Thorax and Abdomen Procedures - Rad Review

The act of inspiration will cause elevation of the 1. sternum. 2. ribs. 3. diaphragm.

1 and 2 only

Which of the following projections of the abdomen may be used to demonstrate air or fluid levels? 1. Dorsal decubitus 2. Lateral decubitus 3. AP Trendelenburg

1 and 2 only

Which of the following structures is (are) located in the right upper quadrant (RUQ)? 1. Hepatic flexure 2. Gallbladder 3. Ileocecal valve

1 and 2 only

In which of the following conditions is a double-contrast BE essential for demonstration of the condition? 1. Polyps 2. Colitis 3. Diverticulosis

1 and 2 only -Double-contrast studies of the large bowel are particularly useful for demonstration of the bowel wall and anything projecting into it, for example, polyps. Polyps are projections of the bowel wall mucous membrane into the bowel lumen. Colitis is inflammation of the large bowel, often associated with ulcerations of the mucosal wall. A single-contrast study most likely would obliterate these mucosal conditions, but coating of the bowel mucosa with barium and subsequent filling of the bowel with air (double contrast) provide optimal delineation. Single-contrast studies will demonstrate projections/outpouchings from the intestinal wall such as diverticulitis.

Endoscopic retrograde cholangiopancreatography (ERCP) usually involves 1. cannulation of the hepatopancreatic ampulla 2. introduction of contrast medium into the common bile duct 3. introduction of barium directly into the duodenum

1 and 2 only -ERCP may be performed to investigate abnormalities of the biliary system or pancreas. The patient's throat is treated with a local anesthetic in preparation for the passage of the endoscope. The hepatopancreatic ampulla (of Vater) is located, and a cannula is passed through it so that contrast medium may be introduced into the common bile duct. Spot images of the common bile duct and pancreatic duct are taken frequently in the oblique position. Direct injection of barium mixture into the duodenum occurs during an enteroclysis procedure of the small bowel.

Characteristics of a patient with pulmonary emphysema include 1. shoulder girdle elevation 2. increased AP diameter of the chest 3. hyperventilation

1 and 2 only -Emphysema is a chronic obstructive pulmonary disease (COPD) characterized by pathologic distension of the pulmonary alveoli with (destructive) changes in their walls, resulting in a loss of elasticity. Emphysema is seen occasionally following asthma or tuberculosis, but it is caused most frequently by cigarette smoking. Because the emphysematous patient's greatest difficulty is exhalation, it becomes a conscious, forced effort. Breathing is shallow and rapid. Forced and ineffective breathing results in expansion of the AP diameter of the chest and elevated shoulder girdle in established emphysema. Hyperventilation results from too frequent deep breaths in the anxious or tense individual. This results in a feeling of dizziness and tingling of the extremities.

Which of the following conditions would require an increase in exposure factors? 1. Congestive heart failure 2. Pleural effusion 3. Emphysema

1 and 2 only -Emphysema is abnormal distention of the alveoli (or tissue spaces) with air. The presence of abnormal amounts of air makes it necessary to decrease from normal exposure factors. Congestive heart failure and pleural effusion involve abnormal amounts of fluid in the chest and thus require an increase in exposure factors.

A patient is usually required to drink barium sulfate suspension to demonstrate which of the following structures? 1. Esophagus 2. Pylorus 3. Ilium

1 and 2 only -Oral administration of barium sulfate is used to demonstrate the upper digestive tract: the esophagus; the fundus, body, and pylorus of the stomach; and the small bowel, consisting of duodenum, jejunum, and ileum (i.e. small bowel..not ilium). Consistent care must be taken to read and record patient information accurately and correctly. The large bowel is usually demonstrated via rectal administration of barium.

During IV urography, the prone position generally is recommended to demonstrate 1. the filling of the ureters 2. the renal pelvis 3. the superior calyces

1 and 2 only -The kidneys lie obliquely in the posterior portion of the trunk with their superior portion angled posteriorly and their inferior portion and ureters angled anteriorly. Therefore, to facilitate filling of the most anteriorly placed structures, the patient is examined in the prone position. Opacified urine then flows to the most dependent part of the kidney and ureter—the ureteropelvic region, inferior calyces, and ureters

Types of inflammatory bowel disease include 1. ulcerative colitis. 2. Crohn's disease. 3. intussusception.

