ARRT Prep questions: Extremities
If a patient has a short stature and a wider pelvis, what direction and to what degree would the femur naturally slant?
10-15 degrees medially
What body part should be radiographed if the patient has a Bennett fracture?
1st metacarpal
How many bones are in the adult hand and wrist?
27
In which of the following ankle projections will the distal tibiofibular articulation be open?
45 degree medial oblique
Calcaneocuboid joint
Identify the structure that is represented by the letter (A) in the following image:
Trochlea
Identify the structure that is represented by the letter (A):
Acromion
Identify the structure that is represented by the letter (B):
Distal phalanx of first digit
Identify the structure that is represented by the letter (B):
Distal phalanx of second digit
Identify the structure that is represented by the letter (G):
What type of fracture is characterized by the ends of the bone are forced together or one fragment is driven into another?
Impacted
This strong band of fibrous connective tissue extends from the femoral condyle to the apex of the fibula.
Lateral collateral ligament
To evaluate the longitudinal arch of the foot, which of the following weight-bearing projections is needed?
Lateral weight-bearing projection
On a lateral ankle image, the technologist notices the fibula superimposing the anterior half of the tibia. What, if any, mistake has been made?
Leg was internally (Medially) rotated
The bony process on the proximal, medial side of the femur is known as the:
Lesser trochanter
If the joint spaces associated with the metatarsals on the lateral side of the foot are the anatomy of interest, which of the following projections would best demonstrate this area?
Medial oblique foot
In order to best visualize the joint space on an anteroposterior (AP) projection of the knee on a patient measuring 21cm between the anterior superior iliac spine (ASIS) and the tabletop, the central ray that should be used is:
Perpendicular
The head of the radius articulates medially with which of the following structures?
Radial notch of the ulna
Which of the following types of joints would be classified as an ellipsoidal joint?
Radiocarpal or wrist joints
The acromion process is part of what bone?
Scapula
Which of the following are common reasons why a skeletal survey, also known as a bone survey, may be performed? (Select three) 1. To assess bone age 2. To determine the length of the long bones 3. In known or suspected cases of child abuse 4. In cases of metabolic bone disease 5. In cases of osteogenesis imperfecta (OI)
3, 4, and 5.
Which of the following describes eversion of the foot?
Outward or lateral stress motion of the foot
Where in the hand would it be most common to see two small sesamoid bones?
Anterior surface of the head of the first metacarpal
What is the correct central ray entrance point for the lateral projection of the foot?
Entering the medial cuneiform, and through the base of the third metatarsal
Which two of the following are true when performing an anteroposterior (AP) projection of the scapula? (Select two) 1. Arm is abducted 90 degrees with the elbow flexed 2. Exposure may be made during shallow breathing 3. Central ray enters the body at the level of T7 4. Patient should reach across the chest and grasp the opposite shoulder
1 and 2
Which four of the following are appropriate guidelines for performing an anteroposterior (AP) axial projection of the foot? (Select four) 1. Place the affected foot flat in the center of the image receptor (IR) 2. Angle the central ray 10 degrees toward the heel 3. Place the central ray perpendicular to the metatarsals 4. Rotate the knee medially 20-30 degrees 5. Place the central ray to enter at the base of the third metatarsal
1, 2, 3, and 5
From the list below, choose four types of movement that take place at a ball and socket, or spheroidal joint. (Select four) 1. Flexion/extension 2. Abduction/adduction 3. Circumduction 4. Pivot 5. Gliding 6. Rotation
1, 2, 3, and 6.
