Rad review extremety*************

Which of the following is (are) accurate positioning or evaluation criteria for an AP projection of the normal knee? 1. Femorotibial interspaces equal bilaterally. 2. Patella superimposed on distal tibia 3. CR enters ½ in. distal to base of patella. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only In the AP projection of the normal knee, the space between the tibial plateau and the femoral condyles is equal bilaterally. It is, therefore, important that there be no pelvic rotation that could change the appearance of an otherwise normal relationship. The AP projection of the knee superimposes the patella and femur. The CR should enter at the knee joint, located ½ in. distal to the patellar apex

What is best elbow position to demonstrate the radial head free of superimposition.? A. Lateral B. Internal Oblique C external oblique D. AP

external oblique

what elbow projection that the epicondyle perpendicular to IR A. AP B. AP internal Oblique C. AP external oblique D. Lateral

Lateral

The instrument that is used to test the accuracy of the x-ray machine's timer or rectifiers show the effect of kilovoltage on contrast. A. aluminum step wedge. B. spinning top. C. densitometer. D. sensitometer.

spinning top

In which projection of the foot are demonstrate the longitudinal arches. A. Lateral oblique foot B. Medial oblique foot C. Lateral Weight-bearing foot D. AP Weight-bearing foot

A weight-bearing lateral projection

The best knee projection are used primarily to evaluate the joint space and articulating structures. A. AP knee. B. AP olique C. PA. D. lateral

A-B-C

In the AP knee projection of an hypersthenic patient who measures greater than 24 cm from the anterior superior iliac spine (ASIS) to tabletop, the CR should be directed A. perpendicularly B. 5 degrees medially C. 5 degrees cephalad D. 5 degrees caudad

5 degrees cephalad.

what condition involves injury to one or more of the muscles participating in formation of that muscular structure. A. Hill-Sachs defect. B. Bankart lesion. C. rotator cuff tear. D. adhesive capsulitis.

A rotator cuff tear

which elbow projection demonstrate the coronoid process in profile ? A. AP B. AP internal Oblique C. AP external oblique D. Lateral

B. AP internal Oblique

In the lateral projection of the knee, the central ray is angled 5° cephalad to prevent superimposition of which of the following structures on the joint space? A. Lateral femoral condyle B. Medial femoral condyle C. Patella D. Tibial eminence

B. Medial femoral condyle For the lateral projection of the knee, the patient is turned onto the affected side. This places the lateral femoral condyle closest to the IR and the medial femoral condyle remote from the IR. Consequently, there is significant magnification of the medial femoral condyle and, unless the central ray is angled slightly cephalad, subsequent obliteration of the joint space

The posterior process of the scapula is which of the following? A. Coronoid process B. Coracoid process C. Carotid process D. Acromion

D. Acromion

Please identify structure "3" in the following labeled image of the lateral humerus. A. Humeral head B. Scapular body C. Humeral epicondyles D. Acromion

D. Acromion In the image of the lateral humerus, the numbers correspond as follows: 1. Coracoid 2. Humeral head (A) 3. Acromion (D) 4. Humeral shaft 5. Humeral epicondyles (C) 6. Olecranon

Which of the following conditions is a malignant bone tumor most common in young children. It attacks long bones and presents a characteristic "onion peel" appearance. A. Ewing sarcoma B. Osgood-Schlatter disease C. Gout D. Exostosis

Ewing sarcoma

Which of the following conditions is a type of arthritis that most commonly attacks the knee and first metatarsophalangeal joint, although other joints also can be involved. High levels of uric acid in the blood are deposited in the joint A. Ewing sarcoma B. Osgood-Schlatter disease C. Gout D. Exostosis

Gout

What term is describes the direction of misalignment. A. angulation B. apposition C. luxation D. sprain

angulation

in which position of shoulder is place the humerus in a true lateral position. The epicondyles should be superimposed and perpendicular to the IR.

internal rotation

In the AP knee projection of a sthenic patient who measures 19 to 24 cm from the anterior superior iliac spine (ASIS) to tabletop, the CR should be directed A. perpendicularly B. 5 degrees medially C. 5 degrees cephalad D. 5 degrees caudad

perpendicularly.

The best projection to demonstrate the the intercondyloid fossa. A. AP knee. B. PA knee. C. tangential ("sunrise") projection. D. tunnel view

D. tunnel view

The lesser tubercle should be visualized in profile in which of the following? A. AP shoulder, external rotation B. AP shoulder, internal rotation C. AP elbow D. Lateral elbow

B

What is best elbow position to demonstrate the corocoid process? A. Lateral B. AP Internal Oblique C AP external oblique D. AP

Internal Oblique

a fracture of the anteroinferior portion of the rim of the glenoid fossa is A. Hill-Sachs defect. B. Bankart lesion. C. rotator cuff tear. D. adhesive capsulitis.

A Bankart lesion

The fifth metacarpal is located on which aspect of the hand? A. Medial B. Lateral C. Radial D. Volar

A. Medial he fifth metacarpal is located on the medial aspect of the hand. Remember to always view a part in its anatomic position. With the arm in the anatomic position, the fifth metacarpal and the ulna lie medially.

what elbow projection that the epicondyle parallel to IR A. AP B. AP internal Oblique C. AP external oblique D. Lateral

AP

In which of the following projections is the talofibular joint best demonstrated? A. AP B. Lateral oblique C. Medial oblique 45 degree D. Lateral

C. medial oblique 45 degree The AP projection demonstrates superimposition of the distal fibula on the talus; the joint space is not well seen. The 15- to 20-degree medial oblique position shows the entire mortise joint; the talofibular joint is well visualized, as well as the talotibial joint. There is considerable superimposition of the talus and fibula in the lateral and lateral oblique projections

Which of the following anatomic structures is indicated by the number 2 in Figure 2-7? A. medial epicondyle B. trochlea C. capitulum D. olecranon process

D. olecranon process 1- medial epicondyle 2-olecranon process 3-the trochlea 4-coronoid process 5-small portion of the radial head The image illustrates a medial oblique (internal rotation) projection of the elbow with epicondyles 45 degrees to the IR. An oblique view of the proximal radius and ulna and the distal humerus is obtained. This projection is particularly useful to demonstrate the coronoid process in profile

what elbow projection that the epicondyle turn 45 degree IR A. AP B. AP internal Oblique C. AP external oblique D. Lateral

Medial obliquie -internal

Synovial fluid is associated with the A. brain. B. spinal canal. C. peritoneal cavity. D. bony articulations.

Synovial fluid is associated with diarthrotic (freely movable) bony articulations. Other types of bony articulations are fibrous (synarthrotic/immovable) and cartilaginous (amphiarthrotic/partially movable). Fluid associated with the brain and spinal canal is cerebrospinal fluid (CSF). The peritoneal and pleural cavities are associated with a lubricating serous fluid.

For an AP projection of the knee on a patient whose measurement from ASIS to tabletop is less than 19 cm thin pelvis, which CR direction will best demonstrate the knee joint? A. 3-5 degrees caudad B. 10 degrees caudad C. 3-5 degrees cephalad D. 0 degrees (perpendicular)

3 to 5 degrees caudad

A compression fracture of the posterolateral humeral head and associated with an anterior dislocation of the glenohumeral joint is called a(an) A. Hill-Sachs defect. B. Bankart lesion. C. rotator cuff tear. D. adhesive capsulitis.

A Hill-Sachs defect is a compression fracture of the posterolateral humeral head, usually associated with anterior dislocation of the shoulder joint. It can involve the cartilage of the humeral head, causing instability and predisposing the shoulder to subsequent dislocations. A Bankart lesion is a fracture of the anteroinferior portion of the rim of the glenoid fossa. A rotator cuff tear involves injury to one or more of the muscles participating in formation of that muscular structure. The supraspinatus, infraspinatus, subscapularis, and teres minor are the major muscles of the rotator cuff. Adhesive capsulitis, or "frozen shoulder," causes very diminished shoulder movement as a result of chronic joint inflammation

In the lateral projection of the scapula, 1. the vertebral and axillary borders are superimposed. 2. acromion and coracoid processes are superimposed 3. .inferior angle is superimposed on the ribs. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only A lateral projection of the scapula superimposes its medial and lateral borders (vertebral and axillary, respectively). The coracoid and acromion processes should be readily identified separately (not superimposed) in the lateral projection. The entire scapula should be free of superimposition with the ribs. The erect position is probably the most comfortable position for a patient with scapular pain.

Which of the following projections require(s) that the shoulder be placed in external rotation? 1. AP humerus 2. Lateral forearm 3. Lateral humerus A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

A. 1 only When the arm is placed in the AP position, the epicondyles are parallel to the plane of the cassette, and the shoulder is placed in external rotation. In this position, an AP projection of the humerus, elbow, and forearm can be obtained. For the lateral projection of the humerus, elbow, or forearm, the epicondyles must be perpendicular to the plane of the cassette.

Which of the following projections will best demonstrate the tarsal navicular free of superimposition? A. AP oblique, medial rotation B. AP oblique, lateral rotation C. Mediolateral D. Lateral weight-bearing

A. AP oblique, medial rotation The medial oblique projection requires that the leg be rotated medially until the plantar surface of the foot forms a 30-degree angle with the IR. This position demonstrates the navicular with minimal bony superimposition. The lateral oblique projection of the foot superimposes much of the navicular on the cuboid. The navicular is also superimposed on the cuboid in lateral projections.

Medial displacement of a tibial fracture would be best demonstrated in the A. AP projection B. lateral projection C. medial oblique projection D. lateral oblique projection

A. AP projection A frontal projection (AP or PA) demonstrates the medial and lateral relationships of structures. A lateral projection demonstrates the anterior and posterior relationships of structures. Two views, at right angles to each other, generally are taken of most structures.

Which of the following fracture classifications describes a small bony fragment pulled from a bony process? A. Avulsion fracture B. Torus fracture C. Comminuted fracture D. Compound fracture

A. Avulsion fracture An avulsion fracture is a small bony fragment pulled from a bony process as a result of a forceful pull of the attached ligament or tendon. A comminuted fracture is one in which the bone is broken or splintered into pieces. A torus fracture is a greenstick fracture with one cortex buckled and the other intact. A compound fracture is an open fracture in which the fractured ends have perforated the skin.

The primary center of ossification in long bones is the A. diaphysis. B. epiphysis. C. metaphysis. D. apophysis.

A. diaphysis. Long bones are composed of a shaft, or diaphysis, and two extremities. The diaphysis is referred to as the primary ossification center. In the growing bone, the cartilaginous epiphyseal plate (located at the extremities of long bones) is gradually replaced by bone. For this reason, the epiphyses are referred to as the secondary ossification centers. The ossified growth area of long bones is the metaphysis. Apophysis refers to vertebral joints formed by articulation of superjacent articular facets.

The tarsals and metatarsals are arranged to form the 1.transverse arch. 2.longitudinal arch. 3.oblique arch. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only The tarsals and metatarsals of the foot are arranged so as to form two arches: the transverse and the longitudinal (which has two parts—lateral and medial). The arches function to support and distribute the body's weight over the body. The ball of the foot usually accommodates about 40 percent of the body's weight, and the heel about 60 percent.

In which type of fracture are the fractured ends of bone forced through the skin? A. Closed B. Compound C. Compression D. Depressed

B. Compound The type of fracture in which the fractured/splintered ends of bone are forced through the skin is a compound fracture. In a closed fracture, no bone protrudes through the skin. Compression fractures are seen in stressed areas, such as the vertebrae. A depressed fracture would not protrude but rather would be pushed in.

All elbow fat pads are best demonstrated in which position? A. AP B. Lateral C. Acute flexion D. AP partial flexion

B. Lateral There are three important fat pads associated with the elbow. The anterior fat pad is located just anterior to the distal humerus. The posterior fat pad is located within the olecranon fossa at the distal posterior humerus. The supinator fat pad/stripe is located at the proximal radius just anterior to the head, neck, and tuberosity. The posterior fat pad is not visible radiographically in the normal elbow. All three fat pads can be demonstrated only in the lateral projection of the elbow.

Which of the following correctly identifies the letter L in the radiograph shown in Figure 7-13? A. Hamate B. Lunate C. Scaphoid D. Trapezium

B. Lunate The eight carpal bones are well visualized in this PA projection of the hand and wrist. The letters E (scaphoid) and L (lunate) are in the proximal carpal row. The capitate (I) is seen in the distal carpal row; just lateral to the capitate is the carpal trapezium, seen articulating with the base of the first metacarpal. The PA projection of the hand provides an oblique projection of the first finger (thumb).