1 and 2 only -The two most common types of chronic inflammation of the intestines are ulcerative colitis and Crohn's disease. The latter can attack any part of the GI tract and extends through all layers of the intestinal wall (therefore the possibility of forming fistulous tracks to contiguous structures). Ulcerative colitis attacks only the large bowel and only the mucosal layer of the intestinal wall. Curiously, cigarette smoking increases the risk for Crohn's disease and decreases the risk for ulcerative colitis. Intussusception is an obstructive disorder.

Which of the following is (are) part of the bony thorax? 1. Manubrium 2. Clavicles 3. 24 ribs

1 and 3 only

During an intravenous urogram (IVU), the RPO position is used to demonstrate the 1. left kidney parallel to the IR 2. right kidney parallel to the IR 3. right kidney perpendicular to the IR

1 and 3 only -Since the kidneys do not lie parallel to the IR in the AP position, the oblique positions are used during IVU to visualize them better. With the AP oblique projections (i.e., RPO and LPO), the kidney that is farther away is placed parallel to the IR, and the kidney that is closer is placed perpendicular to the IR. Therefore, in the RPO position, the right kidney, being closer, is perpendicular to the IR. The left kidney, the one farther away, is placed parallel to the IR.

Dorsal decubitus projections of the chest are used to evaluate small amounts of 1. fluid in the posterior chest 2. air in the posterior chest 3. fluid in the anterior chest

1 only

The patient usually is required to drink barium sulfate suspension in order to demonstrate which of the following structures? 1. Descending duodenum 2. Ilium 3. Splenic flexure

1 only

During studies of the soft tissue of the neck, the exposure can be made 1. during phonation before/after opacification. 2. during Valsalva maneuver. 3. at the height of swallowing motion with opacification.

1, 2, and 3

Examples of COPD include 1. chronic bronchitis. 2. pulmonary emphysema. 3. asthmatic bronchitis.

1, 2, and 3

In which of the following procedures is quiet, shallow breathing recommended during the exposure to obliterate prominent pulmonary vascular markings? 1. RAO sternum 2. Lateral thoracic spine 3. AP scapula

1, 2, and 3

Ingestion of barium sulfate is contraindicated in which of the following situations? 1. Suspected perforation of a hollow viscus 2. Suspected large bowel obstruction 3. Preoperative patients

1, 2, and 3

Inspiration and expiration projections of the chest are performed to demonstrate 1. partial or complete collapse of pulmonary lobe(s) 2. air in the pleural cavity 3. foreign body

1, 2, and 3

Involuntary motion can be caused by 1. peristalsis. 2. severe pain. 3. heart muscle contraction.

1, 2, and 3

Moderate hypertension can produce damage to which of the following organ(s) 1. Lungs 2. Kidneys 3. Brain

1, 2, and 3

Operative cholangiography may be performed to 1. visualize biliary stones or a neoplasm. 2. determine function of the hepatopancreatic ampulla. 3. examine the patency of the biliary tract.

1, 2, and 3

Routine excretory urography usually includes a postmicturition radiograph of the bladder. This is done to demonstrate 1. tumor masses. 2. residual urine. 3. prostatic enlargement.

1, 2, and 3

What instructions might a patient be given following an upper GI examination? 1. Drink plenty of fluids. 2. Take a mild laxative. 3. Increase dietary fiber.

1, 2, and 3

Which of the following are mediastinal structures? 1. Heart 2. Trachea 3. Esophagus

1, 2, and 3

An increase in exposure factors usually is required in which of the following circumstances? 1. Edema 2. Ascites 3. Acromegaly

1, 2, and 3 -An increase in exposure factors will be required when imaging pathologic conditions that cause greater attenuation of the x-ray beam. The x-ray beam suffers more attenuation as the thickness and/or density of the tissues increases. Examples include conditions involving an increase in part size as a result of fluid accumulation (edema) following trauma, an accumulation of fluid in the abdomen (ascites), or an increase in bone size and density (acromegaly) as a result of an endocrine disorder. The radiographer needs a good working knowledge of pathologic conditions, their effect on the body, and the resulting modifications in technical factors required.