From the list, choose three types of movement that take place at an ellipsoidal (condylar) joint. (Select three) 1. Flexion/Extension 2. Abduction/adduction 3. Circumduction 4. Rotation 5. Pivot
1, 2, and 3
Which three of the following statements are true regarding the fibula? (Select three) 1. The fibula lies along the lateral aspect of the tibia 2. The most superior aspect of the fibula is the apex 3. The lateral malleolus of the fibula articulates with the lateral calcaneus 4. The fibula articulates distally with the tibia at the fibular notch
1, 2, and 3
Which three of the following statements are accurate of the foot? (Select three) 1. The metatarsal heads form the "ball" of the foot 2. The inferior surface is referred to as the dorsal surface 3. The first metatarsal is the shortest and thickest 4. The base of the fifth metatarsal ends in a prominent tuberosity 5. The heads of the metatarsals articulate with the distal tarsals
1, 3, and 4
Which three of the following articulation s are classified as gliding joints? (Select three) 1. Intermetatarsal 2. Tibiotalar 3. Tarsometatarsal 4. Distal interphalangeal 5. Proximal tibiofibular
1, 3, and 5
Which three of the following statements are true about endochondral bone formation? (Select three) 1. The epiphyseal plate is found between the metaphysis and epiphysis 2. Takes place in bones needed for protection such as the bones of the calvaria 3. The primary center of ossification is also known as diaphysis 4. Epiphyseal plates disappear by the age of 10-12 years 5. Most secondary centers of ossification appear after birth
1, 3, and 5
Which two of the following joints are considered hinge joints? (Select two) 1. Sternoclavicular 2. Humeroradial 3. Distal interphalangeal 4. Intermetatarsal
2 and 3
Which three of the following statements accurately describe the ulna? (Select three) 1. The ulna lies on the lateral side of the forearm 2. The head is found on the distal end of the ulna 3. The ulna articulates with the scaphoid and lunate 4. The ulna articulates with the radius both proximally and distally 5. The anterior projection of bone at the proximal ulna is called the coronoid process
2, 4, and 5
How many bones are in the adult hand and wrist?
27 bones
The cuboid bone articulates with which of the following bones?
5th metatarsal
A hyposthenic patient is positioned for bilateral acromioclavicular (AC) joints using a single image receptor. What is the appropriate source-to-image receptor distance (SID) and why?
72 inches, to reduce distortion of the joint spaces
In which of the following positions or projections are the cuboid articulations, sinus tarsi, and tuberosity of the fifth metatarsal best demonstrated?
Anteroposterior (AP) oblique foot with medial rotation
The coronoid process can best be visualized by obtaining which of the following projections?
Anteroposterior (AP) oblique projection of the elbow with medial rotation
To evaluate the pisiform free of superimposition from the other carpal bones, which projection should be performed?
Anteroposterior (AP) oblique wrist
What palpable anatomical landmark is generally used to determine the centering point for an anteroposterior (AP) projection of the knee?
Apex of the patella
Which of the following bones form the shoulder girdle?
Clavicle and scapula
What type of fracture is characterized by separation of the bone into numerous fragments at the midshaft?
Comminuted
What type of fracture is characterized by the bone penetrating the skin?
Compound
Orthoroentgenography or long bone measurement of the lower limbs should be performed with the patient in what position?
Erect
For an arthrogram, a combination of which imaging modalities is most commonly utilized?
Fluoroscopy and magnetic resonance imaging (MRI)
An avulsion fracture is characterized as a/an:
Fracture where a tendon or ligament pulls off a piece of bone
A impacted fracture is one in which the:
Fractured ends of bone are forced together
A compound fracture is one in which the:
Fractured ends of bone penetrate the skin
The carpal canal is a passageway at the anterior wrist that is found between which bones?
Hamate and trapezium
The anteroposterior (AP) axial projection of the knee, Beclere method, is used to demonstrate the:
Intercondylar fossa
Which of the following projections would best demonstrate the cuboid bone?
Medial oblique foot
What anatomically important structure is located in the carpal canal?
Median nerve
Which of the following bones lies on the medial aspect of the foot?
Navicular
What position is the first digit in when the palm is pronated and resting on the image receptor (IR)?
Oblique
Which of the following types of pathology might be visualized on a radiograph of the lower leg?
