RADR 1311 Final Positioning
How much CR angle is generally needed for an AP supine or semi-erect projection of the chest?
5°
32. The affected arm should not be abducted for an AP scapula projection. True False
False
45. A posterior dislocation of the shoulder occurs more frequently than an anterior dislocation. True False
False
91. T/F the radiographic criteria for a true lateral finger indicate equal concavity of the anterior and posterior aspects of the phalanges
False
62. a radiograph of the elbow demonstrate the radius directly superimposed over the ulna and the coronoid process in profile. WHich projection of the elbow has been performed
lateral
55. The proximal radius and ulna are seen of superimposition in the following projection
lateral oblique elbow
PA or AP oblique projections are aligned on the monitor with the patient's right side of the body facing the viewer's right. t/f
False
The AP abdomen for the obese patient often requires two separate exposures with the IR placed portrait. True False
False
When viewing a Carpal Canal projection, the metacarpals are superimposed over the carpal bones. What error caused this to occur?
Hand not hyperextended enough/Not enough CR angle
106. Motion of the patient's diaphragm can be stopped by providing proper breathing instructions. t/f
T
Gonadal shielding may be used with male patients for the AP supine abdomen projection. True False
True
The CR is centered to midsternum for the AP apical lordotic projection with a 14- × 17-inch (35- × 43-cm) image receptor (IR). True False
True
Where should the top of the IR be placed for a routine PA projection of the chest on an average sized patient?
1.5-2 inches above the shoulders
71. Grids are generally not required unless the anatomy measures greater than _____ cm in thickness.
10
A well-inspired healthy adult chest PA projection will have a minimum of ____ posterior ribs seen above the diaphragm.
10
A well-inspired healthy adult chest PA projection will have a minimum of ____ posterior ribs seen above the diaphragm. 8 7 10 12
10
At what level should the central ray (CR) be placed for a left lateral decubitus projection of the abdomen? Iliac crest 2 inches (5 cm) above iliac crest ASIS Umbilicus
2 inches (5 cm) above iliac crest
What CR centering should be used for a dorsal decubitus projection of the abdomen (if the diaphragm is to be included)? At level of umbilicus 2 inches (5 cm) above iliac crest At level of iliac crest Place bottom of image receptor at level of ASIS.
2 inches (5 cm) above iliac crest
6. How much CR angulation is required for an asthenic patient for an AP axial projection of the clavicle? 15 degrees 30 degrees 45 degrees No CR angulation should be used for this projection
30 degrees
What is the CR angle & direction for the Gaynor Hart method? (2 answers)
25-30 deg. proximally
65. how much CR angulation to the long axis of the hand is required for the tangential, inferosuperior projection to demonstrate the carpal sulcus (canal)
25-30 degress
49. What type of CR angle is required for the Lawrence method? 15°-20° medially 25°-30° caudal 25°-30° medially 15°-20° caudal
25°-30° medially
The central ray (CR) for an anteroposterior (AP) supine, adult chest projection, should be centered:
3 to 4 inches (8 to 10 cm) below the jugular notch.
The central ray (CR) for an anteroposterior (AP) supine, adult chest projection, should be centered: to the level of T4. 3 to 4 inches (8 to 10 cm) below the jugular notch. at the vertebra prominens. at the xiphoid process.
3 to 4 inches (8 to 10 cm) below the jugular notch.
107. Which of the following kVp ranges (digital system) is recommended for a KUB on an adult? 50 to 60 kVp 70 +/- 5 kVp 80 +/- 5 kVp 110 to 120 kVp
80 +/- 5 kVp
66.how much and which way should the Cr be angled to best visualize the coronoid process when performing a coyle method of the elbow
80 degree flexion with the Cr angled 45 degree away from the shoulder
What is a common palpable landmark for the AP chest projection on the bariatric (obese) patient?
Jugular notch
What must be done to the arm of the patient when positioning the AP projection of the scapula? (2 answers)
Abduct 90 degees/supinate the hand
48. Identify the structure labeled "B". Lesser tubercle Greater tubercle Humeral Neck Acromion Process
Greater tubercle
What tubercle is in profile on an AP projection of the humerus?
Greater tubercle
Which type of body habitus typically requires that the image receptor be placed landscape rather than portrait for a posteroanterior (PA) chest? Hypersthenic Asthenic Sthenic Hyposthenic
Hypersthenic
When viewing a lateral projection of the scapula, the vertebral border of the scapula is superimposed over the ribs. What was the positioning error? (Be Specific)
Insufficient oblique ; less than 45° oblique
67. This projection is correctly referred to as carpal canal, inferosuperior proj carpal tunnel, inferosuperior proj Gaynor-hart Method all of the above
all of the above
An upright position with the arms abducted, palms forward, and head forward describes the _____ position.
anatomic
A patient enters the emergency department with trauma to the 4th digit. What routine projections of the hand should be performed?
PA; PA oblique w/lateral rotation; lateromedial
50. Which projection of the shoulder requires that the patient be rotated 45 to 60 degrees toward the IR from a PA position? Inferosuperior axiolateral projection AP oblique projection PA oblique None of the options
PA oblique
What projection of the thumb is naturally achieved by pronating the hand and placing the palmar surface on the IR?
PA oblique
73. A patient comes to the ED with trauma of the 5th digit. What routine projection should be done for the 5th digit
PA; PA oblique w/ lateral rotation, lateromedial
Which term describes lying down in any position? Horizontal Reverse Trendelenburg Recumbent Anatomic
Recumbent
14. A radiograph of an AP clavicle reveals that the sternal extremity is partially collimated off. What should the technologist do? Repeat the AP projection and correct collimation. Make sure the sternal extremity is included on the AP axial projection. Only repeat it if the patient's pain/symptoms involve the sternal extremity. Ask the radiologist whether he or she wants the projection repeated.
