated by the patient.

Both nuclear medicine and magnetic resonance imaging (MRI) studies can be performed to evaluate metastatic rib lesions before conventional rib radiographic examination. A. True B. False

B. False pg. 363: see table 10.2 Most common radiographic exam for metastases = routine radiographic views, nuclear medicine bone scan.

A lateral projection of the sternum requires that respiration be suspended on expiration. A. True B. False

B. False pg. 365: suspend respiration on inspiration

An erect lateral projection of the sternum requires that respiration be suspended on expiration. A. True B. False

B. False pg. 365: suspend respiration on inspiration

True/False: During a colostomy barium enema, a double-contrast retention enema tip is used. A.) True B.) False

B.) False pg 510: because the stoma has no sphincter with which to retain the barium, a tapered irrigation tip is inserted into the stoma.

True/False: In 80% of all individuals, the common bile duct and the pancreatic duct unite before entering the duodenum. A.) True B.) False

B.) False pg. 447: in about 40% of individuals, these ducts pass into the duodenum as two separate ducts with separate openings. In the remaining 60%, the common bile duct joins the pancreatic duct to form one common passageway through the single papilla into the duodenum.

True/False: Sodium bicarbonate is often used as a negative contrast medium during an upper GI series. A.) True B.) False

B.) False pg. 461: radiolucent, or negative, contrast media include swallowed air, CO2 gas crystals, and the normally present gas bubble in the stomach. Calcium and magnesium citrate carbonate crystals are frequently used to produce CO2.

True/False: Digital fluoroscopy does not require the use of an image intensifier. A.) True B.) False

B.) False pg. 463: fig. 12.53 - the x-ray tube is on the lower portion of the C-arm, and the image intensifier is on the upper portion.

True/False: The ascending colon and upper rectum are intraperitoneal structures. A.) True B.) False

B.) False pg. 491: table 13.1 = the ascending colon and upper rectum are retroperitoneal structures.

True/False: Rectal retention enema tips should be fully inflated by the technologist before beginning a barium enema. A.) True B.) False

B.) False pg. 503: Rectal retention catheters should be fully inflated only under fluoroscopic guidance provided by the radiologist because of the potential danger of intestinal rupture. To prevent discomfort for the patient, the balloon should not be fully inflated until the fluoroscopic procedure begins.

True/False: The height of the enema bag should not exceed 36 inches (92 cm) above the radiographic table at the beginning of the study. A.) True B.) False

B.) False pg. 505: ensure that the intravenous pole/enema bag is no more than 60 cm (24") above the table.

Which radiographic sign is frequently seen with adenocarcinoma of the large intestine? A) "Sail" sign B) Diverticula C) "Napkin ring" or "apple core" sign D) Thickened mucosa

C) "Napkin ring" or "apple core" sign pg. 501: annular carcinoma (adenocarcinoma) = one of the most typical forms of colon cancer, may form an "apple core" or "napkin ring" appearance as the tumor grows.

What type of enema tip is recommended for a barium enema on an infant? A) Rectal retention B) Plastic disposable C) 10 Fr, flexible silicone catheter D) Foley catheter

C) 10 Fr, flexible silicone catheter pg. 511: for an infant, often a 10F, flexible silicone catheter is used.

Which of the following kV ranges should be used for an upper GI series using barium sulfate (single-contrast study)? A) 80 to 90 kV B) 90 to 100 kV C) 110 to 125 kV D) 125 to 140 kV

C) 110 to 125 kV pg. 476: high kV of 110 to 125 is required to penetrate adequately and increase visibility of barium-filled structures. A kV les than 100 would not provide visibility of mucosa of the esophagus, stomach, or duodenum.

How much barium is typically given to a 3- to 10-year-old child during an upper GI series? A) 4 to 6 ounces B) 14 to 16 ounces C) 6 to 12 ounces D) 1 cup

C) 6 to 12 ounces pg. 475: barium volume guidelines... Newborn to 1 year = 2 to 4 oz. 1 to 3 years = 4 to 6 oz. 3 to 10 years = 6 to 12 oz. Older than 10 years = 12 to 16 oz.

Which structure is labeled 7? A) Descending colon B) Sigmoid colon C) Cecum D) Rectum

C) Cecum pg. 490: see figure 13.8

The point of union between both halves of the mandible is termed: A) gonion. B) ramus. C) symphysis menti. D) mental foramina.

C) symphysis menti. pg. 393: the anterior aspect of the adult mandible is best seen on a frontal view. The single body forms each lateral half and unites at the anterior midline. This union is called the symphysis of the mandible (symphysis menti)

The cochlea is labeled: A) v. B) vii. C) viii. D) ix.

C) viii. pg. 387

The "tapered," or "corkscrew," radiographic sign is often seen with: A) diverticulosis. B) neoplasm. C) volvulus. D) intussusception.

C) volvulus pg. 500: table 13.5 Volvulus = tapered or "corkscrew" appearance, with air filled distended region of intestine.

Which aspect of the mandible is best demonstrated with an AP axial projection? A) Body B) Mentum C) Ramus D) Condyloid process

D) Condyloid process pg. 431: Anatomy demonstrated - condyloid process of mandible and TM fossae.

Which of the following structures is not considered to be an accessory organ of digestion? A) Liver B) Pancreas C) Salivary glands D) Kidneys

D) Kidneys pg 450: accessory organs of digestion include the salivary glands, pancreas, liver, and gallbladder.

Part ix refers to the: A) soft palate. B) tonsils. C) uvula. D) epiglottis.

D) epiglottis. pg. 451: figure 12.15

The pituitary gland (hypophysis cerebri) is associated with and protected by the ____ bone. A) temporal B) ethmoid C) palatine D) sphenoid

D) sphenoid pg. 381: the central portion of the sphenoid is the body ... the central depression on the body is termed the sella turcica. The sella turcica partially surrounds and protects a major gland of the body, the hypophysis cerebri, or pituitary gland.

The suture labeled f is termed the: (Anatomic structures are labeled i through vi and sutures a through h.) A) asterion. B) lambdoidal. C) coronal. D) squamosal.

D) squamosal

Gastritis is defined as inflammation of the: A) pancreas. B) large intestine. C) small intestine. D) stomach.

D) stomach. pg. 471: Gastritis = inflammation of the lining of the mucosa of the stomach.

The widest aspect of the bony thorax generally occurs at the level of: A) the eleventh and twelfth ribs. B) T7. C) the sternoclavicular joints. D) the eighth or ninth ribs.

D) the eighth or ninth ribs. pg. 358: the bony thorax is typically widest at the lateral margins of the eighth or ninth ribs.

The part labeled i is the: A) external acoustic meatus. B) tegmen tympani. C) auditory tube. D) tympanic membrane.

D) tympanic membrane. pg. 387

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Obstruction of the small intestine a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

a. Ileus pg. 495: Ileus = is an obstruction of the small intestine

Match each radiographic appearance with the corresponding pathologic indication. (Use each selection only once.) - Excessive bone formation generally involving both the middle and inner ear a. Otosclerosis b. Acoustic neuroma c. Cholesteatoma d. Mastoiditis

a. Otosclerosis pg. 403: Otosclerosis - excessive bone formation involving middle and inner ear

To most effectively demonstrate injured anterior ribs numbers 5 and 6 on the right side, which two projections should be included as part of the series? a. PA and PA oblique with the patient LAO b. PA and PA oblique with the patient RAO c. AP and AP oblique with the patient LPO d. AP and AP oblique with the patient RPO

a. PA and PA oblique with the patient LAO pg. 371: Right anterior pain = side of interest is the right anterior aspect of ribs 5 & 6. PA puts the anterior side (side of interest) closest to the IR. Anterior injury = rotate away from the side of interest because its anterior pain, therefore patient is in a LAO position. LAO = right side anterior pain, plus rotating away from the affected side puts the patient into an LAO

The suprasternal, manubrial, or jugular notch all correspond to the level of: A) T2-3 b) T1 c) T4-5 d) C7

a. T2-3 pg. 356: The jugular notch is at a level of T2-T3.

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Punctate collection of barium surrounded by a "halo" appearance during upper GI series a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

a. Ulcers pg. 473: During an upper GI study, the ulcer appears as a punctate barium collection that may be surrounded by a "lucent-halo" appearance.

Which pairs of ribs are classified as true ribs? a. first 7 pairs b. pairs 8, 9 and 10 c. pairs 8, 9, 10, 11 & 12 d. the last 2 pairs

a. first 7 pairs pg. 357: Ribs 1 to 7 are term,ed true ribs.

What is the proper name for that structure commonly called the "breastbone"? a. scapula b. sternum c. manubrium d. xiphoid process

b. sternum

For the AP projection demonstrating ribs above the diaphragm, when should respiration be suspended and what effect will that have on the diaphragm? a. on full inspiration; will depress the diaphragm b. on full inspiration; will elevate the diaphragm c. on full expiration; will depress the diaphragm d. on full expiration; will elevate the diaphragm

a. on full inspiration; will depress the diaphragm pg. 360: Above diaphragm - suspend respiration and expose on inspiration. This should project the diaphragm below the ninth or tenth ribs on full inspiration.

How should the central ray be directed and centered for the PA projection for bilateral sternoclavicular joints? a. perpendicular to T3 b. perpendicular to T7 c. angled medially 15º, entering at T3 d. angled cephalically 15º, entering at T7

a. perpendicular to T3 pg. 366: CR perpendicular, centered to the level of T2-T3

How should the central ray be directed for the oblique position to best demonstrate the sternum? A) perpendicularly B) 15º caudal C) 15º cephalic D) 20º caudal

a. perpendicularly pg. 364: the CR is perpendicular to the IR, directed to the center of the sternum (1" left of the midline, and midway between the jugular notch and xiphoid process)

Which two projections best demonstrate injured posterior ribs numbers 10, 11 & 12 on the right side? a. AP and AP oblique with the patient LPO b. AP and AP oblique with the patient RPO c. PA and PA oblique with the patient LPO d. PA and PA oblique with the patient RPO

b. AP and AP oblique with the patient RPO pg. 371: Right posterior pain = side of interest is the right posterior aspect of ribs 5 & 6 AP - puts posterior side (side of interest) closest to the IR Posterior injury = rotate toward the side of interest because its posterior pain, therefore patient is in a RPO position. RPO position - right sided posterior pain plus rotating toward the affected side puts the patient into an RPO.

Match each radiographic appearance with the corresponding pathologic indication.(Use each selection only once.) - Bone destruction with widened internal auditory canal a. Otosclerosis b. Acoustic neuroma c. Cholesteatoma d. Mastoiditis

b. Acoustic neuroma pg. 403: Acoustic neuroma - widened internal auditory canal

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Gastric bubble seen above the diaphragm a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

b. Hiatal hernia pg. 473: table 12.6, hiatal hernia = gastric bubble or protruding aspect of stomach above diaphragm or Schatzki ring.

MATCHING Select the imaging modality that would best demonstrate the following pathologies. -Most sensitive modality for detecting differences between normal and abnormal brain tissues a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

b. MRI pg. 412: MRI provides increased sensitivity in detecting differences between normal and abnormal tissues in the brain and associated soft tissues.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - New growth observed in intestine as filling defects a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

b. Neoplasm pg. 496: Neoplasm = "new growth" ... this growth may be benign or malignant.

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.) - Destructive stage of bony areas demonstrated by areas of radiolucency followed by reparative stages of sclerotic (radiodense) regions resulting in a "cotton-wool" appearance a. Multiple myeloma b. Paget's disease c. Metastases d. Pituitary adenoma

b. Paget's disease pg. 402: Paget's disease - radiographically, areas of lucency demonstrate the destructive stage, and a "cotton-wool" appearance with irregular areas of increased density (scerosis) shows the reparative stage.

Which of the following articulates with the articular facets located just lateral to the jugular notch? a. ribs b. clavicles c. sternal body d. xiphoid process

b. clavicles pg. 356: the medial aspect of each clavicle articulates with the lateral aspect of the manubrium of the sternum at the clavicular notch, and is called the sternoclavicular joint.

Which articulation is formed in part with a head of a rib? a. costosternal b. costovertebral c. costotransverse d. sternoclavicular

b. costovertebral pg. 358: see table 10.1 Costovertebral joints - between heads of ribs and thoracic vertebrae

To most effectively demonstrate injured posterior ribs numbers 5 and 6 on the left side, which two projections should be included as part of the series? a. PA and PA oblique with the patient LAO b. PA and PA oblique with the patient RAO c. AP and AP oblique with the patient LPO d. AP and AP oblique with the patient RPO

c. AP and AP oblique with the patient LPO pg. 371: Left posterior pain = side of interest is the left posterior aspect of ribs 5 & 6 AP - puts posterior side (side of interest) closest to the IR Posterior injury = rotate toward the side of interest because its posterior pain, therefore patient is in a LPO position. LPO position - left sided posterior pain plus rotating toward the affected side puts the patient into an LPO.

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Dilated distal esophagus due to reduced peristalsis a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

c. Achalasia (cardiospasm) pg: 466: Achalasia = a motor disorder of the distal two-thirds of the esophagus ... The thoracic esophagus may also lose its normal peristaltic activity and become dilated (megaesophagus).

MATCHING Select the imaging modality that would best demonstrate the following pathologies. - Recent bleeding within the brain a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

c. CT pg. 411

Match each radiographic appearance with the corresponding pathologic indication. (Use each selection only once.) -Bone destruction most commonly involving middle ear a. Otosclerosis b. Acoustic neuroma c. Cholesteatoma d. Mastoiditis

c. Cholesteatoma pg. 403: Cholesteatoma - bone destruction involving middle ear.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Are often found 50 to 100 cm proximal to the ileocecal valve a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

c. Meckel diverticulum pg. 496: Meckel diverticulum = a common birth defect caused by persistence of the yoke sac (umbilical vesicle) resulting in a saclike outpouching of the intestinal wall. This outpouching is seen in the ileum of the small bowel. It is usually 50 to 100 cm proximal to the ileocecal valve.

Match each of the following radiographic appearances with the corresponding pathologic indication. (Use each selection only once.) - Distinctive lesions with moth-eaten appearance, a combination of increased density and destructive irregular border lesions a. Multiple myeloma b. Paget's disease c. Metastases d. Pituitary adenoma

c. Metastases pg. 403: combination osteolytic and osteoblastic lesions have a "moth-eaten" appearance of bone because of the mix of destructive and blastic lesions.

Which radiographic position best demonstrates the sternum projected within the heart shadow? A) LAO B) LPO C) RAO D) RPO

c. RAO pg. 359: Because the thoracic spine is so dense, it is almost impossible to see the sternum in a true PA or AP projection. Therefore, the patient is rotated in a 15° to 20° right anterior oblique (RAO) to shift the sternum just to the left into the homogeneous heart shadow.

Which radiographic position best demonstrates the anterior 6th rib on the left side without vertebral superimposition? a. LAO b. LPO c. RAO d. RPO

c. RAO pg. 372: To demonstrate the axillary portion of the left ribs, perform and LPO or RAO position. Left anterior pain = side of interest is the left anterior aspect of the 6th rib = RAO

Which of the following evaluation criteria pertains to the AP oblique projection for ribs? a. trachea should be seen in the midline of the thorax b. heart and mediastinum should be seen in the center of the image c. axillary portion of the ribs of interest should be free of superimposition d. sternal ends of the clavicles should be equidistant from the vertebral column

c. axillary portion of the ribs of interest should be free of superimposition pg. 372: the axillary portion of the ribs under examination is projected without self super-imposition.

With which structures do heads of ribs articulate? a. cartilage of adjacent ribs b. lateral borders of the sternum c. demifacets of thoracic vertebrae d. transverse processes of thoracic vertebrae

c. demifacets of thoracic vertebrae pg. 357: The vertebral end of a rib consists of a head which articulates with one or two thoracic vertebral bodies pg. 298: Each thoracic vertebrae has a facet or demifacet on each side of the body. Each facet or combination of two demifacets accepts the head of a rib to form a costovertebral joint.

Which classification refers to ribs that have no anterior attachments? a. true b. primary c. floating d. secondary

c. floating pg. 357: Ribs 11 & 12 are termed floating ribs because they are not connected anteriorly.

The dilated portion of the distal esophagus is termed the: A) cardiac antrum B) cardiac notch. C) fundus. D) incisura cardiaca.

cardiac antrum. pg. 452-453: the esophagus pierces the diaphragm at the level of T10. Just before passing through the diaphragm, the esophagus presents a distinct dilation ... the abdominal segment of the esophagus is termed the cardiac antrum.

Which projection best demonstrates the axillary portion of ribs? a. AP projection b. PA projection c. Lateral projection d. AP oblique projection

d. AP oblique projection pg 371: Oblique positions will demonstrate the axillary portion of the ribs that is not well seen on the AP-PA projections.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Patient with lactose or sucrose sensitivities a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

d. Malabsorption syndrome (sprue) pg. 496: Malabsorption syndrome (sprue) = GI tract is unable to process and absorb certain nutrients ... Malabsorption syndrome is often experienced by patients with lactose and sucrose sensitivities.

Match each radiographic appearance with the corresponding pathologic indication.(Use each selection only once.) - Increased densities replace mastoid air cells a. Otosclerosis b. Acoustic neuroma c. Cholesteatoma d. Mastoiditis

d. Mastoiditis pg. 403: Mastoiditis - increased densities (fluid-filled) replace mastoid air cells.

Match each of the following radiographic appearances with the corresponding pathologic indication.(Use each selection only once.) - Enlarged sella turcica a. Multiple myeloma b. Paget's disease c. Metastases d. Pituitary adenoma

d. Pituitary adenoma pg. 402: Pituitary adenoma - plain radiographic images may demonstrate enlargement of the sella turcica and erosion of the dorsum sellae.

Which radiographic position best demonstrates the posterior 11th rib on the right side without vertebral superimposition? a. LAO b. LPO c. RAO d. RPO

d. RPO pg. 372: To demonstrate the axillary portion of the right ribs, perform an RPO or LAO position. Right posterior pain = side of interest is the right posterior aspect of the 11th rib = RPO

MATCHING Select the imaging modality that would best demonstrate the following pathologies. - Hydrocephalus (in neonate) a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

d. Ultrasound pg. 412: sonography - can be valuable in the investigation and follow-up of hydrocephalus.

MATCHING Select the imaging modality that would best demonstrate the following pathologies. - Craniosynostosis (premature suture closing in neonate skull) a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

d. Ultrasound pg. 412: sonography - cranial sutures may be evaluated, assisting in the diagnosis of premature suture closure (craniosynostosis)

MATCHING Select the imaging modality that would best demonstrate the following pathologies. - Intracranial hemorrhage in premature infants a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

d. Ultrasound pg. 412: sonography of the brain of the neonate is an integral part of treatment in the intensive care unit. It allows for rapids evaluation and screening of premature infants for intracranial hemorrhage.

