Chapter 4

A tangential, inferosuperior carpal canal wrist projection with poor positioning demonstrates superimposition of the pisiform and hamulus of the hamate. How should the positioning setup be adjusted for an optimal image to be obtained? a. Externally rotate the hand. b. Internally rotate the hand. c. Decrease the central ray angulation. d. Increase the central ray angulation.

Internally rotate the hand.

Which of the following technical factors should be chosen when 20 mAs is desired and the patient being imaged has difficulty remaining still? a. 200 mA at 0.1 sec b. 400 mA at 0.05 sec c. 100 mA at 0.4 sec d. 100 mA at 0.2 sec

400 mA at 0.05 sec

To take advantage of the anode heel effect when imaging a forearm, a. a detailed screen is used. b. the elbow is positioned at the anode end of the x-ray tube. c. the wrist is positioned at the anode end of the x-ray tube. d. a 55- to 65-kVp technique is used.

the wrist is positioned at the anode end of the x-ray tube.

A lateral forearm projection with accurate positioning demonstrates 1. the distal scaphoid slightly distal to the pisiform. 2. the ulnar styloid in profile. 3. an open elbow joint space. 4. the radial tuberosity in profile.

1,2,3

A lateral hand projection obtained with the hand in slight external rotation demonstrates the 1. shortest of the second through fourth metacarpals anteriorly situated. 2. radius posterior to the ulna. 3. second metacarpal posterior to the other metacarpals. 4. pisiform posterior to the distal scaphoid.

1,2,3

An AP elbow projection with accurate positioning demonstrates 1. the medial and lateral humeral epicondyles in profile. 2. the radial tuberosity in profile medially. 3. an open capitulum-radial joint. 4. the ulna free of radial head and radial tuberosity superimposition.

1,2,3

A PA hand projection obtained with the hand flexed demonstrates 1. foreshortened phalanges. 2. the thumb in a lateral projection. 3. closed IP joint spaces. 4. foreshortened metacarpals.

1,2,3,4

A PA wrist projection obtained with the wrist in a neutral position demonstrates 1. the scaphoid in partial foreshortening. 2. the center of the lunate positioned distal to the radioulnar articulation. 3. closed CM joints. 4. alignment of the long axis of the third metacarpal and radius.

1,2,4

An AP forearm projection with accurate positioning demonstrates the 1. radial styloid in profile laterally. 2. radial head superimposing the ulna by 0.25 inch (0.6 cm). 3. ulnar styloid in profile laterally. 4. humeral epicondyles in profile.

1,2,4

For an externally rotated AP oblique elbow projection with accurate positioning, the 1. capitulum is in profile. 2. capitulum-radial joint space is open. 3. coronoid process is in profile. 4. ulna is demonstrated without radial head superimposition.

1,2,4

Sharply recorded details are demonstrated on extremity images when 1. motion is controlled. 2. a large focal spot is used. 3. a small IR is used for computed radiography images. 4. a large OID is used.

1,3

An externally rotated PA oblique wrist projection with accurate positioning demonstrates 1. the trapezoid and trapezium without superimposition. 2. an open radioulnar articulation. 3. the ulnar styloid in profile. 4. superimposition of the medially located carpals.

1,3,4

When the patient ulnar-deviates for a PA axial, ulnar-deviated wrist projection, the 1. first metacarpal and radius are aligned. 2. distal scaphoid shifts anteriorly. 3. lunate is demonstrated distal to the radius. 4. distal scaphoid shifts posteriorly.

1,3,4

A lateral elbow projection demonstrates the radial head situated anterior and proximal to the coronoid process. How was the patient positioned for such an image to be obtained? 1. The distal forearm was too high. 2. The distal forearm was too low. 3. The proximal humerus was too high. 4. The proximal humerus was too low.