Repeat the AP projection and correct collimation.
A radiograph of a PA projection of the hand reveals that the distal radius and ulna and the carpals were cut off. What should the technologist do to correct this problem?
Repeat the PA projection to include all the carpals and about 1 inch (2.5 cm) of the distal radius and ulna.
A dorsal decubitus abdomen is ordered on a patient. The patient is placed on his back on a cart. The CR will enter the left side of the patient with the patient's right side against the image receptor. What type(s) of marker(s) should be used? Right and decubitus markers. Left and decubitus markers. Write "dorsal decubitus" on image after processing. Do not use any right or left markers, only a decubitus.
Right and decubitus markers.
A patient enters the ED with a possible pneumothorax in the left lung. Because of trauma, the patient cannot stand or sit erect. Which of the following positions would best demonstrate this condition? AP supine Right lateral decubitus Left posterior oblique (LPO) and right posterior oblique (RPO) Left lateral decubitus
Right lateral decubitus
How should the hand be positioned for an AP projection of the forearm?
Supinated
37. When viewing an AP projection of the shoulder w/internal rotation, the lesser tubercle is superimposed over the humeral head and the greater tubercle is in profile laterally. What was the error if any? Your Answer:
They performed an ap shoulder with external rotation and not a ap shoulder with internal rotation.
31. An orthostatic (breathing) technique may be performed for the AP projection of the scapula. True False
True
The most common type of involuntary motion in the abdomen is peristalsis. True False
True
When performing the lateral projection of the upper airway, exposure should be made during a slow, deep inspiration rather than at the end of the inspiration. True False
True
A patient enters the emergency department (ED) with a piece of wire in the palm of the hand. What is the minimum number of projections required to be taken for this radiographic study?
Two
What is the minimal number of projections taken for a postreduction (to realign a fracture) study of the ankle?
Two
What is the minimal number of projections taken for a study of the femur? One Two
Two
What are the breathing instructions for all routine projections of the chest?
hold breath after 2nd complete inspiration
Where is the CR centered for all routine projections of the wrist?
midcarpal
A longitudinal plane that divides the body into equal anterior and posterior parts is the _____ plane.
midcoronal
43. The AP humerus requires that the humeral epicondyles are _____ to the IR. set at a 45-degree angle parallel perpendicular slightly oblique
parallel
53. A general positioning rule is to place the long axis of the part ____ to the long axis of the image receptor
parallel
How should the interepicondylar line of the distal humerus be in relation to the IR for an AP projection of the humerus?
parallel
The radiographic term projection is defined as:
path or direction of the central ray
When viewing a routine PA projection of the chest, the space of the right sternoclavicular joint is decreased when compared to the left. What specific positioning error was made? Correct!
patient is in a slight RAO position
76. How should the humeral epicondyles be aligned for a lateral projection of the elbow?
perpendicular to IR
The CR for an AP supine chest should be aligned: perpendicular to the long axis of sternum. at the level of the jugular notch. at the level of the xiphoid process. perpendicular to the long axis of the clavicles.
perpendicular to the long axis of sternum.
77. Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?
phalanges
What longitudinal body plane is perpendicular to the IR on an AP/PA projection of the chest?
saggital plane
Why should the hand be slightly arched on a PA projection of the wrist?Why should the hand be slightly arched on a PA projection of the wrist?
to bring the carpals closer to the IR/reduce OID
93. what is the purpose of performing the AP partially flexed projections of the elbow
to provide an AP perspective if the patient cannot fully extend the elbow
58. what routine projection of the elbow demonstrate an elevated or visible posterior fat pad
true lateral with 90 degree flexion
Movement in the form of a circle is the definition for:
circumduction.
What part of the anatomy should be used to evaluate for rotation when viewing an AP/PA projection of the chest?
clavicles
Where is the CR centered for a lateral projection of the hand?
2nd MCP
5. Which alternative landmark can be palpated if unable to locate the coracoid process for the shoulder projection for the obese shoulder? Inferior angle of scapula Greater tubercle of humerus AC joint Lesser tubercle of humerus
AC joint
78. which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces
AP
Where is the Central Ray centered for an AP projection of the thumb?
1st MCP
What is the degree of elevation of the hand when positioning for a Modified Stecher of the wrist?
20 deg.
88. how much and which way should the CR be angled for a stecher method of the wrist
20 degree proximally
How much and which way should the CR be angled for a PA axial projection of the clavicle on a sthenic patient? (2 answers)
20°-25° caudal
24. What medial central ray (CR) angle is required for the inferosuperior (transaxially) shoulder (Lawrence method)? 5 to 10 degrees 40 to 45 degrees 25 to 30 degrees 10 to 15 degrees
25 to 30 degrees
98. demonstration of the posterior fat pad on the lateral projection of the adult elbow can be caused by 1. trauma or other pathology 2. greater than 90 flexion 3. insufficient flexion
1 and 3
What can be done if the patient cannot move the unaffected arm to avoid superimposition for a transthoracic projection of the humerus? (Be Specific)
Angle CR 10°-15° cephalad
19. A patient enters the ED with a dislocated shoulder. The technologist attempts to position the patient into the transthoracic lateral projection, but the patient is unable to raise the unaffected arm over his head completely. What can the technologist do to compensate for the patient's inability to raise his arm completely? Perform the Grashey method instead. Use a breathing technique. Increase kVp to penetrate through both shoulders. Angle the CR 10- to 15-degree cephalad.