In which of the following positions/projections will the talocalcaneal joint be visualized? A. Dorsoplantar projection of the foot B. Plantodorsal projection of the calcaneus C. Medial oblique position of the foot D. Lateral foot

B. Plantodorsal projection of the calcaneus The talocalcaneal, or subtalar, joint is a three-faceted articulation formed by the talus and the os calcis (calcaneus). The plantodorsal and dorsoplantar projections of the os calcis should exhibit sufficient receptor exposure to visualize the talocalcaneal joint. This is the only "routine" projection that will demonstrate the talocalcaneal joint. The lateral projection demonstrates the calcaneocuboid joint but does not demonstrate an open talocalcaneal joint. If evaluation of the talocalcaneal joint is desired, special views (such as the Broden and Isherwood methods) are required.

For a true AP of the clavicle, the midclavicle is superimposed over which portion of the scapula? A. Scapular notch B. Superior angle C. Acromion D. Coracoid process

B. Superior angle For a true AP projection of the clavicle, the CR is perpendicular to the IR, and the patient is positioned without rotation and their back in contact with the IR/Bucky. The perpendicular CR projects the midclavicle over the superior angle of the scapula (B), or the uppermost portion of the scapula. The scapular notch (A) is distal and lateral to the midclavicle. Both the acromion (C) and coracoid (D) are toward the distal end and are not superimposed by the clavicle.

The relationship between the ends of fractured long bones is referred to as A. angulation B. apposition C. luxation D. sprain

B. apposition Various terms are used to describe the position of fractured ends of long bones. The term apposition is used to describe the alignment, or misalignment, between the ends of fractured long bones. The term angulation describes the direction of misalignment. The term luxation refers to a dislocation. A sprain refers to a wrenched articulation with ligament injury.

Which of the following statements regarding the radiograph in Figure A is (are) true 1.The tibial eminences are well visualized. 2.The intercondyloid fossa is demonstrated between the femoral condyles. 3.The femorotibial articulation is well demonstrated. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 only

C. 1 and 3 only

**Which of the following statements regarding the radiograph in Figure A is (are) true? 1.The tibial eminences are well visualized. 2.The intercondyloid fossa is demonstrated between the femoral condyles. 3.The femorotibial articulation is well demonstrated. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 only

C. 1 and 3 only The pictured radiograph is an AP projection of the knee with the knee extended. The tibial intercondylar eminences are well demonstrated on the tibial plateau, and the femorotibial joint is well visualized. The intercondyloi fosdsa is not demonstrated here. A "tunnel" view of the knee is required to demonstrate the intercondyloid fossa.

Which of the following terms can be used interchangeably to refer to a part moving away from midline, as well as spreading of the fingers and toes apart? A. Adduction B. Eversion C. Abduction D. Inversion

C. Abduction Abduction refers to the movement of an arm or leg away from the body; however, it can also be used to define spreading the digits apart (C). Adduction, in contrast, refers to the movement of a part toward midline (A). Eversion and inversion are terms used to describe stress movements outward and inward respectively, such as with the ankles (B and D).

In the following mediolateral projection of the ankle, the cuboid is represented by which of the following numbers? A. 1 B. 4 C. 2 D. 5 E. 3

D. 5 1. calcaneus 2. fifth metatarsal 3.talus 4.navicular 5. cuboid .

In the AP knee projection of an asthenic patient who measures less than 19 cm from the anterior superior iliac spine (ASIS) to tabletop, the CR should be directed A. perpendicularly B. 5 degrees medially C. 5 degrees cephalad D. 5 degrees caudad

D. 5 degrees caudad In the AP projection of the knee, the position of the joint space is significantly affected by the patient's overall body habitus and the distance between the ASIS and tabletop. When the patient is of sthenic habitus with a distance of 19 to 24 cm between the ASIS and tabletop, the CR is directed perpendicularly. When the patient is of asthenic habitus with a distance of less than 19 cm between the ASIS and tabletop, the CR is directed 5 degrees caudad. With a patient with a hypersthenic habitus and an ASIS-to-table measurement of greater than 24 cm, the CR is directed 5 degrees cephalad.

Identify the structure labeled 1 in the AP projection of the knee shown in Figure 2-16. A. Lateral condyle B. Lateral epicondyle C. Medial condyle D. Medial epicondyle

D. Medial epicondyle Figure 2-16 shows an AP projection of the knee. The distal femur and proximal tibia and fibula are seen. The femorotibial joint space is open, and the tibial articular facets of the tibial plateau (number 4) are demonstrated. The intercondylar eminence (number 3) is seen. Number 2 is the medial femoral condyle; number 1 is the medial femoral epicondyle; and number 5 is the medial tibial condyle.

What is the structure indicated by the letter A in Figure 7-3? A. greater tubercle B. coronoid process C. coracoid process D. acromion process

D. acromion process The radiograph illustrates an AP projection of the scapula; abduction of the arm moves the scapula away from the rib cage, revealing a greater portion of the scapula than would be visualized with the arm at the side. A number of bony structures are identified: the acromion process (A), the humeral head (B), glenoid fossa (C), scapular spine (D), clavicle (E), supraspinatus fossa (F), acromioclavicular joint (G), scapular notch (H), coracoid process (I), inferior angle/apex (j), body/costal surface (K), lateral/axillary border (L

The first carpometacarpal joint is formed by the articulation of the base of the first metacarpal and the A. distal radius. B. distal ulna. C. scaphoid. D. trapezium.

D. trapezium. The bases of the proximal row of phalanges articulate with the heads of the metacarpals to form the (condyloid) metacarpophalangeal joints, which permit flexion and extension, abduction and adduction, and circumduction. The bases of the metacarpals articulate with each other and the distal row of carpals at the carpometacarpal joints. The first carpometacarpal joint (thumb) is a saddle joint, permitting flexion and extension, abduction and adduction, and circumduction; it is formed by the articulation of the base of the first metacarpal and the trapezium.

in which position of shoulder is true AP position and places the greater tubercle in profile laterally and places the lesser tubercle anteriorly

External rotation

What is best elbow position to demonstrate the olecranon process? A. Lateral B. Internal Oblique C external oblique D. AP

Lateral The olecranon process (number 6) can best be demonstrated in the lateral projection; it can also be demonstrated in the acute flexion position. The AP internal oblique will demonstrate the coronoid process; the AP external oblique will demonstrate the radial head free of superimposition.

The internal projection of the shoulder can be used to demonstrate which of the following? A. Glenohumeral joint B. Anterior dislocation of the humerus C. Lesser tubercle abnormalities D. Posterior dislocation of the humerus

Lesser tubercle abnormalities

In which projection of the foot best demonstrate most of the tarsals and intertarsal spaces (including the cuboid, sinus tarsi, and tuberosity of the fifth metatarsal), a medial oblique projection A. Lateral oblique foot B. Medial oblique foot C. Lateral Weight-bearing foot D. AP Weight-bearing foot

medial oblique projection

To demonstrate the glenoid fossa in profile, the patient is positioned A. 45 degrees oblique, affected side away from IR. B. 45 degrees oblique, affected side adjacent to IR. C. 25 degrees oblique, affected side away from IR. D. 25 degrees oblique, affected side adjacent to IR.

.B. 45 degrees oblique, affected side adjacent to IR. When viewing the glenoid fossa from the anterior, it is seen to angle posteriorly and laterally approximately 45 degrees. To view it in profile, then, it must be placed so that its surface is perpendicular to the IR. The patient is positioned in a 45-degree oblique, affected side adjacent to IR, which places the glenoid fossa approximately perpendicular to the IR. The arm is abducted slightly, the elbow is flexed, and the hand and forearm are placed over the abdomen. The CR is directed perpendicular to the glenohumeral joint

Which of the following statements regarding Figure 2-10 is (are) true? 1. Correct degree of rotation is present. 2. Midphalanges are foreshortened. 3. Fingers are parallel to the IR. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only A PA oblique projection of the hand is shown. The correct degree of obliquity (45 degrees) is evidenced by no overlap of midshaft third, fourth, and fifth metacarpals and minimal overlap of their heads. The interphalangeal joint spaces are not visualized because the fingers are not elevated to be parallel to the IR, hence, they are foreshortened.

Which of the following is (are) valid evaluation criteria for a lateral projection of the forearm? 1. The radius and the ulna should be superimposed distally. 2. The coronoid process and the radial head should be partially superimposed. 3. The humeral epicondyles should be superimposed. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 To accurately position a lateral forearm, the elbow must form a 90-degree angle with the humeral epicondyles superimposed. The radius and ulna are superimposed distally. Proximally, the coronoid process and radial head are partially superimposed. Failure of the elbow to form a 90-degree angle or the hand to be lateral results in a less than satisfactory lateral projection of the forearm.

Which of the following articulates with the base of the first metatarsal? A. First cuneiform B. Third cuneiform C. Navicular D. Cuboid

A. First cuneiform The base of the first metatarsal articulates with the first (medial) cuneiform. The base of the second metatarsal articulates with the second (intermediate) cuneiform; the third base of the metatarsal articulates with the third (lateral) cuneiform. The bases of the fourth and fifth metatarsals articulate with the cuboid. The navicular articulates with the first and second cuneiforms anteriorly and the talus posteriorly.

The secondary center of ossification in long bones is the A. periosteum. B. endosteum. C. epiphysis. D. diaphysis.

C. epiphysis. Bones are classified as long, short, flat, and irregular. Many of the bones making up the extremities are long bones. Long bones have a shaft and two extremities (ends). The shaft (or diaphysis) of long bones is the primary ossification center during bone development. It is composed of compact tissue and covered with a membrane called periosteum. Within the shaft is the medullary cavity, which contains bone marrow and is lined by the membrane called endosteum. In the adult, yellow marrow occupies the shaft, and red marrow is found within the proximal and distal extremities of long bones. The secondary ossification center, the epiphysis, is separated from the diaphysis in early life by a layer of cartilage, the epiphyseal plate. As bone growth takes place, the epiphysis becomes part of the larger portion of bone and the epiphyseal plate disappears, but a characteristic line remains and is thereafter recognizable as the epiphyseal line.

Which of the following indicates the scapular costal surface seen in the figure below A. D B. H C. K D. M

K The radiograph illustrates an AP projection of the scapula; abduction of the arm moves the scapula away from the rib cage, revealing a greater portion of the scapula than would be visualized with the arm at the side. A number of bony structures are identified: the acromion process (A), the humeral head (B), glenoid fossa (C), scapular spine (D), clavicle (E), supraspinatus fossa (F), acromioclavicular joint (G), scapular notch (H), coracoid process (I), inferior angle/apex (j), body/costal surface (K), lateral/axillary border (L), axillary part upper rib (M).

What term is refers to a wrenched articulation with ligament injury. A. angulation B. apposition C. luxation D. sprain

A sprain

Which of the following conditions is a bony growth arising from the surface of a bone and growing away from the joint. It is a benign and sometimes painful condition. A. Ewing sarcoma B. Osgood-Schlatter disease C. Gout D. Exostosis

Exostosis

which elbow projection demonstrate radial head free of superimposition as well as the radial neck and the humeral capitulum. A. AP B. AP internal Oblique C. AP external oblique D. Lateral

The external oblique (lateral rotation)

what projection of elbow that demonstrates the entire radial head free of superimposition as well as the radial neck and the humeral capitulum. A. AP B. External oblique ( lateral rotation) C. Lateral D. Internal oblique ( medial rotation)

The external oblique (lateral rotation) projection

What term is refers to a dislocation. A. angulation B. apposition C. luxation D. sprain

luxation

Which of the following anatomical structures are well visualized in the image below (select the five that apply)? A. Superimposed medial and lateral femoral condyles B. Intercondylar eminence C. Medial malleolus D. Fibular head E. Patellofemoral joint space F. Intercondylar fossa G. Lateral malleolus H. Intrapatellar fat pad region

A-B-D-E-H In the mediolateral projection of the knee, the femoral condyles should be superimposed (A). Proper CR angulation and elimination of tilt will demonstrate the intercondylar eminence (B), and lack of rotation will be evident by visualization of the patellofemoral joint space (E). The fibular head (D) is located on the proximal fibula and will be projected partially superimposed by the tibia. Lastly, soft tissue detail, such as the fat pad anterior to the knee joint (infrapatellar fat pad), will be seen with use of adequate exposure techniques (H). The medial malleolus and lateral malleolus are located on the distal tibia and fibula respectively, and therefore will not be demonstrated in this view (C and G). Additionally, the intercondylar fossa is not seen on the lateral projection of the knee; rather, it is best demonstrated on tunnel views.

Which of the following is (are) true regarding radiographic examination of the acromioclavicular joints? 1. The procedure is performed in the erect position. 2. Use of weights can improve demonstration of the joints. 3. The procedure should be avoided if dislocation or separation is suspected. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 only

B. 1 and 2 only Evaluation of the acromioclavicular joints requires bilateral AP or PA erect projections with and without the use of weights. Weights are used to emphasize the minute changes within a joint caused by separation or dislocation. Weights should be anchored from the patient's wrists rather than held in the patient's hands because this encourages tightening of the shoulder muscles and obliteration of any small separation.

Posterior displacement of a tibial fracture would be best demonstrated in the A. AP projection. B. lateral projection. C. medial oblique projection. D. lateral oblique projection.

