Image Analysis Test 2 Questions

A PA axial, ulnar-deviated wrist projection with poor positioning demonstrates a closed scaphocapitate joint and an open hamate-capitate joint. How should the positioning setup be adjusted for an optimal image to be obtained?

Increase the degree of external wrist rotation.

Match one of the following with each listed projection. PA finger projection

Phalanges demonstrate equal concavity.

Which side of the arm is positioned against the IR for the following lateral finger projections? Fourth finger

ulnar

To prevent radial deviation on a lateral wrist projection for a patient with large muscular or thick proximal forearms, the proximal forearm should hang off the IR. T/F?

True

An optimal AP scapula projection demonstrates all the following except the

glenoid cavity in profile

Match the following humeral epicondyle-floor alignments with the appropriate resulting proximal humeral relationships as seen on an inferosuperior axial shoulder projection. lesser tubercle in partially profile anteriorly

humeral epicondyles at 45 degree angle with the IR

Match the following humeral epicondyle-floor alignments with the appropriate resulting proximal humeral relationships as seen on an inferosuperior axial shoulder projection. greater turbercle in profile posteriorly

humeral epicondyles parallel with the floor

An optimal AP clavicle projection demonstrates all the following except the

middle and lateral thirds of clavicle seen superior to the acromion process.

Match the following humeral epicondyle-IR alignments with the appropriate resulting tubercle visualization on an AP shoulder projection. Greater Tubercle in profile laterally

parallel with the IR

Match the following humeral epicondyle-IR alignments with the appropriate resulting tubercle visualization on an AP shoulder projection. Humeral Head in profile medially

parallel with the IR

Which side of the arm is positioned against the IR for the following lateral finger projections? Second finger

radial

An optimal internally rotated AP oblique elbow projection will demonstrate all the following except the

radioulnar articulation as an open space.

A PA oblique scapular Y shoulder projection with accurate positioning demonstrates 1. the superior angle of the scapular at the same transverse level as the clavicle. 2. superimposed scapular borders. 3. a laterally situated glenoid fossa. 4. the coracoid, acromion, and humerus creating the arms and leg of the Y formation.

1 and 2

An AP clavicle projection with accurate positioning demonstrates 1. the medial clavicular end next to the lateral edge of the vertebral column. 2. the superior scapular angle superior to the clavicle. 3. inferosuperior foreshortening on the kyphotic patient unless the central ray is angled cephalically. 4. an overexposed medial clavicle unless a compensating filter is used.

1 and 3

An AP shoulder projection obtained with the humeral epicondyles positioned parallel with the IR demonstrates the 1. greater tubercle in profile laterally. 2. lesser tubercle in profile medially. 3. humeral head in profile laterally. 4. greater tubercle superimposed over the humeral head.

1 and 3

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 and 4

A lateral wrist projection obtained with the wrist in slight internal rotation demonstrates the 1. distal scaphoid anterior to the pisiform. 2. radius posterior to the ulna. 3. distal scaphoid distal to the pisiform. 4. radius anterior to the ulna.

1 and 4

An AP clavicle projection obtained with the patient rotated away from the affected shoulder demonstrates the 1. medial clavicular end superimposed over the vertebral column. 2. medial clavicular end shifted away from the vertebral column. 3. scapular body with increased thoracic superimposition. 4. scapular body with decreased thoracic superimposition.

1 and 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 and 4

An AP axial clavicle projection with accurate positioning demonstrates the 1. medial clavicular end superimposed over the first and second ribs. 2. the middle and lateral thirds of the clavicle superior to the acromion. 3. the clavicle bowing upward. 4. the medial clavicular end superimposed over the vertebral column.

1, 2 and 3

AP right shoulder projection obtained with the patient's body rotated away from the affected shoulder demonstrates 1. the scapula with decreased thoracic superimposition. 2. the medial end of the right clavicle superimposed over the vertebral column. 3. a transversely foreshortened scapular body. 4. the glenoid fossa in profile.

