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Chapter 20 Positioning

front 1

Which of the following skull types is considered average in size and shape?

a. mesocephalic

b. brachycephalic

c. dolichocephalic

back 1

a. mesocephalic

front 2

Which skull type is narrow from side to side?

a. mesocephalic

b. dolichocephalic

c. brachycephalic

back 2

b. dolichocephalic

front 3

In a typically shaped head, the petrous pyramids project anteriorly and medially at what angle?

a. 37 degrees

b. 40 degrees

c. 47 degrees

d. 54 degrees

back 3

c. 47 degrees

front 4

Which plane of the head is placed parallel to the plane of the IR for a lateral projection of the skull?

a. sagittal

b. transverse

c. midsagittal

d. midcoronal

back 4

c. midsagittal

front 5

The central ray and center of the IR position for a lateral projection of the skull is:

a. 1 inch below the EAM

b. 2 inches below the EAM

c. 1 inch above the EAM

d. 2 inches above the EAM

back 5

d. 2 inches above the EAM

front 6

Which of the following is true regarding the lateral projection of the skull?

1.) the midsagittal plane of the head is parallel to the plane of the IR

2.) the interpupillary line is perpendicular to the IR

3.) the mentomeatal line is parallel with the bottom edge of the IR

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 6

a. 1 and 2

front 7

Which of the following should be seen superimposed on a lateral projection of the skull?

1.) orbital roofs

2.) external acoustic meati

3.) temporomandibular joints

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 7

d. 1, 2, and 3

front 8

Which method of examining the skull will demonstrate the petrous ridges in the orbits, the ethmoid and frontal sinuses, and the crista galli?

a. Towne

b. Caldwell

c. Schüller

d. Rhese

back 8

d. Caldwell

front 9

The central-ray angle for the PA axial (Caldwell) projection of the skull is:

a. 5 degrees cephalad

b. 10 degrees cephalad

c. 12 degrees caudad

d. 15 degrees caudad

back 9

d. 15 degrees caudad

front 10

Which of the following is perpendicular to the plane of the IR for a Caldwell projection of the skull?

a. glabellomeatal line

b. acanthiomeatal line

c. orbitomeatal line

d. mentomeatal line

back 10

c. orbitomeatal line

front 11

Often a patient cannot be turned into the prone position for a PA axial projection of the skull (Caldwell method). What central-ray angle could be used if the AP axial projection is used instead?

a. 10 degrees caudad

b. 15 degrees cephalad

c. 10 to 15 degrees caudad

d. 10 to 15 degrees cephalad

back 11

b. 15 degrees cephalad

front 12

Which of the following lines is placed perpendicular to the plane of the IR for the AP axial (Towne) projection?

a. orbitomeatal line

b. infraorbitomeatal line

c. glabellomeatal line

d. acanthiomeatal line

back 12

a. orbitomeatal line

front 13

If the patient cannot flex the neck to place the orbitomeatal line perpendicular to the IR for an AP axial (Towne) projection, which line should be placed perpendicular?

a. acanthiomeatal line

b. infraorbitomeatal line

c. glabellomeatal line

d. mentomeatal line

back 13

b. infraorbitomeatal line

front 14

Which of the following is true regarding the placement of the IR for an AP axial (Towne) projection of the skull?

1.) its upper margin is at the level of the top of the cranium

2.) its upper margin is 2 inches above the top of the cranium

3.) its upper margin is 2 inches below the top of the cranium

a. 1 only

b. 2 only

c. 3 only

d. 1, 2, and 3

back 14

a. 1 only

front 15

Which method of examining the skull is identified in the figure below?

a. Haas

b. Towne

c. Rhese

d. Caldwell

back 15

b. Towne

front 16

If the infraorbitomeatal line is placed perpendicular to the IR during an AP axial (Towne) projection of the skull, how much is the central ray angled?

a. 15 degrees caudad

b. 30 degrees caudad

c. 37 degrees caudad

d. 45 degrees caudad

back 16

c. 37 degrees caudad

front 17

Which of the following is clearly demonstrated within the foramen magnum during an AP axial (Towne) projection of the skull?

1.) dorsum sellae

2.) sella turcica

3.) posterior clinoid processes

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 17

b. 1 and 3

front 18

What is the central-ray angulation for demonstration of the entire foramen magnum during an AP axial (Towne) projection?

a. 37 degrees caudad

b. 40 degrees caudad

c. 60 degrees caudad

d. 40 to 60 degrees caudad

back 18

d. 40 to 60 degrees caudad

front 19

Which of the following methods will clearly demonstrate the petrous ridges, foramen magnum, dorsum sellae, and posterior clinical processes?