Which of the following statements is (are) correct with respect to postoperative cholangiography? 1. A T-tube is in place in the common bile duct. 2. Water-soluble contrast material is injected. 3. The patency of biliary ducts is evaluated.

1, 2, and 3 -Postoperative, or T-tube, cholangiography frequently is performed to evaluate the patency of the biliary ducts and to identify any previously undetected stones. Following surgery, a T-tube is left in place within the common bile duct, with the vertical portion of the T extending outside the body. Water-soluble iodinated contrast medium is injected, and fluoroscopic examination is carried out

In a posteroanterior (PA) projection of the chest being used for cardiac evaluation, the heart measures 14.7 cm between its widest points. If the magnification factor is known to be 1.2, what is the actual diameter of the heart?

12.25 cm -The formula for magnification factor (MF) = image size/object size. In the stated problem, the anatomic measurement is 14.7 cm, and the magnification factor is known to be 1.2

The AP axial projection of the pulmonary apices requires the CR to be directed?

15 degrees cephalad

Using the PA projection, which of the following tube angle and direction combinations is correct for an axial projection of the clavicle?

15 to 30 degrees caudad -When the clavicle is examined in the PA axial projection, the CR must be directed 15 to 30 degrees caudad to project most of the clavicle's length above the ribs. The direction of the CR is reversed when examining the patient in the AP position.

The act of expiration will cause the 1. diaphragm to move inferiorly 2. sternum and ribs to move inferiorly 3. diaphragm to move superiorly

2 and 3 only

Which projection(s) of the abdomen would be used to demonstrate pneumoperitoneum? 1. Right lateral decubitus 2. Left lateral decubitus 3. Upright

2 and 3 only -An erect abdomen or left lateral decubitus should be performed for demonstration of air-fluid levels in the abdomen. The right lateral decubitus position is used to demonstrate the layering of gallstones. It will not show free air within the peritoneum because of the overlying gastric bubble on the elevated left side of the body.

Which of the following examinations might require the use of 120 kVp? 1. AP abdomen 2. Chest radiograph 3. Barium-filled stomach

2 and 3 only -High-kilovoltage factors are frequently used to even out densities in anatomic parts with high tissue contrast (eg, the chest). However, as high kilovoltage produces added scattered radiation, it generally must be used with a grid. It would be inappropriate to perform an AP abdomen with high kilovoltage because it has such low subject contrast. Barium-filled structures are frequently radiographed using 120 kV or more to penetrate the barium—to see through to structures behind.

Which of the following positions can be used to demonstrate the axillary ribs of the right thorax? 1. RAO 2. LAO 3. RPO

2 and 3 only -The axillary portion of the ribs is best demonstrated in a 45-degree oblique position. The axillary ribs are demonstrated in the AP oblique projection with the affected side adjacent to the IR and in the PA oblique projection with the affected side away from the IR. Therefore, the right axillary ribs would be demonstrated in the RPO (AP oblique with affected side adjacent to the IR) and LAO (PA oblique with affected side away from the IR) positions.

Which of the following positions will demonstrate the right axillary ribs? 1. RAO 2. LAO 3. RPO

2 and 3 only -The axillary portion of the ribs is best demonstrated in a 45° oblique position. The axillary ribs are demonstrated in the AP oblique projection with the affected side adjacent to the IR, and in the PA oblique projection with the affected side away from the IR. Therefore, the right axillary ribs would be demonstrated in the RPO (AP oblique with affected side adjacent to the IR) and LAO (PA oblique with affected side away from the IR) positions.

Free air in the abdominal cavity is demonstrated in which of the following? 1. Lateral recumbent abdomen 2. Erect AP abdomen 3. Left lateral decubitus abdomen

2 and 3 only -When air-fluid levels are to be demonstrated, it is important to direct the central ray horizontally. If the central ray is angled or directed vertically, the air or fluid level will be distorted or entirely obliterated. Free air in the abdominal cavity is best visualized when the patient is left lateral decubitus or erect AP. The decubitus allows the air to accumulate around the homogeneous liver

In what order should the following examinations be scheduled? 1. Upper GI 2. Intravenous pyelogram (IVP) 3. Barium enema (BE)

2, 3, 1 -When scheduling patient examinations, it is important to avoid the possibility of residual contrast medium covering areas of interest on later examinations. The IVP should be scheduled first because the contrast medium used is excreted rapidly. The BE should be scheduled next. Finally, the upper GI series is scheduled. Any barium remaining from the previous BE should not be enough to interfere with the stomach or duodenum (a preliminary scout image should be taken in each case).