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Enlarged recess in the distal esophagus a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

d. Zenker diverticulum

When performing the AP projection to demonstrate ribs below the diaphragm, with reference to the patient, how should the image receptor be positioned? a. center the image receptor at the level of L3 b. center the image receptor at the level of iliac crests c. lower border of the image receptor at the level of L3 d. lower border of the image receptor at the level of iliac crests

d. lower border of the image receptor at the level of iliac crests pg. 370: IR centered to CR (bottom of IR at iliac crest)

For the AP projection demonstrating ribs below the diaphragm, when should respiration be suspended and what effect will that have on the diaphragm? a. on full inspiration; will depress the diaphragm b. on full inspiration; will elevate the diaphragm c. on full expiration; will depress the diaphragm d. on full expiration; will elevate the diaphragm

d. on full expiration; will elevate the diaphragm pg. 360: Below diaphragm - suspend respiration and expose on full expiration. This should allow the diaphragm to rise to the level of the seventh or eighth posterior ribs, providing a uniform density for below diaphragm ribs.

Where on the sternum is the jugular notch located? a. lateral border of the body b. lateral border of the manubrium c. superior border of the body d. superior border of the manubrium

d. superior border of the manubrium pg. 356: the uppermost border of the manubrium is easy to palpate and is called the jugular notch.

Which part of the sternum is located at the level of T10? a. body b. angle c. manubrium d. xiphoid process

d. xiphoid process pg. 356: The xiphoid process corresponds to the level of T9-T10

MATCHING Select the imaging modality that would best demonstrate the following pathologies. - Paget's disease a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

e. Conventional radiography pg. 402: radiographically, areas of lucency demonstrate the destructive stage, and a "cotton-wool" appearance with irregular areas of increased density (scerosis) shows the reparative stage.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Inflammation of the intestine a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

e. Enteritis pg. 494: Enteritis = inflammation of the intestine, primarily of the small intestine.

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Presence indicates a possible sliding hiatal hernia a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

e. Schatzki ring pg. 472: a sliding hiatal hernia may produce a radiographic sign termed Schatzki ring, which is a ring of mucosal tissue that protrudes into the lumen of the esophagus.

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Speckled appearance of the gastric mucosa and absence of rugae a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

f. Gastritis pg. 473: table 12.6, gastritis = absence of rugae, thin gastric wall, and "speckled" appearance of muscosa with acute cases of gastritis.

What is the recommended degree of obliquity for an RAO projection of the sternum for an asthenic (thin-chested) type of patient? A) 20° B) 15° C) 30° D) 10°

A) 20° pg. 359: a patient with a shallow or thin chest requires more rotation than a patient with a deep chest to cast the sternum away from the thoracic spine. Hypersthenic patient has a greater AP measurement and requires less rotation (15°) Asthenic patient has a decreased AP and requires more rotation (20°).

The average adult gallbladder is ____ cm long and ____ cm wide. A) 7 to 10; 3 B) 4 to 6; 2 C) 12 to 15; 5 to 6 D) 2 to 3; 1

A) 7 to 10; 3 pg. 447: the normal gallbladder is 7 to 10 cm long and approximately 3 cm wide. It generally holds 30 to 40 mL of bile.

What kV range (digital systems) is recommended for an AP projection of the ribs found below the diaphragm? A) 75 to 85 kV B) 60 to 65 kV C) 65 to 75 kV D) 70 to 80 kV

A) 75 to 85 kV pg. 360: digital kV = 80 ± 5

For a mesocephalic skull, the width is __________ of the length A) 75% to 80% B) none of the above C) less than 75% D) 80% or more

A) 75% to 80% pg. 405

How much difference is there between the OML and IOML positioning lines? A) 7° to 8° B) 8° to 9° C) 10° to 11° D) 5° to 6°

A) 7° to 8° pg. 407: An average difference of 7° to 8° exists between the angles of the OML and IOML.

A patient comes to radiology for an upper GI series. The patient has a clinical history of hiatal hernia. Which of the following positions may be helpful in demonstrating this condition? A) AP Trendelenburg position B) Left lateral decubitus, AP projection C) Dorsal decubitus, lateral projection D) LAO with compression technique

A) AP Trendelenburg position pg. 486: a full Trendelenburg angulation facilitates the demonstration of hiatal hernia.

Which two projections must be taken for an injury to the left posterior, lower ribs? A) AP and LPO B) AP and RAO C) PA and LPO D) PA and RAO

A) AP and LPO pg. 371: Left posterior pain = side of interest is the left posterior aspect of the ribs AP - puts posterior side (side of interest) closest to the IR Posterior injury = rotate toward the side of interest because its posterior pain, therefore patient is in a LPO position. LPO position - left sided posterior pain plus rotating toward the affected side puts the patient into an LPO.

A radiograph of an AP barium enema (BE) projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum. How can this area be better visualized on the repeat exposure? A) Angle the central ray (CR) 30° to 40° cephalad with AP projection. B) Increase kV. C) Take a PA projection with the patient in the left lateral decubitus position. D) Take a PA projection with a 30° to 40° cephalad CR angle.

A) Angle the central ray (CR) 30° to 40° cephalad with AP projection. pg. 523: AP axial barium enema = elongated views of the rectosigmoid segments should be visible with less overlapping of sigmoid loops than with a 90° AP projection. Angle CR 30° to 40° cephalad, directed 2" inferior to level of ASIS.

Which sections of the large intestine will most likely be filled with air with the patient in the prone position during a double-contrast barium enema (BE)? A) Ascending colon, descending colon, and rectum B) Transverse and sigmoid colon C) Rectum only D) Right and left colic flexure and sigmoid colon

A) Ascending colon, descending colon, and rectum pg. 491: when a patient is prone, air rises to fill the rectum, ascending colon, and descending colon. All of these are retroperitoneal structures. Fig. 13.13: barium = white, air = black

Toward which aspect(s) of the stomach will barium gravitate with the patient in a prone position? A) Body and pylorus B) Fundus C) Cardiac D) Fundus and body

A) Body and pylorus pg. 455: fig. 12.29: Air/gas = black, barium = white Supine position = the fundus is the most posterior portion and is where barium settles. RAO recumbent position (Pt is prone) = the fundus is in the highest position, causing gas to fill this portion of the stomach. The barium settles in the anterior body & pylorus. Erect = air/gas rises to fill the fundus, whereas barium descends to fill the pyloric portion of the stomach.

Which of the following terms describes the anterior fontanel found in the adult skull? A) Bregma B) Pterion C) Asterion D) Lambda

A) Bregma pg. 383: each end of the sagittal suture is identified as a point or area with a specific name as labeled. The anterior end of the sagittal suture is termed bregma.

A patient comes to radiology with severe mastoiditis. Which one of the following imaging modalities will best demonstrate possible bony destruction within the mastoid region? A) CT B) Nuclear medicine C) Ultrasound D) MRI

A) CT pg. 402: mastoiditis - CT scan demonstrates a fluid-filled abscess that replaces air-filled mastoid air cells.

Which of the following projections will best demonstrate the bony nasal septum? A) Parietoacanthial B) Lateral nasal bone C) AP axial projection D) Lateral facial bone

A) Parietoacanthial pg. 420

Which of the following technical factors will best enhance a digital image taken during an upper GI series? A) Collimation B) Low kV techniques C) Long SID D) Use of compensation (wedge) filter

A) Collimation pg. 476: Because of the proximity of the spine, without accurate collimation the imaging system may rescale the image to display a longer than optimal scale of contrast.. This could lead to certain soft tissue structures and pathology being obscured during the image reconstruction process. Careful collimation to the organs of interest minimizes this possibility.

Which of the following structures connects the anterior aspect of the ribs to the sternum? A) Costocartilage B) Sternal tendons C) Costovertebral joints D) Costotransverse joints

A) Costocartilage pg. 357: the anterior ribs do not unite directly to the sternum but do so with a short piece of cartilage termed costocartilage.

Which biliary structure is labeled 4? A) Cystic duct B) Common bile duct C) Common hepatic duct D) Right hepatic duct

A) Cystic duct pg. 447: figures 12.5, 12.6, and 12.7

A radiograph of a parieto-orbital oblique projection for the optic foramen reveals that the optic foramen is projected into the inferior, outer orbital rim. Which of the following modifications is necessary to produce a more diagnostic image? A) Decrease the extension of the head and neck. B) Increase the extension of the head and neck. C) Increase the CR angulation. D) Decrease the CR angulation.

A) Decrease the extension of the head and neck. pg. 428: accurate positioning projects the optic foramen into the lower outer quadrant of the orbit. Over extension of the neck will lower the optic foramen into the orbital rim.

A patient comes to radiology with a history of a gastric ulcer. Which of the following procedures would be most diagnostic to demonstrate this lesion? A) Double-contrast upper GI series B) Single-contrast barium sulfate upper GI series C) Oral, water-soluble upper GI series D) Carbon dioxide upper GI series

A) Double-contrast upper GI series pg. 473: a double-contrast upper GI is recommended for most ulcer studies.

What is an older term for the pancreatic duct? A) Duct of Wirsung B) Hepatopancreatic duct C) Duct of Langerhans D) Ampulla of Vater

A) Duct of Wirsung pg. 447: pancreatic duct (Duct of Wirsung)

Where is cholecystokinin produced? A) Duodenal mucosa B) Liver C) Gallbladder D) Pancreas

A) Duodenal mucosa pg. 447: Food stimulates the duodenal mucosa to secrete the hormone cholecystokinin (CCK).

Which part of the small intestine has the largest diameter? A) Duodenum B) Ileum C) Jejunum D) Cecum

A) Duodenum pg. 489: the duodenum is the first part of the small intestine. It is the shortest, widest, and most fixed portion of the small bowel.

Which part of the small intestine is the shortest? A) Duodenum B) Ileum C) Jejunum D) Pylorus

A) Duodenum pg. 489: the duodenum represents the shortest aspect of the small intestine and averages 20 to 25 cm in length.

What is the most common radiographic procedure performed to diagnose GERD? A) Endoscopy B) Esophagogram C) Upper GI series D) CT

A) Endoscopy pg. 467: endoscopy is often performed to detect early signs of GERD.

Which of the following conditions involves dilated veins in the distal aspect of the esophagus, which in some cases can lead to internal bleeding? A) Esophageal varices B) Esophageal reflux C) Esophageal hypertension D) Esophageal thrombosis

A) Esophageal varices pg. 467: Esophageal varices = characterized by dilation of the veins in the wall of the distal esophagus

Which cranial bone possesses the superior nasal conchae? A) Ethmoid B) Sphenoid C) Frontal D) Temporal

A) Ethmoid pg. 382: contains the superior and middle nasal conchae

A radiograph of an anteroposterior (AP) axial projection of the cranium reveals that the dorsum sellae is projected below the foramen magnum, but the posterior arch of C1 is visible within the foramen. Which of the following positioning errors led to this radiographic outcome? A) Excessive central ray (CR) angulation B) Insufficient CR angulation C) Insufficient flexion of the head and neck D) Tilt of the skull

A) Excessive central ray (CR) angulation pg. 413: Overangulation of CR or excessive neck flexion superimposes the posterior arch of C1 over the dorsum sellae within the foramen magnum and produces foreshortening of the dorsum sellae. Underangulation of CR or insufficient neck flexion projects the dorsum sellae superior to the foreman magnum.

A radiograph of a parietoacanthial (Waters) projection for sinuses reveals that the petrous pyramids are projected over the maxillary sinuses. What positioning error is present on this radiograph? A) Excessive flexion B) Excessive extension C) Excessive CR angulation D) Rotation of the head

A) Excessive flexion pg. 439: adequate extension of neck demonstrates petrous ridges just inferior to the maxillary sinuses.

Which division of the duodenum contains the duodenal bulb or cap? A) First (superior) B) Third (horizontal) C) Second (descending) D) Fourth (ascending)

A) First (superior) pg. 456: the duodenum is shaped like the letter "C" and consists of four parts. The first (superior) portion begins at the pylorus of the stomach. The first part of the superior portion is termed the duodenal bulb.

A radiograph taken during an esophagogram using thin barium mixture demonstrates that there is very little contrast media in the esophagus. Which of the following points will improve filling of the esophagus? (The exposure was made on inspiration after the last swallow.) A) Have the patient drink during the exposure. B) Have the patient perform the Valsalva maneuver during the exposure. C) Have the patient perform the Müller maneuver during the exposure. D) Shorten the exposure time.

A) Have the patient drink during the exposure. pg. 478: thin barium = for complete filling of the esophagus with thin barium, the patient may have to drink through a straw, with continuous swallowing and exposure made after 3 or four swallows without suspending respiration.

A radiograph of a PA projection of the sinuses reveals that the petrous ridges are projected over the ethmoid sinuses. Which of the following modifications will eliminate this superimposition while not compromising diagnostic quality? A) Increase extension of the head and neck slightly. B) Angle the CR 5° to 10° caudad. C) Increase flexion of the head and neck slightly. D) Have the patient open his mouth.

A) Increase extension of the head and neck slightly. pg. 438: petrous ridges should be projected into lower one-third of orbits. Over-flexion projects petrous pyramids into the ethmoid sinuses.

A radiograph of a submentovertex projection of the cranium reveals that the mandibular condyles are projected into the petrous pyramids. What must be altered during the repeat exposure to produce a more diagnostic radiograph? A) Increase the extension of the skull. B) Increase the flexion of the skull. C) Decrease the CR angulation. D) None of the above; it is an acceptable image.

A) Increase the extension of the skull. pg. 432: correct extension of the neck puts mandibular condyles anterior to the petrous pyramids.

A radiograph of an axiolateral oblique projection of the mandible with the head in a lateral position reveals that the mandibular body is greatly foreshortened. Which of the following modifications is necessary to produce a more diagnostic image? A) Increase the rotation of skull toward the image receptor. B) Decrease the rotation of skull toward the image receptor. C) Decrease the CR angulation. D) Increase the CR angulation.

A) Increase the rotation of skull toward the image receptor. pg. 429: the ramus and body should be demonstrated without foreshortening (indicating correct rotation of head). 30° rotation toward IR best demonstrates body. Head in true lateral position best demonstrates ramus. 10° to 15 ° rotation best provides a general survey of the mandible. 45° rotation best demonstrates mentum.

A radiograph of a parietoacanthial (Waters) projection reveals that the petrous ridges are superimposed over the lower 30% of the maxillary sinuses. What specific positioning error (if any) led to this radiographic finding? A) Insufficient extension of skull and neck B) Excessive extension of skull and neck C) Excessive CR angulation D) No error exists; accept the initial radiograph.

A) Insufficient extension of skull and neck pg. 410: to visulize the facial bone mass with conventional radiography, the petrous pyramids must be removed from the facial bone area of interest. This can be done either by tube angulation or by extension of the neck. The neck is extended by raising the chin so that the petrous pyramids are projected just below the maxillary sinuses. Except for the mandible, the facial bones are projected superior to the dense petrous pyramids and are not superimposed by them. Pg. 420: correct neck extension demonstrates petrous ridges just inferior to the maxillary sinuses.

A patient comes to radiology for a barium enema (BE). He has a possible fistula extending from the rectum to the urinary bladder. Which one of the following projections and/or positions would best demonstrate the fistula? A) Lateral rectum position B) AP erect projection C) LPO axial projection D) LPO and RPO positions

A) Lateral rectum position pg. 519: Lateral rectum/ventral decubitus lateral = demonstrates polyps, strictures, and fistulas between the rectum and bladder/uterus.

Which imaging modality can demonstrate abscesses in the retroperitoneum? A) MRI B) Nuclear medicine C) Sonography D) Conventional radiography

A) MRI pg. 512: abscesses in the mesentery or retroperitoneum can be demonstrated easily on T2-weighted MRI.

Part 10 is part of which bone? A) Maxilla B) Sphenoid C) Zygomatic D) Ethmoid

A) Maxilla pg. 398: orbital surface of maxilla

What is the only paranasal sinus not contained within a cranial bone? A) Maxillary B) Sphenoid C) Ethmoid D) Frontal

A) Maxillary pg. 395: Only the maxillary sinus is part of the facial bone structure. The frontal, ethmoid, and sphenoid sinuses are contained within their respective cranial bones.

Which sinuses are best demonstrated with a parietoacanthial projection? A) Maxillary B) Frontal and maxillary C) Frontal, maxillary, and ethmoid D) Sphenoid and maxillary

A) Maxillary pg. 439: maxillary sinuses with the inferior aspect visualized free from superimposing alveolar processes and petrous ridges.

Which of the following substances are not digested chemically? A) Minerals B) Carbohydrates C) Proteins D) Lipids

A) Minerals pg. 457: Only carbohydrates, proteins, and lipids must be chemically digested to be absorbed.

Which of the following terms describes the junction of the two nasal bones? A) Nasion B) Acanthion C) Glabella D) Supraorbital groove

A) Nasion pg. 391: The point of junction of the two nasal bones with the frontal bone is a surface landmark called the nasion.

How much skull rotation (from a lateral position) is required to place the ramus parallel to the IR for the axiolateral oblique projection of the mandible? A) None. Keep skull in true lateral position. B) 10 to 15° toward the IR C) 30° toward the IR D) 45° toward the IR

A) None. Keep skull in true lateral position. pg. 429: Head in true lateral position best demonstrates ramus. 10° to 15 ° rotation best provides a general survey of the mandible. 30° rotation toward IR best demonstrates body. 45° rotation best demonstrates mentum.

How much skull rotation (from a lateral position) is required to place the ramus parallel to the IR for the axiolateral/axiolateral oblique projection of the mandible? A) None. The skull should be kept in a lateral position. B) 30° C) 45° D) 53°

A) None; the skull should be kept in a lateral position. pg. 429: Head in true lateral position best demonstrates ramus. 10° to 15 ° rotation best provides a general survey of the mandible. 30° rotation toward IR best demonstrates body. 45° rotation best demonstrates mentum.

Which of the following imaging modalities is ideal for demonstrating signs of Barrett esophagus? A) Nuclear medicine B) MRI C) Sonography D) CT

A) Nuclear medicine pg. 477: NM is very effective in demonstrating Barrett esophagus.

Which positioning line is perpendicular to the IR for a PA projection of the mandible? A) OML B) AML C) IOML D) GAL

A) OML pg. 430: tuck chin, bringing OML perpendicular to IR.