Angle the CR 10- to 15-degree cephalad.
7. How much and which way should the CR be angled to view the supraspinatus outlet on a Neer Method projection of the shoulder? (2 answers)
CR angle 10-15 caudad
A patient comes to radiology with a clinical history of an umbilical hernia. Which one of the following abdomen projections would best demonstrate it? AP erect abdomen Left lateral decubitus KUB Dorsal decubitus
Dorsal decubitus
A patient is erect facing the image receptor. The left side of the body is turned 45 degrees toward the image receptor. The CR enters the posterior aspect of the body and exits the anterior. What is this radiographic position?
LAO
105. Which of the following muscles should be demonstrated on a properly exposed abdomen projection on an average-size patient? Latissimus dorsi Erector spinae Psoas major Quadratus lumborum
Psoas major
What specific parts of the anatomy can be used to evaluate for rotation of the digits on PA projections?
The concavity of the shaft of the phalanges and soft tissues
17. When viewing a PA axial projection of the clavicle, the lateral portion of the clavicle is superimposed over the superior angle of the scapula on an asthenic patient. What was the error? (Be specific) Your Answer:
The cr is not angle at 30 caudal
68. a radiograph of an ap projection of the elbow reveals that there is complete separation of the proximal radius and ulna. what positioning error has been commited
excessive lateral rotation
30. The line between what 2 points of the scapula should be perpendicular to the IR for a true lateral projection of the scapula? (2 answers) Your Answer:
the superior angle of the scapula and ac joint
4. A radiograph of a transthoracic lateral projection reveals that it is difficult to visualize the proximal humerus due to the ribs and lung markings. The following analog exposure factors were used: 75 kVp, 30 mAs, 40-inch (100-cm) SID, grid, and suspended respiration. Which of the following changes will improve the visibility of the proximal humerus? Make the exposure on second inspiration. Use a compression band to prevent patient movement. Use a 72-inch (180-cm) SID. Use an orthostatic (breathing) technique.
use an orthostatic (breathing) technique.
64. Which of the following apply to the lateral elbow projection 1. Cr is directed 1.5 inches medial to posterior surface of olecranon process 2. Elbow should be flexed 90 3. radial head should be free of superimpostion
1 and 2 only
79. a patient unable to extend their arm is seated at the end of the x-ray table, elbow flexed 90, hand pronated. the cr is directed 45 toward the shoulder. which of the following structure will be demonstrated best 1. radial head 2. coronoid process 3. capitulum
1 and 3
82. what structures should be included when collimating for an ap projection of the forearm 1. distal humerus 2. distal metacarpal 3. elbow and wrist joints
1 and 3
28. Which of the following apply to the above projection. 1. Requires a 90° abduction of the affected arm 2. CR centered to scapulohumeral joint 3. Hand should be supinated
1 and 3 only
47. Where is the CR centered for the bilateral acromioclavicular (AC) joint projection on a single 14- × 17-inch (35- × 43-cm) image receptor? At the affected AC joint 1 inch (2.5 cm) above the jugular notch At the level of the thyroid cartilage At the sternal angle
1 inch (2.5 cm) above the jugular notch
Which of the following are reasons for performing chest projections in an upright position? 1. Provides proper visualization of air-fluid levels 2. Prevents engorgement of pulmonary vessels 3. Allows lungs to fully aerate during inspiration
1, 2 and 3
16. Which of the following apply to the AP shoulder projection w/internal rotation? 1. Interepicondylar line should be perpendicular to the IR 2. The lesser tubercle should be in profile medially 3. CR should be centered 1 inch inferior to the coracoid process 1 only 2 only 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3
1, 2, and 3
What is the CR angle and direction for PA axial Scaphoid projection of the wrist w/ulnar deviation? (2 answers)
10-15 deg. Proximally
What type of CR angle is required for the AP axial (alternative lordotic) projection for the lung apices? None. CR is perpendicular to IR. 10- to 15-degree caudad. 15- to 20-degree cephalad. 25- to 35-degree caudad.
15- to 20-degree cephalad.
How much and which way should the CR be angled for an AP axial projection of the clavicle on a hypersthenic patient? (2 answers)
15°-20° cephalad
94. what structures are best demonstrated for an AP oblique w/ medial rotation of the elbow 1. radial head 2. coronoid process 3. trochlea
2 and 3
21. Which of the following apply to the above projection? another scapula Y 1. Requires a 60° anterior oblique of the patient 2. Best demonstrates the body of the scapula 3. Requires a 45° anterior oblique of the patient
2 and 3 only
How can you locate the scaphoid on the wrist for accurate centering of the CR?
2 cm (3/4 in.) distal and medial to radial styloid process
Where is the CR centered for the AP erect projection of the abdomen? Level of iliac crest Xiphoid process 2 inches (5 cm) above iliac crest 2 inches (5 cm) below iliac crest
2 inches (5 cm) above iliac crest
9. Where is the CR centered for the AP oblique (Grashey method) position for the glenoid cavity? Acromion 2 inches (5 cm) medial and inferior to the superolateral border of shoulder Coracoid process 1-inch (2.5-cm) superior to the coracoid process
2 inches (5 cm) medial and inferior to the superolateral border of shoulder
How can you locate the exact centering point for the CR on an AP projection of the scapula? (Be specific)
2 inches inferior to the coracoid process & 2 inches medial from lateral border of patient
How can you locate the exact centering point for the CR on a Carpal Canal projection of the wrist? (Be specific)
2-3 cm. or (1 in.) distal to base of 3rd metacarpal
96. This projection is perform to rule out: 1. median nerve impingement 2. calcification in carpal sulcus 3. carpal tunnel syndrom 4. all
4
How much and in which way should the wrist be turned for an oblique projection of the wrist? (2 answers)
45 deg. Laterally
59. how much rotation of the humeral epicondyles is require for the AP medial oblique projection of the elbow
45 degree
89. From a pronated position, which of the following is required for a PA oblique projection of the fourth digit of the hand?