B. lateral projection. A frontal projection (AP or PA) demonstrates the medial and lateral relationship of structures. A lateral projection demonstrates the anterior and posterior relationship of structures. Two views, at right angles to each other, are generally taken of most structures

Which surface must be adjacent to the IR to obtain a lateral projection of the fourth finger with optimal spatial resolution? A. Anterior B. Posterior C Medial D. Lateral

C Medial lateral projection of the fourth finger is best obtained if the finger is positioned so that there is as little OID as possible. Therefore, with only the fourth finger extended in the lateral position, the arm is positioned on the ulnar (medial) surface. This places the finger closer to the IR than if it were positioned radial side down. Excessive magnification distortion is avoided, and better spatial resolution is obtained.

When positioning for the PA projection of the wrist, arching the hand by slightly curling the fingers works to 1. Reduce OID 2. Demonstrate the carpal tunnel 3. Better visualize intercarpal joint spaces 4. Project the scaphoid free of superimposition A. 1 and 2 B. 2 and 3 C. 1 and 3 D. 2 and 4

C. 1 and 3 A slight arch of the hand helps bring the anterior surface of the wrist closer to the IR, achieving reduced OID (1) and better visualization of the intercarpal joint spaces (3) due to alignment with divergent rays (C). The carpal tunnel is best demonstrated through the Gaynor-Hart method of tangential wrist projection (2) (A and B). In order to free the scaphoid from superimposition, the wrist must be placed in ulnar deviation (4) (D).

For an AP projection of the knee on a patient whose measurement from ASIS to tabletop is 21 cm, which CR direction will best demonstrate the knee joint? A. 5 degrees caudad B. 10 degrees caudad C. 5 degrees cephalad D. 0 degrees (perpendicular)

D. 0 degrees (perpendicular) The knee is formed by the proximal tibia, the patella, and the distal femur, which articulate to form the femorotibial and femoropatellar joints. Body habitus will change the relationship of the knee-joint space with the tabletop/IR considerably. The CR should be directed to ½ inch below patellar apex (knee joint). The direction of CR depends on distance between the ASIS and tabletop/IR. When this distance is up to 19 cm (thin pelvis), the CR should be directed 3 to 5 degrees caudad; when the distance is between 19 to 24 cm, the CR is directed vertically/perpendicular (0 degrees); when the distance is greater than 24 cm (thick pelvis), the CR is directed 3 to 5 degrees cephalad.

Which of the following statements is (are) true regarding the radiograph in Figure 2-12? 1. The patient is placed in an RAO position. 2. The midcoronal plane is about 60 degrees to the IR. 3. The acromion and coracoid processes form the upper extensions of the "Y". A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 A right scapular Y is illustrated; this refers to the characteristic Y formed by the clearly visible humerus, acromion, and coracoid. The patient is positioned in a PA oblique position—in this case, an RAO projection to demonstrate the right side. The MCP is adjusted to approximately 60 degrees to the IR, and the affected arm is left relaxed at the patient's side. The scapular Y position is employed to demonstrate anterior or posterior humeral dislocation. The humerus is superimposed on the scapula in this position; any deviation from this may indicate dislocation. A similar image can be obtained in the LPO position.

Which projection used to demonstrate anterior or posterior shoulder/glenohumeral joint dislocation. 1. Scapular Y projection 2. mInferosuperior axial 3. Transthoracic lateral A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

1- Scapular Y projection The scapular Y projection is an oblique projection of the shoulder that is used to demonstrate anterior or posterior shoulder/glenohumeral joint dislocation. The inferosuperior axial projection may be used to evaluate the glenohumeral joint when the patient is able to abduct the arm. The transthoracic lateral projection is used to evaluate the glenohumeral joint and upper humerus when the patient is unable to abduct the arm

which criteria is right for AP knee projection( choose 4) 1. the space between the tibial plateau and the femoral condyles is equal bilaterally 2. Femorotibial interspaces equal bilaterally. 3. Patella superimposed on distal tibia 4. superimposes the patella and femur. 5. CR enters ½ in. distal to base of patella. 6. CR enter ½ in. distal to the patellar apex 7. No pelvic rotation

1. the space between the tibial plateau and the femoral condyles is equal bilaterally 4. superimposes the patella and femur. 6. CR enter ½ in. distal to the patellar apex 7. No pelvic rotation

Which of the following articulations is/are well visualized in the extension lateral position of the hand? 1. Radiocarpal 2. 1st carpometacarpal 3. Proximal interphalangeal A. 1 only B. 2 only C. 2 and 3 only D. 1, 2, and 3

A. 1 only The extension lateral position of the hand is most commonly utilized for visualization of fractures and foreign objects. In this view, the only joint that will be well-visualized is the radiocarpal (1), because the wrist will be in the true lateral position. Both the carpometacarpal joints (2) and all interphalangeal joints (3) will either be closed due to positioning (1st digit) or superimposed on each other (2nd-5th).

Which of the labeled bones in Figure 6-14 identifies the tarsal navicular? A. Number 2 B. Number 3 C. Number 6 D. Number 7

A. Number 6 1.the fibular (lateral) malleolus 2. The talus articulates with the calcaneus 3. The cuboid 4. digit 5cuneiform . 6. navicular 7. articulation of the tibia, fibula, and talus 8.The tibial (medial) malleolus An anterior view of the foot and ankle bones is shown. The ankle joint is formed by the articulation of the tibia, fibula, and talus (number 7). The tibial (medial) malleolus is labeled 8; the fibular (lateral) malleolus is labeled 1. The talus articulates with the calcaneus (number 2) inferiorly and with the navicular (number 6) anteriorly. The cuboid (number 3) is seen anterior to the calcaneus, and the three cuneiforms (number 5) are anterior to the navicular.

what condition causes very diminished shoulder movement as a result of chronic joint inflammation A. Hill-Sachs defect. B. Bankart lesion. C. rotator cuff tear. D. adhesive capsulitis.

Adhesive capsulitis, or "frozen shoulder,

Which type of articulation is evaluated in arthrography? A. Synarthrodial B. Diarthrodial C. Amphiarthrodial D. Cartilaginous

B. Diarthrodial Diarthrodial joints are freely movable joints that distinctively contain a joint capsule. Contrast medium is injected into this joint capsule to demonstrate the menisci, articular cartilage, bursae, and ligaments of the joint under investigation. Synarthrodial joints are immovable joints composed of either cartilage or fibrous connective tissue. Amphiarthrodial joints allow only slight movement.

In which of the following positions can the sesamoid bones of the foot be demonstrated to be free of superimposition with the metatarsals or phalanges? A. Dorsoplantar metatarsals/toes B. Tangential metatarsals/toes C. 30-degree medial oblique foot D. 30-degree lateral oblique foot

B. Tangential metatarsals/toes The tangential projection projects the sesamoid bones separate from adjacent structures. The patient is best examined in the prone position because this places the parts of interest closest to the IR. The affected foot is dorsiflexed so as to place its plantar surface 15 to 20 degrees with the vertical. The CR is directed perpendicular to the posterior surface of the foot (near the metatarsophalangeal joints). The dorsoplantar and oblique projections of the foot will demonstrate the sesamoid bones superimposed on adjacent bony structures.

In the 45-degree medial oblique projection of the ankle, 1.thetalotibial joint is visualized 2. tibiofibular joint is visualized 3. foot is dorsiflexed nearly 90° A. 1 only B. 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only The medial oblique projection of the ankle can be performed either as a 15- to 20-degree oblique or as a 45-degree oblique. The 15- to 20-degree oblique projection demonstrates the ankle mortise, that is, the articulations between the talus, tibia, and fibula. The 45-degree oblique opens the distal tibiofibular joint. It is essential that the foot and leg be rotated together.

For an AP projection of the knee on a patient whose measurement from ASIS to tabletop is more than 24 cm thin pelvis, which CR direction will best demonstrate the knee joint? A. 3-5 degrees caudad B. 10 degrees caudad C. 3-5 degrees cephalad D. 0 degrees (perpendicular)

C. 3-5 degrees cephalad

Which projection of the foot will best demonstrate the longitudinal arch? A. Mediolateral B. Lateromedial C. Lateral weight-bearing D. 30-degree medial oblique

C. Lateral weight-bearing The bones of the foot are arranged to form a number of longitudinal and transverse arches. The longitudinal arch facilitates walking and is evaluated radiographically in lateral weight-bearing (erect) projections. Recumbent laterals would not demonstrate any structural change that occurs when the individual is weight-bearing erect.

What is the structure labeled number 2 in Figure 2-37 A. Base of the 2nd metacarpal B. Pisiform C. Trapezium D. Trapezoid

C. Trapezium 1. base of the second metacarpal 2. trapizium 3. scaphoid lateral carpal, proximal row 4 The pisiform 5 radial styloid process 6 ulnar styloid process

All of the following bones are associated with condyles except the A. femur. B. tibia. C. fibula. D. mandible.

C. fibula. The distal femur is associated with two large condyles; the deep depression separating them is the intercondyloid fossa (Fig. A). The proximal tibia has two condyles; their superior surfaces are smooth, forming the tibial plateau. The mandible has a condyle that articulates with the mandibular fossa of the temporal bone, forming the temporomandibular joint. The fibula has a proximal styloid process and a distal malleolus, but no condyle.

The structure labeled number 5 in Figure 2-41 is the A. sternoclavicular joint B. acromioclavicular joint C. glenohumeral joint D. acromiohumeral joint

C. glenohumeral joint An AP, external rotation, projection of the shoulder is pictured. The hand is supinated, and the arm is in the anatomical position. Therefore, the greater tubercle (number 3) is well visualized. The greater portion of the clavicle is seen, the acromioclavicular joint (number 1), the acromion process (number 2), the coracoid process (number 4), and the glenohumeral joint (number 5). The coronoid process is located on the ulna.

The best projection to demonstrate vertical fractures of the patella. A. AP knee. B. PA knee. C. tangential ("sunrise") projection. D. tunnel view

C. tangential ("sunrise") projection

Which of the following is proximal to the carpal bones? A. Distal interphalangeal joints B. Proximal interphalangeal joints C. Metacarpals D. Radial styloid process

D. Radial styloid process The term proximal refers to structures closer to the point of attachment. For example, the elbow is described as being proximal to the wrist; that is, the elbow is closer to the point of attachment (the shoulder) than is the wrist. Referring to the question, then, the interphalangeal joints (both proximal and distal) and the metacarpals are both distal to the carpal bones. The radial styloid process is proximal to the carpals.

Which of the following is used to obtain a lateral projection of the upper humerus on patients who are unable to abduct their arm? A. Bicipital groove projection B. Superoinferior lateral C. Inferosuperior axial D. Transthoracic lateral

D. Transthoracic lateral A transthoracic projection is used to obtain a lateral projection of the upper half to two-thirds of the humerus when the arm cannot be abducted. The affected arm is placed next to the upright Bucky, the unaffected arm rests on the head, and the CR is directed horizontally through the thorax, exiting the upper humerus. The superoinferior and inferosuperior projections of the shoulder both require abduction of the arm.

What portion of the humerus articulates with the ulna to help form the elbow joint? A. Semilunar/trochlear notch B. Radial head C. Capitulum D. Trochlea

D. Trochlea The distal humerus articulates with the proximal radius and ulna to form the elbow joint. Specifically, the semilunar/trochlear notch of the proximal ulna articulates with the trochlea of the distal medial humerus. The capitulum is lateral to the trochlea and articulates with the radial head

The mediolateral projection of the knee shown in Figure 6-1 could best be improved by A..rotating the patient forward B. rotating the patient backward C. angling the central ray (CR) about 5 degrees caudad D. angling the CR about 5 degrees cephalad

D. angling the CR about 5 degrees cephalad The knee is formed by the proximal tibia, the patella, and the distal femur, which articulate to form the femorotibial and femoropatellar joints. The distal posterior femur presents two large medial and lateral condyles separated by the deep intercondyloid fossa. Because the medial femoral condyle is further from the IR, it is magnified and will obscure the femorotibial joint space, as seen in the figure. If the CR is angled about 5 degrees cephalad, the medial femoral condyle will be projected superiorly and superimposed on the lateral femoral condyle, thus opening the joint space. The patient should lie on the affected side with the patella perpendicular to the tabletop and the knee flexed 20 to 30 degrees. Rotating the part forward or backward will affect visualization of the femoropatellar joint.

All the following can be associated with the distal ulna except A. head. B. radioulnar joint. C. styloid process. D. trochlear notch.

D. trochlear notch. The distal ulna presents a head and styloid process and articulates with the distal radius to form the distal radioulnar joint. The ulna is slender distally but enlarges proximally and becomes the larger of the two bones of the forearm. At its proximal end, the ulna presents the olecranon process (posteriorly) and coronoid process (anteriorly) that are joined by a large articular cavity, the semilunar, or trochlear notch. The coronoid process fits into the humeral coronoid fossa during flexion, and the olecranon process fits into the humeral olecranon fossa during extension. Just distal and lateral to the semilunar/trochlear notch is the radial notch, which provides articulation for the radial head to form the proximal radioulnar articulation. The ulna is the principal bone of the elbow joint, and the radius is the principal bone of the wrist joint.