Free air in the abdominal cavity is best demonstrated in which of the following positions? A. AP projection, left lateral decubitus position B. AP projection, right lateral decubitus position C. PA recumbent position D. AP recumbent position

A. AP projection, left lateral decubitus position

Which of the following groups of organs/structures are located in the left upper quadrant? A. Left kidney, left suprarenal gland, and gastric fundus B. Left suprarenal gland, pylorus, and duodenal bulb C. Hepatic flexure, cecum, and pancreas D. Gastric fundus, liver, and cecum

A. Left kidney, left suprarenal gland, and gastric fundus

The pyloric canal and duodenal bulb are best demonstrated during an upper GI series in which of the following positions? A. RAO B. Left lateral C. Recumbent PA D. Recumbent AP

A. RAO -The RAO position affords a good view of the pyloric canal and duodenal bulb. It is also a good position for the barium-filled esophagus, projecting it between the vertebrae and the heart. The left lateral projection of the stomach demonstrates the left retrogastric space, the recumbent PA projection is used as a general survey of the gastric surfaces, and the recumbent AP projection with slight left oblique affords a double contrast of the pylorus and duodenum.

All the following positions are used frequently to demonstrate the sternoclavicular articulations except: A. weight-bearing B. RAO C. LAO D. PA

A. weight-bearing -Sternoclavicular articulations may be examined with the patient PA, either bilaterally with the patient's head resting on the chin or unilaterally with the patient's head turned toward the side being examined. The sternoclavicular articulations also may be examined in the oblique position, with either the patient rotated slightly or the CR angled slightly medialward. Weight-bearing positions are used frequently for evaluation of acromioclavicular joints.

Place the following anatomic structures in order from anterior to posterior: 1. Trachea 2. Apex of heart 3. Esophagus

Apex of heart, trachea, esophagus

Which of the following sequences correctly describes the path of blood flow as it leaves the left ventricle? A. Arteries, arterioles, capillaries, venules, veins B. Arterioles, arteries, capillaries, veins, venules C. Veins, venules, capillaries, arteries, arterioles D. Venules, veins, capillaries, arterioles, arteries

Arteries, arterioles, capillaries, venules, veins

The sternoclavicular joints will be best demonstrated in which of the following positions? A. Apical lordotic B. Anterior oblique C. Lateral D. Weight-bearing

B. Anterior oblique -The (diarthrotic) sternoclavicular joints are formed by the medial (sternal) extremities of the clavicles and the clavicular notches of the manubrium (of the sternum). They can be demonstrated in the LAO and RAO positions. The LAO projection demonstrates the left sternoclavicular joint, whereas the RAO projection demonstrates the joint on the right. The patient is obliqued about 15 degrees with the side of interest adjacent to the IR.

Widening of the intercostal spaces is characteristic of which of the following conditions? A. Pneumothorax B. Emphysema C. Pleural effusion D. Pneumonia

B. Emphysema

Which of the following positions is required to demonstrate small amounts of fluid in the pleural cavity? A. Lateral decubitus, affected side up B. Lateral decubitus, affected side down C. AP Trendelenburg D. AP supine

B. Lateral decubitus, affected side down

Which of the following pathologic conditions probably will require a decrease in exposure factors? A. Osteomyelitis B. Osteoporosis C. Osteosclerosis D. Osteochondritis

B. Osteoporosis -Osteoporosis is a condition, often seen in the elderly, marked by increased porosity and softening of bone. The bones are much less dense, and thus a decrease in exposure is required.

Which of the following radiologic procedures requires that a contrast medium be injected into the renal pelvis via a catheter placed within the ureter? A. Nephrotomography B. Retrograde urography C. Cystourethrography D. IVU

B. Retrograde urography -Retrograde urography requires ureteral catheterization so that a contrast medium can be introduced directly into the pelvicalyceal system. This procedure provides excellent opacification and structural information but does not demonstrate the function of these structures. IV studies such as the IVU demonstrate function. Cystourethrography is an examination of the bladder and urethra, frequently performed during voiding. Nephrotomography is performed after IV administration of a contrast agent; it may be used to evaluate small intrarenal lesions and renal hypertension.