45 degree lateral rotation
Which direction and how much should you rotate the hand for a PA oblique projection of the hand?
45° laterally
Which way and how much should the hand be rotated for an oblique projection of the 5th digit?
45° laterally
What is the kVp range for all projections of the fingers?
55-65
How much oblique is needed when positioning the patient for lateral projection of the scapula when the acromion process is the area of interest?
60°
For an average-size female patient, where is the CR placed for a PA projection of the chest? 7 inches (18 cm) below the vertebra prominens 3 inches (7.6 cm) below the jugular notch 8 inches (20 cm) below the vertebra prominens 2 inches (5 cm) above the shoulders
7 inches (18 cm) below the vertebra prominens
For an average-size female patient, where is the CR placed for a PA projection of the chest? Correct!
7 inches (18 cm) below the vertebra prominens
Which of the following factors must be applied to minimize distortion of the heart? 72-inch (180-cm) SID High-kVp technique Performing study recumbent Using high mA and short exposure time
72-inch (180-cm) SID
What is the recommended kVp range for adult upper airway projections? 50 to 65 kVp 110 to 120 kVp 75 to 85 kVp 90 to 100 kVp
75 to 85 kVp
How much is the elbow flexed for a lateral projection of the forearm?
90
20. Identify the above projection. you need to know the different between AP clavicle and Ap axial Clavicle AP Clavicle AP Acromioclavicular Joints AP Axial Clavicle AP Shoulder w/internal rotation
AP Axial Clavicle
26Which specific projection of the shoulder would best demonstrate a Bankart lesion? AP Humerus AP Oblique Shoulder AP shoulder w/external rotation Inferosuperior axial projection of the shoulder
AP Oblique Shoulder
A patient comes to radiology with a clinical history of pneumoperitoneum. The patient is able to stand and lie recumbent. Which one of the following projections will best demonstrate the severity of this condition? AP KUB AP erect abdomen Right lateral decubitus Dorsal decubitus
AP erect abdomen
104. A patient comes to radiology with a possible mass beneath the right clavicle. The PA and left lateral projections are inconclusive. Which additional projection/position can be taken to demonstrate this possible mass? AP erect Right lateral AP and lateral of upper airway AP lordotic
AP lordotic
11. A patient enters the ED with severe trauma to the proximal humerus. The attending physician requests projections of the humerus. Which series should be done to obtain the AP and Lateral projections of the humerus? AP and rotational Lateral Projections AP neutral and rotational lateral projections AP neutral and transthoracic projections AP w/external rotation and transthoracic lateral projection
AP neutral and transthoracic projections
22. A patient enters the ED with multiple injuries including a possible fracture of the left proximal humerus. Which positioning rotation should be performed first to determine what series should be done? AP neutral shoulder rotation AP internal rotation Transthoracic Lateral AP external rotation
AP neutral shoulder rotation
10. Identify the above projection of the shoulder. AP w/external rotation AP w/internal rotation AP oblique AP neutral
AP oblique
72. which routine projection of the elbow best demonstrate the radial head and tuberosity free of superimposition
AP oblique with external rotation
29. A patient enters the ED with multiple injuries. The physician is concerned about a dislocation of the left proximal humerus. The patient is unable to stand and is on a backboard. Which of the following routines is advisable to best demonstrate this condition? AP shoulder and inferosuperior axial projection AP shoulder and 35- to 45-degree AP oblique (Grashey method) AP shoulder and Neer projection AP shoulder and recumbent AP oblique (scapular Y) projection
AP shoulder and recumbent AP oblique (scapular Y) projection
23. Identify the projection in the above radiograph. You can see the greater tubercle laterally Grashey method AP shoulder w/internal rotation AP shoulder w/external rotation AP shoulder neutral
AP shoulder w/external rotation
Which positioning line must be placed perpendicular to the plane of the IR for an AP projection of the upper airway? Mentomeatal Midcoronal Acanthiomeatal Orbitomeatal
Acanthiomeatal
39. A radiograph of an AP oblique (Grashey method) projection for the glenoid cavity reveals that the anterior and posterior rims of the glenoid process are not superimposed. Which of the following modifications should produce a more acceptable image? Angle CR 5- to 10-degree caudad. Angle CR 5- to 10-degree cephalad. Adjust rotation of the body toward the IR. Abduct the arm slightly.
Adjust rotation of the body toward the IR.
103. Why is the left lateral decubitus preferred over the right lateral decubitus abdomen for an acute abdomen series? It is more comfortable for the patient. Any intraperitoneal air will be visualized along the spleen. Any intraperitoneal air will be visualized along the lower liver margin. It allows any gas in the large intestine to move toward the liver.
Any intraperitoneal air will be visualized along the lower liver margin.
How should the arm of the patient be positioned for a lateral scapula if the body of the scapula is the area of interest?
Arm across the chest grasping opposite shoulder
Where is the CR centered for a PA projection of the hand?