1.) Haas (PA axial)

2.) Towne (AP axial)

3.) Schüller (SMV)

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 19

a. 1 and 2

front 20

What is the average central-ray angulation for the PA axial (Haas) projection of the skull?

a. 25 degrees caudad

b. 25 degrees cephalad

c. 30 degrees caudad

d. 30 degrees cephalad

back 20

b. 25 degrees cephalad

front 21

Which line should be placed parallel to the plane of the IR for the SMV projection of the cranial base?

a. acanthiomeatal line

b. orbitomeatal line

c. infraorbitomeatal line

d. mentomeatal line

back 21

c. infraorbitomeatal line

front 22

Radiographic demonstration of the cranial base is performed by which method?

a. Haas

b. Rhese

c. Towne

d. Schüller

back 22

d. Schüller

front 23

What is the central-ray angulation for the SMV projection?

a. 0 degrees

b. 5 degrees caudad

c. 5 degrees cephalad

d. 5 to 7 degrees cephalad

back 23

a. 0 degrees

front 24

The x-ray projection demonstrated in the figure below is the:

a. SMV

b. VSM

c. AP axial

d. PA axial

back 24

b. VSM

front 25

For an SMV projection of the cranial base, the central ray should always be perpendicular to the:

a. mentomeatal line

b. orbitomeatal line

c. infraorbitomeatal line

d. acanthiomeatal line

back 25

c. infraorbitomeatal line

front 26

Which of the following are clearly demonstrated on an SMV projection of the cranial base?

1.) mastoid process

2.) sphenoid process

3.) carotid canals

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 26

d. 1, 2, and 3

front 27

Which of the following methods will demonstrate the optic canal?

a. Rhese

b. Towne

c. Schüller

d. Caldwell

back 27

a. Rhese

front 28

Which line is placed perpendicular to the IR for the parietoorbital oblique (Rhese) projection of the optic canal?

a. mentomeatal line

b. acanthiomeatal line

c. orbitomeatal line

d. infraorbitomeatal line

back 28

b. acanthiomeatal line

front 29

How many degrees is the head rotated for the parietoorbital (Rhese) projection of the optic canal?

a. 30 degrees

b. 45 degrees

c. 53 degrees

d. 60 degrees

back 29

c. 53 degrees

front 30

The central-ray angulation for the parietoorbital (Rhese) projection of the optic canal is:

a. 0 degrees

b. 5 degrees

c. 10 degrees

d. 15 degrees

back 30

a. 0 degrees

front 31

Which of the following would be demonstrated in the projection shown in the figure below?

a. petrous ridge

b. sphenoid sinus

c. optic canal

d. zygomatic arch

back 31

c. optic canal

front 32

Which parts of the patient's face touch the table for a PA axial projection (Caldwell method)?

1.) forehead

2.) nose

3.) chin

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 32

a.1 and 2

front 33

Which of the following are demonstrated on an AP axial (Towne method) projection of the skull?

1.) petrous pyramids

2.) occipital bone

3.) posterior portion of the foramen magnum

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 33

d. 1, 2, and 3

front 34

For an optimal image of the mastoid process, which of the following must occur?

1.) use of a 0.6-mm focal spot or less

2.) use of a high-resolution screen/IR

3.) use of the smallest possible field size

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3

back 34

d. 1, 2, and 3

front 35

For an AP axial Towne Method projection, to what level of the patient should the upper boarder of the IR be aligned?

back 35

Highest point of the vertex (about 2.5 inches superior to the glabella)

front 36

What image characteristic indicates that a general survey image of the skull is an AP projection instead of a PA projection?

back 36

the orbits are considerably magnified

front 37

When performing either the AP or AP axial projection for general surveys of the skull, where on the skull should the central ray be directed?

back 37

the nasion

front 38

For the AP axial projection of the skull, how should the central ray be directed?

back 38

15 degrees cephalic

front 39

For the AP projection of the skull, how should the central ray be directed?

back 39

Perpendicularly

front 40

For AP and AP axial projections, how should the OML be positioned with reference to the plane of the IR?

back 40

Perpendicular

front 41

For AP and AP axial projections, how should the midsagittal plane be positioned with reference to the plane of the IR?

back 41

Perpendicular

front 42

For the PA projection with a perpendicular central ray, list 5 structures shown:

back 42

- the orbits filled by the margins of the petrous pyramids

- the posterior ethmoidal air cells

- crista galli

- frontal bone

- frontal sinuses

front 43

For PA and PA axial projections of the skull, which parts of the patient's facial area should be in contact with the table or vertical grid device?

back 43

Forehead and nose

front 44

For PA and PA axial projections of the skull, how should the OML be positioned with reference to the plane of the IR?

back 44

Perpendicular

front 45

For PA and PA axial projections of the skull, how should the midsagittal plane be positioned with reference to the plane of the IR?

back 45

Perpendicular

front 46

For a lateral projection of the skull, which positioning line of the head should be parallel with the plane of the IR?

back 46

the IOML

front 47

For a lateral skull projection, how should the interpupillary line be positioned with reference to the plane of the IR?

back 47

Perpendicular

front 48

For a lateral skull projection, how should the midsagittal plane be positioned with reference to the plane of the IR?