Which of the following procedures will best demonstrate the cephalic, basilic, and subclavian veins? A. Aortofemoral arteriogram B. Upper-limb venogram C. Lower-limb venogram D. Renal venogram

B. Upper-limb venogram

All the following statements regarding respiratory structures are true except A. the right lung has three lobes. B. the inferior portion of the lung is the apex. C. each lung is enclosed in serous membrane. D. the main stem bronchi enter the lung hilum.

B. the inferior portion of the lung is the apex.

Which of the following is the preferred scheduling sequence? A. Lower GI series, abdomen ultrasound, upper GI series B. Abdomen ultrasound, lower GI series, upper GI series C. Abdomen ultrasound, upper GI series, lower GI series D. Upper GI series, lower GI series, abdomen ultrasound

B.Abdomen ultrasound, lower GI series, upper GI series -Diagnostic imaging examinations must be scheduled appropriately. Retained barium sulfate contrast medium can obscure necessary anatomic details in x-ray or ultrasound studies that are scheduled later. Therefore, the ultrasound examination should come first, followed by the lower GI series (BE), and finally the upper GI series. Retained barium from the lower GI series probably will not obscure upper GI structures.

Which of the following techniques would provide a posteroanterior (PA) projection of the gastroduodenal surfaces of a barium-filled high and transverse stomach? A. Place the patient in a 35- to 40-degree right anterior oblique (RAO) position. B. Place the patient in a lateral position. C. Angle the CR 35 to 45 degrees cephalad. D. Angle the CR 35 to 45 degrees caudad.

C. Angle the CR 35 to 45 degrees cephalad -In the PA position, portions of the barium-filled hypersthenic stomach superimpose on themselves. Thus, patients with a hypersthenic body habitus usually present a high transverse stomach with poorly defined curvatures. If the PA stomach is projected with a 35- to 45-degree cephalad CR, the stomach "opens up." That is, the curvatures, the antral portion, and the duodenal bulb all appear as a sthenic habitus stomach would appear. A 35-to 40-degree RAO position is used to demonstrate many of these structures in the average, or sthenic, body habitus

Which of the following examinations most likely would be performed to diagnose Wilm's tumor? A. BE B. Upper GI C. IVU D. Bone survey

C. IVU -Wilm's tumor is a rapidly developing tumor of the kidney(s). It is the most common childhood renal tumor, usually affecting only one kidney. Newer treatments are effective in controlling about 90% of these tumors. As the kidneys are affected, an IVU would be the most appropriate of the examinations listed

A near-frontal (AP/PA) view of the sternum is best accomplished in which of the following positions? A. AP B. PA C. RAO D. LAO

C. RAO

Which cholangiographic procedure uses an indwelling drainage tube for contrast medium administration? A. Endoscopic retrograde cholangiographic pancreatography (ERCP) B. Operative cholangiography C. T-tube cholangiography D. Percutaneous transhepatic cholangiography

C. T-tube cholangiography -Contrast media may be administered in a variety of manners in cholangiography, including (1) an endoscope with a cannula placed in the hepatopancreatic ampulla (of Vater) for an ERCP, (2) a needle or small catheter placed directly in the common bile duct for an operative cholangiogram, (3) a very fine needle through the patient's side and into the liver for a percutaneous transhepatic cholangiogram, and (4) via an indwelling T-tube for a postoperative or T-tube cholangiogram.

Which of the following equipment is mandatory for performance of a myelogram? A. Cine camera B. 105-mm spot film C. Tilting x-ray table D. Tomography

C. Tilting x-ray table

The AP Trendelenburg position is often used during an upper GI examination to demonstrate A. the duodenal loop B. filling of the duodenal bulb C. hiatal hernia D. hypertrophic pyloric stenosis

C. hiatal hernia

All the following procedures demonstrate renal function except A. IVP. B. descending urography. C. retrograde urography. D. infusion nephrotomography.