At the third metacarpophalangeal joint
What type of projection is created with the CR directed along or parallel to the long axis of a structure or anatomic part? Axial Tangential Lordotic Transthoracic
Axial
36. A patient comes to the emergency department (ED) with a possible right AC joint separation. Right clavicle and AC joint examinations are ordered. The clavicle is taken first, and a small linear fracture of the midshaft of the clavicle is discovered. What should the technologist do in this situation? Perform the weight-bearing phase as ordered. Reduce the amount of weight that would normally be given to the patient and perform the weight-bearing study. Consult with the ED physician before continuing with the AC joint study. Slowly give the patient more weight to hold until he begins to complain and then complete the AC joint study.
Consult with the ED physician before continuing with the AC joint study.
44. Identify the structure labeled D. J Acromion Process Lesser Tubercle Greater Tubercle Coracoid Process
Coracoid Process
74. A patient enters the ED with an elbow injury. The partially flexed AP and lateral positions reveal a possible fracture of the coronoid process. The patient's elbow is partially flexed and he refuses to extend it farther. which one of the following positions/projections should be performed to confirm the fracture of the coronoid process
Coyle method with 80 degree flexion, Cr angled 45 degree away from the shoulder
A 16-year-old female patient enters the emergency department (ED) with a possible kidney stone. She complains of pain in the right lower pelvis region. Which of the following options should be taken in regard to gonadal shielding? Do not use it. Use it on all projections if correctly placed. Use it on the preliminary projection only. Ask the patient or her parents for their permission to not shield the gonads.
Do not use it.
A patient is lying on her back. The x-ray tube is horizontally directed with the CR entering the right side of the body. The image receptor is adjacent to the left side of the body. What is the radiographic position?
Dorsal decubitus
Which term describes the back or posterior aspect of the hand?
Dorsum manus
52. which of the following best demonstrates the radial head using the trauma lateral Coyle method routine
Elbow flexed 90 degrees, Cr angled 45 toward shoulder
What structures need to be on the same plane when positioning the patient for projections of the elbow or wrist?
Elbow, Wrist, Shoulder joints
102. A patient enters the ED with a possible hemothorax in the right lung. With assistance, the patient can sit erect on a cart. Which of the following routines would best demonstrate this condition? Erect PA and erect right lateral on cart Right lateral decubitus Left lateral decubitus RPO and LAO erect
Erect PA and erect right lateral on cart
A radiograph of a PA oblique of the hand reveals that the midshaft of the fourth and fifth metacarpals is superimposed. What specific positioning error has been committed?
Excessive rotation of the hand and/or wrist laterally
What type of respiration should be employed prior to exposure for the anteroposterior (AP) kidneys, ureter, and bladder (KUB) abdomen projection? Inspiration Expiration Shallow breathing during exposure Either inspiration or expiration
Expiration
34. For an AP oblique (Grashey method) projection of the shoulder, the CR is centered to the acromion. True False
F
It is legally acceptable to annotate "right" or "left" on a digital image if the anatomic side marker is not visible. t/f
F
1. Which of the following shoulder projections best demonstrates the glenoid cavity in profile? Grashey method Clements modification Garth method AP shoulder, neutral rotation
Grashey method
Which of the following objects does NOT have to be removed or moved before a chest radiography?
Hearing aids
Which of the following objects does NOT have to be removed or moved before a chest radiography? Necklace Bra T-shirt Hearing aids
Hearing aids
38. A patient enters the ED with a midshaft humeral fracture. The AP projection taken on the cart demonstrates another fracture near the surgical neck of the humerus. The patient is unable to stand or rotate the humerus because of the extent of the trauma. What other projection should be taken for this patient? Scapular Y lateral—AP oblique projection Apical oblique projection Horizontal beam transthoracic lateral projection for humerus Rotational lateral projection for humerus
Horizontal beam transthoracic lateral projection for humerus
42. A radiograph of a PA oblique (scapular Y) lateral position reveals that the scapula is slightly rotated (the vertebral and axillary borders are not superimposed). The axillary border of the scapula is determined to be more lateral compared with the vertebral border. Which of the following modifications should be made for the repeat exposure? Decrease rotation of affected side of thorax (away from the IR). Decrease CR angle. Increase rotation of affected side of thorax (toward the IR). Abduct the arm more and flex it at the elbow.
Increase rotation of affected side of thorax (toward the IR).
3. A radiograph of an PA axial projection of the clavicle demonstrates that the clavicle is superimposed over the scapular spine. What should the technologist do to correct this error? Do nothing; this is an acceptable AP axial clavicle projection. Increase the caudad CR angle during repeat exposure. Increase the cephalic CR angle during repeat exposure. Make the exposure upon complete inspiration.
Increase the caudad CR angle during repeat exposure.
What is the primary disadvantage of performing an AP projection of the chest rather than a PA? More radiation exposure to the lungs Distortion of the ribs Increased magnification of the heart
Increased magnification of the heart
41. Which one of the following projections/positions should NOT be performed for a possible shoulder dislocation? AP neutral shoulder rotation Transthoracic lateral Inferosuperior axial (Lawrence Method) Scapular Y projection
Inferosuperior axial (Lawrence Method)
25. Which of the following AP shoulder projections demonstrates the lesser tubercle in profile medially? External rotation Internal rotation Neutral rotation None of the options
Internal rotation
13. Which rotation of the humerus will result in a lateral position of the proximal humerus? Internal rotation (epicondyles perpendicular to image receptor) Neutral rotation (epicondyles 45 degrees to the image receptor) External rotation (epicondyles parallel to the image receptor) None of the options
Internal rotation (epicondyles perpendicular to image receptor)
What should be done to the hand and wrist when positioning the Tangential, Inferosuperior projection of the wrist to avoid superimposition of the pisiform and hamate?