Which two projections must be taken for an injury to the right anterior, upper ribs? A) PA and LAO B) PA and RAO C) AP and RAO D) AP and LPO

A) PA and LAO pg. 371: Right anterior pain = side of interest is the right anterior aspect of the ribs PA puts the anterior side (side of interest) closest to the IR. Anterior injury = rotate away from the side of interest because its anterior pain, therefore patient is in a LAO position. LAO = right side anterior pain, plus rotating away from the affected side puts the patient into an LAO

The part labeled 8 is part of which bone? A) Palatine B) Sphenoid C) Ethmoid D) Zygomatic

A) Palatine pg. 398-399

Which structure is labeled 9? A) Pancreatic duct B) Common bile duct C) Cystic duct D) Common hepatic duct

A) Pancreatic duct pg. 447: figures 12.5, 12.6, and 12.7

Which condition of the sternum is often termed "funnel chest"? A) Pectus excavatum B) Flail chest C) Pectus eruptus D) Pectus deforminens

A) Pectus excavatum pg. 363: Pectus excavatum - also referred to as funnel chest, this deformity is characterized by a depressed sternum.

Which two forces or processes propel food down the esophagus? A) Peristalsis and gravity B) Peristalsis and rhythmic segmentation C) Gravity and deglutition D) Deglutition and mastication

A) Peristalsis and gravity pg. 453: fluids tend to pass from the mouth and pharynx to the stomach, primarily by gravity. A bolus of solid material tends to pass both by gravity and by peristalsis.

Which division of the temporal bone contains the organs of hearing and equilibrium? A) Petrous B) Mastoid C) Squamous D) Antrum

A) Petrous pg. 385: The organs of hearing and equilibrium are the main structures found within the petrous portion of the temporal bones.

What is the classification of barium sulfate as a contrast media? A) Radiopaque B) Radiolucent C) Isodense D) Negative contrast media

A) Radiopaque pg. 461: the most common positive, or radiopaque, contrast medium used to visualize the gastrointestinal system is barium sulfate (BaS04).

A radiograph of a lateral projection of the facial bones reveals that the sella turcica is not a clear saddle. What specific positioning error is present on the radiograph? A) Rotation B) Excessive extension C) Tilt D) Excessive flexion

A) Rotation

Which one of the following positioning errors most often results in a repeat exposure of a cranial position? A) Rotation B) Incorrect central ray placement C) Slight flexion D) Slight extension

A) Rotation pg. 409: five common positioning errors 1. Rotation 2. Tilt 3. Excessive neck flexion 4. Excessive neck extension 5. Incorrect CR angle

In what position is the patient placed for the enema tip insertion? A) Sims' B) Lithotomy C) Modified lithotomy D) Prone

A) Sims' pg. 504: Sim's position relaxes the abdominal muscles and decreases pressure within the abdomen. The patient is asked to roll onto the left side and lean forward. The right leg is flexed at the knee & hip and is placed in front of the left leg. The left knee is comfortably flexed.

A PA radiograph of the sternoclavicular (SC) joints demonstrates unequal distance from the SC joints to the midline of the spine. The left SC joint is farther from the sternum than the right. What specific positioning error is present on this radiograph? A) Slight right rotation (right side toward the image receptor) B) Slight left rotation (left side toward the image receptor) C) Tilt of the upper thorax D) Excessive angulation of the CR

A) Slight right rotation (right side toward the image receptor) pg. 366-367: In an RAO, the patients right side is closest to the IR, therefore their left is farthest from the IR. In this situation, the patient is rotated too far to the right for the PA projection.

Which of the following imaging modalities is an alternative to an esophagogram for detecting esophageal varices? A) Sonography B) CT C) Nuclear medicine D) MRI

A) Sonography pg. 477: intraesophageal sonography for esophageal varices and carcinoma of the esophagus is becoming an alternative to the esophagram.

Which cranial bone contains the foramen ovale? A) Sphenoid B) Occipital C) Ethmoid D) Temporal

A) Sphenoid pg. 381: Three pairs of small openings or foramina exist in the greater wings (of the sphenoid) for passage of certain cranial nerves... 1. formen rotundum 2. foramen ovale 3. foramen spinosum

Which of the following statements is true about radiography of ribs located above the diaphragm? A) Suspend breathing upon inspiration. B) Perform the study with the patient recumbent. C) Use an analog kV range of 85 to 95. D) Always include an anteroposterior (AP) projection as part of the routine.

A) Suspend breathing upon inspiration. pg. 360: Suspend respiration and expose on inspiration - Perform the study with the PT erect, gravity assists in lowering the diaphragm. - Use an analog kV range of 70 to 80 - You don't always use an AP projection - the decision to do an AP or PA projection is dependent upon the area of injury (posterior or anterior ribs) and putting the side of interest closest to the IR.

The sternal angle is a palpable landmark at the level of: A) T4-5 B) T2-3. C) T7. D) T9-10.

A) T4-5 pg. 356: the sternal angle is at the level of the intervertebral disk space between T4 and T5 for an average adult.

Which of the following bones is part of the floor of the cranium? A) Temporal B) Occipital C) Frontal D) Parietal

A) Temporal pg. 377: Floor of the cranium bones - Right temporal - Left temporal - Sphenoid - Ethmoid

Which of the following statements is NOT true in regard to a pediatric small bowel series? A) The transit time for barium through the small intestine is longer than that of an adult. B) Barium sulfate is the contrast medium of choice. C) The small bowel series should be scheduled early in the morning. D) A gonadal shield often cannot be used during the later stages of the study.

A) The transit time for barium through the small intestine is longer than that of an adult. pg. 511: The pediatric small bowel series and the barium enema are similar in many ways to the procedures in adults. However, the transit time of barium from the stomach to the ileocecal region is faster in children compared with adults.

Which term describes the small flap of cartilage covering the opening to the ear? A) Tragus B) Pinna C) Acanthion D) EAM

A) Tragus pg. 406: tragus, the small cartilaginous flap that covers the opening of the ear.

True/False: The lateral projection of the facial bones is typically a unilateral projection. A) True B) False

A) True

True/False: The sensory apparatus of both equilibrium and hearing are contained in the internal ear. A) True B) False

A) True pg. 387: the complex internal ear contains the essential sensory apparatus of both hearing and equilibrium.

True/False: The osseous labyrinth includes the cochlea, the vestibule, and the semicircular canals. A) True B) False

A) True pg. 387: the osseous (bony) labyrinth can be divided into three distinctly shaped parts: the cochlea (meaning "snail shell"), the vestibule, and the semicircular canals.

True/False: All of the sinuses intercommunicate with each other and with the nasal cavity. A) True B) False

A) True pg. 395: All the paranasal sinus cavities communicate with one another and with the nasal cavity.

True/False: Both CT (computed tomography) and MRI (magnetic resonance imaging) can provide reconstructed images in three planes: axial, sagittal, and coronal. A) True B) False

A) True pg. 411: CT provides sectional images of the facial bones, orbits, mandible, and TMJs in axial, sagittal, or coronal planes. pg. 412: MRI also provides images of the brain in axial, sagittal, or coronal planes

True/False: The submentovertex projection requires that the inferior OML (IOML) is placed parallel to the image receptor. A) True B) False

A) True pg. 417: raise the patients chin and hyperextend the neck if possible until the IOML is parallel to the IR.

True/False: For a lateral facial bones projection, the chin should be adjusted so the IOML is perpendicular to the front edge of the IR. A) True B) False

A) True pg. 419: adjust chin to bring IOML perpendicular to the front edge of IR.

True/False: Optic foramen studies are routinely taken as bilateral projections. A) True B) False

A) True pg. 428: parieto-orbital oblique optic foramen = radiographs of both sides generally are take for comparison.

A patient comes to radiology for a routine study of the cranium. He is unable to flex his head and neck sufficiently to place the OML perpendicular to the IR for the AP axial projection. What should the technologist do to compensate for this problem without creating excessive magnification of the occipital bone? A) Use the inferior OML and increase the CR angulation by 7°. B) Perform the Haas method. C) Perform a submentovertex projection in place of the AP axial projection. D) Use the AML and increase the CR angulation by 10°.

A) Use the inferior OML and increase the CR angulation by 7°. pg. 413: if patient is unable to depress the chin sufficiently to bring OML perpendicular to IR even with a small spong under the head, IOML can be placed perpendicular instead and the CR angle increased to 37° caudad. This maintains the 30° angle between the OML and CR and demonstrates the same anatomic relationships (a 7° to 8° difference exists between the IMOL and OML).

The sutural point or area labeled d is termed: (Anatomic structures are labeled i through vi and sutures a through h.) A) bregma. B) lambda. C) asterion. D) pterion.

A) bregma.

The tip of the catheter is advanced to the ____ during an enteroclysis. A) duodenojejunal junction (ligament of Treitz) B) C-loop of the duodenum C) pyloric sphincter D) ileocecal sphincter

A) duodenojejunal junction (ligament of Treitz) pg. 498: Enteroclysis = the catheter is passed through the stomach into the duodenojejunal junction (ligament of Treitz).

The ____ sinuses develop last and are not fully developed until the teenage years. A) ethmoid B) sphenoid C) nasal D) maxillary

A) ethmoid pg. 395: the ethmoid sinus develops last.

The part labeled x is the: A) eustachian tube. B) internal auditory canal. C) tympanic tube. D) internal auditory meatus.

A) eustachian tube. pg. 387

Which bone classification are ribs? A) flat B) long C) short D) irregular

A) flat pg. 9: flat bones consist of two plates with cancellous bone and bone marrow between them. Examples of flat bones are the bones that make up the calveria, sternum, ribs, and scapulae.

The frontal bone articulates with ____ cranial bones. A) four B) six C) two D) five

A) four pg. 378: the frontal bone articulates with four cranial bones: right & left parietals, sphenoid, and ethmoid.

The bone labeled 2 is the: A) lacrimal. B) maxilla. C) ethmoid. D) palatine.

A) lacrimal. pg. 398

The left mastoid fontanel becomes the ____ in an adult. A) left asterion B) left pterion C) left bregma D) squamosal suture

A) left asterion Pg. 383: Two smaller lateral fontanels that close soon after birth are the sphenoid (pterion in an adult) and mastoid (asterion in an adult) fontanels.

An average-shaped skull with a 47° angle between the petrous pyramids and the midsagittal plane is classified as: A) mesocephalic B) brachycephalic C) dolichocephalic D) morphocephalic.

A) mesocephalic pg. 405: the shape of the average head is termed mesocephalic. In the mesocephalic head, the petrous pyramids form an angle of 47°.

Part iii refers to the: A) nasopharynx. B) laryngopharynx. C) oropharynx. D) nasal cavity.

A) nasopharynx. pg. 451: figure 12.15

The radiographic appearance of the erosion of bony rib margins is a possible indication of: A) osteomyelitis. B) osteoblastic metastases. C) spondylolysis. D) osteolytic metastases.

A) osteomyelitis. pg. 363: Osteomyelitis radiographic appearance - erosion of bony margins.

The widest portion of the cranium is found at the level of the: A) parietal tubercles B) right and left pterion C) squamous portion of the temporal bone D) external acoustic meatus (EAM).

A) parietal tubercles pg. 379: the widest portion of the entire skull is located between parietal tubercles (eminences) of the two parietal bones.

Part ii refers to the: A) soft palate. B) tonsils. C) hard palate. D) epiglottis.

A) soft palate. pg. 451: figure 12.15

Saliva contains certain enzymes to begin the digestion of: A) starch. B) minerals. C) proteins. D) lipids.

A) starch pg. 451: saliva dissolves foods to begin the digestion process. It also contains the enzyme amylase, which breaks down starches.

The oval window is labeled: A) vi. B) ix. C) vii. D) i. E) v.

A) vi. pg. 387

True/False: The circular staircase, or herringbone pattern, is a common radiographic sign for a mechanical ileus. A.) True B.) False

A.) True pg. 495: mechanical obstruction = The loops of the intestine proximal to the site of obstruction are markedly dilated with gas. This dilation produces the radiographic sign commonly called the "circular staircase" or "herringbone" pattern.

True/False: Meckel diverticulum is best diagnosed with a radionuclide (nuclear medicine) scan. A.) True B.) False

A.) True pg. 496: Meckel diverticulum = is rarely seen on barium studies of the small bowel because of rapid emptying during a barium study. It is best diagnosed with a radionuclide (nuclear medicine) scan.

True/False: The enteroclysis procedure is indicated for patients with regional enteritis. A.) True B.) False

A.) True pg. 498: enteroclysis is indicated for patients with clinical histories of small bowel ileus, regional enteritis (Crohn disease), or malabsorption syndrome.

True/False: CT may be performed to diagnose acute appendicitis. A.) True B.) False

A.) True pg. 500: a barium enema generally is not performed in cases of acute appendicitis because of the danger of perforation. High resolution ultrasound with graded compression and CT have become the modalities of choice for the diagnosis of acute appendicitis.

True/False: Ultrasound, with graded compression, can be used in diagnosing acute appendicitis. A.) True B.) False

A.) True pg. 500: a barium enema generally is not performed in cases of acute appendicitis because of the danger of perforation. High resolution ultrasound with graded compression and CT have become the modalities of choice for the diagnosis of acute appendicitis.

True/False: Overhead, radiographic projections are often not taken when using digital fluoroscopy. A.) True B.) False

A.) True pg. 505: routine "overhead" radiographs may be requested within the bowel filled. pg. 506: "spot" radiographs may be obtained to document any suspicious areas ... with digital fluoroscopy these "spot" images are obtained digitally rather than with separate IRs.

True/False: A single-stage, double-contrast barium enema involves instilling both the negative and positive contrast media at the same time. A.) True B.) False

A.) True pg. 506: in a single-stage, double contrast procedure, barium & air are instilled in a single procedure that reduces time and radiation exposure to the patient.

True/False: The opening leading into the intestine for the patient with a colostomy is termed the stoma. A.) True B.) False

A.) True pg. 509: the terminal end of the intestine is brought to the anterior surface of the abdomen, where an artificial opening is created. This artificial opening is termed a stoma.

True/False: Computed tomography colonography (CTC) is considered as an effective alternative to endoscopic colonoscopy. A.) True B.) False

A.) True pg. 511: CT colonography = "virtual colonoscopy". CT colonography is reported to be an effective diagnostic tool in detecting polyps, tumors, diverticula, defects, and strictures within the large intestine. It is considered to be an alterative to endoscopic colonoscopy.

A radiograph of an RAO projection of the ribs demonstrates the left axillary ribs are foreshortened, whereas the right side is elongated. Which of the following is the most likely reason for this radiographic outcome? A) The patient requires more rotation to the right. B) An LAO was performed rather than the RAO position. C) The technologist should have performed a PA projection to demonstrate the left axillary ribs, not an RAO. D) CR angulation was incorrect.

B) An LAO was performed rather than the RAO position. pg. 372: to demonstrate the axillary portion of the right ribs perform an RPO or LAO position. To demonstrate the axilalry portion of the left ribs, perform an LPO or RAO. An LAO would demonstrate the side that is away from the IR, which would be the right side. This would lead to foreshortening of the left side.

A PA projection taken during an upper GI series performed on an infant reveals that the body and pylorus of the stomach are superimposed. What modification needs to be made during the repeat exposure to separate these two regions? A) Perform the AP projection instead. B) Angle the CR 20° to 25° cephalad. C) Angle the CR 30° to 45° cephalad. D) Use the AP Trendelenburg position.

B) Angle the CR 20° to 25° cephalad. pg. 483: alternative PA axial = for infants a 20° to 25° cephalic CR angle is recommended to open the body and pylorus of the stomach.

A PA radiograph taken on a hypersthenic patient during an upper GI series reveals that the pylorus and duodenal bulb are superimposed. Which of the following modifications will best eliminate the superimposition between these structures? A) Roll the patient into a slight RAO position. B) Angle the CR 35° to 45° cephalad. C) Place a rolled towel or a filled compression paddle under the patient's abdomen before exposure. D) Increase the kV.

B) Angle the CR 35° to 45° cephalad. pg. 483: an alternative PA axial position may be used = a 35° to 45° cephalad CR angle separates the duodenal bulb and pyloric region of the stomach.

A patient comes to radiology for a sinus series. She cannot fully extend her head and neck for the submentovertex projection. What else can the technologist do to produce a diagnostic submentovertex projection? A) Angle the CR to place it perpendicular to the OML. B) Angle the CR to place it perpendicular to IOML. C) Perform the projection with the patient recumbent. D) Place sandbags on the forehead to extend the skull.

B) Angle the CR to place it perpendicular to IOML. pg. 440: CR directed perpendicular to IOML - if the patient is unable to extend the neck sufficiently, angle the tube from horizontal as needed to align CR perpendicular to IOML.

What is another term for the AP axial projection taken during a barium enema procedure? A) Sims' position B) Butterfly position C) Chassard-Lapine position D) Smith position

B) Butterfly position

Which part of the stomach is labeled 3? A) Angular notch B) Cardiac notch C) Incisura angularis D) Esophagogastric junction

B) Cardiac notch pg. 454: Fig. 12.23

Which of the following is not a main subdivision of the stomach? A) Fundus B) Cardium C) Pylorus D) Body

B) Cardium pg. 454: the stomach is composed of three main subdivisions (1) the fundus, (2) the body, (3) the pylorus.

A radiograph of a PA Caldwell projection reveals that the petrous ridges are projected into the lower one third of the maxillary sinuses. Which of the following modifications should be made during the repeat exposure to produce a more diagnostic image? A) Increase the extension of the head and neck. B) Decrease the extension of the head and neck. C) Nothing; accept the initial radiograph. D) Angle the CR 10° caudad.

B) Decrease the extension of the head and neck. Pg. 438: PA Caldwell = correct alignment of OML and CR projects petrous ridges into lower one-third of orbits.

Which one of the following cardinal principles of radiation protection is most effective in reducing the dose to the technologist during fluoroscopy? A) Time B) Distance C) Intensity D) Shielding

B) Distance pg. 465: the most effective method of reducing dose during fluoroscopy procedures is to increase the distance between the x-ray tube and the technologist.

A patient comes to radiology with possible diverticulosis. Which of the following studies is most diagnostic for detecting this condition? A) Single-contrast barium enema B) Double-contrast barium enema C) Evacuative proctogram D) Small bowel series

B) Double-contrast barium enema pg. 500: table 13.5 - most common radiographic examination for Diverticula (diverticulosis/diverticulitis) = double contrast barium enema recommended pg. 515: Double contrast barium enema is ideal for demonstrating diverticulosis, polyps, and mucosal changes.