1,4

The IP joint spaces on finger projections are open and demonstrated without distortion when the 1. central ray is aligned parallel with the IP joint spaces. 2. central ray is aligned perpendicular to the IP joint spaces. 3. IP joints are aligned parallel with the IR. 4. IP joints are aligned perpendicular to the IR.

1,4

A PA wrist projection obtained in slight external rotation demonstrates 1. superimposition of the laterally located carpal bones. 2. a closed radioulnar articulation. 3. open lateral carpal joint spaces. 4. the radial styloid in profile.

2,3

A lateral finger projection obtained with the finger in a 45-degree PA oblique projection demonstrates 1. equal soft tissue width on both sides of the phalanges. 2. more midshaft concavity on one side of the phalanges than on the opposite side. 3. twice as much soft tissue on one side of the phalanges as on the opposite side. 4. convexity on one side of the phalanges and concavity on the opposite side.

2,3

What is the central ray angulation used for the PA axial, ulnar-deviated wrist projection: a scaphoid wrist fracture is suspected, and the patient is unable to ulnar-deviate the wrist? a. 15 degrees b. 20 degrees c. 5 to 10 degrees d. 20 to 25 degrees

20 degrees

An internally rotated AP oblique elbow projection with accurate positioning demonstrates which of the following structures in profile? 1. Capitulum 2. Radial head 3. Medial trochlea 4. Coronoid process

3,4

A poorly positioned PA oblique wrist projection demonstrates superimposition of the trapezoid and trapezium, and the capitate is superimposed by more than one fourth of the trapezoid. How should the positioning setup be adjusted to obtain an optimal projection? a. Align the third metacarpal and midforearm, decreasing radial flexion. b. Increase the degree of external wrist rotation. c. Decrease the degree of external wrist rotation. d. Increase hand extension.

Decrease the degree of external wrist rotation.

What is the projection for the lateral finger? a. Phalanges demonstrate equal concavity. b. Phalanges demonstrate more concavity on one side than on the other. c. Phalanges demonstrate concavity on one side and convexity on the other.

Phalanges demonstrate concavity on one side and convexity on the other

What is the projection for the PA oblique finger? a. Phalanges demonstrate equal concavity. b. Phalanges demonstrate more concavity on one side than on the other. c. Phalanges demonstrate concavity on one side and convexity on the other.

Phalanges demonstrate more concavity on one side than on the other.

Which side of the arm is positioned against the IR for the lateral second finger projection? Select one: a. Ulnar b. Radial

Radial

To properly position an AP humerus, place the elbow at the _____ end of the tube, _____ the hand and wrist, and align the humeral condyles _____ with the IR. a. anode; supinate; parallel b. cathode; supinate; perpendicular c. anode; pronate; perpendicular d. cathode; supinate; parallel

anode; supinate; parallel

Where are the soft tissue structures that can be used to indicate joint effusion located on the lateral wrist projection? a. Anteriorly b. Medially c. Laterally d. Posteriorly

anteriorly

An optimally positioned PA wrist projection demonstrates all of the following except a. an open radioulnar articulation. b. open second through fifth MC joint spaces. c. alignment of the long axis of the third metacarpal and midforearm. d. the pronator fat stripe.

the pronator fat stripe

An optimal AP elbow projection is obtained when a. an imaginary line connecting the humeral epicondyles is aligned perpendicular with the IR. b. the radial tuberosity is demonstrated in profile laterally. c. the radial head articulating surface is demonstrated. d. the radial head superimposes the lateral aspect of the proximal ulna by 0.25 inch (0.6 cm).

the radial head superimposes the lateral aspect of the proximal ulna by 0.25 inch (0.6 cm)

A less than optimal AP elbow projection demonstrating the ulna without radial head superimposition a. was obtained with the elbow in external rotation. b. will also demonstrate the radial head articulating surface. c. was obtained with the hand pronated. d. was obtained with the elbow in internal rotation. d. was obtained with the elbow in internal rotation.

was obtained with the elbow in external rotation