Internally rotate 10 deg.
A patient comes to radiology with possible bleeding within the abdomen. The patient is unable to stand or sit for any projections. Which of the following projections would be most effective in demonstrating fluid within the abdomen for this patient? AP KUB AP supine chest Right lateral dorsal decubitus Left lateral decubitus
Left lateral decubitus
A patient is in the intensive care unit after abdominal surgery. The surgeon is concerned about a possible perforated bowel. The patient cannot stand or sit. Which of the following positions will best demonstrate any possible intra-abdominal free air? Right lateral decubitus Dorsal decubitus Left lateral decubitus
Left lateral decubitus
A patient is in the intensive care unit with multiple injuries. The attending physician is concerned about a pleural effusion in the left lung. The patient cannot stand or sit erect due to age. Which position/projection would be best to rule out the pleural effusion? AP supine Right lateral decubitus Apical lordotic Left lateral decubitus
Left lateral decubitus
A patient is erect facing the x-ray tube and leaning the shoulders backward 20 to 30 degrees toward the IR. The central ray is perpendicular to the IR. What specific position has been performed?
Lordotic
Where is the CR centered for all projections of the forearm?
Mid forearm
Where is the CR centered for all projections of the humerus?
Mid humerus
Where do you center the CR for a lateral scapula projection?
Mid vertebral border
12. Where is the CR centered for a transthoracic lateral projection for humerus? 1-inch (2.5-cm) inferior to the acromion Level of the greater tubercle Mid-diaphysis Midaxilla
Mid-diaphysis/surgical neck if he decide to change it
54. Why is it recommended that PA oblique with medial rotation projection be performed rather than the PA oblique with lateral rotation for the second digit fo the hand
Minimized object image receptor distance
27. Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh? Internal rotation Neutral rotation External rotation AP axial
Neutral rotation
18. How much CR angulation is required for a PA oblique (scapular Y) projection? No CR angle is required 10 to 15 degrees 20 to 30 degrees 35 to 45 degrees
No CR angle is required
2. A patient enters the ED with a possible AC joint separation. The patient is paraplegic; therefore, the study cannot be done erect. Which of the following routines would be performed to diagnose this condition? Non-weight-bearing and weight-bearing types of projections performed with the patient recumbent by pulling down on the shoulders. Recumbent AP and AP axial projection of the clavicles to include AC joints. AP projections of shoulders with external and internal rotation performed recumbent. AP and AP apical oblique projection of the shoulder performed recumbent.
Non-weight-bearing and weight-bearing types of projections performed with the patient recumbent by pulling down on the shoulders.
8. Which of the following AP shoulder projections demonstrates the greater tubercle in profile medially? External rotation Internal rotation Neutral rotation None of the options
None of the options
What kind of breathing technique is best for the transthoracic projection of the humerus?
Orthostatic
An ambulatory patient comes to radiology with a clinical history of possible pneumonia. The patient complains of pain in the center of her chest. What positioning routine should be performed on this patient? PA and left lateral projections PA and right and left lateral projections PA and both decubitus projections AP and right lateral projections
PA and left lateral projection
90. which projection is pictured below? its ulnar deviation
PA axial w/ ulnar deviation
A patient enters the ED with trauma to the 2nd digit. What routine projections of the finger should be performed?
PA; PA oblique w/medial rotation; mediolateral
Where is the CR centered for a PA oblique projection of the 2nd digit?
PIP
What is the final step taken before making the exposure during a positioning routine?
Patient Instructions
Which of following is NOT one of the evaluation criteria applied in the evaluation of images? Patient condition Anatomy demonstrated Collimation and CR Exposure criteria
Patient condition
Of the following factors, which one is most crucial to demonstrate possible air and fluid levels in the chest? 72-inch (180-cm) SID High-kVp technique Patient in erect or decubitus position Using high mA and short exposure time
Patient in erect or decubitus position
Which of the following factors must be followed for an AP erect abdomen projection? Collimate lower border to level of ASIS. Use a higher kVp technique. Patient needs to be upright a minimum of 5 minutes before imaging. Increase SID to 72 inches (180 cm) to minimize magnification.
Patient needs to be upright a minimum of 5 minutes before imaging.
33. What additional maneuver must be added to the inferosuperior (transaxially) shoulder projection to best demonstrate a possible Hill-Sachs defect? Increase medial CR angulation. Angle the CR 10 to 15 degrees downward or posteriorly in addition to the medial angle. Perform exaggerated external rotation of the affected upper limb. Increase abduction of the affected upper limb.
Perform exaggerated external rotation of the affected upper limb.
Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?
Phalanges
Which of the following terms describes the sole of the foot?
Plantar
The top of the foot is placed against the image receptor with the perpendicular central ray entering the sole of the foot. What specific projection has been performed?
Plantodorsal
40. A radiograph for an AP projection with external rotation of the proximal humerus reveals that the greater tubercle is profiled laterally. What should be changed to improve this image for a repeat exposure? Rotate epicondyles so they are perpendicular to the image receptor. Move the patient obliquely 10 to 15 degrees toward the affected side. Positioning is acceptable; do not repeat it.
Positioning is acceptable; do not repeat it.
What part of the anatomy can be used to evaluate for rotation when critiquing a lateral view of the chest?
Posterior ribs
Why must the technologist slightly angle the CR caudad for most AP projections of the chest?