1,2, and 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, and 3

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, and 4

A nondislocated AP oblique scapular Y shoulder projection demonstrates 1. the humeral head superimposed over the glenoid fossa. 2. the glenoid fossa on end. 3. the medial scapular border closer to the ribs than the lateral scapular border. 4. magnification of the scapula and humerus.

1,2, and 4

For an AP scapular projection, the 1. patient's arm is abducted 90 degrees to the body. 2. image is exposed on expiration. 3. patient's upper midcoronal plane leans slightly away from the IR. 4. central ray is centered 2 inches (5 cm) inferior to the coracoid

1,2, and 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, and 4

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, and 4

For a carpal canal wrist image, the 1. wrist is hyperextended until the long axes of the metacarpals are vertical. 2. hand is rotated 10 degrees internally until the fifth metacarpal is perpendicular to the IR. 3. central ray is angled 25 to 30 degrees proximally. 4. central ray is centered to the palm of the hand.

1,2,3, and 4

For an AP axial clavicle projection, 1. the patient's shoulders are positioned at equal distances from the IR. 2. the central ray is angled 15 to 30 degrees cephalad. 3. a compensating filter is positioned over or under the lateral clavicle. 4. the central ray is centered halfway between the medial and lateral clavicular ends.

1,2,3, and 4

For an AP oblique shoulder projection (Grashey method), the 1. patient's midcoronal plane is rotated to a 45-degree angle with the IR. 2. central ray is centered 1 inch (2. 5 cm) inferior and medial to the coracoid. 3. patient is rotated toward the affected shoulder. 4. image is obtained with the patient in an upright position.

1,2,3, and 4

For an AP shoulder projection, the 1. shoulders are positioned at equal distances from the IR. 2. central ray is centered 1 inch (2. 5 cm) inferior to the coracoid. 3. imaginary line connecting the humeral epicondyles is positioned at a 45-degree angle to the IR. 4. central ray is angled cephalically when a kyphotic patient is imaged.

1,2,3, and 4

An AP scapular projection with accurate positioning demonstrates 1. almost superimposed anterior and posterior glenoid fossa margins. 2. the vertebral scapular border without thoracic cavity superimposition. 3. the humeral shaft at a 90-degree angle with the body. 4. the supraspinatus fossa and superior scapular angle without clavicular superimposition.

1,3, and 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, and 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 and 3

A PA oblique scapular Y shoulder projection obtained with the patient's upper midcoronal plane tilted toward the IR demonstrates 1. the glenoid fossa on end. 2. the superior scapular angle superior to the clavicle. 3. a longitudinally foreshortened scapular body. 4. the superior scapular angle inferior to the clavicle.

2 and 3 only

An AP oblique shoulder projection (Grashey method) obtained with the patient rotated less than required to obtain accurate positioning demonstrates 1. more than 0.25 inch (0. 6 cm) of the coracoid superimposed over the humeral head. 2. a closed glenohumeral joint. 3. increased longitudinal clavicular foreshortening. 4. an increase in the amount of thorax and scapular body superimposition.

2 only

A lateral wrist projection obtained with the elbow flexed 90 degrees and the humerus placed parallel with the IR demonstrates 1. the ulnar styloid distal to the midline of the ulnar head. 2. superimposition of the radius and ulna. 3. superimposition of the distal scaphoid and pisiform. 4. the ulnar styloid in profile.

2,3, and 4

An AP oblique shoulder projection (Grashey method) with accurate positioning demonstrates 1. the glenoid fossa in profile and facing superiorly. 2. an open glenohumeral joint space. 3. a longitudinally foreshortened clavicle. 4. the glenohumeral joint in the center of the collimated field.

2,3, and 4

The lesser tubercle is demonstrated in profile on a(n) 1. neutral AP shoulder projection. 2. lateral humeral projection. 3. transthoracic lateral proximal humeral projection. 4. inferosuperior axial shoulder projection.

2,3, and 4

Match the central ray angulation used for the listed PA axial, ulnar-deviated wrist projections. A scaphoid waist fracture is suspected, and the patient is unable to ulnar-deviate the wrist.