Osgood-Schlatter disease
This condition is an inflammation of bone usually resulting from a bacterial infection.
Osteomyelitis
The carpal and tarsal bones are classified as: a. Long bones b. Irregular bones c. Sesamoid bones d. Short bones
Short bones (The short bones are roughly cube-shaped with an outer layer of compact bone surrounding a center of cancellous bone. Short bones are found only in the carpal and tarsal regions.)
Cancellous bone is most commonly described as:
Sponge-like
What type of fracture is characterized by having star-shaped fracture lines?
Stellate
The clavicle articulates with what two anatomical structures?
Sternum and scapula
How is the greater tubercle visualized on a lateral image of the humerus?
The greater tubercle is superimposed over the humeral head
For the Béclère method of the intercondylar fossa of the knee, what is the recommended source-to-image distance (SID) for the anteroposterior (AP) axial projection? a. 40 inches (102 cm) b. 48 inches (122 cm) c. 60 inches (152 cm) d. 72 inches (183 cm)
a
Using a 10-degree cephalic angle for anteroposterior (AP) axial foot radiographs will allow the central ray to: a. Superimpose the metatarsals b. Be perpendicular to the metatarsal joint space c. Show the cuboid d. Provide visualization of the sinus tarsi
b
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 (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 articular surfaces of the talocalcaneal joint. The lateral projection demonstrates the calcaneocuboid joint but does not demonstrate the entirety of the talocalcaneal joint, demonstrating all its articular surfaces. If evaluation of the talocalcaneal joint is desired, special views)
To demonstrate the glenoid cavity 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 (When viewing the glenoid cavity/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.)
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 is/are well demonstrated? 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 (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. (Long, Rollins, Smith, 13th ed., p. 162))
Which of the following structures does not need to be included in a diagnostic anteroposterior (AP) ankle radiograph? a. Open tibiotalar articulations b. Open tibiofibular articulation c. Lateral malleoli d. Medial malleoli
b (A diagnostic anteroposterior (AP) ankle radiograph must demonstrate the entire ankle joint, the medial and lateral malleoli, talus, and an open tibiotalar space, with proper visualization of soft tissue and bony detail.)
Where should the central ray be directed for an anteroposterior (AP) knee radiograph? a. 1 inch (3 cm) below the medial epicondyle of the femur b. 1 inch (3 cm) above the medial epicondyle of the femur c. 0.5 inch (1 cm) below the apex of the patella d. 0.5 inch (1 cm) above the apex of the patella
c
The sternoclavicular joint is classified as which type of joint: a. Spheroidal b. Ginglyumus c. Plane d. Trochoid
c (The sternoclavicular joint is a plane or gliding joint marked by a sliding/gliding motion between the sternum and clavicle (C). This type of joint does not allow for much movement. Spherical or ball-and-socket joints are freely movable and are found in the hip and shoulder joints (A). Ginglymus or hinge joints are found in the interphalangeal and elbow joints (B). Trochoid or pivot joints are found between C1 and C2 and between the radius and ulna (proximal and distal) (D). (Lampignano & Kendrick, 182))
What tube angle is recommended for a radiograph of an anteroposterior (AP) projection of the fifth digit of the foot when the area of concern is the joint spaces? a. 5-degree cephalic b. 10-degree caudal c. 15-degree cephalic d. 20-degree caudal
c (A 15-degree cephalic angle should be added when the area of concern is the joint spaces in an anteroposterior (AP) axial projection of the fifth digit of the foot.)
Which surface must be adjacent to the IR to obtain a lateral projection of the fourth digit/finger with optimal recorded detail? a. Anterior b. Posterior c. Medial d. Lateral
c (A lateral projection of the fourth digit/finger is best obtained if the finger is positioned so that there is as little OID as possible. Therefore, with only the fourth digit extended in the lateral position, the arm is positioned on the ulnar (medial) surface. This places the digit closer to the IR than if it were positioned radial side down. Excessive magnification distortion is avoided, and better spatial resolution is obtained. (Long, Rollins, and Smith, vol 1, p 112))
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 (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.)