C. retrograde urography -Retrograde urography is not considered a functional study of the urinary system. IVP, descending urography, and infusion nephrotomography are all considered functional urinary tract studies because the contrast medium is introduced intravenously and excreted by the kidneys. Retrograde urography involves introduction of contrast medium into the kidneys via catheter, thereby demonstrating their structure but not their function

All the following positions are likely to be employed for both single- and double-contrast examinations of the large bowel except A. lateral rectum B. AP axial rectosigmoid C. right and left lateral decubitus abdomen. D. RAO and LAO abdomen.

C. right and left lateral decubitus abdomen -Radiographic examinations of the large bowel generally include the AP or PA axial position to "open" the S-shaped sigmoid colon, the lateral position especially for the rectum, and the LAO and RAO (or LPO and RPO) positions to "open" the colic flexures. The left and right decubitus positions usually are employed only in double-contrast barium enemas to better demonstrate double contrast of the medial and lateral walls of the ascending and descending colon.

All the following statements regarding large bowel radiography are true except: A. the large bowel must be completely empty prior to examination. B. retained fecal material can obscure pathology. C. single-contrast studies help to demonstrate intraluminal lesions. D. double-contrast studies help to demonstrate mucosal lesions.

C. single-contrast studies help to demonstrate intraluminal lesions. -Perhaps the most important prerequisite to a successful BE examination is a thoroughly clean large bowel. Any retained fecal material can simulate or obscure pathology. A single-contrast examination demonstrates the anatomy and contour of the large bowel, as well as anything that may project out from the bowel wall (e.g., diverticula). In a double-contrast examination, the bowel wall (mucosa) is coated with barium, and then the lumen is filled with air. This enables visualization of any intraluminal lesions such as polyps and tumor masses.

Following the ingestion of a fatty meal, what hormone is secreted by the duodenal mucosa to stimulate contraction of the gallbladder?

Cholecystokinin -About 30 minutes after the ingestion of fatty foods, cholecystokinin is released from the duodenal mucosa and absorbed into the bloodstream. As a result, the gallbladder is stimulated to contract, releasing bile into the intestine.

During endoscopic retrograde cholangiopancreatography (ERCP) examination, contrast medium is injected into the?

Common bile duct -Endoscopic retrograde cholangiopancreatography (ERCP) is performed to diagnose disease of the biliary and/or pancreatic organs. Fluoroscopic control is used to introduce the fiber-optic endoscope through the mouth and into the duodenum. The hepatopancreatic ampulla (of Vater) then is located and cannulated, and contrast medium is injected into the common bile duct.

Which of the following pathologic conditions would require an increase in exposure factors? A. Pneumoperitoneum B. Obstructed bowel C. Renal colic D. Ascites

D. Ascites -ascites, there is an abnormal accumulation of fluid in the abdominal cavity, necessitating an increase in exposure factors.

Which of the following structures will usually contain air, in the PA recumbent position on a sthenic patient, during a double-contrast upper GI (UGI) examination? A. Duodenal bulb B. Descending duodenum C. Pyloric vestibule D. Gastric fundus

D. Gastric fundus -The stomach is normally angled with the fundus lying posteriorly and the body, pylorus, and duodenum inferior to the fundus and angling anteriorly. Therefore, when the patient ingests barium and lies AP recumbent, the heavy barium gravitates easily to the fundus and fills it. With the patient PA recumbent, barium gravitates inferiorly to the body, pylorus, and duodenum, displacing air into the fundus

Which of the following structures will be filled with barium in the AP recumbent position of a sthenic patient during an upper GI examination? A. Duodenal bulb B. Descending duodenum C. Pyloric vestibule D. Gastric fundus

D. Gastric fundus -The stomach is normally angled with the fundus lying posteriorly and the body, pylorus, and duodenum inferior to the fundus and angling anteriorly. Therefore, when the patient ingests barium and lies AP recumbent, the heavy barium gravitates easily to the fundus and fills it. With the patient PA recumbent, barium gravitates inferiorly to the body, pylorus, and duodenum, displacing air into the fundus.

All of the following statements regarding the RAO position of the sternum are true, except A. the sternum is generally projected to the left of the vertebral column. B. shallow breathing during the exposure can obliterate prominent pulmonary markings. C. it is helpful to project the sternum over the heart. D. a thin thorax requires a lesser degree of obliquity than a thicker thorax.