20 degrees

An AP forearm projection obtained with the wrist and elbow in lateral rotation demonstrates 1. superimposed first and second metacarpal bases. 2. the proximal radius superimposed over the ulna by more than 0.25 inch (0.6 cm). 3. superimposed fourth and fifth metacarpal bases. 4. the proximal radius and ulna without superimposition.

3 and 4

For a PA oblique scapular Y shoulder projection, the patient's 1. humerus is elevated until the hand is placed on the hip. 2. body is rotated toward the unaffected shoulder. 3. body is rotated until an imaginary line connecting the acromion angle and coracoid processes is aligned parallel with the IR. 4. midcoronal plane is vertical.

3 and 4

A right lateral fourth finger projection obtained with the hand internally rotated to 20 degrees demonstrates 1. equal soft tissue width on both sides of the phalanges. 2. more phalangeal midshaft concavity on the side facing the fifth finger. 3. convexity on one side of the phalanges and concavity on the opposite side. 4. greater phalangeal midshaft concavity on the side facing the fifth finger.

4 only

Match the following humeral epicondyle-IR alignments with the appropriate resulting tubercle visualization on an AP shoulder projection. Greater tubercle in partial profile

45 degrees with IR

Match the central ray angulation used for the listed PA axial, ulnar-deviated wrist projections. A proximal scaphoid fracture is suspected, and the patient is unable to ulnar-deviate the wrist.

5-10 degrees

A lateral scapular projection obtained with the patient rotated less than needed to superimpose the borders of the scapula will demonstrate the thick border next to the ribs and the thin border laterally. T/F?

False

Which of the follow statements is true as demonstrated on a lateral elbow projection?

When the wrist is in a lateral projection, the radial tuberosity is superimposed by the radius.

To prevent longitudinal scapular foreshortening when obtaining an AP shoulder projection on a patient with excessive thoracic kyphosis, the

central ray should be angled cephalically until it is aligned perpendicular to the scapular body.

How is a patient positioned for a PA wrist projection to superimpose the anterior and posterior margins of the distal radius and obtain open radioscaphoid and radiolunate joint spaces?

depress the proximal forearm

A poorly positioned inferosuperior axial shoulder projection demonstrates the inferior glenoid cavity medial to the lateral edge of the coracoid process. To obtain an optimal projection,

decrease the central ray to lateral body surface angle

The trapezium is demonstrated without superimposition of other anatomy on a lateral wrist projection when the patient

depresses the distal first metacarpal

A less than optimal ulnar-deviated PA axial (scaphoid) wrist projection demonstrates closed scaphotrapezium, scaphotrapezoidal, and CM joint spaces. How should the positioning setup be adjusted to obtain an optimal projection?

extend the hand, placing it flat against the IR

Match the following humeral epicondyle-floor alignments with the appropriate resulting proximal humeral relationships as seen on an inferosuperior axial shoulder projection. humeral head in profile posteriorly

humeral epicondyles parallel with the floor

Match the following humeral epicondyle-floor alignments with the appropriate resulting proximal humeral relationships as seen on an inferosuperior axial shoulder projection. humeral head in profile anteriorly

humeral epicondyles perpendicular to the floor

Match the following humeral epicondyle-IR alignments with the appropriate resulting tubercle visualization on an AP shoulder projection. Lesser tubercle in profile medially

perpendicular to IR

Longitudinal foreshortening of the scapula is demonstrated on an AP shoulder projection when the

superior scapular angle is visualized superior to the clavicle

A less than optimal PA wrist projection demonstrates an elongated scaphoid and the second through fourth metacarpals superimposing the CM joint spaces. Which of the following is true about this projection?

the hand was overflexed

An optimally positioned PA wrist projection demonstrates all of the following except

the pronator fat stripe

A less than optimal AP elbow projection demonstrating the ulna without radial head superimposition

was obtained with the elbow in external rotation

Accurate alignment of the central ray and glenoid cavity on an inferosuperior axial shoulder projection

will demonstrate the lateral edge of the coracoid process base aligned with the inferior glenoid cavity.