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 (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). (Long, Rollins & Smith, 14th ed., vol. II))
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 (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.)
For an anteroposterior (AP) axial projection, Béclère method for the intercondylar fossa, the tube must be angled perpendicular to which of the following? a. Femur b. Patella c. Tibia/fibula d. Toes
c (Béclère method for the intercondylar fossa, the tube must be angled perpendicular to the tibia/fibula.)
Which of the following describes proper placement of the image receptor (IR) when performing an anteroposterior (AP) projection of the proximal femur? a. Center of the IR at the hip joint b. Center of the IR 2 inches (5 cm) inferior to the anterior superior iliac spine (ASIS) c. Top of the IR at the level of the anterior superior iliac spine (ASIS) d. Bottom of the IR at the apex of the patella
c (Placing the top of the image receptor (IR) at the level of the anterior superior iliac spine (ASIS) assures that the hip joint and entire proximal femur will be included in the image. If the entire femur, hip, and knee can be included on a single IR, the centering point would be to the mid-femur.)
Which of the following methods demonstrates the intercondylar fossa and places the patient in an anteroposterior (AP) axial projection? a. Camp Coventry method b. Holmblad method c. Béclère method d. Rosenberg method
c (The Béclère method is an anteroposterior (AP) axial projection for the intercondylar fossa that demonstrates the intercondylar fossa while the patient is lying supine. The Holmblad method is obtained while the patient is standing or kneeling, the Camp Coventry while the patient is lying prone, and the Rosenberg method is obtained while the patient is weight-bearing or standing.)
For an anteroposterior (AP) axial projection, Béclère method for the intercondylar fossa, the affected knee should be flexed to place the long axis of the femur at an angle of: a. 10 - 20 degrees b. 25 - 35 degrees c. 40 - 60 degrees d. 90 - 110 degrees
c (Béclère method for the intercondylar fossa, the affected knee should be flexed to place the long axis of the femur at a 40 - 60 degree angle to the long axis of the tibia. Using sandbags under the knee can assist in stabilizing and supporting the knee at a 40 - 60 degree angle while the radiograph is taken.)
The functions of which body system include mineral homeostasis, protection, and triglyceride storage? a. Endocrine b. Integumentary c. Skeletal d. Muscular
c (The skeleton functions to provide support and protect vital internal organs such as the heart and lungs. Bone continuously grows, repairs, produces blood cells, and 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 and regulation/control of activities of distant cells/tissues; the integumentary system includes the skin that is important in protection, excretion, and sensation of stimuli; the muscular system is responsible for movement and heat production. (Lampignano and Kendrick, 10th ed.))
It is necessary to rotate the patient's foot 30 degrees medially for a medial oblique foot radiograph to: a. Be perpendicular to the metatarsal joint space b. Show the entire foot c. Superimpose the metatarsals d. Reduce superimposition of the cuboid bone
d
What is the correct central ray entrance point for a medial oblique foot radiograph? a. Third metatarsophalangeal (MTP) b. Talonavicular joint c. Subtalar joint d. Base of the third metatarsal
d
Which of the following anatomic structures are visualized on an anteroposterior (AP) projection tibia and fibula radiograph? a. Superimposed femoral condyles, medial and lateral malleoli, and bony detail b. Lateral aspect of the tibia and fibula c. Anterior and posterior aspects of the tibia and fibula d. Tibia and fibula, femorotibial articulation, medial and lateral malleoli, and proper visualization of soft tissue and bony detail
d
A comminuted fracture is one in which the:
Bone is broken in more than one place
Movable joints are called?
Diarthrosis (Synovial joints)
A Hill-Sachs lesion is associated with which of the following bones?