An ambulatory patient enters the ED with a possible injury to the right upper posterior ribs. Which of the following positioning routines should be taken to demonstrate the involved area? A) Erect PA and LPO B) Erect AP and RPO C) Recumbent AP and RPO D) Erect PA and LAO

B) Erect AP and RPO pg. 360: Above Diaphragm = take the radiograph erect. pg. 371: Right posterior pain = side of interest is the right posterior aspect of the ribs AP - puts posterior side (side of interest) closest to the IR Posterior injury = rotate toward the side of interest because its posterior pain, therefore patient is in a RPO position. RPO position - right sided posterior pain plus rotating toward the affected side puts the patient into an RPO.

Which two bones form the bony nasal septum? A) Superior and inferior nasal conchae B) Ethmoid and vomer C) Vomer and maxilla D) Sphenoid and ethmoid

B) Ethmoid and vomer pg. 392: Two bones - the ethmoid and the vomer - form the bony nasal septum.

A patient comes to radiology with a history of rectocele. Which of the following procedures best demonstrates this condition? A) Single-contrast barium enema B) Evacuative proctogram C) Double-contrast barium enema D) Enteroclysis

B) Evacuative proctogram pg. 508: clinical indications for evacuative proctography include rectoceles, rectal intussusception, and prolaps.

The purpose of the breathing technique for an oblique sternum is to place the anatomy closest to the IR. A) True B) False

B) False pg. 359: Orthostatic breathing - if performed properly, the lung markings overlying the sternum will become obscured, whereas the image of the sternum will remain sharp and well defined.

Which positioning line is parallel to the IR for the oblique inferosuperior (tangential) projection of the zygomatic arches? A) Midsagittal plane B) Infraorbitomeatal C) Orbitomeatal D) Glabelloalveolar

B) Infraorbitomeatal pg. 426: raise chin hyperextending neck until IOML line is parallel to IR.

True/False: The vestibule is located in the middle ear. A) True B) False

B) False pg. 387: the complex internal ear contains the essential sensory apparatus of both hearing and equilibrium. Lying within the densest portion of the petrous pyramid, it can be divided into two main parts: the osseous (bony) labyrinth and the membranous labyrinth. The osseous (bony) labyrinth can be divided into three distinctly shaped parts: the cochlea (meaning "snail shell"), the vestibule, and the semicircular canals.

True/False: Infections involving the upper teeth may involve the frontal sinuses. A) True B) False

B) False pg. 395: Projecting into the floor of each maxillary sinus are several conic elevations related to roots of the first and second upper molar teeth. Occasionally, one or more of these roots can allow infection that originates in the teeth, particularly in the molars and premolars, to travel upward into the maxillary sinuses.

True/False: Lesions of decreased density are termed osteoblastic lesions. A) True B) False

B) False pg. 402: osteoblastic lesions are proliferative bony lesions of increased density (brightness). Osteolytic lesions are destructive lesions with irregular margins.

True/False: The PA axial projection (Haas method) for the cranium requires a CR angle of 25° caudad. A) True B) False

B) False pg. 418: Angle CR 25° cephalad

True/False: The modified parietoacanthial (modified Waters) projection requires more extension of the head and neck as compared with the parietoacanthial (Waters) projection. A) True B) False

B) False pg. 420 & 422 parietoacanthial (Waters) = adjust head until MLM is perpendicular to the IR (more extension to make this line perpendicular to the IR). Modified parietoacanthial (modified Waters) = adjust head until LML is perpendicular to the IR (less extension to make this line perpendicular to the IR).

True/False: The lateral projection for the nasal bones is generally a unilateral projection. (Both right and left lateral projections are usually not required.) A) True B) False

B) False pg. 423: both sides should be examined for comparison, with side closest to IR best demonstrated

True/False: The proper name for the parieto-orbital oblique projection is the Schuller method. A) True B) False

B) False pg. 428: parieto-orbital oblique projection = Rhese Method

True/False: The 15° PA axial (Caldwell) projection produces an unobstructed view of the maxilla. A) True B) False

B) False pg. 438: correct alignment of OML and CR projects petrous ridges into lower 1/3 of orbits.

What is the classification of the joint found between the teeth and maxilla? A) Synovial B) Fibrous C) Cartilaginous D) Synarthrodial

B) Fibrous pg. 394: two types of fibrous joints involve the skull, both of which are synarthrodial (immovable). First are the sutures between cranial bones. Second is a unique type of fibrous joint involving the teeth with the mandible and maxillae. This is a gomphosis subclass type of fibrous joint that is found between the roots of the teeth and the alveolar processes of both the maxillae and mandible.

Which ribs are considered to be true ribs? A) First only B) First through seventh ribs C) First through ninth ribs D) Eleventh and twelfth ribs

B) First through seventh ribs pg. 357: ribs 1 to 7 are termed true ribs.

How many facial bones help make up the bony orbit? A) Three B) Four C) Five D) Seven

B) Four pg. 398: the seven bones that make up each orbit include three cranial bones and four facial bones. 3 cranial bones: frontal, sphenoid, ethmoid 4 facial bones: maxilla, zygoma, lacrimal, palatine

Which sinuses are best demonstrated with the PA projection? A) Maxillary and sphenoid B) Frontal and ethmoid C) Sphenoid and ethmoid D) Frontal and maxillary

B) Frontal and ethmoid pg. 438: frontal sinuses projected above the frontonasal suture are demonstrated. Anterior ethmoid air cells are visualized lateral to each nasal bone, directly below the frontal sinuses.

Which three cranial bones articulate directly with the zygomatic bone? A) Frontal, ethmoid, temporal B) Frontal, sphenoid, temporal C) Sphenoid, frontal, occipital D) Ethmoid, parietal, frontal

B) Frontal, sphenoid, temporal pg. 391: each zygoma articulates with three cranial bones (frontal, sphenoid, and temporal) and with one facial bone (maxilla).

Which aspect of the gallbladder is labeled 1? A) Neck B) Fundus C) Body D) Apex

B) Fundus pg. 447: figures 12.5, 12.6, and 12.7

Along with the use of erect positions, what other technical factor is important to demonstrate air/fluid levels in paranasal sinuses? A) Use of medium kV B) Horizontal x-ray beam C) Use of IR without a grid D) Small focal spot

B) Horizontal x-ray beam pg. 408: air-fluid levels in the sinuses or other cranial cavities may indicate certain pathologic conditions that are visible only in the erect position or with the use of a horizontal beam.

Which positioning line should be perpendicular to the plane of the IR for the AP axial (Towne) projection with a 37° caudad CR angle? A) OML B) IOML C) AML D) LML

B) IOML pg. 413: Anlge CR 30° caudad to OML, or 37° caudad to IOML

A PA axial projection with a 25° caudad angle of the cranium reveals that the petrous ridges are at the level of the superior orbital margins. Which of the following modifications are required to correct this error? A) Decrease CR angle. B) Increase extension of cranium. C) Increase flexion of cranium. D) No corrections are required; this is an acceptable position.

B) Increase extension of cranium. pg. 415: the patients neck is flexed too much, which puts the petrous ridges at the level of the SOM. PA axial with a 25° to 30° caudal angle to OML - with proper flexion of the neck this projection should demonstrate the petrous pyramids projected at or just below the IOM to allow visualization of the entire orbital margin.

A radiograph of an RAO projection of the sternum demonstrates excessive lung markings obscuring the sternum. A 1-second exposure time and an orthostatic (breathing) technique were used. Which of the following will produce a more diagnostic image of the sternum? A) Ensure that the patient is not breathing during the exposure. B) Increase the exposure time; decrease the mA. C) Decrease the kV; increase the mA or time. D) Initiate exposure on deeper inspiration.

B) Increase the exposure time; decrease the mA. pg. 364: orthostatic breathing technique requires a minimum of a 3-second exposure time and a low mA to produce blurring of overlying vascular structures.

Which part of the small intestine has a feathery appearance when filled with barium? A) Ileum B) Jejunum C) Cecum D) Duodenum

B) Jejunum pg. 489: The jejunum contains numerous mucosal folds (plicae circulares), which increase the surface area to aid with absorption of nutrients. These numerous mucosal folds produce the "feathery appearance of the jejunum".

At what level should the CR and image receptor be centered for the RAO or PA upper GI projection and/or position on a sthenic body type of patient? A) Lower costal margin B) L1 C) L3-4 D) iliac crest

B) L1 pg. 482: Sthenic = CR @ L1 Asthenic = CR 2" below L1 Hypersthenic = CR 2" above L1

One radiograph of an upper GI series needs repeating. The technologist is unsure which projection and/or position is seen on this radiograph. The fundus is filled with barium, and the pylorus and duodenal bulb are profiled and air filled. The patient was recumbent for all projections. Which projection and/or position needs to be repeated? A) PA B) LPO C) RAO D) Right lateral

B) LPO pg. 485: LPO position = fundus should be filled with barium, with a double contrast procedure, body and pylorus and occasionally duodenal bulb are air-filled.

Which projection and/or position is most commonly performed during an evacuative proctogram? A) Anteroposterior (AP) erect B) Lateral C) Right posterior oblique (RPO) and left posterior oblique (LPO) D) AP axial

B) Lateral pg. 509: the lateral rectum position usually is preferred by most radiologists. Position patient on the commode and take radiographs in the strain and evacuation phases, with patient in a lateral position.

Which of the following barium enema projections and/or positions provides the greatest amount of gonadal dosage to both male and female patients? A) AP/PA B) Lateral rectum C) Left lateral decubitus D) Left posterior oblique

B) Lateral rectum

Which aspect of the large intestine is located highest, or most superior, in the abdomen? A) Right colic flexure B) Left colic flexure C) Transverse colon D) Ascending colon

B) Left colic flexure

Which structure is labeled 1? A) Ascending colon B) Left colic flexure C) Right colic flexure D) Sigmoid colon

B) Left colic flexure pg. 490: see figure 13.8

Which of the following imaging modalities should NOT be used to rule out a possible metal foreign body in the eye? A) CT B) MRI C) Nuclear medicine D) Radiography

B) MRI pg. 404: foreign body of the eye refers to metal or other types of fragments in the eye. The patient interview before an MRI procedure includes questions regarding history of a foreign object in the eye. Because the magnetic field causes the metal fragment to move, injury occurs due to the soft tissue.

Which bony structure is labeled v? (Anatomic structures are labeled i through vi and sutures a through h.) A) EAM B) Mastoid process C) Styloid process D) Zygomatic process

B) Mastoid process

Part 9 is part of which bone? A) Zygomatic B) Maxilla C) Sphenoid D) Ethmoid

B) Maxilla pg. 398

To which aspect of the ear does the eustachian tube attach? A) External ear B) Middle ear C) Inner ear D) Cochlea

B) Middle ear pg. 385: three main parts of the middle ear = tympanic membrain, auditory ossicles, tympanic cavity (tympanic cavity proper and attic/epitympanic recess). The tympanic cavity communicates anteriorly with the nasopharynx by way of the eustachian tube.

Which projection best demonstrates the floor of the orbits? A) Parietoacanthial (Waters) B) Modified parietoacanthial (modified Waters) C) PA axial (Caldwell) D) Lateral facial bones

B) Modified parietoacanthial (modified Waters) pg. 422

Which of the following modalities best demonstrates early signs of Paget's disease of the skull? A) CT B) Nuclear medicine C) MRI D) Sonography

B) Nuclear medicine pg. 402: Paget disease - Nuclear medicine scans can demonstrate both regions of no (cold) and increased (hot) uptake of the radionuclide based on the stage of the disease.

Other than the esophagogram, what imaging modality is performed to diagnose Barrett's esophagus? A) Computed tomography B) Nuclear medicine C) Magnetic resonance D) Sonography

B) Nuclear medicine pg. 468: table 12.5 = esophagram or NM

When are small bowel series deemed to be complete? A) Two hours after the ingestion of barium B) Once the contrast media passes the ileocecal valve C) Once the contrast media reaches the rectum D) Once the contrast media passes the duodenojejunal flexure

B) Once the contrast media passes the ileocecal valve pg. 497: For the first two hours in the small bowel series, radiographs are obtained at 15-minute to 30-minute intervals. If the examination needs to be continued beyond the 2-hour time frame, radiographs are usually obtained every hour until barium passes through the ileocecal valve.

A patient enters the ED with an injury to the left anterior lower ribs. Which of the following projections should be taken to demonstrate the involved area? A) AP and LAO B) PA and RAO C) AP and LPO D) PA and LAO

B) PA and RAO pg. 371: Left anterior pain = side of interest is the left anterior aspect of the ribs PA puts the anterior side (side of interest) closest to the IR. Anterior injury = rotate away from the side of interest because its anterior pain, therefore patient is in a RAO position. RAO = left side anterior pain, plus rotating away from the affected side puts the patient into an RAO

A patient enters the ED with a possible nasal bone fracture. The physician is concerned about a possible bony nasal septum deviation and fractured nasal bones. Which of the following routines would best diagnose these injuries? A) Fifteen-degree PA Caldwell and lateral facial bone projections B) Parietoacanthial, lateral nasal bone, and superoinferior (axial) projections C) Modified parietoacanthial and lateral nasal bone projections D) Modified parietoacanthial, submentovertex, and oblique axial projections

B) Parietoacanthial, lateral nasal bone, and superoinferior (axial) projections Routine series = Lateral nasal bone and superoinferior (axial) pg. 420: Parietoacanthial - demonstrates nasal septum pg. 423: Lateral nasal bone - nasal bone fractures, frontonasal suture and anterior nasal spine demonstrated. pg. 424: superoinferior (axial) - nasal bone fractures, tangential projection of midnasal and distal nasal bones (with little superimposition of the glabella or alveolar ridge).

Which of the following conditions may produce the "cobblestone" or "string" sign? A) Whipple disease B) Regional enteritis (Crohn's disease) C) Giardiasis D) Ileus

B) Regional enteritis (Crohn's disease) pg. 494: regional enteritis = segments of lumen narrowed and irregular; "cobblestone" appearance and "string sign" common

A patient enters the ED with trauma to the bony thorax. The initial radiographs reveal that there are fractured ribs and a possible pneumothorax of the left thorax. The physician orders a chest study to confirm the pneumothorax; however, the patient cannot stand. Which of the following positions would best demonstrate the pneumothorax? A) Left lateral decubitus B) Right lateral decubitus C) Ventral decubitus D) Dorsal decubitus

B) Right lateral decubitus pg. 361: If the patient cannot assume the erect position and the presence of air-fluid levels must be ruled out, an image obtained with a horizontal beam with the patient in a decubitus position should be included. pg. 97: radiograph may be taken as a right or left lateral decubitus. For possible fluid in the pleural cavity (pleural effusion), the suspected side should be down. For possible small amounts of air in the pleural cavity (pneumothorax) the affected side should be up.

Which pair of ribs attaches to the sternum at the level of the sternal angle? A) First B) Second C) Third D) Fourth and fifth

B) Second pg. 357: the second costocartilage connects to the sternum at the level of the sternal angle.

Which aspect of the gastrointestinal (GI) tract is primarily responsible for the absorption of digestive end products along with water, vitamins, and minerals? A) Stomach B) Small intestine C) Large intestine D) Pancreas

B) Small intestine pg. 457: most of the absorption of digestive end products occurs in the small intestine. Simple sugars, amino acids, fatty acids, glycerol, water, and most salts & vitamins are absorbed into the bloodstream or the lymphatic system through the the lining of the small intestine.

Which cranial bone possesses the sella turcica? A) Temporal B) Sphenoid C) Ethmoid D) Occipital

B) Sphenoid pg. 381: the central portion of the sphenoid is the body. The central depression on the body is termed the sella turcica.

Which of the following projections of the mandible results in the highest skin dose? A) Axiolateral oblique B) Submentovertex C) PA axial D) AP axial

B) Submentovertex

Which of the following projections will best demonstrate the entire mandible with one exposure? A) AP axial B) Submentovertex C) Axiolateral D) Tomography

B) Submentovertex pg. 432: anatomy demonstrated - entire mandible and coronoid and condyloid processes demonstrated.

What structure indicates the junction between the duodenum and jejunum? A) Duodenal cap B) Suspensory muscle of the duodenum C) Valvulae conniventes D) C-loop of the duodenum

B) Suspensory muscle of the duodenum pg. 456: the junction of the duodenum with the second portion of the small intestine, the jejunum is termed the duodenojejunal flexure. This portion is relatively fixed and is held in place by a fibrous muscular band, the ligament of Treitz (suspensory muscle of the duodenum). This structure is a significant radiographic reference point.

What is the joint classification and type of movement for the sternoclavicular joints? A) Cartilaginous with diarthrodial (ginglymus) movement B) Synovial with diarthrodial (gliding) movement C) Synovial with amphiarthrodial, limited movement D) Cartilaginous with synarthrodial or no movement

B) Synovial with diarthrodial (gliding) movement pg. 358: the sternoclavicular joints are synovial joints, containing articular capsules that permit a plane of motion, or gliding motion, and are therefore termed diarthrodial joints.

What is the joint classification and type of movement for the costotransverse joint? A) Cartilaginous with diarthrodial (ginglymus) movement B) Synovial with diarthrodial (plane) movement C) Synovial with amphiarthrodial, limited movement D) Cartilaginous with synarthrodial or no movement

B) Synovial with diarthrodial (plane) movement pg. 358: synovial joints with articular capsules lined by synovial membrane, which allow plane or gliding motion, and are therefore diarthrodial.

The xiphoid process corresponds to the vertebral level of: A) T7 B) T9-10 C) T4-5 D) L1-2

B) T9-10 pg. 356: the xiphoid process corresponds to the level of T9-T10

Why is the RAO sternum preferred to the LAO position? A) The RAO produces less magnification of the sternum. B) The RAO projects the sternum over the shadow of the heart. C) The RAO reduces dose to the thyroid gland. D) The RAO projects the sternum away from the hilum and heart.

B) The RAO projects the sternum over the shadow of the heart. pg. 359: The patient is rotated into a 15° to 20° right anterior oblique (RAO) position to shift the sternum just to the left of the thoracic vertebrae and into the homogeneous heart shadow.

Why is it important for the technologist to review the patient's chart and inform the radiologist before beginning the barium enema examination if a biopsy was performed as part of a prior sigmoidoscopy or colonoscopy procedure? A) A sigmoidoscopy or colonoscopy would make the BE examination unnecessary. B) The biopsy of the colon may weaken that portion of the colon, which could lead to a perforation during the BE examination. C) The radiologist would want to confer with the referring physician to see whether the biopsy revealed a malignancy. D) None of the above; the radiologist does not need to know this information before the BE examination.