D. a thin thorax requires a lesser degree of obliquity than a thicker thorax

To obtain an exact axial projection of the clavicle, place the patient A. supine and angle the central ray 30° caudally. B. prone and angle the central ray 30° cephalad. C. supine and angle the central ray 15° cephalad. D. in a lordotic position and direct the central ray at right angles to the coronal plane of the clavicle.

D. in a lordotic position and direct the central ray at right angles to the coronal plane of the clavicle -The exact axial projection is performed by placing the patient in a lordotic position, leaning against the vertical grid device. This places the clavicle at right angles, or nearly so, to the plane of the IR. The central ray is directed to enter the inferior border of the clavicle, at right angles to its coronal plane. Other axial projections may include a prone position with a 25° to 30° caudal angle. However, none of these produce an exact axial projection of the clavicle.

Which of the following positions is obtained with the patient lying supine on the radiographic table with the CR directed horizontally to the iliac crest?

Dorsal decubitus position

Gas-producing powder or crystals usually are ingested for which of the following examinations?

Double-contrast gastrointestinal (GI) series

A patient suffering from orthopnea would experience the least discomfort in which body position?

Erect -Orthopnea is a respiratory condition in which the patient has difficulty breathing (dyspnea) in any position other than erect. The patient is usually comfortable in the erect, standing, or seated position.

How should a chest examination to rule out air-fluid levels be obtained on a patient having traumatic injuries?

Include a lateral chest examination performed in dorsal decubitus position

Which of the following positions will most effectively move the gallbladder away from the vertebrae in an asthenic patient? A. LAO B. RAO C. LPO D. Erect

LAO -The position of the gallbladder varies with the body habitus of the patient. Hypersthenic patients are more likely to have their gallbladder located high and lateral. The asthenic patient's gallbladder is most likely to occupy a low and medial position, occasionally superimposed on the vertebrae or iliac fossa. The LAO position is used most often to move the gallbladder away from the spine. The erect position would make the gallbladder move even more inferior and medial.

During an upper gastrointestinal (GI) examination, a stomach of average shape demonstrates a barium-filled fundus and double contrast of the pylorus and duodenal bulb. The position used is most likely?

LPO -With the body in the AP recumbent position (or LPO position), barium flows easily into the fundus of the stomach (from the more distal portions of the stomach), displacing/drawing the stomach somewhat superiorly. The fundus, then, is filled with barium, whereas the air that had been in the fundus is now displaced into the gastric body, pylorus, and duodenum, illustrating them in double contrast. Double-contrast delineation of these structures allows us to see through the stomach to the retrogastric areas and structures. The RAO position demonstrates a barium-filled pylorus and duodenum. Anterior and posterior aspects of the stomach are visualized in the lateral position; medial and lateral aspects of the stomach are visualized in the AP projection

Correct preparation for a patient scheduled for an upper gastrointestinal (GI) series is most likely to be?

NPO after midnight

An acute infection of the lungs is called?

Pneumonia

Which of the following positions may be used to effectively demonstrate the right posterior axillary ribs?

RPO

The ileocecal valve normally is located in which of the following body regions?

Right iliac -The abdomen is divided into nine regions. The upper lateral regions are the left and right hypochondriac, with the epigastric separating them. The middle lateral regions are the left and right lumbar, with the umbilical region between them. The lower lateral regions are the left and right iliac, with the hypogastric region between them. The ileocecal valve, cecum, and appendix (if present) are located in the lower right abdomen—therefore, the right iliac region.

During an air-contrast BE, in what part of the colon is air most likely to be visualized with the body in the AP recumbent position?

Transverse Colon -During a double-contrast BE, barium and air will distribute themselves according to the position of parts of the colon within the body and according to body position. When the body is in the AP recumbent position, the most anterior structures will be air filled. Anterior structures include the transverse colon and a portion of the sigmoid colon. Both flexures would be air filled in the erect position

A patient in a recumbent position with the head lower than the feet is said to be in which of the following positions?