Which of the following may be used to evaluate the glenohumeral joint when the patient is able to abduct the arm. 1. Scapular Y projection 2. Inferosuperior axial 3. Transthoracic lateral A. 2 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

The inferosuperior axial projection

Which of the following may be used to evaluate the glenohumeral joint and upper humerus when the patient is unable to abduct the arm 1. Scapular Y projection 2. mInferosuperior axial 3. Transthoracic lateral A. 3 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

3- The transthoracic lateral projection

The greater tubercle should be visualized in profile in which of the following? A. AP shoulder, external rotation B. AP shoulder, internal rotation C. AP elbow D. Lateral elbow

A. AP shoulder, external rotation The greater and lesser tubercles are prominences on the proximal humerus, separated by the bicipital groove. The AP projection of the humerus in external rotation demonstrates the greater tubercle in profile. With the arm placed in internal rotation, the humerus is placed in a true lateral position and the lesser tubercle is demonstrated.

What projection of the calcaneus is obtained with the leg extended, the plantar surface of the foot vertical and perpendicular to the IR, and the CR directed 40 degrees cephalad? A. Axial plantodorsal projection B. Axial dorsoplantar projection C. Lateral projection D. Weight-bearing lateral projection

A. Axial plantodorsal projection The plantodorsal projection of the os calsis/calcaneus is described. It is performed supine and requires cephalad angulation. The CR enters the plantar surface and exits the dorsal surface. The axial dorsoplantar projection requires that the CR enter the dorsal surface of the foot and exit the plantar surface

During knee arthrography, into what space is the contrast medium injected? A. Synovial capsule B. Meniscus C. Medial collateral ligament D. Patellofemoral space

A. Synovial capsule Knee injuries are common in the population, especially in athletes. To evaluate the extent of injury to either the thin fibrous cartilage pads (called lateral and medial menisci) cushioning the knee joint or the anterior and posterior cruciate ligaments that attach the femur to the tibia, a knee arthrogram may be performed. Freely movable joints such as the knee are enclosed in a synovial capsule that produces synovial fluid for lubrication. To visualize the structures within the capsule, an iodinated contrast medium and air (in a dual-contrast arthrography study) is injected within the capsule. Stress views of the knee are often obtained to further radiographically demonstrate the menisci or cruciate ligaments (A). Injection of contrast media directly within the meniscus would prevent infusion of the contrast media into the joint space, which is required to enhance visualization of the structures within the joint capsule (B). Injection of contrast media into the medial collateral ligament (located medial to the joint capsule) connecting the medial femoral condyle with the medial tibial tuberosity would mean the needle was not inserted far enough to penetrate the synovial capsule (C). Although the patellofemoral joint is lined with synovial fluid and is a proximal extension of the knee synovial capsule, there exists a bursa (small fluid-filled sac) providing a cushion between the patella and femur. Injection into the bursae would not allow adequate infusion of the contrast media into the knee joint proper (D).

All the following can be associated with the distal radius except A. head. B. styloid process. C. ulnar notch. D. radioulnar joint.

A. head. The distal radius presents a styloid process laterally; the ulnar notch is located medially, helping to form the distal radioulnar articulation. The distal surface of the radius (carpal articular surface) is smooth for accommodating the scaphoid and lunate to form the radiocarpal (wrist) joint. The proximal radius has a cylindrical head with a medial surface that participates in the proximal radioulnar joint; its superior surface articulates with the capitulum of the humerus. Fracture of the distal radius is one of the most common skeletal fractures. Fractures of the radial head and neck frequently result from a fall onto an outstretched hand with the elbow partially flexed. Severe fractures often are accompanied by posterior dislocation of the elbow joint. Colles' fractures of the distal radius usually result from a fall onto an outstretched hand with the arm extended

A spontaneous fracture most likely would be associated with A. pathology. B. crepitus. C. trauma. D. metabolism.

A. pathology. Spontaneous fractures most often affect bone weakened by a pathologic condition, for example, metastatic bone disease. The spontaneous fracture occurs suddenly, without trauma. One measure of a good radiographer is his or her ability to be cautious and resourceful when examining injured or debilitated patients having pathologic or traumatic conditions such as metastatic bone disease, arthritis, or bone fractures. Crepitus refers to a crackling sound made by a body part—such as the sound of fractured ends of bones rubbing together. Metabolism refers to the numerous energy and material transformations that take place in the body and is not associated with spontaneous fractures.

What is best elbow position to demonstrate the radial head and ulna normally are somewhat superimposed.

AP projection of the elbow, the radial head and ulna normally are somewhat superimposed. The lateral oblique projection demonstrates the radial head free of ulnar superimposition. The lateral projection demonstrates the olecranon process in profile. The medial oblique projection demonstrates considerable overlap of the proximal radius and ulna but should clearly demonstrate the coronoid process free of superimposition and the olecranon process within the olecranon fossa.

What projection was used to obtain the image seen in Figure 2-41? A. AP, internal rotation B. AP, external rotation C. AP, neutral position D. AP axial

B. AP, external rotation An AP, external rotation, projection of the shoulder is pictured. The hand is supinated, and the arm is in the anatomical position. Therefore, the greater tubercle (number 3) is well visualized. The greater portion of the clavicle is seen, the acromioclavicular joint (number 1), the acromion process (number 2), the coracoid process (number 4), and the glenohumeral joint (number 5). The coronoid process is located on the ulna.

An axial projection of the clavicle is often helpful in demonstrating a fracture that is not visualized using a perpendicular CR. When examining the clavicle in the PA axial projection, how should the Central Ray directed? A. Cephalad B. Caudad C. Medially D. Laterally

B. Caudad With the patient positioned AP erect or supine, the CR is directed cephalad 25 to 30°. This serves to project the clavicle away from the pulmonary apices and ribs, projecting most of the clavicle above the thorax. The reverse is true when the patient is examined for the PA axial projection, i.e. the CR is directed caudally. The PA and PA axial projections can be useful for better resolution because of the reduced OID.

What could be done to improve the mediolateral projection of the knee seen in Figure 2-3? A. Rotate the pelvis slightly forward/anteriorly. B. Rotate the pelvis slightly backward/posteriorly. C. Angle the x-ray tube 5 degrees cephalad. D. Angle the x-ray tube 5 degrees caudad.

B. Rotate the pelvis slightly backward/posteriorly. The figure illustrates a mediolateral projection of the knee. The femoral condyles are not superimposed posteriorly, indicating incorrect degree of forward (anterior)/backward (posterior) rotation. Because the magnified medial femoral condyle is obscuring the femoropatellar articulation, the radiographer should rotation the pelvis backward, i.e. posteriorly, a bit. This will superimpose the femoral condyles, place the patella perpendicular to the tabletop, and open the femoropatellar joint space.

When performing either a Homblad or a Camp-Coventry method of the knee to visualize the intercondylar fossa, which of the following statements are true? (select the two that apply) A. The knee is flexed 30°° B. The central ray is directed parallel to the tibial plateau C. The central ray is directed perpendicular to the long axis of the tibia D. The central ray is directed parallel to the long axis of the tibia E. The proximal tibiofibular articulation will be open

B. The central ray is directed parallel to the tibial plateau C. The central ray is directed perpendicular to the long axis of the tibia Several methods are available to visualize the intercondylar fossa of the knee. The Homblad method is a PA projection with 70 degrees flexion of the knee, the lower leg running parallel to the IR. The Camp-Coventry method raises the lower leg off of the IR, utilizing 40 to 50 degrees of knee flexion, with a matching caudal angle. Both views require that the central ray travel parallel to the plane of the tibial plateau, perpendicular to the long axis of the tibia (B and C). None of the tunnel projections of the knee completely open the proximal tibiofibular joint, which is best revealed on a medial oblique (internal rotation) projection (E). The other answer choices are incorrect as per the previous explanation

Which of the following projections will best demonstrate the carpal scaphoid? A. Lateral wrist B. Ulnar deviation C. Radial deviation D. Carpal tunnel

B. Ulnar deviation The carpal scaphoid is somewhat curved and consequently foreshortened radiographically in the PA projection/position. To better separate it from the adjacent carpals, the ulnar deviation maneuver is frequently employed. In addition to correcting foreshortening of the scaphoid, ulnar deviation opens the interspaces between adjacent lateral carpals. Radial deviation is used to better demonstrate medial carpals.

The structure labeled number 4 in Figure 2-41 is the A. acromion process B. coracoid process C. coronoid process D. glenoid process

B. coracoid process An AP, external rotation, projection of the shoulder is pictured. The hand is supinated, and the arm is in the anatomical position. Therefore, the greater tubercle (number 3) is well visualized. The greater portion of the clavicle is seen, the acromioclavicular joint (number 1), the acromion process (number 2), the coracoid process (number 4), and the glenohumeral joint (number 5). The coronoid process is located on the ulna. (

Important considerations for radiographic examinations of traumatic injuries to the upper extremity include 1. only the joint closest to the injured site must be supported during movement. 2. both joints must be included in long bone studies. 3. two views, at 90 degrees to each other, are required. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only

The AP oblique projection (medial rotation) of the elbow demonstrates which of the following? 1.Radial head free of superimposition 2.Olecranon process within the olecranon fossa 3.Coronoid process free of superimposition A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only

Each of the digits 2 through 5 of the hand contain how many interphalangeal joints? A. 3 B. 1 C. 2 D. 4

C. 2 If the question had asked about the number of phalanges in fingers 2 through 5, the right answer would be 3 interphalangeal joints (A). Just by logical deduction, knowing that a joint is where two bones meet, and that interphalangeal means between phalanges, the number of interphalangeal joints between 3 phalangeal bones arranged linearly must be 2 (C). The thumb has just 1 interphalangeal joint, and no digit has 4 phalanges in normal anatomy (B and D).

Which of the following projections is most likely to demonstrate the carpal pisiform free of superimposition? A. Radial flexion/deviation B. Ulnar flexion/deviation C. AP (medial) oblique D. AP (lateral) oblique

C. AP (medial) oblique In the direct PA projection of the wrist, the carpal pisiform is superimposed on the carpal triquetrum. The AP oblique projection (medial surface adjacent to the IR) separates the pisiform and triquetrum and projects the pisiform as a separate structure. The pisiform is the smallest and most palpable carpal.

In which position of the shoulder is the lesser tubercle demonstrated in profile on the medial aspect of the humeral head? A. AP B. External rotation C. Internal rotation D. Neutral position

C. Internal rotation The external rotation position is the true AP position and places the greater tubercle in profile laterally and places the lesser tubercle anteriorly. The internal rotation position demonstrates the lesser tubercle in profile medially and places the humerus in a true lateral position. The epicondyles should be superimposed and perpendicular to the IR. The neutral position places the epicondyles about 45 degrees to the IR and the greater tubercle is partially superimposed on the humeral head.

The functions of which body system include mineral homeostasis, protection, and triglyceride storage? A. Endocrine B. Integumentary C. Skeletal D. Muscular

C. Skeletal The skeleton's design functions to protect vital internal organs such as the heart and lungs. Bone stores important minerals (e.g., calcium and phosphorus) and releases them into the blood as needed. Yellow bone marrow is composed mainly of fat cells and stores triglycerides for use as an energy reserve. The endocrine system is associated with hormone production; the integumentary system includes the skin that is important in protection and excretion; the muscular system is responsible for movement and heat production.

Which of the following statements is true regarding the following AP ankle projection? A. The distal half of the metatarsals are well visualized B. The mortise joint is open on all sides C. Superimposition of the distal tibia and fibula is present D. The talus is projected inferior to the calcaneus

C. Superimposition of the distal tibia and fibula is present For the AP projection of the ankle, the ankle will be positioned by ensuring there is no rotation of the lower leg. This positioning will allow the distal thirds of the tibia and fibula, the talus, and the malleoli to be well-visualized. Slight superimposition of the distal tibia and fibula will occur with proper positioning (C). The proximal half of the metatarsals will be visible; however, the distal half will not be included in the image (A). The mortise joint will be open medially, while the lateral side will remain closed (B). The talus will be projected superior to the calcaneus, directly below the distal tibia (D).

Which of the following positions can be used to demonstrate a vertical patellar fracture and the patellofemoral articulation? A. AP knee B. Lateral knee C. Tangential patella D. Tunnel view

C. Tangential patella In the tangential (sunrise) projection of the patella, the CR is directed parallel to the longitudinal plane of the patella, thereby demonstrating a vertical fracture and providing the best view of the patellofemoral articulation. The AP knee projection could demonstrate a vertical fracture through the superimposed femur, but it does not demonstrate the patellofemoral articulation. The tunnel view of the knee is used to demonstrate the intercondyloid fossa.