B) The biopsy of the colon may weaken that portion of the colon, which could lead to a perforation during the BE examination. pg. 500: It is important to review the patient's chart to determine whether the patient has had a recent sigmoidoscopy or colonoscopy before undergoing the barium enema. If a biopsy of the colon was performed during these procedures, the involved section of the colon wall may be weakened. This may lead to perforation during the barium enema.

Which of the following patient care concerns would prevent the use of an oral, water-soluble contrast medium? A) The patient has a possible ulcer. B) The patient is sensitive to iodine. C) The patient has esophageal reflux. D) The patient has dysphasia.

B) The patient is sensitive to iodine. pg. 462: water-soluble iodinated contrast media should not be used if the patient is sensitive to iodine, or if the patient is experiencing severe dehydration.

A twisting of the intestine on its own mesentery is termed: A) intussusception. B) volvulus. C) diverticulosis. D) enteritis.

B) volvulus. pg. 501: volvulus = a twisting of a portion of the intestine on its own mesentery.

A radiograph of a lateral projection of the cranium reveals that the orbital roofs (plates) are not superimposed, one is slightly superior to the other. Which of the following positioning errors led to this radiographic outcome? A) Rotation B) Tilt C) Excessive flexion D) Excessive extension

B) Tilt pg. 414: tilt is evident by superior and inferior separation of symmetric horizontal structures such as the orbital roofs (plates), and greater wings of the sphenoid.

Why would a patient undergo Valsalva maneuver during an esophagogram? A) To demonstrate possible esophageal varices B) To demonstrate possible esophageal reflux C) To demonstrate possible esophagitis D) To demonstrate a possible bezoar

B) To demonstrate possible esophageal reflux pg. 470: various breathing exercises (Valsalva maneuver, Mueller maneuver) are designed to increase both intrathoracic and intra-abdominal pressures. The increase in intra-abdominal pressure may produce the reflux of ingested barium that would confirm the presence of esophageal reflux.

Why is oral contrast media sometimes given during computed tomography colonography? A) To determine if a fistula is present B) To mark or "tag" possible fecal matter C) To demonstrate possible diverticula D) To prevent spasm of the large intestine

B) To mark or "tag" possible fecal matter pg. 512: a small rectal tube is inserted through which air or CO2 gas is instilled into the large intestine. The purpose of the gas is to distend the large intestine so that the intestinal wall is completely visualized. In some cases, oral contrast material may be given to mark or "tag" fecal matter.

Which of the following landmarks corresponds with the level of the petrous ridge? A) EAM B) Top of ear attachment (TEA) C) Squamosal suture D) Inion

B) Top of ear attachment (TEA) pg. 380: the petrous ridge of each pyramid corresponds to the level of an important external land mark, the TEA (top of the ear attachment).

Which part of the colon has the greatest amount of potential movement? A) Descending colon B) Transverse colon C) Sigmoid colon D) Ascending colon

B) Transverse colon pg. 490: the transvers colon has a wide range of motion and normally loops down farther.

Which of the following positioning considerations does NOT apply for a study of the lower ribs? A) Perform positions recumbent. B) Use a digital kV range between 65 and 70 kV. C) Exposure on full expiration. D) Both A and B are incorrect.

B) Use a digital kV range between 65 and 70 kV. pg. 360: Below diaphragm - take the radiographs with the patient recumbent - suspend respiration and expose on expiration. - select a medium, kV range (analog: 70-80; digital 80 ± 5)

Which of the following terms describes the small irregular bones occasionally found in the sutures? A) Asterion B) Wormian C) Sesamoid D) Squamosal

B) Wormian pg. 383: Certain small, irregular bones called sutural, or wormian, bones sometimes develop in adult skull sutures.

Central ray and image receptor centering for a 1-hour small bowel radiograph should be: A) 2 inches (5 cm) above level of the iliac crest. B) at the level of the iliac crest. C) 1 inch (2.5 cm) below the level of the iliac crest. D) at the level of the ASIS.

B) at the level of the iliac crest. pg. 513: CR ⊥ IR 1.) 15 or 30 minutes: center CR 2" above iliac crest (center here to include stomach) 2.) Hourly: center CR to iliac crest

Research suggests that peptic ulcers may be caused by: A) smoking. B) bacteria. C) alcohol. D) antibiotics.

B) bacteria. pg. 437: some more recent studies suggest that ulcers may be caused by bacteria and can be treated with antibiotics.

Enzymes that aid in chemical digestion are classified as: A) lipids. B) biologic catalysts. C) digestive acids. D) amino acids.

B) biologic catalysts. pg. 457: chemical digestion is sped up by various enzymes. Enzymes are biologic catalysts.

Radiographic examination of the biliary ducts only is termed: A) cholecystography. B) cholangiography. C) cholelithiasis. D) cholecystocholangiography.

B) cholangiography. pg. 448: table 12.1 cholangiography = radiographic examination of biliary ducts.

The main function of bile is to: A) break down cholesterol. B) emulsify fats. C) begin the digestion of proteins. D) begin the digestion of complex sugars.

B) emulsify fats. pg. 446: the major functions of bile are to aid in the digestion of fats by emulsifying (breaking down) fat globules, and aid in the absorption of fat following its digestion.

Most esophagograms begin with the patient: A) recumbent-supine. B) erect. C) recumbent-prone. D) in a left lateral decubitus position.

B) erect. pg. 469: because esophagram studies begin with the table in the vertical position, the footboard should be in place.

Fracture of adjacent ribs in two or more places with associated pulmonary injury is known as a(n) _____ rib injury. A) compound B) flail chest C) acute D) compression

B) flail chest pg. 363: flail chest - this fracture of adjacent ribs in two or more places is caused by blunt trauma and is associated with underlying pulmonary injury.

The liver is divided into ____ major and minor lobes. A) three B) four C) two D) six

B) four pg. 446: the liver is divided into 2 major lobes and 2 minor lobes. 2 major = right & left lobes 2 minor = quadrate lobe & caudate lobe

The RAO position of the esophagus is preferred over the left anterior oblique (LAO) because it: A) is a more comfortable position for the patient. B) increases the visibility of the esophagus between the vertebrae and heart. C) reduces thyroid exposure to the patient. D) is easier for the patient to hold the cup of barium in his or her left hand.

B) increases the visibility of the esophagus between the vertebrae and heart. pg. 478: RAO provides better visibility of pertinent anatomy between vertebrae and heart.

The ____ passageway drains the maxillary sinus into the middle nasal conchae. A) ethmoid bulla B) infundibulum C) uncinate process D) inferior nasal concha

B) infundibulum pg. 396: the large maxillary sinus drains through the infundibulum passageway down through the middle nasal meatus.

During the initial enema tip insertion, the tip is aimed: A) toward the coccyx. B) toward the umbilicus. C) directly posterior. D) directly superior.

B) toward the umbilicus. pg. 505: the rectum and anal canal present a double curvature; the tube is inserted first in a forward direction (1" to 1.5"). This initial insertion should be aimed toward the umbilicus.

The only bony connection between the shoulder girdle and the bony thorax is the acromioclavicular joint. A. True B. False

B. False pg. 356: each clavicle articulates medially with the manubrium of the sternum at the clavicular notch and is called the sternoclavicular joint, which is the only bony connection between each shoulder girdle and the bony thorax.

The tubercle portion of a typical rib articulates with the vertebral facet/demifacet. A. True B. False

B. False pg. 357: The vertebral end of a rib consists of a head which articulates with one or two thoracic vertebral bodies pg. 298: Each facet or combination of two demifacets accepts the head of a rib to form a costovertebral joint. pg. 357: Lateral to the neck is an elevated tubercle that articulates with the transverse process of a vertebra and allows for attachment of a ligament/ pg. 298: in addition to costovertebral joints, all of the first 10 thoracic vertebrae also have facets (one on each transverse process) that articulate with the tubercles of ribs 1-10 to form costotransverse joints.

The left anterior oblique (LAO) position of the sternum provides the best frontal image of the sternum with a minimal amount of distortion. A. True B. False

B. False pg. 359: RAO

True/False: Digital fluoroscopy has distinct advantages but produces a slightly higher patient dose as compared with conventional fluoroscopy. A.) True B.) False

B.) False

True/False: Synthetic latex enema tips are safe to use for latex-sensitive patients. A.) True B.) False

B.) False pg. 503: patients with sensitivity to latex experience anaphalactoid-type reactions that include severe sneezing, redness, rash, difficulty breathing, and even death. If the patient has a history of latex sensitivity, the technologist must ensure that the enema tip, tubing, and gloves are latex-free.

True/False: Evacuative proctography is most commonly performed on geriatric patients. A.) True B.) False

B.) False pg. 508: Evacuative proctography is a more specialized procedure that is performed in some departments, especially in children or younger adult patients.

What is the difference, in degrees, between the infraorbitomeatal and orbitomeatal lines? A) 10° B) 15° to 2° C) 7° to 8° D) 20° to 25°

C) 7° to 8° pg. 407: an average difference of 7° to 8° exists between the angles of the orbitomeatal line (OML) and the infraorbitalmeatal line (IOML).

The patient must be NPO a minimum of ____ hours before the small bowel series. A) 4 B) 6 C) 8 D) 24

C) 8 pg. 499: The goal of patient preparation is an empty stomach. Food and fluid must be withheld for at least 8 hours before the exam is performed.

The liver secretes approximately ____ mL of bile per day. A) 100 to 250 B) 500 to 700 C) 800 to 1000 D) 1200 to 1500

C) 800 to 1000 pg. 446: The liver performs more than 100 different functions, but the function most applicable to radiographic study is the production of large amounts of bile. It secretes 800 to 1000 ml, or about 1 quart of bile per day.

Where does the CR exit for a modified parietoacanthial (modified Waters) projection of the facial bones? A) Nasion B) Glabella C) Acanthion D) Midorbits

C) Acanthion pg. 422: align CR perpendicular, centered to exit at the acanthion.

What can the technologist do if the patient cannot extend the head and neck adequately for the routine submentovertex projection of the zygomatic arches? A) Perform the Haas method. B) Use a short SID to magnify the arches. C) Angle the CR to place it perpendicular to the IOML. D) Rotate the skull 15° away from the affected side.

C) Angle the CR to place it perpendicular to the IOML. pg. 425: if the patient is unable to extend neck adequately, angle CR perpendicular to IOML.

Which specific aspect of the large intestine must be demonstrated during evacuative proctography? A) Sigmoid colon B) Haustra C) Anorectal angle D) Rectal ligament

C) Anorectal angle pg. 509: the anorectal angle or junction must be demonstrated during the procedure. This angle represents alignment between the anus and the rectum that shifts between the straining, and evacuating phases.

Which of the fontanels is the last to close at about 18 months of age? A) Sphenoid B) Mastoid C) Anterior D) Posterior

C) Anterior pg. 383: the anterior fontanel is the largest and at birth measures about 2.5 cm wide and 4 cm long. It does not completely close until about 18 months of age.

Where is the CR centered for an AP axial projection for the mandible? A) At the nasion B) 2 inches (5 cm) above glabella C) At the glabella D) At the mentum

C) At the glabella pg. 431: center CR 1" superior to glabella

What is the name of the joint found between the lateral condylar processes of the skull and the atlas of C1? A) Zygapophyseal joint B) Intervertebral joint C) Atlanto-occipital joint D) Cervico-occipital joint

C) Atlanto-occipital joint pg. 379: the two lateral condylar portions (occipital condyles) are oval processes with convex surfaces, with one on each side of the formen magnum. These articulate with depressions on the first cervical vertebrae, called the atlas. The two-part articulation between the skull and the cervical spine is called the atlanto-occipital joint.

Which of the following devices reduces scatter exposure during fluoroscopy from the fluoroscopy tube? A) Compression paddle B) Bucky tray C) Bucky slot shield D) Lead gloves

C) Bucky slot shield pg. 465: bucky slot shield - this shield significantly reduces scatter radiation resulting from the fluoroscopy x-ray tube located under the table.

Which of the following is classified as an irritant laxative? A) Magnesium citrate B) Magnesium sulfate C) Castor oil D) None of the above

C) Castor oil pg. 503: two classes of laxatives: 1.) Irritant: - Castor oil 2.) Saline: - Magnesium citrate - Magnesium sulfate

Which part of the large intestine has the widest diameter? A) Descending colon B) Transverse colon C) Cecum D) Ascending colon

C) Cecum pg. 490: The cecum, the widest portion of the large intestine, is fairly free to move about in the RLQ.

A patient comes to radiology for an esophagogram. The radiologist is concerned about the upper portion of the esophagus, near the level of T1, which did not visualize well on the previous routine projection-position esophagogram. Which of the following special projections and/or positions would be most helpful in demonstrating this region? A) Soft tissue lateral B) LAO C) Cervicothoracic (swimmer's) lateral position D) AP with 25° to 30° cephalad CR angle

C) Cervicothoracic (swimmer's) lateral position pg. 479: optional swimmer's lateral position = this position allows for better demonstration of the upper esophagus without superimposition of arms and shoulders.

Which of the following structures of the inner ear is responsible for hearing? A) Vestibule B) Semicircular canals C) Cochlea D) Round window

C) Cochlea pg. 387: the cochlea relates to the sense of hearing because of its connection to the stapes through the oval window.

Which plane or perspective is most often produced for a CT scan of the sinuses? A) Sagittal B) Transverse C) Coronal D) Axial oblique

C) Coronal pg. 411: CT sinus studies may be performed in the prone position, which allows for coronal scans to be created. Coronal CT scans demonstrate any air-fluid levels that are present.

Which of the following structures passes through the superior orbital fissure? A) Optic nerve B) Olfactory nerve C) Cranial nerves III to VI D) Maxillary branch of the fifth cranial nerve

C) Cranial nerves III to VI pg. 399: The superior orbital fissue allows transmission of four primary cranial nerves (CN III to VI), which control movement of the eye and eyelid.

What is a potential risk associated with the use of water-soluble contrast agents, especially for geriatric patients? A) Bowel obstruction B) Cardiac arrest C) Dehydration D) Shock

C) Dehydration pg. 475: the risk of dehydration during GI studies is a concern for geriatric patients. The use of water soluble contrast agents such as Gastrographin or MD-Gastroview may increase the risk of dehydration further.

A patient comes to radiology for an upper GI series. Her clinical history indicates that there may be a tumor posterior to the stomach. Which one of the following projections and/or positions will best demonstrate this condition? A) RAO B) PA C) Right lateral D) LPO

C) Right lateral pg. 484: Right lateral clinical indications = patholigc processes of the retrogastric space (space behind the stomach) ... demonstrates diverticula, tumors, gastric ulcers and trauma.

A radiograph of a lateral projection of the sternum reveals that the patient's ribs are superimposed over the sternum. What needs to be done to correct this problem during the repeat exposure? A) Increase the SID. B) Angle the CR 5° anterior. C) Ensure that the patient is not rotated. D) Increase the kV.

C) Ensure that the patient is not rotated. pg. 365: correct position with no rotation demonstrates the following: - no superimposition of hermi, shoulders, or soft tissue on sternum. - entire sternum with no superimposition of ribs. - lower aspect of the sternum not obscured by breasts.

Which of the following conditions is an example of GERD? A) Esophageal varices B) Gastric carcinoma C) Esophageal reflux D) Bezoar

C) Esophageal reflux pg. 467: Gastroesophageal reflux disease (GERD), or esophageal reflux, is the entry of gastric contents into the esophagus, irritating the lining of the esophagus.

Which group of sinuses is shaded (screened) in the frontal and lateral views of the illustration below? A) Maxillary B) Sphenoid C) Ethmoid D) Frontal

C) Ethmoid pg. 396: fig. 11.61

Which cranial bone is labeled vi in this figure? (Anatomic structures are labeled i through vi and sutures a through h.) A) Temporal B) Occipital C) Greater wing of sphenoid D) Parietal

C) Greater wing of sphenoid

A pediatric patient enters radiology for a paranasal sinus series. Because of her age, the child is unable to hold still for the projections even with the use of immobilization devices. The decision is to hold the child during each exposure. Which of the following individuals should be asked to hold the child? A) Technologists B) Referring physician C) Guardian D) Student

C) Guardian pg. 411: If it is necessary for the guardian to hold the patient, the technologist must provide a lead apron or gloves or both.

While attempting to insert an enema tip into the rectum, the technologist experiences resistance. What should be the next step taken by the technologist? A) Retry the insertion using more lubrication. B) Ask the patient to try to insert it himself. C) Have the radiologist insert it using fluoroscopic guidance. D) Cancel the procedure.

C) Have the radiologist insert it using fluoroscopic guidance. pg. 502: box 13.5 = never force enema tip into rectum. This action may lead to a perforated rectum. The radiologist inserts the enema tip under fluoroscopic guidance, if needed.

Which aspect of the rib articulates with the thoracic vertebral body? A) Neck B) Tubercles C) Head D) Facets

C) Head pg. 357: The vertebral end of a rib consists of a head which articulates with one or two thoracic vertebral bodies

Which specific part of the pancreas is adjacent to the C-loop of the duodenum? A) Tail B) Body C) Head D) Neck

C) Head pg. 456: the head of the pancreas is nestled in the C-loop of the duodenum.

Which of the following conditions may occur with trauma to the ribs? A) Airway obstruction of the trachea B) Pneumonia C) Hemothorax D) Pulmonary embolus

C) Hemothorax pg. 361: Trauma to the bony thorax may result in injury to the respiratory system, and patients may require erect AP and lateral projections of the chest to rule out a possible pnuemothorax, hemothorax, pulmonary contusion, or other chest pathology.

Which one of the following cranial projections will best demonstrate a possible basilar fracture? A) PA axial-Caldwell method B) Lateral recumbent C) Horizontal beam lateral D) AP axial (Townes method)

C) Horizontal beam lateral pg. 402: Basal skull fractures - if bleeding occurs, plain radiographic images may reveal an air-fluid level in the sphenoid sinus if a horizontal ray is used for the lateral view.

Which part of the small intestine makes up three fifths of its entirety? A) Duodenum B) Jejunum C) Ileum D) Ilium

C) Ileum pg. 489: The ileum makes up the distal three-fifths of the remaining aspect of the small intestine and is the longest portion of the small intestine.

A radiograph of an RAO sternum reveals that it is partially superimposed over the spine. What must be done to eliminate this problem during the repeat exposure? A) Perform an LPO projection instead of an RAO. B) Angle the CR 5° to 10° laterally to the sternum. C) Increase rotation of the body. D) Increase kV.