Humerus
What is the name of the border that extends on the innominate bone from the posterior superior iliac spine to the anterior superior iliac spine? a. Iliac crest b. Greater sciatic notch c. Iliac auricular surface d. Brim of the lesser pelvis
a (The broad, flat portion of each ilium is the ala, or wing; the upper part of the ala forms a ridge of bone called the iliac crest, which extends between the anterior superior and posterior superior iliac spines.)
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 (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. (Long, Rollins & Smith, 14th ed., vol. I))
What tube angulation is used for the tangential projection of the knee, Settegast method? a. 15 - 20 degrees b. 25 - 30 degrees c. 40 - 55 degrees d. 55 - 60 degrees
a (Used to match the flexion of the patient's knee.)
Which of the following is the correct central ray entrance point for an anteroposterior (AP) medial oblique projection of the knee? a. ½ inch (1 cm) inferior to the apex of the patella b. ½ inch (1 cm) superior to the apex of the patella c. At the base of the patella d. At the center of the patella
a (When radiographing the knee, the central ray should pass directly through the joint space. When the patient is erect or supine with the leg extended, the center of the knee joint corresponds to a point ½ inch (1 cm) inferior to the apex of the patella.)
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
What amount of collimation is appropriate for a lateral proximal femur radiograph? a. 2 inches (5 cm) on either side b. 1 inch (3 cm) on either side c. 2 inches (5 cm) on one side only d. Open to the size of the image receptor (IR)
b (For a lateral proximal femur radiograph, the image should be collimated with 1 inch (3 cm) on either side.)
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
When performing a recumbent lateral projection of the knee, the patient's knee should be: a. Straight with the leg fully extended b. Flexed 5 degrees c. Flexed 20 - 30 degrees d. Flexed 90 degrees
c (When performing a recumbent lateral projection of the knee, the patient's knee should be flexed 20 - 30 degrees. Flexion of 20 - 30 degrees is generally comfortable for the patient, provides stability in the lateral position, and will demonstrate maximal joint cavity.)
What anatomic structures should be visible in a diagnostic lateral calcaneus radiograph? a. Calcaneus only b. Entire foot c. Entire calcaneus, the ankle joint, and adjacent tarsals d. Calcaneocuboid and talonavicular joints only
c (A diagnostic lateral calcaneus radiograph should demonstrate the entire calcaneus, including the ankle joint, and adjacent tarsals, with proper visualization of soft tissue and bony detail.)
How should the image receptor be positioned for a lateral projection tibia and fibula? a. Horizontally b. Vertically c. Diagonally
c (The image receptor is positioned diagonally for a lateral projection of the tibia and fibula, allowing the leg to fit from corner to corner.)
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 (The transthoracic (Lawrence) method is used when trauma exists, and the arm cannot be rotated or abducted because of an injury. This method results in a projection 90 degrees from the AP projection and shows the relationship between the proximal humerus and the scapula.)
Which of the following may be used to evaluate the scapulohumeral/glenohumeral relationship ? 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 (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 scapulohumeral/glenohumeral joint when the patient is able to abduct the arm. The transthoracic lateral projection is used to evaluate the scapulohumeral/glenohumeral joint and upper humerus when the patient is unable to abduct the arm. (Long, Rollins, and Smith, vol. 1, 14th ed., p. 242-245))
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 (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.)
Which of the following describes the correct image receptor (IR) placement for a lateral projection of the distal femur? a. Top of IR at anterior superior iliac spine (ASIS) b. Center of IR 2 inches (5 cm) distal to the greater trochanter c. Center of IR 2 inches (5 cm) superior to the patellar apex d. Bottom of IR 2 inches distal to the patellar apex
d (To include this anatomy, the bottom of the image receptor (IR) should be adjusted to extend two inches below the knee joint. The knee joint and proximal tibia should be included on images of the distal femur.)
What is the correct tube angulation for a plantodorsal axial calcaneus radiograph? a. 20 degrees caudad b. 25 degrees cephalad c. 30 degrees caudad d. 40 degrees cephalad
d (entering near the base of the third metatarsal.)