The best projection to demonstrate the articular surfaces of the femoropatellar articulation is the A. AP knee. B. PA knee. C. tangential ("sunrise") projection. D. tunnel view

C. tangential ("sunrise") projection. The tangential ("sunrise") projection is used to demonstrate the articular surfaces of the femur and patella. It is also used to demonstrate vertical fractures of the patella. The AP, PA, and oblique projections of the knee are used primarily to evaluate the joint space and articulating structures. The tunnel view is used to demonstrate the intercondyloid fossa.

Which of the following are components of a trimalleolar fracture? 1. Fractured lateral malleolus 2. Fractured medial malleolus 3. Fractured posterior tibia A. 1 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 A trimalleolar fracture involves three separate fractures. The lateral malleolus is fractured in the "typical" fashion, but the medial malleolus is fractured on both its medial and posterior aspects; the posterior aspect is often referred to as the posterior malleolus. The trimalleolar fracture frequently is associated with subluxation of the articular surfaces.

Which of the following criteria is (are) required for visualization of the greater tubercle in profile? 1.Epicondyles parallel to the IR 2.Arm in external rotation 3.Humerus in AP position A. 1 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The greater and lesser tubercles are prominences on the proximal humerus separated by the intertubercular (bicipital) groove. The AP projection of the humerus/shoulder places the epicondyles parallel to the IR and the shoulder in external rotation, and demonstrates the greater tubercle in profile. The lateral projection of the humerus places the shoulder in extreme internal rotation with the epicondyles perpendicular to the IR and demonstrates the lesser tubercle in profile.

To better demonstrate the interphalangeal joints of the toes, which of the following procedures may be employed? 1. Angle the CR 15 degrees caudad. 2. Angle the CR 15 degrees cephalad. 3. Place a sponge wedge under the foot with the toes elevated 15 degrees. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 onl.

D. 2 and 3 only Because the toes curve naturally downward, the interphalangeal joints are not well demonstrated in the AP (dorsoplantar) projection. To "open" the interphalangeal joints, the CR should be directed 15 degrees cephalad. Another method is to place a 15-degree foam sponge wedge under the foot, elevating the toes 15 degrees from the IR; the CR then would be directed perpendicularly

Which of the following positions would be the best choice for a right shoulder examination to rule out fracture? A. Internal and external rotation B. AP and tangential C. AP and AP axial D. AP and scapular Y

D. AP and scapular Y The AP projection will give a general survey and show mediolateral and inferosuperior joint relationships. The scapular Y position (LAO or RAO) is employed to demonstrate anterior (subcoracoid) or posterior (subacromial) humeral dislocation. The humerus normally is superimposed on the scapula in this position; any deviation from this may indicate dislocation. Rotational views must be avoided in cases of suspected fracture. The AP and scapular Y combination is the closest to two views at right angles to each other.

Standard radiographic protocols may be reduced to include two views, at right angles to each other, in which of the following situations? A. Barium examinations B. Spine radiography C. Skull radiography D. Emergency and trauma radiography

D. Emergency and trauma radiography Standard radiographic protocols may be reduced to include two views, at right angles to each other, in emergency and trauma radiography. Department policy and procedure manuals include protocols for radiographic examinations. In the best interest of the patient, and to enable the radiologist to make an accurate diagnosis, standard radiographic protocols should be followed. If the radiographer must deviate from the protocol or believes that additional projections may be helpful, then this should be discussed with the radiologist. Emergency and trauma radiography occasionally is an exception to this rule. If the emergency department physician's request varies from the department protocol, the radiographer must respect this. A note should be added to the request so that the radiologist is informed of the reason for a change in protocol. For example, a patient who has been involved in a motor vehicle accident may need many radiographic studies, but the emergency department physician may order an AP chest and an AP and cross-table lateral C-spine only. Standard protocol may include a lateral chest and a cone-down view of the atlas and axis, as well as cervical oblique views. The emergency department physician has made a decision based on experience and expertise that overrules standard protocols. At a later time, when the patient has been stabilized, the patient may be sent back to radiology for additional views.

n a routine (mediolateral) lateral projection of the knee, if the fibular head is seen to be completely free from superimposition of the proximal tibia, what positioning error likely occurred? A. The patient extended their knee too much. B. The patient was rotated posteriorly. C. The patient flexed their knee too much. D. The patient was rotated anteriorly.

D. The patient was rotated anteriorly. A positioning error may be committed during a lateral knee radiograph when the patient is over-rotated from the supine position onto the side of the affected knee. If not corrected by the radiographer, proper superimposition of the femoral condyles of the affected knee will not be obtained and the over-rotation will draw the fibular head posteriorly out of normal partial superimposition of the proximal tibia (approximately one-third of the fibular head should be superimposed with proper positioning). To avoid a repeat radiograph, careful palpation and proper superimposition of the posterior femoral condyles by palpating the femoral epicondyles should be performed (D). If the lateral knee is otherwise positioned correctly, flexion of 20 to 30 degrees is preferred as this relaxes the muscles and demonstrates maximum volume of the joint cavity. However, if the knee is extended either too much or too little and the femoral condyles are properly superimposed, this extension or flexion would not draw the fibular head posteriorly out of normal superimposition of the proximal tibia. The radiographer must use caution not to flex the knee more than 10 degrees if there is a known patellar fracture to avoid displacing the fracture (A and C). If the knee is under-rotated, this would superimpose more than one-third of the fibular head under the tibia (B).

Which shoulder position is used in the following image? Courtesy of Orthopedic + Fracture Specialists, Portland OR A. AP projection—external rotation B. AP oblique projection—glenoid cavity C. AP projection—internal rotation D. Apical AP axial projection

In this projection of the shoulder, you can see that the lesser tubercle is visualized in profile; this indicates that the projection is the AP with internal rotation (C). The AP oblique projection for the glenoid cavity (B), also known as the Grashey method, would demonstrate an open joint space between the humeral head and the glenoid of the scapula. The AP projection with external rotation (A) would show the greater tubercle in profile rather than the lesser tubercle. The apical AP axial projection (D) is used to open the acromiohumeral space.

The scapula shown in Figure 2-29 demonstrates 1. its posterior aspect 2. its costal surface 3. its sternal articular surface A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

1. its posterior aspect Visualization of the scapular spine (number 13) indicates that this is a view of the posterior aspect of the scapula. The scapula's anterior, or costal, surface is that which is adjacent to the ribs. The scapula has no sternal articulation.

Which of the following are fat pads or fat stripes that may be visible on the lateral projection of the elbow during trauma? (select the three that apply) A. Posterior B. Anterior C. Superior D. Distal E. Flexor F. Supinator

A-B-F When imaging the lateral elbow, fat pads or stripes may become visible and are indicative of trauma. During injuries such as fractures, the fat pads become more visible due to shape change and inflammation. The posterior fat pad (A) is located behind the olecranon and can only be properly visualized with 90-degree flexion of the elbow. The anterior fat pad (B) is located anterior to the distal humerus and is formed by two overlapping fat pads: the coronoid and radial fat pads. These are typically located in the depression of the coronoid fossa. The supinator fat stripe (F) is located just anterior to the radial neck and, when visible, most likely indicates fractures of the radial head.

Which of the following is (are) located on the anterior aspect of the femur? 1. Patellar surface 2. Intertrochanteric crest 3. Linea aspera A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

A. 1 only The femur is the longest and strongest bone in the body. The femoral shaft is bowed slightly anteriorly and presents a long, narrow ridge posteriorly called the linea aspera. The proximal femur consists of a head that is received by the pelvic acetabulum. The femoral neck, which joins the head and shaft, normally angles upward about 120 degrees and forward (in anteversion) about 15 degrees. The greater and lesser trochanters are large processes on the posterior proximal femur. The intertrochanteric crest runs obliquely between the trochanters; the intertrochanteric line parallels the intertrochanteric crest on the anterior femoral surface. The intercondyloid fossa, a deep notch, is found on the distal posterior femur between the large femoral condyles, and the popliteal surface is a smooth surface just superior to the intercondyloid fossa. Just opposite the popliteal surface, on the distal anterior femur is the patellar surface—a smooth surface for patellar motion during flexion and extension of the knee.

Which of the following is (are) located on the proximal aspect of the humerus? 1. Intertubercular groove 2. Capitulum 3. Coronoid fossa A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

A. 1 only The intertubercular (bicipital) groove is located on the proximal humerus, distal to the head, between the greater and lesser tubercles. The distal humerus articulates with the radius and ulna to form the elbow joint. The lateral aspect of the distal humerus presents a raised, smooth, rounded surface, the capitulum, which articulates with the superior surface of the radial head. The trochlea is on the medial aspect of the distal humerus and articulates with the semilunar notch of the ulna. Just proximal to the capitulum and the trochlea are the lateral and medial epicondyles; the medial is more prominent and palpable. The coronoid fossa is found on the anterior distal humerus and functions to accommodate the coronoid process with the elbow in flexion.

To demonstrate a profile view of the glenoid fossa, the patient is AP recumbent and obliqued 45 degrees A. toward the affected side B. away from the affected side C. with the arm at the side in the anatomic position D. with the arm in external rotation

A. toward the affected side In an AP projection of the shoulder, there is superimposition of the humeral head and glenoid fossa. With the patient obliqued 45 degrees toward the affected side, the glenohumeral joint is open, and the glenoid fossa is seen in profile. The patient's arm is abducted somewhat and placed in internal rotation.

The Grashey projection of the shoulder below can be used to demonstrate which of the following? A. Glenohumeral joint B. Anterior dislocation of the humerus C. Lesser tubercle abnormalities D. Posterior dislocation of the humerus

A. Glenohumeral joint The Grashey method of the oblique shoulder is used to demonstrate the glenohumeral joint space, fractures of the glenoid and proximal humerus, and degenerative changes of the shoulder girdle (A). This projection should not be utilized for evaluation of anterior or posterior dislocations; the scapular Y or axial projections provide more useful information (B and D). The lesser tubercle is best seen on the AP projection of the shoulder with internal rotation, which brings the lesser tubercle in profile (C).

In which projection of the foot are the interspaces between the first and second cuneiforms best demonstrated? A. Lateral oblique foot B. Medial oblique foot C. Lateral foot D. Weight-bearing foot

A. Lateral oblique foot The lateral oblique demonstrates the interspaces between the first and second metatarsals and between the first and second cuneiforms. To best demonstrate most of the tarsals and intertarsal spaces (including the cuboid, sinus tarsi, and tuberosity of the fifth metatarsal), a medial oblique projection is required (plantar surface and IR form a 30-degree angle). A weight-bearing lateral projection of the feet is used to demonstrate the longitudinal arches.

Which of the following is an important consideration to avoid excessive metacarpal joint overlap in the oblique projection of the hand? A. Oblique the hand no more than 45 degrees. B. Use a support sponge for the phalanges. C. Clench the fist to bring the carpals closer to the IR. D. Use ulnar flexion.

A. Oblique the hand no more than 45 degrees The oblique projection of the hand should demonstrate minimal overlap of the third, fourth, and fifth metacarpals. Excessive overlap of these metacarpals is caused by obliquing the hand more than 45 degrees. The use of a 45-degree foam wedge ensures that the fingers will be extended and parallel to the IR, thus permitting visualization of the interphalangeal joints and avoiding foreshortening of the phalanges. Clenching of the fist and ulnar flexion are maneuvers used to better demonstrate the carpal scaphoid..

When examining a patient whose elbow is in partial flexion, A. the AP projection requires two separate positions and exposures. B. the AP projection is made through the partially flexed elbow, resting on the olecranon process, CR perpendicular to IR. C. the AP projection is made through the partially flexed elbow, resting on the olecranon process, CR parallel to the humerus. D. the AP projection is eliminated from the routine.

A. the AP projection requires two separate positions and exposures. When a patient's elbow needs to be examined in partial flexion, the lateral projection offers little difficulty, but the AP projection requires special attention. If the AP projection is made with a perpendicular CR and the olecranon process resting on the table-top, the articulating surfaces are obscured. With the elbow in partial flexion, two exposures are necessary to achieve an AP projection of the elbow joint articular surfaces. One is made with the forearm parallel to the IR (humerus elevated), which demonstrates the proximal forearm. The other is made with the humerus parallel to the IR (forearm elevated), which demonstrates the distal humerus. In both cases, the CR is perpendicular if the degree of flexion is not too great or angled slightly into the joint space with greater degrees of flexion.

Which of the following projections will visualize a trimalleolar fracture? (select the four that apply) A. AP ankle B. AP foot C. 15° oblique ankle D. 45° oblique foot E. Lateral ankle F. Lateral foot

A.-C-E-F A trimalleolar fracture involves the medial and posterior malleoli of the tibia and the lateral malleolus of the fibula. The AP ankle and 15° oblique ankle demonstrate the medial and lateral malleoli free of superimposition (A and C). Both the lateral ankle and the lateral foot can visualize a posterior malleolus fracture, since they both will include the distal third of the tibia (E and F). The 45° oblique foot does not clearly demonstrate either malleoli for fracture evaluation (D).