C) Increase rotation of the body. pg. 364: correct rotation is demonstrated by visualizing the sternum alongside the vertebral column with no superimposition by vertebrae. No distortion of sternum due to excessive rotation of the thorax. i.e. the sternum should be just offset from the spine - if this distance is large, then we are over rotated. If the sternum is sitting on the spine partially, then the patient is under rotated.

Which of the following is not one of the cardinal principles of radiation protection? A) Time B) Distance C) Intensity D) Shielding

C) Intensity pg. 465: cardinal principles of radiation protection = time, distance, shielding.

Which positioning line is placed perpendicular to the plane of the IR with a true lateral nasal bone projection? A) OML B) AML C) Interpupillary D) Midsagittal

C) Interpupillary pg. 423: Align IPL perpendicular to table/upright imaging device surface.

Which of the following statements is true about barium sulfate? A) It should be discarded if not used within an hour after mixing. B) The patient may become ill if it is not prepared with sterile water. C) It rarely produces an allergic reaction. D) It is soluble in water.

C) It rarely produces an allergic reaction pg. 461: this particular compound, which is a salt of barium, is relatively inert because of its extreme insolubility in water and other aqueous solutions, such as acids. Because it does not interact chemically with the body, it rarely produces an allergic reaction.

Which of the following landmarks can be palpated to locate the upper margin of the sternum on the obese patient? A) Vertebra prominens B) Sternal angle C) Jugular notch D) Thyroid cartilage

C) Jugular notch pg. 362: the easiest landmark to locate through palpation is the jugular notch. Use this landmark for sternum and rib positioning to determine the upper boarder of the sternum, SC joints, and ribs.

Which one of the following structures is part of the middle ear? A) Tragus B) Cochlea C) Tympanic cavity D) Eustachian tube

C) Tympanic cavity pg. 385: three main parts of the middle ear = tympanic membrain, auditory ossicles, tympanic cavity (tympanic cavity proper and attic/epitympanic recess).

Which of the following positions will best demonstrate the axillary portion of the right ribs? A) AP B) PA C) LAO D) RAO

C) LAO pg. 371: Posterior oblique positions = affected side toward IR. Anterior oblique positions = affected side away from IR pg. 372: To demonstrate the axillary portion of the right ribs, perform a RPO or LAO. To demonstrate the axillary portion of the left ribs, perform an LPO or RAO position. pg. 361: Select the projections that will place the area of interest closest to the IR and rotate the spine away from the area of interest.

Which position can replace the RAO of the sternum if the patient cannot lie prone? A) LAO B) Left lateral decubitus C) LPO D) RPO

C) LPO pg. 364: adaptation - this can be obtained in an LPO position if the patients condition does not permit an RAO position. Also, if the patient cannot be rotated, an oblique image may be obtained by angling the CR 15° to 20° across the right side of the patient to project the sternum lateral to the vertebral column, onto the heart shadow. LPO: patient faces away from the board, left posterior side is against the IR, CR is 1" to the right of the midline of the patient.

A patient enters the ED with blunt trauma to the sternum. The patient is in great pain and cannot lie prone on the table or stand erect. Which of the following positioning routines would be best for the sternum examination in this situation? A) RPO and lateral recumbent projections B) AP and horizontal beam lateral projections C) LPO and horizontal beam lateral projections D) LPO and lateral recumbent projections

C) LPO and horizontal beam lateral projections pg. 364: adaptation - RAO can be obtained in an LPO position if the patients condition does not permit an RAO position. pg. 365: the lateral image can be obtained with the use of a horizontal x-ray beam with the patient in the supine position if the patient's condition warrants this modification.

Which cranial suture is labeled g? (Anatomic structures are labeled i through vi and sutures a through h.) A) Coronal B) Squamosal C) Lambdoidal D) Sagittal

C) Lambdoidal

Which of the following positions will best demonstrate the axillary portion of the left ribs? A) AP B) Posteroanterior (PA) C) Left posterior oblique (LPO) D) LAO

C) Left posterior oblique (LPO) pg. 371: Posterior oblique positions = affected side toward IR. Anterior oblique positions = affected side away from IR pg. 372: To demonstrate the axillary portion of the right ribs, perform a RPO or LAO. To demonstrate the axillary portion of the left ribs, perform an LPO or RAO position. pg. 361: Select the projections that will place the area of interest closest to the IR and rotate the spine away from the area of interest.

Where is bile formed? A) Gallbladder B) Duodenal mucosa C) Liver D) Pancreas

C) Liver pg. 447: bile is formed in small lobules of the liver .

What is the name of the structure labeled "v"? A) Head B) Body C) Manubrium D) Xiphoid process

C) Manubrium pg. 356: see figures 10. and 10.3

Which of the following definitions would describe a bezoar? A) Inflammation of the gastric lining B) Outpouching of the stomach wall C) Mass of undigested material D) Stomach neoplasm

C) Mass of undigested material pg. 471: bezoar describes a mass of undigested material that becomes trapped in the stomach.

What is the largest immovable bone of the face? A) Vomer B) Mandible C) Maxilla D) Zygomatic

C) Maxilla pg. 389: the two maxillae are the largest immovable bones of the face.

Which facial bone forms the majority of the hard palate? A) Mandible B) Palatine C) Maxilla D) Zygomatic

C) Maxilla pg. 390: the fourth process of each maxillary bone is the palatine process, which can be demonstrated only on an inferior view of the two maxillae. The two palatine processes form the anterior portion of the roof of the mouth called the hard, or bony, palate.

Patient preparation for an adult upper GI series includes: A) nothing; no patient preparation is required. B) NPO 4 hours before the procedure. C) NPO 8 hours before the procedure. D) NPO 24 hours before the procedure.

C) NPO 8 hours before the procedure. pg. 474: food and fluids should be withheld for at least 8 hours before the examination.

Which aspect of the gallbladder is located most posterior within the abdomen? A) Fundus B) Body C) Neck D) Apex

C) Neck pg. 447: The fundus is the distal end of the broadest part of the gallbladder. The body is the main section of the gallbladder. The neck is the narrow proximal end.

Which of the following ribs is considered to be a false rib? A) Seventh B) First C) Ninth D) None of the above

C) Ninth pg. 357: Ribs 1-7 are true ribs Ribs 8 to 12 are false ribs Ribs 11 & 12, which are also false ribs, are termed floating ribs because they are not connected anteriorly.

A radiograph of a PA Caldwell projection reveals that the petrous ridges are projected into the lower one third of the orbit. Which of the following modifications should be made during the repeat exposure to produce a more diagnostic image? A) Increase the extension of the head and neck. B) Decrease the extension of the head and neck. C) Nothing; accept the initial radiograph. D) Angle the CR 10° caudad.

C) Nothing; accept the initial radiograph.

Which of the following imaging modalities is utilized to determine the degree of skeletal metastases especially in the cranium? A) CT B) MRI C) Nuclear medicine D) Radiography

C) Nuclear medicine pg. 412: NM provides a senesitive screening procedure (radionuclide bone scan) for detection of skeletal metastases.

Which positioning line must be used with a 30° caudad angle for an AP axial projection of zygomatic arches? A) IOML B) AML C) OML D) GAL

C) OML pg. 427: angle CR 30° caudad to OML, or 37° caudad to IOML.

Which of the following conditions would contraindicate the use of a cathartic (laxative) before a barium enema? A) Colitis B) Diverticulosis C) Obstruction D) Diverticulitis

C) Obstruction (ileus) pg. 502: certain conditions contraindicate the use of the very effective cathartics or purgatives needed to cleanse the large bowel. These conditions include: 1. gross bleeding 2. severe diarrhea 3. obstruction 4. inflammatory conditions

Which bony landmark represents the highest level of the facial bone mass? A) Nasion B) Acanthion C) Orbital plates D) Supraorbital notch

C) Orbital plates pg. 378: The SOG becomes an important landmark because it corresponds to the floor of the anterior fossa of the cranial vault, which is also at the level of the orbital plate or at the highest level of the facial bone mass. The orbital plate on each side forms the superior part of each orbit. Below the orbital plates lie the facial bones, and above the orbital plates is the anterior part of the floor of the brain case.

Which disease or condition may be associated with postoperative complications of open heart surgery? A) Spondylitis B) Osteoblastic metastases C) Osteomyelitis D) Flail chest

C) Osteomyelitis pg. 363: Osteomyelitis - this localized or generalized infection of bone and marrow can be associated with postoperative complications of open heart surgery, which requires the sternum to be split. The most common cause of osteomyelitis is a bacterial infection.

Where should the optic foramen be located with a well-positioned parieto-orbital oblique projection of the optic foramina? A) Inner, lower quadrant of orbit B) Center of orbit C) Outer, lower quadrant of orbit D) Inner, upper quadrant of orbit

C) Outer, lower quadrant of orbit pg 428: accurate positioning projects the optic foramen into the lower outer quadrant of the orbit.

A patient enters the ED with a possible fracture of the proximal ramus of the mandible. Which of the following routines would best diagnose this fracture? A) Parietoacanthial projection, axiolateral oblique projection with a 30° rotation toward film, and lateral facial bone projection B) PA mandible projection, axiolateral oblique projection with a 45° rotation, and 35° AP axial projection C) PA axial mandible projection, axiolateral oblique projection with no rotation, and a 35° AP axial projection D) PA mandible projection, axiolateral oblique projection with a 45° rotation toward film, and submentovertex projection

C) PA axial mandible projection, axiolateral oblique projection with no rotation, and a 35° AP axial projection Mandible routine = PA (or PA axial), axiolateral oblique, AP axial (Towne method, CR 35° to 42°) pg. 430: PA axial mandible pg. 429: axiolateral oblique projection - head in true lateral position (no rotation) best demonstrates ramus. pg. 431: AP axial 35° - if patient is unable to bring OML perpendicular to IR, align IOML perpendicular and increase the 35° CR angle by 7° (to 42° caudad).

A patient comes to radiology with a history of a possible erosion of the superior orbital fissures. Which of the following projections would best demonstrate this structure? A) PA axial with a 15° caudal angle to OML B) Submentovertex C) PA axial with a 25° to 30° caudal angle to OML D) AP axial with a 37° caudal angle to OML

C) PA axial with a 25° to 30° caudal angle to OML pg. 415: Alternative 25° to 30° projection allows better visualization of the superior orbital fissures, foreman rotundum, and the inferior orbital rim.

Which of the following clinical indications would mandate the use of an oral, water-soluble contrast agent? A) Patient with esophageal reflux B) Patient with a bezoar C) Patient with a possible perforated bowel D) Patient with a possible peptic ulcer

C) Patient with a possible perforated bowel pg. 462: barium sulfate mixtures are contraindicated (not used) if there is any chance that the mixture might escape into the peritoneal cavity.

Which of the following conditions may lead to an adynamic ileus? A) Small bowel tumor B) Scar tissue within the jejunum C) Peritonitis D) Stricture of ileum due to an inguinal hernia

C) Peritonitis pg. 495: adynamic ileus is due to the cessation of peristalsis. Causes include: infection (such as peritonitis or appendicitis); the use of certain drugs; and postsurgical complications.

Which part of the stomach is labeled 6? A) Body B) Pyloric portion C) Pyloric antrum D) Pyloric canal

C) Pyloric antrum pg. 454: Fig. 12.23

Which aspect of the stomach is attached to the duodenum? A) Fundus B) Body C) Pylorus D) Cardiac

C) Pylorus pg. 455: the first (superior) portion of the duodenum begins at the pylorus of the stomach.

Initial PA projections of the SC joints indicate a possible bony defect involving the right SC joint. The vertebral column is preventing a clear view of it. Which of the following projections will demonstrate the right SC joint without superimposition over the spine? A) Horizontal beam lateral B) LAO C) RAO D) Erect lateral projection

C) RAO pg. 367: the RAO visualizes the right SC joint, and the LAO visualizes the left SC joint RAO: patient prone, the right side is down touching the IR, and left side is rotated up 10° to 15°.

The liver is located primarily in the ____ of the abdomen. A) LLQ B) RLQ C) RUQ D) LUQ

C) RUQ pg. 446: the liver occupies most of the right upper quadrant.

Which of the following pathologic conditions is best demonstrated with evacuative proctography? A) Intussusception B) Volvulus C) Rectal prolapse D) Diverticulosis

C) Rectal prolapse pg. 508: clinical indications for evacuative proctography (defecography) include: rectoceles, rectal intussusception, and prolapse of the rectum.

Which of the following structures is not considered part of the colon? A) Transverse colon B) Right and left colic flexures C) Rectum D) All of the above are part of the colon.

C) Rectum pg. 490: the colon consists of four sections and two flexures and does not include the cecum and rectum. Colon sections: 1.) ascending colon 2.) transverse colon 3.) descending colon 4.) sigmoid colon The right (hepatic) and left (splenic) colic flexures are also included as part of the colon.

Which of the following procedures will not demonstrate possible esophageal reflux? A) Toe-touch maneuver B) Water test C) Reverse Trendelenburg method D) Compression technique

C) Reverse Trendelenburg method pg. 470: one or more of the following procedures may be performed to detect esophageal reflux: (1) breathing exercises, (2) water test, (3) compression paddle technique, (4) toe-touch maneuver.

What is the minimum number of ribs that must be demonstrated for a unilateral rib study above the diaphragm? A) Ribs 1 through 6 B) Ribs 1 through 8 C) Ribs 1 through 9 D) All ribs must be demonstrated.

C) Ribs 1 through 9 pg. 360: states that on the upper, we should suspend on inspiration to project the diaphragm below the ninth or tenth ribs on full inspiration. pg. 368: above diaphragm - ribs 1-9 should be visualized.

During a double-contrast barium enema (BE) procedure, the radiologist suspects a polyp in the descending colon. Which position would best demonstrate this? A) Supine for AP projection B) 45° erect PA projection C) Right lateral decubitus D) Left lateral decubitus

C) Right lateral decubitus pg. 520: Note - the descending colon is located anatomically on the left side. Right lateral decubitus demonstrates polyps of the left side or air filled portions of the large intestine. Both R and L decubitus positions generally are taken with the double-contrast study. Entire large intestine is demonstrated to include air-filled left colic flexure and descending colon.

What type of breathing instructions should be given to the patient during an esophagogram using a thin barium mixture? A) Suspended respiration while continuing to swallow B) Suspended inspiration after the last swallow C) Shallow breathing and continued swallowing during exposure D) Exposure immediately after last bolus is swallowed (patient will not be breathing immediately after swallow)

C) Shallow breathing and continued swallowing during exposure pg. 478: thin barium = for complete filling of the esophagus with thin barium, the patient may have to drink through a straw, with continuous swallowing and exposure made after 3 or four swallows without suspending respiration.

Which part of the large intestine is located between the rectum and the descending colon? A) Left colic flexure B) Right colic flexure C) Sigmoid colon D) Cecum

C) Sigmoid colon

Which cranial bone articulates with all the other cranial bones? A) Parietal B) Ethmoid C) Sphenoid D) None of the above

C) Sphenoid pg. 382: because of its central location, the sphenoid articulates with all seven of the other cranial bones. The sphenoid also articulates with five facial bones.

Which sinus often produces an air/fluid level indicating a basilar skull fracture? A) Ethmoid B) Maxillary C) Sphenoid D) Frontal

C) Sphenoid pg. 396: because the sphenoid sinuses are so close to the base/floor of the cranium, sometimes pathologic processes make their presence known by their effect on these sinuses. An example is the demonstration of an air-fluid level within the sphenoid sinuses after skull trauma. This air-fluid level may provide evidence that the patient has a basal skull fracture and that either blood or CSF is leaking through the fracture into the sphenoid sinuses (sphenoid effusion)

Which sinus is projected through the oral cavity with a parietoacanthial transoral projection? A) Ethmoid B) Maxillary C) Sphenoid D) Frontal

C) Sphenoid pg. 441: ... spehnoid sinuses visualize through the open mouth

What is the joint space between the manubrium and body of sternum called? A) Sternal notch B) Costocartilage C) Sternal angle D) SC joint

C) Sternal angle pg. 356: the lower end of the manubrium joins the body of the sternum to form a palpable prominence, the sternal angle (manubriosternal joint)

What is the name of the part labeled "i" in this figure? A) Facet for the first rib B) Body C) Sternoclavicular joint D) Sternal angle

C) Sternoclavicular joint pg. 356: see figures 10. and 10.3

What is a primary function of cholecystokinin? A) Serves as an enzyme to break down certain food nutrients B) Stimulates the production of bile C) Stimulates the gallbladder to contract D) Inhibits the formation of gallstones.

C) Stimulates the gallbladder to contract pg. 447: Food stimulates the duodenal mucosa to secrete the hormone cholecystokinin (CCK). Increased levels of CCK in the blood cause the gallbladder to contract and the terminal opening of the common bile duct to relax.

Number 6 is which of the following? A) Inferior orbital fissure B) Optic foramina C) Superior orbital fissure D) Lacrimal duct

C) Superior orbital fissure pg. 399

CR centering for an esophagogram should be to the vertebral level of: A) the sternal angle. B) T3 or T4. C) T5 or T6. D) T7.

C) T5 or T6. pg. 478: position = CR is centered at level of T5 and T6 to include entire esophagus.

Which cranial bone possesses the zygomatic process? A) Frontal B) Sphenoid C) Temporal D) Ethmoid

C) Temporal pg. 380: extending anteriorly from the squamous portion of the temporal bone is an arch of bone termed the zygomatic process. This process meets the temporal process of the zygomatic bone (one of the facial bones) to form the zygomatic arch.

Which of the following statements is true about floating ribs? A) They do not possess a head B) They do not possess a costovertebral joint. C) They do not possess costocartilage. D) They are ribs 8 through 12.

C) They do not possess costocartilage. pg. 357: the last two pairs of false ribs (11 & 12) are unique in that they do not possess costocartilage. The term floating ribs can be used to designate these two pairs of ribs.

Where is the CR centered for a PA projection of the sternoclavicular joints? A) At the level of the vertebra prominens (T1) B) At the level of the sternal angle (T4-5) C) Three inches (7 cm) distal to the vertebra prominens (T2-3) D) At the level of the thyroid cartilage (T9)

C) Three inches (7 cm) distal to the vertebra prominens (T2-3) pg. 366: CR perpendicular, centered to the level of T2-T3, or 3" (7 cm) distal to the vertebrae prominens (spinous process of C7).

Why is the chin extended for an axiolateral oblique projection of the mandible? A) To open up the TMJ B) To profile the condylar process C) To prevent superimposition upon the cervical spine D) To better visualize the mentum

C) To prevent superimposition upon the cervical spine pg. 429: Extend neck slightly to prevent superimposition of the gonion over the cervical spine.