Prevents clavicles from obscuring apices of the lungs.
Why must the technologist slightly angle the CR caudad for most AP projections of the chest? Elongates the carina. Prevents overlap of the chin on the upper airway. Separates the heart from the great vessels. Prevents clavicles from obscuring apices of the lungs.
Prevents clavicles from obscuring apices of the lungs.
Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?
Prevents foreshortening of phalanges and obscuring of interphalangeal joints.
What structures must be included in the collimation field on all routine projections of the wrist?
Proximal Metacarpals, Carpals, Distal radius/ulna
The patient is lying on her right side on a cart. The anterior surface of the patient is against the image receptor. A horizontal central ray enters the posterior surface and exits the anterior surface of the body. What specific position has been performed?
Right lateral decubitus
Of the following positioning actions, which one will remove most of the scapulae from the lung fields? Roll shoulders forward. Depress shoulders. Elevate chin. None of the options.
Roll shoulders forward.
A PA chest radiograph reveals that the left sternoclavicular joint is closer to the spine than the right joint. What specific positioning error has been committed? Left tilt Rotation into the left anterior oblique (LAO) position Right tilt Rotation into the right anterior oblique (RAO) position
Rotation into the left anterior oblique (LAO) position
A radiograph of an anteroposterior (AP) abdomen demonstrates elongation (widening) of the left iliac wing and narrowing of the right iliac wing. Which one of the following positioning errors produced this radiographic outcome? Rotation to the left (left posterior oblique) Rotation to the right (right posterior oblique) CR off center to the left Left hip was internally rotated more than right
Rotation to the left (left posterior oblique)
What is the best method to control involuntary motion during abdominal radiography? Short exposure time Second breath hold Caul breathing instructions to patient Use of small focal spot
Short exposure time
What 2 joints must be included in the collimation field on all routine projections of the humerus? (2 Answers)
Shoulder & Elbow
What is the CR perpendicular to on an AP supine projection of the chest?
Sternum
The line between what 2 points of the scapula should be perpendicular to the IR for a true lateral projection of the scapula? (2 answers)
Superior angle of scapula & AC joint
A PA chest radiograph reveals that only seven ribs are seen above the diaphragm on a healthy adult. Which of the following suggestions would improve the inspiration of lungs? Use higher kVp to penetrate the diaphragm. Perform chest position supine. Take exposure on the second inspiration rather than on the first. Use a shorter exposure time.
Take exposure on the second inspiration rather than on the first.
Why is the AP projection of the thumb recommended instead of the PA?
The AP projection of the thumb reduces the OID and makes for a better image resolution
46. What specific pathology is demonstrated in the above radiograph? Your Answer: This is anterior dislocation of the shoulder
This is anterior dislocation of the shoulder
A radiograph of an AP KUB reveals that the obturator foramina are cut off from the bottom of the image. The kidneys and symphysis pubis are demonstrated. What centering adjustments should the technologist make to improve this image? Use two 14- × 17-inch (35- × 42-cm ) cassettes landscape. Center the cassette 2 inches (5 cm) below the iliac crest. Open up the collimators to include the ischial tuberosities. This radiograph is correctly centered. No centering adjustments are necessary.
This radiograph is correctly centered. No centering adjustments are necessary.
The position in which the head is lower than the feet
Trendelenburg
How can you determine on the radiograph if the patient was in a true lateral position on a lateral projection of the forearm? (At least 2 ways)
Ulnar head superimposed over distal radius, radial head slightly superimposed by coronoid process, humeral epicondyles superimposed
A 3-year-old patient comes to radiology for an abdominal study. Even with careful instructions and immobilization, the patient is having difficulty holding still. Which of the following should be done to minimize motion on the radiograph? Increase kVp. Decrease SID. Use a shorter exposure time. Ask an older experienced radiographer to hold the patient.
Use a shorter exposure time.
A radiograph of a supine KUB on an obese patient reveals that the symphysis pubis is cut off along the bottom of the radiograph. The top of the left kidney is also cut off along the top of the radiograph. What modifications does the technologist need to make for the repeat exposure? Center the cassette lower and make the exposure on inspiration. Use two 14- × 17-inch (35- × 43-cm) cassettes landscape, one centered lower and the other one higher. Use two 14- × 17-inch (35- × 43-cm) cassettes portrait, one centered lower and one centered higher. Center the cassette higher and use a second smaller cassette to include the bladder region.
Use two 14- × 17-inch (35- × 43-cm) cassettes landscape, one centered lower and the other one higher.
81. A young child comes to radiology with an elbow injury. The basic elbow projections demonstrate a possible nondisplaced fracture of the coronoid process. Beyond the medial oblique projection, what additional projection(s) can be performed to demonstrate the coronoid process in profile? a. Coyle method with 45° CR angle away from shoulder b. Radial head lateral projections c. Coyle method with 45° CR angle toward shoulder d. Acute flexion projection
a. Coyle method with 45° CR angle away from shoulder
100. what projection of the elbow is pictured in the above radiograph
ap oblique w/ lateral rotation google the pic?
51. Where is the central ray placed for a PA projection of the third digit
at the proximal interphalageal joint
87. Where is the CR centered for a PA projection of the hand?
at the third metacarpophalangeal joint
To ensure that the diaphragm is included on the erect abdomen projection, the top of the image receptor should be at the approximate level of the: inferior costal margin. jugular notch. xiphoid process. axilla.
axilla.