Consider an upright right lateral humerus projection of a patient who has been injured and insists on supporting their affected side with their contralateral hand to alleviate the pain. Which of the following methods would be best for the radiographer to use? A. Patient standing with the posterior surface of the shoulder of the affected side against the wall Bucky and rotating the affected arm medially to place the humeral epicondyles perpendicular to the IR B. Patient standing with the lateral surface of the shoulder of the affected side against the wall Bucky and rotating the affected arm medially to place the humeral epicondyles perpendicular to the IR C. Patient standing with the anterior surface of the shoulder of the unaffected arm against the wall Bucky and rotating the affected arm laterally to place the humeral epicondyles perpendicular to the IR D. Patient standing with their body in the lateral position against the wall Bucky with the affected humerus closest to the IR but with no manipulation of the arm

B. A minimum of two projections 90 degrees from each other must be performed during extremity radiography to detect a possible fracture and any associated displacement. In the lateral projection of the humerus, the humeral epicondyles must be superimposed to place the coronal plane perpendicular to the IR. Either the anterior or posterior approach may be used. However, the radiographer must consider all aspects of how to best conduct a procedure in such a way to minimize the patient's pain, prevent potential displacement of a fracture, and minimize OID. In this scenario, it is best to allow the patient to continue supporting their arm in front of them and place the lateral surface of the humerus against the wall Bucky. This minimizes any further patient discomfort and places the humerus closest to the IR. Reducing the OID whenever possible is important to reduce magnification distortion and provide optimal spatial resolution (B). Although the anterior approach may be used to project the lateral humerus, in his case, it would be difficult and painful for the patient to place the palm of their hand of the affected side on their hip to superimpose the humeral epicondyles. Minimizing movement of an injured patient is critical, as such movement may cause displacement of a fracture and increase the severity of the injury. Since the patient in this scenario must support their arm to alleviate pain, the anterior approach would place the lateral humerus at an unacceptable OID (A). With the patient standing with the anterior surface of the shoulder of the unaffected arm against the wall Bucky and rotating the affected arm laterally to place the humeral epicondyles perpendicular to the IR and using a lateromedial projection, there would be a risk of fracture displacement, and patient discomfort and OID would be unacceptable (C). As mentioned previously, a minimum of two projections 90 degrees from each other must be performed during extremity radiography to detect a possible fracture and any associated displacement. If the patient is standing with their body in the lateral position against the wall Bucky and with the affected humerus closest to the IR but with no manipulation of the arm or body, the humeral epicondyles would not be superimposed and a true 90-degree projection from the AP projection would not be achieved (D)

Conditions in which there is a lack of normal bone calcification include 1.rickets. 2.osteomalacia. 3. osteoarthritis. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only Rickets and osteomalacia are disorders in which there is softening of bone. Rickets results from a deficiency of vitamin D and usually is found affecting the growing bones of young children. The body's weight on the soft bones of the legs results in bowed and misshapen legs. Osteomalacia is an adult condition in which new bone fails to calcify. It is a painful condition and can result in easily fractured bones, especially in the lower extremities. Osteoarthritis is seen often in the elderly and is characterized by degeneration of articular cartilage in adjacent bones. The resulting rubbing of bone against bone results in pain and deterioration.

Which of the following can be used to demonstrate the intercondyloid fossa? 1. Prone, knee flexed 40 degrees, CR directed caudad 40 degrees to the popliteal fossa 2. Supine, IR under flexed knee, CR directed cephalad to knee, perpendicular to tibia 3. Prone, patella parallel to IR, heel rotated 5 to 10 degrees lateral, CR perpendicular to knee joint A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only Statement number 1 describes the PA axial projection (Camp-Coventry method) for demonstration of the intercondyloid fossa. Statement number 2 describes the AP axial projection (Béclère method) for demonstration of the intercondyloid fossa. The positions are actually the reverse of each other. Statement number 3 describes the method of obtaining a PA projection of the patella

Examples of synovial pivot articulations include the 1. atlantoaxial joint 2. radioulnar joint 3. temporomandibular joint A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3 only

B. 1 and 2 only Synovial pivot joints are diarthrotic, that is, freely movable. Pivot joints permit rotation motion. Examples include the proximal radioulnar joint that permits supination and pronation of the hand. The atlantoaxial joint is the articulation between C1 and C2 and permits rotation of the head. The temporomandibular joint is diarthrotic, having both hinge and planar movements.

In the following image, the base of the 3rd metatarsal articulates with 1. The lateral cuneiform 2. The base of the second metatarsal 3. The medial cuneiform 4. The base of the fifth metatarsal A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 4 only

B. 1 and 2 only The AP (dorsoplantar) projection of the foot should adequately demonstrate the phalanges, metatarsals, and the articulations between the metatarsals and cuneiforms, navicular, and cuboid tarsals. The base of the third metatarsal articulates with the lateral (3rd) cuneiform, the base of the second metatarsal, and the base of the 4th metatarsal (A and B). The medial cuneiform articulates with the base of the second metatarsal and navicular. The base of the fifth metatarsal articulates with the cuboid and base of the 4th metatarsal.

A patient unable to extend his or her arm is seated at the end of the x-ray table, elbow flexed 90 degrees, with epicondyles perpendicular to IR. The CR is directed 45 degrees medially. Which of the following structures will be demonstrated best? 1. Radial head 2. Capitulum 3. Coronoid process A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only The axial trauma lateral (Coyle) position is described. If routine elbow projections in extension are not possible because of limited part movement, this position can be used to demonstrate the coronoid process and/or radial head. With the elbow flexed 90 degrees, the epicondyles perpendicular to the IR, and the CR directed to the elbow joint at an angle of 45 degrees medially (i.e., toward the shoulder), the joint space between the radial head and capitulum should be revealed. With the elbow flexed 80 degrees and the CR directed to the elbow joint at an angle of 45 degrees laterally (i.e., from the shoulder toward the elbow), the elongated coronoid process will be visualized

The following procedure can be employed to better demonstrate the carpal scaphoid: 1.elevate hand and wrist 20°. 2.place wrist in ulnar deviation. 3.angle CR 20° distally (toward fingers). A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

B. 1 and 2 only The carpal scaphoid is a curved, boat-shaped, bone, and is therefore superimposed on itself ("self-superimposition") in a routine PA projection. Since the scaphoid is the most frequently fractured carpal, special projections have been developed to help overcome self-superimposition. Stecher (in 1937) recommended elevating the hand and wrist 20° and using a perpendicular CR directed to the scaphoid. Effective variations of this position include employing ulnar deviation and angling the CR 20° proximally (toward the elbow). The 20° tube angulation would be used in place of the elevated hand/wrist.

In the following image, which of the following statements is/are true regarding positioning? 1. Digits are parallel to the IP 2. There is a 45-degree obliquity 3. Centering is at the 3rd PIP joint A. 2 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only The image is an example of the PA oblique projection of the hand. In the image, you can see that the digits are parallel to the IP because the interphalangeal joints are open and the digits are not for shortened (1). The proper 45-degree obliquity is used (2), demonstrated by slight overlapping of the 3rd through 5th metacarpal heads. The centering, however, is at the head of the 3rd metacarpal, not at the 3rd PIP joint (3)

Which of the following are visible on the mortise view of the ankle? 1. Talotibial joint 2. Talofibular joint 3. Talocalcaneal joint A. 1 only B. 1 and 2 only C. 1 and 3 only D. 2 and 3 only

B. 1 and 2 only The mortise view of the ankle is a 15-20-degree medial oblique position utilized to demonstrate the mortise joint. The mortise joint is comprised of the 3 articular surfaces between the fibula, tibia, and talus. The joint spaces visualized with the mortise position include the talotibial (1) and talofibular (2). The talocalcaneal joint is not well visualized from the mortise position as it is superimposed by the tarsals.

In the typical AP projection of the ankle, 1. the plantar surface of the foot is vertical. 2. fibula projects more distally than the tibia. 3. calcaneus is well visualized. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 2 only To demonstrate the ankle joint space to best advantage, the plantar surface of the foot should be vertical in the AP projection of the ankle. Note that the fibula is the more distal of the two long bones of the lower leg and forms the lateral malleolus. The calcaneus is not well visualized in this projection because of superimposition with other tarsals.

**Which of the following statements are true regarding the fracture in the following clavicle? 1. It is superior to the 5th rib 2. It is medial to the sternal extremity 3. It is inferior to the 2nd rib 4. It is lateral to the acromion A. 1 and 2 only B. 1 and 3 only C. 2 and 4 only D. 2, 3, and 4 only

B. 1 and 3 only The height of the fracture in the image rests at the arch of the 3rd rib, placing it both superior to the 5th rib (1) and inferior to the 2nd rib (3). The fracture is located on the acromial extremity of the clavicle. This would place the fracture external to the sternal extremity (2), and medial to the acromion (4).

Ulnar deviation will best demonstrate which carpal(s)?1. Medial carpals 2. Lateral carpals 3. Scaphoid A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

B. 2 and 3 only The carpal scaphoid is somewhat curved and consequently foreshortened radiographically in the PA position. To better separate it from the adjacent carpals, the ulnar deviation maneuver is employed frequently. In addition to correcting foreshortening of the scaphoid, ulnar deviation opens the interspaces between adjacent lateral carpals. Radial deviation is used to better demonstrate medial carpals.

With the patient positioned as shown in Figure 6-13, how should the CR be directed to best demonstrate the intercondyloid fossa? pt with Homblas position A. Perpendicular to the popliteal depression B. 40 degrees caudad to the popliteal depression C. Perpendicular to the long axis of the femur D. 40 degrees cephalad to the popliteal depression

B. 40 degrees caudad to the popliteal depression To demonstrate the intercondyloid fossa, the CR must be directed perpendicular to the long axis of the tibia (Figure 6-25). Because the knee is flexed so that the tibia forms a 40-degree angle with the IR, the CR must be directed 40 degrees caudad to place the CR perpendicular to the long axis of the tibia. Directing the CR to the popliteal depression aligns the CR parallel with the knee joint space. (Bontrager and Lampignano, 6th ed., p. 250)

What should be done to better demonstrate the coracoid process shown in Figure 2-22? A. Use a perpendicular CR. B. Angle the CR about 30 degrees cephalad. C. Angle the CR about 30 degrees caudad. D. Angle the MSP 15 degrees toward the affected side.

B. Angle the CR about 30 degrees cephalad. The figure shows an AP projection of the shoulder. A plane passing through the epicondyles is parallel to the IR (and perpendicular to the CR). To project the coracoid process with less self-superimposition, the CR must be angled cephalad 15 degrees. The amount of cephalad angulation depends on the degree of thoracic kyphosis; the greater the degree of kyphosis, the greater is the degree of cephalad angulation required. A 30-degree angle is used for the average patient

The anterior process of the scapula is which of the following? A. Coronoid process B. Coracoid process C. Carotid process D. Acromion

B. Coracoid process The two processes that extend from the body of the scapula are the acromion and the coracoid processes (B). The acromion extends from the posterior surface of the scapula (D). Coronoid processes can be found at the mandible and the elbow (A). Students should remember the phrase "A sea (C) between two (N)ations" as a memory tool to distinguish coronoids from coracoids. The one spelled with an extra C is between the ones spelled with an N. The carotid refers to arteries in the neck, not a bony process (C)

Positioning for the PA lateral scapula image below can be corrected by which of the following? A. Increasing the patient's rotation to bring the humeral head further into the ribs B. Decreasing the patient's rotation to bring the humeral head away from the ribs C. Bringing the patient's elbow back to project the humeral shaft onto the scapular body D. Use breathing technique and longer exposure time to blur out ribs

B. Decreasing the patient's rotation to bring the humeral head away from the ribs In the image of the PA lateral scapula, the patient is over rotated, which is causing the scapular body to be in an oblique position rather than true lateral. To fix this positioning error, the patient's rotation must be decreased, which would move the humeral head out of the ribs (B). Increasing the rotation would worsen the rotation (A). Bringing the elbow posterior would be useful in a scapular Y view of the shoulder but obstructs the body of the scapula for this study's purpose (C). Lastly, a breathing technique would not help with the rotation of the scapula (D).

Which projection should be performed and evaluated prior to performing a Settegast projection for trauma? A. PA oblique projection B. Lateral projection C. AP projection D. PA projection

B. Lateral projection A tangential projection of the patella for trauma should not be performed until a transverse fracture has been ruled out with a lateral projection. If a transverse fracture exists and the patient's knee is flexed, this could cause further separation and displacement of the fracture (B). Other projections, such as the PA oblique projection, AP projection, or PA projection may also be useful, but the lateral projection provides a more definitive determination of a transverse fracture

Which of the following projections/positions would best demonstrate structure number 6 seen in Figure 7-7? A. PA projection B. Lateral projection C. AP external oblique D. AP internal oblique

B. Lateral projection The figure shows a posterior view of the elbow. The distal posterior humerus (number 1) is seen, as well as the proximal posterior radius (number 4) and ulna (number 3). Additional structures identified are the medial epicondyle (number 2), the olecranon fossa (number 5), olecranon process (number 6), lateral epicondyle (number 7), and radial head (number 8) The olecranon process (number 6) can best be demonstrated in the lateral projection; it can also be demonstrated in the acute flexion position. The AP internal oblique will demonstrate the coronoid process; the AP external oblique will demonstrate the radial head free of superimposition.