What is the position of the skull for an axiolateral projection (Schuller method) of the TMJ? A) Midsagittal plane at a 53° angle to the image receptor B) Skull rotated 15° toward the IR from the lateral position C) True lateral position D) OML is at a 37° angle to the image receptor

C) True lateral position pg. 436: Adjust head into true lateral position

Where is the CR centered for a lateral projection of the cranium? A) EAM B) Three-fourths inch (2 cm) anterior and 3/4 inch (2 cm) superior C) Two inches (5 cm) superior to EAM D) Midway between EAM and nasion

C) Two inches (5 cm) superior to EAM pg. 414: CR is perpendicular, centered 2" superior to EAM or halfway between the glabella and the inion for other types of skull morphologies.

A patient comes to radiology with a clinical history of HPS. Which of the following imaging modalities will best demonstrate this condition? A) CT B) Nuclear medicine C) Ultrasound D) Upper GI series

C) Ultrasound pg. 472: sonography has become the modality of choice in diagnosing HPS. Sonography can measure the diameter and length of the antral muscle to determine whether its larger (hypertrophic) than normal.

A patient comes to radiology for a double-contrast barium enema. The patient cannot lie on her side during the study. Which of the following projections could replace the lateral rectum projection? A) AP axial B) LPO axial projection C) Ventral decubitus D) Dorsal decubitus

C) Ventral decubitus pg. 519: alternative ventral decubitus lateral horizontal beam positions are beneficial for double-contrast studies.

Which structure is labeled 6? A) Cecum B) Sigmoid colon C) Vermiform appendix D) Iliac colon

C) Vermiform appendix pg. 490: see figure 13.8

"Chole-" is a prefix for terms pertaining to the: A) gallbladder. B) ducts. C) bile. D) liver.

C) bile. pg. 448: table 12.1 "Chole-" = prefix denoting relationship to bile

The condition flail chest is most commonly caused by: A) pneumothorax. B) emphysema. C) blunt trauma. D) congenital heart defect.

C) blunt trauma. pg. 363: flail chest - this fracture of adjacent ribs in two or more places is caused by blunt trauma and is associated with underlying pulmonary injury.

Once food enters the stomach and is mixed with gastric secretions, it is termed: A) bile. B) lipids. C) chyme. D) biologic catalysts.

C) chyme pg. 457: the stomach contents are churned or mixed with stomach fluids into a semifluid mass term chyme.

The act of swallowing is termed: A) mastication. B) digestion. C) deglutition. D) aphasia.

C) deglutition. pg. 451: the act of swallowing is termed deglutition.

The term describing a double-contrast small bowel procedure is: A) two-stage small bowel procedure. B) diagnostic intubation. C) enteroclysis. D) none of the above.

C) enteroclysis. pg. 497: box 13.3 Enteroclysis = double-contrast small bowel series

The opening between the stomach and esophagus is termed the: A) cardiac antrum. B) cardiac notch. C) esophagogastric junction. D) esophagocardiac junction.

C) esophagogastric junction. pg. 453: the opening between the esophagus and the stomach is termed the esophagogastric junction.

The cranial bone labeled i is the: (Anatomic structures are labeled i through vi and sutures a through h.) A) sphenoid. B) lacrimal. C) ethmoid. D) palatine.

C) ethmoid.

A telescoping, or invagination, of one part of the intestine into another is termed: A) diverticulosis. B) volvulus. C) intussusception. D) colitis.

C) intussusception. pg. 501: intussusception is a telescoping, or invagination, of one part of the intestine into another.

The part labeled ii is the: A) stapes. B) incus. C) malleus. D) cochlea.

C) malleus pg. 387

The term antrum of Highmore is an older term for the: A) frontal sinuses. B) ethmoid sinuses. C) maxillary sinuses. D) nasal cavity.

C) maxillary sinuses. pg. An older term for maxillary sinus is antrum, an abbreviation for antrum of Highmore.

Achalasia is generally defined as: A) difficulty in swallowing. B) a common malignancy of the esophagus. C) motor disorder of the esophagus. D) large outpouching of the esophagus.

C) motor disorder of the esophagus. pg. 466: Achalasia = also termed cardiospasm, is a motor disorder of the esophagus in which peristalsis is reduced along the distal two-thirds of the esophagus.

Part i refers to the: A) nasal sinus. B) maxillary sinus. C) nasal cavity D) upper oral cavity.

C) nasal cavity pg. 451: figure 12.15

Part iv refers to the: A) laryngopharynx. B) nasopharynx. C) oropharynx. D) posterior oral cavity.

C) oropharynx. pg. 451: figure 12.15

A congenital defect characterized by anterior protrusion of the lower sternum and xiphoid process is termed: A) pectus excavatum. B) flail chest. C) pectus carinatum. D) sternal protrusion.

C) pectus carinatum. pg. 363: pectus carinatum - this congenital defect is characterized by anterior protrusion of the lower sternum and xiphoid process. It is usually a benign condition but could lead to cardiopulmonary complications in rare cases.

There are a total of ____ fontanels in an infant. A) four B) two C) six D) eight

C) six Pg. 383: Six fontanels occur in an infant as follows: 1. anterior fontanel (bregma) 2. posterior fontanel (lambda) 3. R sphenoid fontanel (R pterion) 4. L sphenoid fontanel (L pterion) 5. R mastoid fontanel (R asterion) 6. L mastoid fontanel (L asterion)

Lipids (fats) are broken down into fatty acids and glycerol as they are digested and absorbed by the: A) stomach and small bowel. B) stomach only. C) small bowel only. D) None of the above (are not digested).

C) small bowel only. pg. 457: lipid, or fat, digestion essentially occurs only in the small bowel, although small amounts of the enzyme necessary for fat digestion are found in the stomach.

A stomach with the duodenal bulb at the level of L1-2 would be found in a(n) ____ patient. A) hyposthenic B) asthenic C) sthenic D) hypersthenic

C) sthenic pg. 458: sthenic = the dueodenal bulb is at the approximate level of L1 to L2.

The slight depression above each eyebrow is termed the: A) glabella B) supraorbital foramina C) supraorbital groove D) frontal tuberosity.

C) supraorbital groove pg. 378: the supraorbital groove is the slight depression above each eyebrow

Which of the following points is NOT true about the oblique inferosuperior (tangential) projection of the zygomatic arches? A) It requires both rotation and tilt of the skull. B) A small focal spot should be used. C) The AEC should not be used. D) A grid must be used.

D) A grid must be used. pg. 426: can be grid or non-grid

The average time to scan the large intestine during a computed tomography colonography is: A) 1 hour. B) 20 minutes. C) 30 minutes. D) 10 minutes.

D) 10 minutes. pg. 512: the scan itself takes approximately 10 minutes to complete.

How many bones make up the facial bone region? A) 6 B) 8 C) 12 D) 14

D) 14 pg. 377: the skull, or bony skeleton of the head, rests on the superior end of the vertebral column and is divided into two main sets of bones - 8 cranial bones and 14 facial bones.

What CR angle is required for the AP axial projection for the temporomandibular joints (TMJs) with the IOML perpendicular to the image receptor? A) 30° B) 37° C) 25° D) 42°

D) 42° pg. 434: angle CR 35° caudad from OML, or 42° caudad from IOML

What is the angle between the midsagittal plane and the IR for a parieto-orbital oblique projection of the optic foramen? A) 45° B) 12° C) 30° D) 53°

D) 53° pg. 428: Rotate the head 37° toward the affected side. The angle formed between the MSP and plane of IR measures 53°.

What is the recommended SID for the lateral sternum position? A) 40 inches (102 cm) B) 44 inches (113 cm) C) 46 inches (117 cm) D) 60 to 72 inches (152 to 183 cm)

D) 60 to 72 inches (152 to 183 cm) pg. 365: an SID of 40" in the minimum SID that should be used, but 60" to 72" is recommended to reduce magnification of the sternum caused by increased OID.

Which analog kV range is recommended for an AP study of the ribs found below the diaphragm? A) 85 to 90 kV B) 60 to 65 kV C) 65 to 75 kV D) 70 to 80 kV

D) 70 to 80 kV pg. 360: medium kV (analog = 70 to 80)

Where does the CR exit for the optional PA axial projection of the mandible? A) Junction of the lips B) Nasion C) Mentum D) Acanthion

D) Acanthion pg. 430: Optional PA axial CR 20° to 25° cephalad, exit at the acanthion. PA (0°) = CR exits at the junction of the lips OML Ʇ IR for both

Which of the following functions are performed by the gallbladder? A) Storage of bile B) Concentration of bile C) Contraction and release of bile D) All of the above

D) All of the above pg. 447: three primary functions of the gallbladder are (1) to store bile, (2) to concentrate bile, (3) contract when stimulated.

Which of the following technical factors do NOT apply to lateral nasal bone projections? A) The technologist should not use automatic exposure control (AEC). B) The technologist should use a small focal spot. C) The technologist should use low to medium kV. D) All of the above apply.

D) All of the above apply. pg. 408

Which of the following structures is not one of the salivary glands? A) Parotid B) Sublingual C) Submandibular D) All of the above are salivary glands.

D) All of the above are salivary glands. pg. 451: three pairs of glands secrete most of the saliva in the oral cavity. These glands are the (1) parotid, (2) submandibular, (3) sublingual.

Which of the following cranial bones does not articulate with the parietal bone? A) Frontal B) Sphenoid C) Occipital D) All of the above articulate with the parietal bone.

D) All of the above articulate with the parietal bone pg. 379: each parietal bone articulates with five cranial bones - frontal, occipital, temporal, sphenoid, and opposite parietal.

Which of the following positions is not normally considered to be part of the esophagogram basic routine? A) Posteroanterior (PA) B) Left lateral C) Right anterior oblique (RAO) D) Anteroposterior (AP)

D) Anteroposterior (AP)

An infant is brought to the ED with a possible intussusception. Which of the following procedures may actually correct this condition? A) Small bowel enema B) Small bowel series C) Defecography D) Barium or air enema

D) Barium or air enema pg. 501: intussusception - a barium enema or an air/gas enema may play a therapeutic role in re-expanding the involved bowel.

Why is the posteroanterior (PA) rather than the AP projection recommended for a small bowel series? A) Less gonadal dose for female patients B) More comfortable for patient C) Places small intestine closer to image receptor (IR) D) Better separation of loops of small intestine

D) Better separation of loops of small intestine pg. 499: the prone position is most appropriate for a small bowel series. The prone position allows abdominal compression to separate the various loops of bowel, creating a higher degree of visibility. Asthenic patients may be placed in the Trendelenburg position to separate overlapping loops of ileum.

What primary type of joint movement occurs with the temporomandibular joint? A) Plane B) Gomphosis C) Spheroidal D) Bicondylar

D) Bicondylar pg. 394: The complex TMJ is classified as a synovial type of joint ... the TMJ is classified as a bicondylar joint similar to the knee.

A patient comes in with a clinical history of a possible pituitary adenoma. Because this is a rural hospital, CT and MRI are not available. Which radiographic projection or position would best demonstrate signs of bony erosion of the sella turcica because of the tumor? A) AP axial-Towne method B) PA-Caldwell method C) Lateral position D) Both A and C

D) Both A and C pg. 402: pituitary adenomas - investigated primarily by CT or MRI. Plain radiographic images may demonstrate enlargement of the sella turcica and erosion of the dorsum sellae (AP axial-Towne & lateral).

A patient with metastatic disease in the ribs comes to radiology following a nuclear medicine scan. The radiologist orders a right, upper posterior rib study. Which of the following positioning factors should be followed for this specific study? A) Perform positions erect if the patient's condition permits. B) Exposure on full expiration. C) Include the RPO position as part of the positioning routine. D) Both A and C are correct.

D) Both A and C are correct pg. 360: Uppers - take the radiograph erect if the patient is able to stand or sit. Pg. 371: Posterior right rib study = side of interest is the posterior right aspect of the ribs. AP - puts posterior side (side of interest) closest to the IR RPO will demonstrate the axillary portion of the right ribs.

Which part of the stomach is labeled 2? A) Esophagogastric junction B) Incisura angularis C) Incisura cardiaca D) Cardiac antrum

D) Cardiac antrum pg. 454: Fig. 12.23

What type of solution is formed when barium is mixed with water? A) Water-soluble solution B) Isotonic solution C) Hypotonic solution D) Colloidal suspension

D) Colloidal suspension pg. 461: a mixture of barium sulfate and water forms a colloidal suspension.

Which of the following structures are described as scroll-like projections found in the nasal cavity? A) Perpendicular plate B) Pterygoid processes C) Septal cartilage D) Conchae

D) Conchae pg. 392: Within the nasal cavity are two plate-like, curved (or scroll-shaped) facial bones called the inferior nasal conchae. There are three pairs of nasal conchae. The superior and middle pairs are parts of the ethmoid bone, and the inferior pair consists of separate facial bones.

What is the name of the part labeled "iv"? A) Facet for the sternum attachment B) Head of the sternum C) Facet for the second rib attachment D) Costocartilage for the first rib attachment

D) Costocartilage for the first rib attachment pg. 356: see figures 10. and 10.3

A pediatric patient enters the emergency department (ED) with a small, plastic object stuck in her esophagus. PA and lateral chest radiographs fail to demonstrate the foreign body. Which of the following procedures would be most effective in demonstrating the location of the object? A) Upper GI series B) Esophagogram with the water test C) Esophagogram using very thick barium D) Esophagogram using shredded cotton soaked in barium

D) Esophagogram using shredded cotton soaked in barium pg 467: foreign bodies = radiolucent foreign bodies may required the use of additional materials and techniques for detection. Cotton may be shredded and placed in a cup of barium and then swallowed by the patient. The intent of this technique is to cause a tuft of the cotton to be caught by the radiolucent foreign body and show its location under fluoroscopy.

Which cranial bone contains the cribriform plate? A) Sphenoid B) Occipital C) Temporal D) Ethmoid

D) Ethmoid pg. 382: the smaller upper horizontal portion of the ethmoid bone, termed the cribiform plate, contains many small openings or foramina through which segmental branches of the olfactory nerves pass.

The ethmoid notch is part of which cranial bone? A) Temporal B) Ethmoid C) Sphenoid D) Frontal

D) Frontal pg. 378: each orbital plate is separated from the body by the ethmoidal notch. The ethmoid bone, one of the bones of the floor of the cranium, fits into this notch.

Which term describes the outer, lateral border of the stomach? A) Lesser curvature B) Incisura angularis C) Gastric border D) Greater curvature

D) Greater curvature pg. 454: the greater curvature is found along the lateral border of the stomach.

Which region of the biliary system is labeled 10? A) Duct of Vater B) Hepatopancreatic ampulla C) Duct of Wirsung D) Hepatopancreatic sphincter

D) Hepatopancreatic sphincter pg. 447: figures 12.5, 12.6, and 12.7

A patient comes to radiology for a sinus series on a cart (gurny). She is unable to stand or sit erect for any of the projections. Which of the following projections will best detect any air/fluid levels present in the maxillary sinuses? A) PA B) Parietoacanthial C) Parietoacanthial transoral D) Horizontal beam lateral

D) Horizontal beam lateral pg. 408: air-fluid levels in the sinuses or other cranial cavities may indicate certain pathologic conditions that are visible only in the erect position or with the use of a horizontal beam radiography.

A patient enters the emergency department (ED) with a possible basilar skull fracture. Which of the following skull projections would best demonstrate any blood present in the sphenoid sinus? A) AP with a 15° cephalic angle B) Haas method C) Submentovertex D) Horizontal beam lateral projection

D) Horizontal beam lateral projection pg. 402: Basal skull fractures - if bleeding occurs, plain radiographic images may reveal an air-fluid level in the sphenoid sinus if a horizontal ray is used for the lateral view.

Which one of the following technical considerations is most critical for demonstrating air and/or fluid levels within the cranium? A) Medium kV range B) Detail image receptor (IR) C) Short exposure time D) Horizontal x-ray beam

D) Horizontal x-ray beam pg. 408: air-fluid levels in the sinuses or other cranial cavities may indicate certain pathologic conditions that are visible only in the erect position or with the use of a horizontal beam radiography.

A radiograph of a submentovertex projection reveals that the mandible is superimposed over the ethmoid and sphenoid sinuses. Which of the following modifications will eliminate this problem? A) Perform the projection with the patient supine. B) Perform the axiolateral oblique instead of the submentovertex projection. C) Increase the flexion of the head and neck. D) Increase the extension of the head and neck.

D) Increase the extension of the head and neck. pg. 423: correct extension is indicated by the mandibular symphysis superimposing the frontal bone, and mandibular condyles projected anterior to petrous ridges.

A radiograph taken during an upper GI series demonstrates poor visibility of the gastric mucosa. The following factors were used: 80 kV, 30 mAs, and 1/40-second exposure time. Barium sulfate was used during the procedure. Which of the following factors needs to be modified during the repeat exposure? A) Use of detail-speed screens (adjust mAs accordingly) B) Shortened exposure time (increase mAs accordingly) C) Use of a water-soluble contrast medium D) Increased kV (decrease mAs as needed)

D) Increased kV (decrease mAs as needed) pg. 476: high kV of 110 to 125 is required to penetrate adequately and increase visibility of barium-filled structures. A kV les than 100 would not provide visibility of mucosa of the esophagus, stomach, or duodenum.

A radiograph of a parietoacanthial transoral (open-mouth Waters) projection reveals that the mouth is open but the sphenoid sinus is superimposed over the maxilla and upper teeth. What positioning error led to this radiographic outcome? A) Insufficient flexion of the head and neck B) Excessive CR angulation C) Insufficient CR angulation D) Insufficient extension of the head and neck

D) Insufficient extension of the head and neck pg. 441: sphenoid sinuses visualized through the open mouth

What is the primary term for the superior margin of the sternum? A) Sternal notch B) Manubrial notch C) Suprasternal notch D) Jugular notch

D) Jugular notch pg. 356: the uppermost border of the manubrium is easy to palpate and is called the jugular notch. Another secondary name for this area is the suprasternal or manubrial notch.

Which of the following upper GI projections and/or positions will best demonstrate the pylorus and duodenal bulb in profile during a double-contrast study? A) AP B) LAO C) PA D) LPO

D) LPO pg. 485: unobstructed view of duodenal bulb without superimposition of pylorus.