15. What structures are best demonstrated for the projection performed in the radiograph pictured? its a lateral scapula pic.
coracoid and acromion processes
What longitudinal body plane is perpendicular to the IR on a lateral position of chest?
coronal plane
86. A patient with a history of carpal tunnel syndrome comes to radiology. The physician wants to rule out abnormal calcifications in the carpal sulcus. Which of the following projections would best demonstrate this region? a. Coyle method b. Jones method c. Carpal bridge d. Gaynor-Hart method
d. Gaynor-Hart method
What structures should be included on your radiograph for an AP projection of the thumb?
distal and proximal phalanges, the first metacarpal, and trapezium
84. a radiograph of an AP oblique elbow with medial rotation reveal that the radial head is superimposed over part of the coronoid process. What positioning error has been commited
excessive medial roation
57. A radiograph of a PA oblique of the hand reveals that the midshaft of the fourth and fifth metacarpals is superimposed. what specific positioning error has been commited
excessive rotation of the hand and/or wrist latterally
101. To ensure that the inferior margin of the abdomen is included on a KUB radiograph, the technologist should palpate the: iliac crest. ASIS. greater trochanter. inferior costal margin.
greater trochanter.
A patient enters the emergency department (ED) to be treated for severe trauma. The physician orders an AP supine chest to evaluate the lungs. What can the technologist do to reduce the magnification of the heart? Place the cassette landscape. Use a short exposure time. Increase super optical device (SOD) as much as possible. Increase SID as much as possible.
increase SID as much as possible.
99. Which basic projection of the elbow best demonstrates the trochlear notch in profile?
lateral
When viewing a PA oblique projection of the hand, the 3rd and 4th distal metacarpals are not superimposed. What specific positioning error led to this?
insufficient lateral rotation
When viewing a lateral projection of the forearm, the distal radius is projected anteriorly in relation to the distal ulna. What error caused this to occur? (Be Specific)
insufficient lateral rotation/Excessive medial rotation
92. A radiograph of the PA scaphoid projection reveals extensive superimposition of the scaphoid and adjacent carpals. Which of the following factors can lead to this problem?
insufficient ulnar deviation
When viewing a lateral projection of the humerus, the lesser tubercle is superimposed over the humeral head. What was the positioning error? (Be Specific)
interepicondylar line not perpendicular to the IR; insufficient medial rotation
The two most common landmarks for chest positioning are the:
jugular notch and vertebra prominens.
The two most common landmarks for chest positioning are the: top of shoulders and xiphoid process. jugular notch and top of shoulders. lower margin of thyroid cartilage and vertebra prominens. jugular notch and vertebra prominens.
jugular notch and vertebra prominens.
70. Which routine projection of the elbow best demonstrates the olecranon process in profile?
lateral
Which way should the hand be rotated for a PA oblique of the second digit to best visualize the anatomy?
medially
The vertical plane that divides the body into equal right and left halves describes the _____ plane.
median or midsagittal
97. A patient enters the ED with a possible scaphoid fracture. The patient is unable to assume the ulnar deviation position. Which of the following positions should be performed to confirm the diagnosis
modified strecher
95. a lateral elbow radiograph demonstrates about half of the radial head superimposed by the coronoid process of the ulna. which of the following occured
no positioning errors occured
When viewing a PA axial projection of the clavicle, the lateral portion of the clavicle is superimposed over the superior angle of the scapula on a hypersthenic patient. What was the error? (Be Specific)
not angled 15°-20° caudal
56. A radiograph of a lateral projection of the elbow shows that the epicondyles are superimposed and the trochlear notch is not clearly seen. what must be done to correct this position error during the repeat exposure
place humerus/forearm in the same horizontal plane
Moving the foot and toes downward is:
plantar flexion.
35. When viewing a PA oblique scapular Y lateral projection of the shoulder, the humeral head is located inferior to the acromion process. What specific pathology is demonstrated? anterior disclocation no patholody posterior dislocation bankart lesion
posterior dislocation
What is the purpose of rolling the shoulders forward during a routine PA projection of the chest?
prevent scapulae from superimposing lung field
60. why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?
prevents foreshortening of phalanges and obscuring of the interphalangeal joints
85. what specific position of the hand will place the thumb in a natural 45 oblique position
pronated
80. which of the following actions will lead to the proximal radius crossing over the ulna
pronation of the hand
69. A radiograph of a PA projection of the hand reveals that the distal radius and ulna and the carpals were cut off. What should the technologist do to correct this problem?
repeat the PA projection to include all of the carpal and about 1 inches of the distal radius and ulna
A recumbent position in which the patient is lying on the right anterior surface with the body rotated toward the image receptor is termed:
right anterior oblique.
75. A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamular process is superimposed over the pisiform. WHich of the following measures will correct this problem?
rotate the wrist and hand 10 degrees internally
61. how can you determine optimal exposure when evaluating radiograph
sharp lines and bony trabecular marking
As a general rule, the use of high kVp (110 to 120 kVp) requires the use of a grid during chest radiography. t/f
t
Scoliosis and kyphosis may produce asymmetry of the sternoclavicular joints and rib cage as demonstrated on a PA chest radiograph. t/f
t
When aligning images of the hand on the monitor, the digits should be pointing upward. t/f
t
When viewing a lateral projection of the 3rd digit, you notice the interphalangeal joint spaces are not open. What positioning error occurred?
the third phalange is not parallel to the IR
63. WHen viewing an oblique projection of the wrist, the distal ulna is superimposed over the distal radius. What specific positioning error caused this to occur
there is an excessive lateral rotation
83. a patient enters the ED with a smith fracture. which region of the upper limb must be radiographed to demonstrate this injury
wrist and forearm