Carpal tunnel syndrome shows impingement of what nerve? A. Radial B. Median C. Ulnar D. Transverse

B. Median In carpal tunnel syndrome, PA and lateral wrist views should be performed for the most common radiographic examination. The median nerve is the main nerve that is located in the hand (B). This nerve originates as a group of nerve roots in the neck. The roots come together to form a single nerve in the arm. The median nerve extends down the arm and passes through the carpal tunnel at the wrist. The median nerve provides feeling to the thumb, ring fingers, and index and middle fingers. The nerve also controls the muscles around the base of the thumb. The radial nerve supplies the posterior portion of the upper limb (A). The radial nerve and its branches provide motor innervation to the dorsal arm muscles. The ulnar nerve runs from the neck to the hand and alongside the ulna bone in the forearm (C). The ulnar collateral ligament of the elbow joint is related with the ulnar nerve. The transverse nerve is a nerve located in the cervical area. It innervates the scalp, face, and side of neck

Which of the following conditions is limited specifically to the tibial tuberosity? A. Ewing sarcoma B. Osgood-Schlatter disease C. Gout D. Exostosis

B. Osgood-Schlatter disease Osgood-Schlatter disease is most common in adolescent boys, involving osteochondritis of the tibial tuberosity epiphysis. The large patellar tendon actually will pull the tibial tuberosity away from the tibia. Immobilization generally will resolve the issue. Ewing sarcoma is a malignant bone tumor most common in young children. It attacks long bones and presents a characteristic "onion peel" appearance. Gout is a type of arthritis that most commonly attacks the knee and first metatarsophalangeal joint, although other joints also can be involved. High levels of uric acid in the blood are deposited in the joint. Exostosis is a bony growth arising from the surface of a bone and growing away from the joint. It is a benign and sometimes painful condition.

In which of the following projections was the image in Figure 2-7 made? A. AP B. medial oblique C. lateral oblique D. acute flexion

B. medial oblique The image illustrates a medial oblique (internal rotation) projection of the elbow with epicondyles 45 degrees to the IR. An oblique view of the proximal radius and ulna and the distal humerus is obtained. This projection is particularly useful to demonstrate the coronoid process in profile, the trochlea, and the medial epicondyle. The external oblique (lateral rotation) projection demonstrates the radial head free of superimposition as well as the radial neck and the humeral capitulum. The acute flexion projection (Jones Method) of the elbow is a two-projection method demonstrating the elbow anatomy when the part cannot be extended for an AP projection.

All the following are posterior structures except A. the linea aspera. B. the intertrochanteric line. C. the popliteal surface. D. the intercondyloid fossa.

B. the intertrochanteric line. The femur is the longest and strongest bone in the body. The femoral shaft is bowed slightly anteriorly. The proximal end of the femur consists of a head, which is received by the acetabulum of the pelvis. The femoral head has a small notch, the fovea capitis femoris, for ligament attachment. The femoral neck, which joins the head and shaft, angles upward approximately 120 degrees and forward (in anteversion) approximately 15 degrees. The greater (lateral) and lesser (medial) trochanters are large processes on the posterior proximal femur. The greater trochanter is a prominent positioning landmark that lies in the same transverse plane as the public symphysis and coccyx. The intertrochanteric crest runs obliquely between the trochanters; the intertrochanteric line runs anteriorly parallel to the crest. The femoral shaft presents a long, narrow ridge posteriorly called the linea aspera. Its distal anterior portion presents the patellar surface—a triangular depression over which the patella glides during flexion. The distal posterior surface presents the popliteal surface—a depression that houses the popliteal artery. The medial and lateral femoral condyles are very prominent posterior structures, and between them is the deep intercondyloid fossa. Just above the condyles are the medial and lateral femoral epicondyles. (Bontrager and Lampignano, 6th ed., pp. 217, 262)

Which of the following is (are) located on the distal aspect of the humerus? 1.Capitulum 2.Intertubercular groove 3.Coronoid fossa A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

C. 1 and 3 only The distal humerus articulates with the radius and ulna to form the elbow joint. The lateral aspect of the distal humerus presents a raised, smooth, rounded surface, the capitulum, that articulates with the superior surface of the radial head. The trochlea is on the medial aspect of the distal humerus and articulates with the semilunar notch of the ulna. Just proximal to the capitulum and the trochlea are the lateral and medial epicondyles; the medial is more prominent and palpable. The coronoid fossa is found on the anterior distal humerus and functions to accommodate the coronoid process with the elbow in flexion. The intertubercular (bicipital) groove is located on the proximal humerus.

In the PA tunnel view of the knee, the intercondyloid fossa is labeled with which of the following numbers? A. 5 B. 4 C. 2 D. 3 E. 1

C. 2 The intercondyloid fossa (2) is the cavity formed between the condyles of the femur (C). This is best demonstrated utilizing tunnel views of the knee. The medial and lateral condyles of the femur are represented by (1) and (3) respectively (D and E). The proximal tibiofibular joint is labeled (4), and the tibial plateau is labeled (5) (A and B)

Which of the following is (are) typically associated with a Colles' fracture? 1. Transverse fracture of the radial head 2. Chip fracture of the ulnar styloid 3. Posterior or backward displacement A. 1 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only A Colles fracture usually is caused by a fall onto an outstretched (extended) hand to "brake" a fall. The wrist then suffers an impacted transverse fracture of the distal inch of the radius, most often with an accompanying chip fracture of the ulnar styloid process. Because of the hand position at the time of the fall, the fracture usually is displaced backward approximately 30 degrees. The proximal radius, the radial head, is not involved in this type fracture.

With the patient and the x-ray tube positioned as illustrated in Figure 2-2, which of the following will be visualized? 1. Intercondyloid fossa 2. Patellofemoral articulation 3. Tangential patella A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only Note the relationship between the thigh, lower leg, patella, and CR. The CR is directed parallel to the plane of the patella, thereby providing a tangential projection of the patella (i.e., patella in profile) and an unobstructed view of the patellofemoral articulation (Figure 2-42). A tunnel view is required to demonstrate the intercondyloid fossa and the articulating surfaces of the tibia and femur.

Shoulder arthrography is performed to 1. evaluate humeral luxation 2. demonstrate complete or partial rotator cuff tear 3. evaluate the glenoid labrum A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only Shoulder arthrograms (Figure 2-64) are used to evaluate rotator cuff tear, glenoid labrum (a ring of fibrocartilaginous tissue around the glenoid fossa), and frozen shoulder. Routine radiographs demonstrate arthritis, and the addition of a transthoracic humerus or scapular Y projection would be used to demonstrate luxation (dislocation).

Which of the following statements regarding the PA oblique scapular Y projection of the shoulder joint is (are) true? 1. The midsagittal plane should be about 60 degrees to the IR. 2. The scapular borders should be superimposed on the humeral shaft. 3. An oblique projection of the shoulder is obtained. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only The AP oblique projection (medial rotation) of the elbow superimposes the radial head and neck on the proximal ulna. It demonstrates the olecranon process within the olecranon fossa, and it projects the coronoid process free of superimposition. The radial head is projected free of superimposition in the AP oblique projection (lateral rotation) of the elbow.

In the 45-degree medial oblique projection of the ankle, 1. thetalotibial joint is visualized 2. tibiofibular joint is visualized 3. foot is dorsiflexed nearly 90° A. 1 only B. 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only The medial oblique projection of the ankle can be performed either as a 15- to 20-degree oblique or as a 45-degree oblique. The 15- to 20-degree oblique projection demonstrates the ankle mortise, that is, the articulations between the talus, tibia, and fibula. The 45-degree oblique opens the distal tibiofibular joint. It is essential that the foot and leg be rotated together.

Valid evaluation criteria for a lateral projection of the forearm requires that 1. the epicondyles be parallel to the IR. 2. the radius and ulna be superimposed distally. 3. the radial tuberosity should face anteriorly. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only To accurately position a lateral forearm, the elbow must form a 90-degree angle with the humeral epicondyles perpendicular to the IR and superimposed. The radius and ulna are superimposed distally. Proximally, the coronoid process and radial head are superimposed, and the radial head faces anteriorly. Failure of the elbow to form a 90-degree angle or the hand to be lateral results in a less than satisfactory lateral projection of the forearm

On the lateral projection of the knee, which of the following part and CR positions are needed to demonstrate superimposition of the femoral condyles? 1. 7-10-degree cephalic angulation for a short patient with a narrow pelvis 2. Position plane of patella perpendicular to IR 3. 5-degree cephalic angulation for a tall patient with a narrow pelvis A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1 and 3 only

C. 2 and 3 only When performing the lateral projection of the knee, superimposition of the femoral condyles requires adequate positioning free of rotation. To prevent over- or under-rotation and accomplish anterior/posterior superimposition of the condyles, align the plane of the patella perpendicular with the plane of the IR (2). For superimposition of the distal borders of the condyles, the proper CR angulation must be utilized. For the average patient, a 5-7-degree cephalic angulation will be required. For short patients with wide hips (not a narrow pelvis) (1), a 7-10-degree cephalic angulation should be used. For a tall patient with a narrow pelvis, a 5-degree cephalic angulation should be used (3).

Which of the following projection(s) require(s) that the shoulder be placed in internal rotation? 1.AP humerus 2.AP thumb 3.Lateral humerus A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only When the arm is placed in the AP position, the epicondyles are parallel to the plane of the IR and the shoulder is placed in external rotation. In this position, an AP projection of the humerus, elbow, and forearm can be obtained; it places the greater tubercle of the humerus in profile. For the lateral projection of the humerus, the arm is internally rotated, elbow somewhat flexed, with the back of the hand against the thigh and the epicondyles superimposed and perpendicular to the IR. The AP projection of the thumb requires that the arm extended and internally rotated, placing the posterior surface of the thumb on the IR. The lateral projections of the humerus, elbow, and forearm all require that the epicondyles be perpendicular to the plane of the IR.

Which of the following views would best demonstrate arthritic changes in the knees? A. AP recumbent B. Lateral recumbent C. AP erect D. Medial oblique

C. AP erect Arthritic changes in the knee result in changes in the joint bony relationships. These bony relationships are best evaluated in the AP position. Narrowing of the joint spaces is readily detected more on AP weight-bearing projections than on recumbent projections.

What process is best seen using a perpendicular CR with the elbow in acute flexion and with the posterior aspect of the humerus adjacent to the image receptor? A. Coracoid B. Coronoid C. Olecranon D. Glenoid

C. Olecranon When the elbow is placed in acute flexion with the posterior aspect of the humerus adjacent to the image receptor and a perpendicular CR is used, the olecranon process of the ulna is seen in profile. The coronoid process is best visualized in the medial oblique position. The coracoid and glenoid are associated with the scapula.

Which of the following correctly describes/identifies the letter T in the radiograph shown in Figure 7-13? Jt between thump & Wrist A. Gliding joint B. Pivot joint C. Diarthrotic joint D. Amphiarthrotic joint

C. Diarthrotic joint The radiograph is a PA projection of the hand and wrist; an oblique projection of the thumb is obtained. The letter T is pointing out the first carpometacarpal joint, formed by the base of the first metacarpal and the trapezium. This is classified as a saddle-type diarthrotic joint. Diarthrotic joints are freely movable joints and the most plentiful type of joint in the human body. Amphiarthrotic joints are partially movable; synarthrotic joints are immovable

The distal end of the non-weight bearing bone of the lower leg is called which of the following? A. Apex of the fibula B. Medial malleolus C. Lateral malleolus D. Fovea capitus

C. Lateral malleolus The two bones of the lower leg are the tibia and fibula. Distal is a medical term meaning furthest from the point of attachment—in this case, furthest from the hip. The distal end of the tibia is the medial malleolus, the distal end of the fibula is the lateral malleolus (B and C). The apex of the fibula lies at the proximal end (A). For a student to better intuitively understand proximal versus distal, it's important to understand that they have the same roots as proximity and distance, respectively. The fovea capitus is a ligament attachment point on the femoral head that keeps it anchored within the acetabulum (D). It's is the most proximal anatomy of all the choices listed. To select the correct choice, the student would have to know that the fibula is the non-weight bearing bone of the lower leg and is located laterally while the tibia is medial, as well as the difference between proximal and distal, as described above.