back 48

Parallel

front 49

List 5 common positioning errors of the skull:

back 49

- Rotation

- Tilt

- Excessive Flexion

- Excessive Extension

- Incorrect central ray

front 50

What is the most effective way to protect the patient from unnecessary radiation during an x-ray of the skull?

back 50

restricting the radiation beam by using proper collimation

front 51

The majority of repeat examinations is due to this:

back 51

uncomfortable body position resulting in rotation or other motion

front 52

In a dolichocephalic skull, the petrous pyramids lie at what angle with the midsagittal plane?

back 52

40 degrees

front 53

Whether the radiographer elects to perform the exam with the patient in the recumbent or upright position depends on these 4 variables:

back 53

- the equipment available

- the age & condition of the patient

- radiographer and or radiologist preference whether upright images would increase diagnostic value (ex: showing air-fluid levels in paranasal sinuses)

front 54

In a brachycephalic skull, the petrous pyramids lie at what angle with the midsagittal plane?

back 54

54 degrees

front 55

What is the exit point of the CR for the Caldwell Method?

back 55

the nasion at an angle of 15 degrees caudad

front 56

Where is the CR for the Towne Method?

back 56

2.5" above the glabella

front 57

What is the exit point of the CR for the Haas Method?

back 57

1.5" superior to the nasion

front 58

Where is the CR for the SMV method?

back 58

A point 3/4" anterior to the level of the EAM

front 59

Where is the CR for a lateral projection of the eye?

back 59

Perpendicular through the outer canthus

front 60

Where is the CR for a lateral skull?

back 60

Perpendicular entering 2" superior to the EAM

front 61

What is the CR for the lateral dorsal decubitus skull?

back 61

2" above EAM

front 62

What is the CR angulation for a lateral skull?

back 62

0 degrees

front 63

What is the CR angulation for a lateral dorsal decubitus skull?

back 63

0 degrees

front 64

What is the CR angulation for the Caldwell Method (Pa axial)?

back 64

15 degrees caudad

front 65

What is the CR angulation for an AP/AP axial projection of the skull?

back 65

0 or 15 degrees cephalad

front 66

What is the CR angulation for the Towne Method?

back 66

30 degrees caudad to the OML or 37 degrees to the IOML

front 67

What is the CR angulation for the Haas Method?

back 67

25 degrees cephalad

front 68

What is the CR angulation for the SMV?

back 68

0 degrees

front 69

What is seen on a lateral skull?

back 69

- Superimposed orbital roofs and greater wings of sphenoid
- Superimposed mastoid regions and EAM
- Sella turcica seen in profile
- Radiographic penetration of parietal region
- No overlap of cervical spine by mandible

front 70

What is seen on a lateral dorsal decubitus?

back 70

- Superimposed orbital roofs and greater wings of sphenoid
- Superimposed mastoid regions and EAM
- Sella turcica seen in profile
- Radiographic penetration of parietal region
- No overlap of cervical spine by mandible

front 71

What is seen on a Caldwell method (PA axial)?

back 71

- Entire cranial perimeter showing three distinct tables of squamous bone
- Equal distance from lateral border of skull to lateral border of orbit on both sides
- Symmetric petrous ridges
- Petrous pyramids lying in lower third of orbit with a caudal central ray angulation of 15 degrees and filling the orbits with a 0 degree CR angulation
- Penetration of frontal bone without excessive density at lateral borders of the skull

front 72

What is seen on an AP axial projection of the skull?

back 72

- Entire cranial perimeter showing three distinct tables of squamous bone
- Equal distance from lateral border of skull to lateral border of orbit on both sides
- Symmetric petrous ridges
- Petrous pyramids lying in lower third of orbit with a caudal central ray angulation of 15 degrees and filling the orbits with a 0 degree CR angulation
- Penetration of frontal bone without excessive density at lateral borders of the skull

front 73

What is seen on a Towne method(AP axial)?

back 73

- Equal distance from lateral border of skull to lateral margin of foramen magnum on both sides, indicating no rotation
- Symmetric petrous pyramids
- Dorsum sellae and posterior clinoid processes visible within foramen magnum
- Penetration of occipital bone without excessive density at lateral borders of skull

front 74

What is seen on a Haas method (PA axial)?

back 74

- Projection of dorsum sellae and posterior clinoid processes within foramen magnum
- Equal distance from lateral border of skull to lateral margin of foramen magnum on both sides, indicating no rotation
- Symmetric petrous pyramids
- Entire cranium

front 75

What is seen on an SMV(Schuller Method)?

back 75

- Clearly visible structures of the cranial base, indicated by adequate penetration
- Equal distance from lateral border of skull to mandibular condyles on both sides, indicating no tilt
- Superimposition of mental protuberance over anterior frontal bone, indicating full extension of the neck
- Mandibular condyles anterior to petrous pyramids
- Symmetric petrosae