During a single-contrast barium enema, the radiologist detects a possible defect within the right colic flexure. Which of the following projections and/or positions best demonstrates this region of the colon? A) RPO B) LAO C) AP axial D) LPO

D) LPO pg. 517: LAO demonstrates left colic flexure (demonstrating the down-side) pg. 518: RPO demonstrates left colic flexure (demonstrating the up-side) pg. 517: RAO demonstrates right colic flexure (demonstrating the down-side) pg. 518: LPO demonstrates right colic flexure (demonstrating the up-side)

During barium enema fluoroscopy, the radiologist detects a possible defect in the right colic flexure. He asks the technologist to produce a radiograph that will best demonstrate this region of the large intestine. Which one of the following positions will accomplish this goal? A) LAO B) AP axial projection C) AP recumbent D) LPO

D) LPO pg. 517: LAO demonstrates left colic flexure (demonstrating the down-side) pg. 518: RPO demonstrates left colic flexure (demonstrating the up-side) pg. 517: RAO demonstrates right colic flexure (demonstrating the down-side) pg. 518: LPO demonstrates right colic flexure (demonstrating the up-side)

Which of the following sutures separates the parietal from the occipital bone? A) Squamosal B) Sagittal C) Coronal D) Lambdoidal

D) Lambdoidal pg. 383: posteriorly, the lambdoidal suture separates the two parietal bones from the occipital bone.

Which part of the gastrointestinal (GI) tract synthesizes and absorbs vitamins B and K? A) Ileum B) Duodenum C) Jejunum D) Large intestine

D) Large intestine pg. 493: table 13.2 Large intestine functions: some reabsorption of water, inorganic salts, vitamins B & K, and certain amino acids. Primary function is deification.

Where are the ethmoid sinuses located within the ethmoid bone? A) Perpendicular plate B) Pterygoid processes C) Cribriform plate D) Lateral masses

D) Lateral masses pg. 396: the ethmoid sinuses are contained within the lateral masses or labyrinths of the ethmoid bone.

Which of the following positions best demonstrates the left colic flexure? A) LPO B) Left lateral decubitus C) Left lateral D) Left anterior oblique (LAO)

D) Left anterior oblique (LAO) pg. 517: LAO = the left colic flexure should be seen as "open" without significant superimposition. RAO demonstrates the right colic flexure "open" without significant superimposition.

Which structure is labeled 6? A) Cystic duct B) Pancreatic duct C) Right hepatic duct D) Left hepatic duct

D) Left hepatic duct pg. 447: figures 12.5, 12.6, and 12.7

A patient comes to radiology with a clinical history of an acoustic neuroma. Which of the following imaging modalities will provide the best assessment for this tumor? A) Radiography B) Ultrasound C) Nuclear medicine D) MRI

D) MRI pg. 402: acoustic neuroma - it typically is diagnosed with the use of CT or MRI, but may be visualized on plain images in advanced cases.

Where is the CR centered for a lateral projection of the sinuses? A) Upside EAM (side away from image receptor) B) At the level of the nasion C) Midway between the acanthion and the EAM D) Midway between the outer canthus and the EAM

D) Midway between the outer canthus and the EAM pg. 437: Center CR to a point midway between outer canthus and EAM

A patient enters the ED with facial bone injuries. The physician is concerned about a possible blow-out fracture of the left orbit. Which of the following three-projection routines would best diagnose this injury? A) Parietoacanthial, lateral facial bone, and 15° PA Caldwell facial bone projections B) Parietoacanthial, lateral facial bone, and submentovertex projections C) Modified parietoacanthial, superoinferior (tangential), and lateral facial bone projections D) Modified parietoacanthial, 30° PA facial bone, and lateral facial bone projections

D) Modified parietoacanthial, 30° PA facial bone, and lateral facial bone projections Facial bone routine = lateral, parietoacanthial (waters method), PA axial (Caldwell method) pg. 419: Lateral - demonstrates orbital roofs pg. 421: PA Axial (Caldwell) - 30° caudad angle projects petrous ridges below the IOM demonstrating the orbital floors. pg. 422: modified parietoacanthial - demonstrates orbital fractures (blowout), provides a less distorted view of the orbital rims than the parietoacanthial (waters method).

Which of the following conditions, if severe, often requires a decrease adjustment of manual exposure factors? A) Osteoblastic metastases B) Osteomyelitis C) Flail chest D) None of the above

D) None of the above pg. 363 Osteoblastic metastases = proliferative bony lesions of increased density = none, or decrease of exposure factors depending on severity. Osteomyelitis = no change in exposure factors Flail chest = no change in exposure factors Osteolytic metastases = destructive lesions = none, or increase of exposure factors depending on severity.

A radiograph of a lateral cranium reveals that the mentum was cut off from the bottom of the radiograph. A 24 x 30-cm (10 x 12-inch) IR was used, and it was placed crosswise. What must be altered if a repeat exposure is performed? A) Center the CR at the EAM. B) Increase SID to reduce magnification. C) Place the 24 *30-cm (10 *12-inch) IR lengthwise. D) None of the above; all of the structures were demonstrated.

D) None of the above; all of the structures were demonstrated. pg. 414: anatomy demonstrated = entire cranium, superimposed parietal bones, entire sellae turcica, anterior & posterior clinoid processes, dorsum sellae, and clivus. IR size = 10" x 12", CW

Patient preparation for an esophagogram includes NPO _____ before the procedure. A) 4 to 6 hours B) 30 minutes to 1 hour C) 4 to 6 hours and no gum chewing or smoking D) None of the above; patient preparation is not needed as long as an upper GI series is not scheduled to follow.

D) None of the above; patient preparation is not needed as long as an upper GI series is not scheduled to follow. pg. 469: because the esophagus is empty most of the time, patient need no preparation for an esophagram unless an upper GI series is to follow.

A radiograph of a posteroanterior (PA) axial projection (Caldwell method) of the cranium reveals that the petrous ridges are located at the level of the lower one third of the orbits. The technologist performed this projection with the CR angled 15° caudal to the orbitomeatal line (OML). How must positioning be altered if a repeat exposure is performed? A) Increase the extension of the skull B) Increase the flexion of the skull C) Increase the CR angulation D) None of the above; positioning was correct.

D) None of the above; positioning was correct pg. 415: PA Axial 15° caudal angle - petrous pyramids are projected into the lower one-third of the orbits. Supraorbital margin is visualized without superimposition.

Which one of the following imaging modalities and/or procedures is very effective in detecting the Meckel diverticulum? A) CT B) Double-contrast barium enema C) Sonography D) Nuclear medicine

D) Nuclear medicine pg. 512: the use of radionuclides can assist in the diagnosis of Meckel diverticulum

Which of the following upper GI projections and/or positions will best fill the body and pylorus with barium? A) AP B) Right lateral C) Left posterior oblique (LPO) D) PA

D) PA pg. 483: PA = body and pylorus of the stomach are filled with barium.

A young female patient from the emergency department (ED) is brought to radiology for rib examination. She is able to sit up or stand for the procedure. She indicates that the region of pain is to the right anterior-to-mid axillary region. Which rib projections should be performed to minimize the effective dose to this patient? A) PA and RPO B) AP and RPO C) PA and RAO D) PA and LAO

D) PA and LAO pg. 371: Right anterior pain = side of interest is the right anterior aspect of the ribs PA puts the anterior side (side of interest) closest to the IR. Anterior injury = rotate away from the side of interest because its anterior pain, therefore patient is in a LAO position. LAO = right side anterior pain, plus rotating away from the affected side puts the patient into an LAO

A patient comes to radiology with a possible bone cyst within the squamous portion of the frontal bone. Which of the following projections would best demonstrate this region with a minimal amount of distortion of the frontal bone? A) AP axial with a 30° caudal angle to OML B) PA axial with a 30° caudal angle to OML C) PA axial with a 15° caudal angle to OML D) PA with no CR angulation to OML

D) PA with no CR angulation to OML pg. 416: PA projection, CR 0° - this projection is intended to demonstrate the frontal bone with minimal distortion.

What is the primary purpose of the membranous folds located within the cystic duct? A) Produces cholecystokinin B) Prevents gallstones from entering the gallbladder C) Provides blood supply to the gallbladder D) Prevents distention or collapse of the cystic duct

D) Prevents distention or collapse of the cystic duct pg. 447: the cystic duct is 3 to 4 cm long and contains several membranous folds along its length. These folds are called the spiral valve, which functions to prevent distention or collapse of the cystic duct.

A radiograph of a lateral projection of the facial bones reveals that the mandibular rami are not superimposed. What specific positioning error is present on this radiograph? A) Tilt B) Excessive flexion C) Excessive extension D) Rotation

D) Rotation pg. 419: rotation is evident by anterior and posterior separation of symmetric vertical bilateral structures such as the mandibular rami and greater wings of the sphenoid.

What is the term for the longitudinal mucosal folds found within the stomach? A) Gastric canal B) Valvulae conniventes C) Haustra D) Rugae

D) Rugae pg. 455: when the stomach is empty, the internal lining is thrown into numerous longitudinal mucosal folds terms rugae.

Which of the following procedures is considered as a functional study? A) Barium enema B) Enteroclysis C) Air-contrast BE D) Small bowel series

D) Small bowel series pg. 494: the purpose of the small bowel series are to study the form and function of the three components of the small bowel and o detect any abnormal conditions. Because this study also examines function of the small bowel, the procedure must be timed.

Part 7 is part of which bone? A) Ethmoid B) Lacrimal C) Zygomatic D) Sphenoid

D) Sphenoid pg. 398

What is an older term for the hepatopancreatic sphincter? A) Duodenal papilla B) Sphincter of Vater C) Duodenal sphincter D) Sphincter of Oddi

D) Sphincter of Oddi pg. 447: hepatopancreatic sphincter (Sphincter of Oddi)

What is the name of the part labeled "ii"? A) Xiphoid process B) Body C) Sternoclavicular joint D) Sternal angle

D) Sternal angle pg. 356: see figures 10. and 10.3

A patient enters the ED with a possible fracture of the right zygomatic arch. Which of the following routines would best diagnose a possible fracture of this structure? A) Submentovertex, parietoacanthial, and bilateral tangential superoinferior projections B) Parietoacanthial, parieto-orbital, and lateral facial bone projections C) Modified parietoacanthial, 15° PA Caldwell, and lateral facial bone projections D) Submentovertex, bilateral oblique inferosuperior (tangential), and AP axial projections

D) Submentovertex, bilateral oblique inferosuperior (tangential), and AP axial projections Routine Series = SMV, oblique inferosuperior (tangential), AP axial (modified Towne method) pg. 425: Submentovertex - fractures of zygomatic arches, zygomatic arches are demonstrated laterally from each other. pg. 426: Oblique Inferosuperior (Tangential) bilateral - fractures of zygomatic arches, radiographs of both sides generally are taken, single zygomatic arch free of superimposition. pg. 427: AP axial projections - fractures of zygomatic arches, bilateral zygomatic arches free of superimposition demonstrated.

At what stage of respiration should the enema tip be inserted into the rectum? A) During deep breaths B) During shallow breaths C) Suspended inspiration D) Suspended expiration

D) Suspended expiration pg. 505: because the abdominal muscles relax on expiration, the tip should be inserted during the exhalation phase of respiration.

What is the term for the three bands of muscle that pull the large intestine into pouches? A) Haustra B) Valvulae conniventes C) Suspensory ligaments D) Taenia coli

D) Taenia coli pg. 491: the muscular portion of the intestinal wall contains three external bands of longitudinal muscle fibers of the large bowel that form three bands of muscle called taenia coli, which tend to pull the large intestine into pouches (haustrum).

Which of the imaging modalities or procedures is most effective and preferred in diagnosing HPS? A) Nuclear medicine B) CT C) Upper GI series D) Ultrasound

D) Ultrasound pg. 472: hypertrophic pyloric stenosis (HPS) is the most common gastric obstruction in infants ... Sonography has become the modality of choice in diagnosing (HPS).

Which of the following techniques is most effective in preventing lung markings from obscuring the sternum on an oblique projection? A) Use a high kV. B) Oblique as much as needed to not superimpose the sternum over the hilum region. C) Decrease the source image receptor distance (SID) to magnify the sternum. D) Use an orthostatic (breathing) technique.

D) Use an orthostatic (breathing) technique. pg. 359: a breathing technique may be used for radiographic examination of the sternum. A breathing technique involves the patient taking shallow breaths during the exposure. This technique is also referred to as an orthostatic technique. If performed properly, the lung markings overlying the sternum will become obscured, whereas the image of the sternum will remain sharp and well defined.

A large outpouching of the proximal esophagus above the upper esophageal sphincter is termed: A) Barrett esophagus. B) esophageal varices. C) esophageal reflux. D) Zenker diverticulum.

D) Zenker diverticulum. pg. 467: Zenker diverticulum = characterized by a large outpouching of the esophagus just above the upper esophageal sphincter.

Where is the CR centered for a lateral projection of the facial bones? A) Outer canthus B) Acanthion C) Midway between the glabella and the EAM D) Zygoma, midway between the EAM and the outer canthus

D) Zygoma, midway between the EAM and the outer canthus pg. 419: center CR to zygoma, midway between outer canthus and EAM.

Which bone is involved with a tripod fracture? A) Maxilla B) Ethmoid C) Temporal D) Zygomatic

D) Zygomatic pg. 404: a tripod fracture is caused by a blow to the cheek, resulting in fracture of the zygoma in three places (orbital process, maxillary process, and arch).

The upper and lower teeth are embedded in the: A) symphysis menti. B) condyloid processes. C) palatine processes. D) alveolar processes.

D) alveolar processes. pg. 390: the alveolar process is the inferior aspect of the body of each maxilla. Eight upper teeth occur along the inferior margin of each alveolar process. pg. 393: the lower teeth are rooted in the mandible. An alveolar process extends along the entire superior portion of the body of the mandible.

The "stovepipe" radiographic sign is often seen with: A) volvulus. B) intussusception. C) neoplasm. D) chronic ulcerative colitis.

D) chronic ulcerative colitis. pg. 500: ulcerative colitis = patients with long-term bouts of ulcerative colitis may develop "stovepipe" colon, in which haustral marking and flexures are absent.

A fracture involving the facial bones where a blow to one side causes a fracture to the opposite side is termed a ____ fracture. A) tripod B) blow-out C) Le Fort D) contrecoup

D) contrecoup pg. 404: a contrecoup fracture is a fracture to one side of a structure that is caused by an impact on the opposite side.

The most common radiographic sign for secondary osteomyelitis of the paranasal sinuses is: A) polyps. B) mucosal thickening. C) deviation of the bony nasal septum. D) erosion of the bony margins.

D) erosion of the bony margins. pg. 404: secondary osteomyelitis - results in erosion of the bony margins of the sinus.

The CR must be placed parallel to the ____ positioning line for the superoinferior (tangential) projection of nasal bones. A) glabellomeatal B) mentomeatal C) lips-meatal D) glabelloalveolar

D) glabelloalveolar pg. 424: center CR to nasion and angle as needed to ensure that it is parallel to GAL

A high and transverse stomach would be found in a(n) ____ patient. A) hyposthenic B) asthenic C) sthenic D) hypersthenic

D) hypersthenic pg. 458: the stomach is very high and assumes a transverse position.

Which procedure should be performed for the lateral projection of the sternum? A) rotate the shoulders forward B) ask the patient to take slow, shallow breaths C) raise both arms and rest forearms on top of the head D) increase the source-to-image receptor distance to 72"

D) increase the source-to-image receptor distance to 72" pg. 365: - Shoulders and arms drawn back - Suspend respiration on inspiration - SID of 60" to 70" is recommended to reduce magnification of the sternum caused by increased OID.

Part v refers to the: A) nasopharynx. B) larynx. C) oropharynx. D) laryngopharynx.

D) laryngopharynx. pg. 451: figure 12.15

When using computed radiography (CR), inadequate kV or mAs will produce a ____ image. A) dark B) light C) blurry D) mottled

D) mottled pg. 476: inadequate kV or mAs produces a "mottled" image.

The structure labeled "iii" is the costocartilage: A) of the tenth rib. B) portion of the first false rib. C) of the last true rib. D) of the sixth rib.

D) of the sixth rib pg. 356: see figures 10. and 10.3

The aditus is defined as a(n): A) large chamber containing the mastoid air cells. B) thin plate of bone separating the mastoid air cells from the brain. C) passageway for the auditory nerve. D) opening between the epitympanic recess and the mastoid air cells.

D) opening between the epitympanic recess and the mastoid air cells. pg. 386: The aditus is the opening between the epitympanic recess and the mastoid portion of the temporal bone

The sutural point or area labeled e is the: (Anatomic structures are labeled i through vi and sutures a through h.) A) lambda. B) asterion. C) bregma. D) pterion.

D) pterion

Match each of the following radiographic appearances with the corresponding pathologic indication. (Use each selection only once.) - Radiolucent areas within the bony cranium a. Multiple myeloma b. Paget's disease c. Metastases d. Pituitary adenoma

a. Multiple myeloma pg. 403: Multiple myeloma - osteolytic (radiolucent) areas scattered throughout the skull.

MATCHING Select the imaging modality that would best demonstrate the following pathologies. - Early detection of metastases a. Nuclear medicine b. MRI c. CT d. Ultrasound e. Conventional radiography

a. Nuclear medicine pg. 412: NM provides a senesitive screening procedure (radionuclide bone scan) for detection of skeletal metastases.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Chronic inflammatory disease of the GI tract a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

f. Regional enteritis (Crohn's disease) pg. 494: Regional enteritis (Crohn's disease) = a form of inflammatory bowel disease of unknown origin ... in advance cases segments of the intestine become narrowed as the result of chronic spasm ... this disorder has a high rate of reoccurrence after treatment.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Common parasitic infection of the small intestine a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

g. Giardiasis pg. 495: Giardiasis = a common infection of the lumen of the small intestine that is caused by the flagellate protozoan Giardia lambila.

MATCHING Match each of the definitions or descriptions with the corresponding pathologic indication for the small bowel series. (Use each option only once.) - Obstruction of the small intestine due to the cessation of peristalsis a. Ileus b. Neoplasm c. Meckel diverticulum d. Malabsorption syndrome (sprue) e. Enteritis f. Regional enteritis (Crohn's disease) g. Giardiasis h. Adynamic or paralytic ileus

h. Adynamic or paralytic ileus pg. Adynamic (paralytic ileus) = ileus due to the cessation of peristalsis.

MATCHING Match each radiographic appearance or description with the corresponding disease or condition.(Use each selection only once.) -Irregular filling defect within the stomach a. Ulcers b. Hiatal hernia c. Achalasia (cardiospasm) d. Zenker diverticulum e. Schatzki ring f. Gastritis g. Esophageal varices h. Gastric carcinoma

h. Gastric carcinoma pg. 471: Gastric carcinoma = radiographic signs include a large, irregular filling defect within the stomach...