Which of the following projections of the ankle would best demonstrate the distal tibiofibular joint? A. Medial oblique 15° to 20° B. Lateral oblique 15° to 20° C. Medial oblique 45° D. Lateral oblique 45°

C. Medial oblique 45° To best demonstrate the distal tibiofibular articulation, a 45° medial oblique projection of the ankle is required. The 15° medial oblique is used to demonstrate the ankle mortise (joint). Although the joint is well demonstrated in the 15° medial oblique, there is some superimposition of the distal tibia and fibula, and greater obliquity is required to separate the bones.

The instrument that is used frequently in quality-control programs to measure varying degrees of x-ray exposure is the A. aluminum step wedge. B. spinning top. C. densitometer. D. sensitometer.

C. densitometer. Every radiographic image is composed of a number of different densities. These densities may be measured and given a numeric value with a device called a densitometer. A sensitometer is another device used in QA programs; it is used to give a precise exposure to a film emulsion. An aluminum step wedge (penetrometer) may be used to show the effect of kilovoltage on contrast. A spinning top is used to test the accuracy of the x-ray machine's timer or rectifiers.

All the following structures are associated with the posterior femur except A. popliteal surface B. intercondyloid fossa C. intertrochanteric line D. linea aspera

C. intertrochanteric line The femur is the longest and strongest bone in the body. The femoral shaft is bowed slightly anteriorly and presents a long, narrow ridge posteriorly called the linea aspera. The distal femur is associated with two large condyles; the deep depression separating them posteriorly is the intercondyloid fossa (Figure 2-49). Just superior to the large condyles are the smaller medial and lateral epicondyles. The posterior distal femoral surface presents the popliteal surface, whereas the distal anterior surface presents the patellar surface. Proximally, the femur presents a head, neck, and greater and lesser trochanters. The intertrochanteric crest is a prominent ridge of bone between the trochanters posteriorly; anteriorly the intertrochanteric line is seen. The femoral head presents a roughened prominence, the fovea capitis femoris—ligaments attached here secure the femoral head to the acetabulum.

All of the following statements regarding the inferosuperior axial (nontrauma, Lawrence method) projection of the shoulder are true, except A. the coracoid process and lesser tubercle are seen in profile. B. the arm is abducted about 90° from the body. C. the arm should be in internal rotation. D. the CR is directed medially 25° to 30° through the axilla.

C. the arm should be in internal rotation. The inferosuperior axial (nontrauma, Lawrence method) projection of the shoulder demonstrates the glenohumeral joint and adjacent structures. The patient is supine with arm abducted 90°, and in external rotation. The (horizontal) CR is directed medially 25° to 30° through the axilla. The coracoid process and lesser tubercle are seen in profile.

All the following can be associated with the elbow joint except A. the capitulum. B. the trochlea. C. the tubercles. D. the epicondyles.

C. the tubercles. The distal humerus articulates with the radius and ulna to form the elbow joint. The lateral aspect of the distal humerus presents a raised, smooth, rounded surface, the capitulum, that articulates with the superior surface of the radial head. The trochlea is on the medial aspect of the distal humerus and articulates with the semilunar/trochlear notch of the ulna. Just proximal to the capitulum and trochlea are the lateral and medial epicondyles; the medial is more prominent and palpable. Lateral epicondylitis ("tennis elbow") is a painful condition caused by prolonged rotary motion of the forearm. The tubercles are prominences located at the proximal humerus and are anatomically remote from the elbow joint. (Tortora and Grabowski,

Which of the following may be used to evaluate the glenohumeral joint? 1.Scapular Y projection 2.Inferosuperior axial 3.Transthoracic lateral A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The scapular Y projection is an oblique projection of the shoulder and is used to demonstrate anterior or posterior shoulder dislocation. The inferosuperior axial projection may be used to evaluate the glenohumeral joint when the patient is able to abduct the arm. The transthoracic lateral projection is used to evaluate the glenohumeral joint and upper humerus when the patient is unable to abduct the arm.

Which of the following statements regarding the Norgaard method, "Ball-Catcher's position," is (are) correct? 1. Bilateral AP oblique hands are obtained. 2. It is used for early detection of rheumatoid arthritis. 3. The hands are obliqued about 45 degrees, palm up. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Bilateral AP oblique hands are obtained using the Norgaard method or "Ball-Catcher position." The method is used to detect early rheumatoid arthritis changes or fracture to the base of the fifth metacarpal. The hands are positioned and supported in a 45-degree oblique, palm-up position. The CR is directed to the level of the fifth metacarpophalangeal joint (MPJ) midway between the hands—both hands are exposed simultaneously.

Angulation of the central ray may be required 1.to avoid superimposition of overlying structures. 2.to avoid foreshortening or self-superimposition. 3.to project through certain articulations. A. 1 only B. 2 only C. 1 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 If structures are overlying or underlying the area to be demonstrated (eg, the medial femoral condyle obscuring the joint space in the lateral knee projection), central ray angulation is employed (eg, 5° cephalad angulation to see the joint space in the lateral knee). If structures would be foreshortened or self-superimposed (eg, the scaphoid in a PA wrist), central ray angulation may be employed to place the structure more closely parallel with the IR. Another example is the oblique cervical spine, where cephalad or caudad angulation is required to "open" the intervertebral foramina

Which of the following articulations participate in the formation of the elbow joint? 1. Between the humeral trochlea and the semilunar/trochlear notch 2. Between the capitulum and the radial head 3. The proximal radioulnar joint A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The distal humerus articulates with the radius and ulna to form a part of the elbow joint. The lateral aspect of the distal humerus presents a raised, smooth, rounded surface, the capitulum, that articulates with the superior surface of the radial head. The trochlea is on the medial aspect of the distal humerus and articulates with the semilunar notch of the ulna. All three articulations are enclosed in a common capsule to form the elbow joint proper.

Muscles that contribute to the formation of the rotator cuff include the 1. subscapularis. 2. infraspinatus. 3. teres minor. A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The rotator cuff is a musculotendinous structure that includes the supraspinatus, infraspinatus subscapularis, and teres minor muscles. The muscles function to stabilize the humeral head in all arm motions and, together with the deltoid, function to abduct and rotate the arm. Weakness of the rotator cuff can lead to impingement syndrome and/or tendonitis. A tear of the cuff can result in subluxation; calcification can lead to shoulder immobilization.

Which of the following may be used to evaluate the glenohumeral joint? 1. Scapular Y projection 2. mInferosuperior axial 3. Transthoracic lateral A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 The scapular Y projection is an oblique projection of the shoulder that is used to demonstrate anterior or posterior shoulder/glenohumeral joint dislocation. The inferosuperior axial projection may be used to evaluate the glenohumeral joint when the patient is able to abduct the arm. The transthoracic lateral projection is used to evaluate the glenohumeral joint and upper humerus when the patient is unable to abduct the arm

A modified axiolateral inferosuperior projection of the femoral neck is particularly useful 1.when the "cross-table" axiolateral is contraindicated. 2.for patients with bilateral hip fractures. 3.for patients with limited movement of the unaffected leg. A. 1 only B. 1 and 2 only C. 1 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 Typically, traumatic injury to the hip requires a cross-table (axiolateral) lateral projection. Occasionally, this projection may be contraindicated, for example, a patient with suspected bilateral hip fractures, or one who is unable to move the unaffected hip out of the way as required by the axiolateral. In these instances, the axiolateral inferosuperior trauma projection (Clements-Nakayama method) can be employed. The patient is recumbent with lateral surface of affected side close to table/stretcher edge. The CR is directed almost horizontally to the affected femoral neck (inferosuperior), with a 15° posterior angulation. Correct placement and angulation of the grid cassette is essential to avoid grid cutoff.

Which of the following statements regarding knee x-ray arthrography is (are) true? 1. Ligament tears can be demonstrated. 2. Sterile technique is observed. 3. MRI can follow x-ray. A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3 X-ray arthrography requires the use of local anesthesia; sterile technique must be observed to avoid introducing infection into the joint. Fluoroscopy is used for proper placement of the needle and to obtain images immediately after the introduction of contrast medium. Many physicians follow up the x-ray arthrogram with an magnetic resonance (MR) arthrogram to visualize additional soft tissue structures. Arthrography is performed to detect compromised knee capsule structures, meniscal damage, ligament tears, and Baker cysts.

Tangential axial projections of the patella can be obtained in which of the following positions? 1.supine flexion 45° (Merchant) 2.prone flexion 90° (Settegast) 3.prone flexion 55° (Hughston) A. 1 only B. 1 and 2 only C. 2 and 3 only D. 1, 2, and 3 only

D. 1, 2, and 3 only The tangential axial projections of the patella are also often referred to as "sunrise" or "skyline" views. The supine flexion 45° (Merchant) position requires a special apparatus, and the patellae can be examined bilaterally. This position also requires patient comfort without muscle tension—muscle tension can cause a subluxed patella to be pulled into the intercondyler sulcus, giving the appearance of a normal patella. The two prone positions differ according to the degree of flexion employed. The 90° flexion (Settegast) position must not be employed with suspected patellar fracture.

Which of the following projections will best demonstrate acromioclavicular separation? A. AP recumbent, affected shoulder B. AP recumbent, both shoulders C. AP erect, affected shoulder D. AP erect, both shoulders

D. AP erect, both shoulders Acromioclavicular (AC) joints usually are examined when separation or dislocation is suspected. They must be examined in the erect position because in the recumbent position a separation appears to reduce itself. Both AC joints are examined simultaneously for comparison because separations may be minimal.

Which of the following projections of the elbow should demonstrate the radial head free of ulnar superimposition? A. AP B. Lateral C. Medial oblique D. Lateral oblique

D. Lateral oblique - On the AP projection of the elbow, the radial head and ulna normally are somewhat superimposed. The lateral oblique projection demonstrates the radial head free of ulnar superimposition. The lateral projection demonstrates the olecranon process in profile. The medial oblique projection demonstrates considerable overlap of the proximal radius and ulna but should clearly demonstrate the coronoid process free of superimposition and the olecranon process within the olecranon fossa.

What is the projection to demonstrate the longitudinal arch of the foot, while permitting the patient to keep weight equally distributed on both feet? A. Mediolateral B. Lateromedial C. Mediolateral weight-bearing lateral D. Lateromedial weight-bearing lateral

D. Lateromedial weight-bearing lateral Weight-bearing lateral projections of the foot are requested often to evaluate the longitudinal arch structure of the foot. The patient stands on a small platform, weight equally distributed on feet. The IR is placed between the feet, in a slot provided on the platform, with the top of the IR against the medial aspect of the foot. The CR is directed to enter the lateral aspect of the foot perpendicular to the base of the fifth metatarsal and to exit the medial side of the foot. When the mediolateral projection is used, the patient must balance on the foot being imaged while bringing the other foot back. (Long, Rollins and Smith, 13th ed., vol. 1, pp. 262-263)

Which of the following correctly identifies the radial styloid process in the illustration in Figure A. Number 1 B. Number 4 C. Number 10 D. Number 11

D. Number 11 8- An anterior view of the forearm is pictured. The proximal anterior surface of the ulna (number 8) presents a rather large pointed process at the anterior margin of the semilunar (trochlear) notch (5) called the coronoid process (6). The olecranon process is identified as number 4, and the radial notch of the ulna is number 7. Distally, the ulnar head is number 9, and the styloid process is labeled 10. The radius (number 12) is the lateral bone of the forearm. The radial head is number 3, the radial neck is number 2, and the radial tuberosity is number 1. Distally, the radial styloid process is labeled 11

Which of the following is most useful for bone age evaluation? A. Lateral skull B. PA chest C. AP pelvis D. PA hand

D. PA hand A PA projection of the left hand and wrist is obtained most often to evaluate skeletal maturation. These images are compared with standard normal images for the age and sex of the child. Additional supplemental images may be requested

Which of the following projections or positions will best demonstrate subacromial or subcoracoid dislocation? A. Tangential B. AP axial C. Transthoracic lateral D. PA oblique scapular Y

D. PA oblique scapular Y The scapular Y refers to the characteristic Y formed by the humerus, acromion, and coracoid processes. The patient is placed in a PA oblique position—an RAO or LAO position depending on which is the affected side. The midcoronal plane is adjusted approximately 60 degrees to the IR, and the affected arm remains relaxed at the patient's side. The scapular Y position is employed to demonstrate anterior (subcoracoid) or posterior (subacromial) humeral dislocation. The humerus normally is superimposed on the scapula in this position; any deviation from this may indicate dislocation

The instrument that is used to show the effect of kilovoltage on contrast. A. aluminum step wedge. B. spinning top. C. densitometer. D. sensitometer.

aluminum step wedge

In which position of shoulder is the epicondyles about 45 degrees to the IR and the greater tubercle is partially superimposed on the humeral head.

neutral position

A patient unable to extend his or her arm is seated at the end of the x-ray table the elbow flexed 80 degrees and the CR directed to the elbow joint at an angle of 45 degrees laterally (i.e., from the shoulder toward the elbow), 1. Radial head 2. Capitulum 3. Coronoid process A. 3 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

the elongated coronoid process will be visualized