Trendelenburg

The body habitus characterized by a long and narrow thoracic cavity and low midline stomach and gallbladder is the?

asthenic -The four types of body habitus describe differences in visceral shape, position, tone, and motility. One body type is hypersthenic, characterized by the very large individual with short, wide heart and lungs, high transverse stomach and gallbladder, and peripheral colon. The sthenic individual is the average, athletic, most predominant type. The hyposthenic patient is somewhat thinner and a little frailer, with organs positioned somewhat lower. The asthenic type is smaller in the extreme, with a long thorax, a very long, almost pelvic stomach, and a low medial gallbladder. The colon is medial and redundant. Hypersthenic patients usually demonstrate the greatest motility.

Which of the following is a major cause of bowel obstruction in children? A. Appendicitis B. Intussusception C. Regional enteritis D. Ulcerative colitis

b. Intussusception

The ridge that marks the bifurcation of the trachea into the right and left primary bronchi is the?

carina

Correct preparation for a patient scheduled for a lower GI series is most likely to be?

cathartics and cleansing enemas -Diagnostic x-ray examinations that require contrast agents include upper GI series, lower GI series (BE), IVU, and the occasional GB series. Patient preparation is somewhat different for each of these examinations. An iodinated contrast agent, usually in the form of several pills, is taken by the patient the evening before a scheduled GB examination, and only water is allowed the morning of the examination. The patient scheduled for an upper GI series must receive NPO (nothing by mouth) after midnight. A lower GI series (BE) requires that the large bowel be very clean prior to the administration of barium; this requires the administration of cathartics (laxatives) and cleansing enemas

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?

caudad

Another name for Hirschsprung's disease, the most common cause of lower GI obstruction in neonates, is?

congenital megacolon -Hirschsprung disease, or congenital megacolon, is caused by the absence of some or all of the bowel ganglion cells—usually in the rectosigmoid area but occasionally more extensively. Hirschsprung disease is the most common cause of lower GI obstruction in neonates and is treated surgically by excision of the affected area followed by reanastomosis with the normal, healthy bowel. Hirschsprung disease is diagnosed by BE or, in mild cares, by rectal biopsy.

Abnormal accumulation of air in pulmonary tissues, resulting in overdistention of the alveolar spaces, is?

emphysema

The uppermost portion of the iliac crest is at approximately the same level as the?

fourth lumbar vertebra

Double-contrast examinations of the stomach or large bowel are performed to better visualize the?

gastric or bowel mucosa

What is the position of the stomach in a hypersthenic patient?

high and horizontal

When the erect position is requested as part of an IVU, it is used to demonstrate?

kidney mobility

The stomach of an asthenic patient is most likely to be located

low, vertical, and toward the midline

Compared with that of the hypersthenic and sthenic body types, the gallbladder of an asthenic patient is most likely to be located?

lower and more medial -The four types of body habitus describe differences in visceral shape, position, tone, and motility. One body type is hypersthenic, the very large individual with short, wide heart and lungs, high transverse stomach and gallbladder, and peripheral colon. The sthenic individual is the average, athletic, most predominant type. The hyposthenic patient is somewhat thinner and a little more frail, with organs positioned somewhat lower. The asthenic type is smaller in the extreme, with a long thorax, a very long, almost pelvic stomach, and a low medial gallbladder. The asthenic colon is medial and redundant.

The plane that passes vertically through the body, dividing it into anterior and posterior halves, is termed the

midcoronal plane

The thoracic cavity is lined by?

parietal pleura

A lesion with a stalk projecting from the intestinal mucosa into the lumen is a(n)?

polyp

An aspirated foreign body is more likely to enter the lower respiratory tract via the?

right main stem bronchus

Deoxygenated blood from the head and thorax is returned to the heart by the?

superior vena cava

To demonstrate esophageal varices, the patient must be examined in?

the recumbent position -Esophageal varices are tortuous dilatations of the esophageal veins. They are much less pronounced in the erect position and always must be examined with the patient recumbent. The recumbent position affords more complete filling of the veins because blood flows against gravity

When a GI series has been requested on a patient with a suspected perforated ulcer, the type of contrast medium that should be used is?

water-soluble iodinated media -Whenever a perforation of the GI tract is suspected, a water-soluble contrast agent (such as Gastrografin or oral Hypaque) should be used because it is easily absorbed from within the peritoneal cavity. Leakage of barium sulfate into the peritoneal cavity can have serious consequences. Water-soluble contrast agents also may be used in place of barium sulfate when the possibility of barium impaction exists. Oil-based contrast agents are used rarely today