The two most common landmarks for chest positioning are the:

jugular notch and vertebra prominens.

The xiphoid process is a reliable positioning landmark for determining the lower margin of the lungs for chest positioning.

False

The laryngeal prominence is a positioning landmark located at the level of:

C5.

The heart is located in the anterior chest at the level of:

T5-8.

The central ray (CR) for an anteroposterior (AP) supine, adult chest projection, should be centered:

3 to 4 inches (8 to 10 cm) below the jugular notch.

Which type of body habitus typically requires that the image receptor be placed crosswise rather than lengthwise for a posteroanterior (PA) chest?

Hypersthenic

A general rule states that radiographic grids must be used in chest radiography for:

exposure factors using 100 kV or greater.

Top of image receptor placed approximately 3 inches (7.6 cm) above the shoulders is a recommended centering technique for adult chest radiography.

False

Collimation guidelines indicate the upper border of the collimation field should be about 2 inches (5 cm) above the vertebra prominens.

False

A well-inspired average adult chest PA projection will have a minimum of ____ posterior ribs seen above the diaphragm.

10

Which of the following technical factors is ideal for adult chest radiography?

120 kV, 800 mA, 1/40 sec, 72-inch (183 cm) SID

For an average size female patient, where is the CR placed for a PA projection of the chest

7 inches (18 cm) below the vertebra prominens

What type of CR angle is required for the AP semiaxial projection for the lung apices?

15 to 20

The CR is centered to midsternum for the AP apical lordotic projection with a 14-  17-inch (35  43 cm) image receptor (IR).

True

Motion of the patient’s diaphragm can be stopped by providing proper breathing instructions.

True

The most inferior positioning landmark on the abdomen/pelvis is the:

ischial tuberosity

Which of the following manual exposure factors would produce the desired qualities for an abdominal projection on an average-sized adult?

75 kV, 600 mA, 1/30 sec, grid, 40-inch (102 cm) SID

At what level should the central ray (CR) be placed for a left lateral decubitus projection of the abdomen?

2 inches (5 cm) above iliac crest

Which radiographic landmark is most reliable to evaluate the posteroanterior (PA) projection of the abdomen for rotation?

Ala of ilium

Where is the CR centered for the left lateral decubitus projection of the abdomen?

2 inches (5 cm) above iliac crest

Which of the following kV ranges is recommended for a KUB on an adult?

70 to 80

What CR centering should be used for a dorsal decubitus projection of the abdomen?

2 inches (5 cm) above iliac crest

Which of the following factors must be observed for an AP erect abdomen projection?

Patient needs to be upright a minimum of 5 minutes before imaging.

Where must the CR be centered for an AP supine projection of the abdomen as part of the acute abdominal series?

At level of iliac crest

What two bony landmarks are palpated for positioning of the elbow?

Humeral epicondyles

The smooth, depressed, center portion of the trochlea used for evaluating rotation on a lateral elbow is termed the trochlear:

sulcus.

The bending or forcing of the hand laterally with the hand pronated in a posteroanterior (PA) projection is known as:

ulnar deviation.

What is the distance between the tabletop and Bucky tray on most floating tabletop type of tables?

3 to 4 inches (8 to 10 cm)

A general positioning rule is to place the long axis of the part ____ to the long axis of the image receptor.

parallel

How should the original kV range be changed with a fiberglass cast applied for a wrist or forearm radiographic procedure?

Increase 3 to 4 kV

Which of the following sets of exposure factors would be best for an adult upper limb study using an analog (film-screen) system?

64 kV, 300 mA, 1/30 sec, small focal spot, detail-speed screens

Grids are generally not required unless the anatomy measures greater than _____ cm in thickness.

10

Where is the central ray (CR) placed for a PA projection of the third digit?

At the proximal interphalangeal joint

The radiographic criteria for a true lateral finger indicate equal concavity of the anterior and posterior aspects of the phalanges.

True

From a pronated position, which of the following is required for a PA oblique projection of the fourth digit of the hand?

45 lateral rotation

Why is it recommended that the medial oblique projection be performed rather than the lateral oblique for the second digit of the hand?

To improve radiographic contrast

Where is the CR centered for a PA projection of the hand?

At the third metacarpophalangeal joint

Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?

Phalanges

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces if the patient can assume this position?

AP

The CR placement for an AP projection (modified Robert’s method) of the thumb is at the:

first carpometacarpal joint.

What CR angle is required with the modified Robert’s method?

15 proximally (toward the wrist)

How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the elbow?

45

How much rotation of the hands is required for the AP oblique bilateral (Norgaard method) hand projection?

45

Which special projection of the wrist is ideal for demonstrating possible calcification in the dorsal aspect of the carpals?

Carpal bridge

What is the purpose of performing the AP partially flexed projections of the elbow?

To provide an AP perspective if patient cannot fully extend elbow

Which routine projection of the elbow best demonstrates the radial head and tuberosity free of superimposition?

AP oblique with lateral rotation

Which routine projection of the elbow best demonstrates the olecranon process in profile?

Lateral

Which basic projection of the elbow best demonstrates the trochlear notch in profile?

Lateral

How should the humeral epicondyles be aligned for a lateral projection of the elbow?

Perpendicular to image receptor

A radiograph of the elbow demonstrates the radius directly superimposed over the ulna and the coronoid process in profile. Which projection of the elbow has been performed?

Medial rotation oblique

Which routine projection of the elbow will best demonstrate an elevated or visible posterior fat pad?

True lateral with 90 flexion

With the radial head projections, what is the only difference between the four projections?

The position of the hand and/or wrist

Which of the following best demonstrates the radial head using the trauma lateral Coyle method routine?

Elbow flexed 90, CR angled 45 toward shoulder

A patient enters the emergency department (ED) with a Smith fracture. Which region of the upper limb must be radiographed to demonstrate this injury?

Wrist and forearm

A radiograph of a PA projection of the hand reveals that the distal radius and ulna and the carpals were cut off. What should the technologist do to correct this problem?

Repeat the PA projection to include all the carpals and about 1 inch (2.5 cm) of the distal radius and ulna.

The AP oblique bilateral hands projection (“ball-catcher’s position”) is performed to evaluate for early signs of:

rheumatoid arthritis.

Which rotation of the humerus will result in a lateral position of the proximal humerus?

Internal rotation (epicondyles perpendicular to image receptor)

Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh?

Neutral rotation

What medial central ray (CR) angle is required for the inferosuperior axial shoulder (Lawrence method)?

25 to 30

What additional maneuver must be added to the inferosuperior axial shoulder (Lawrence method) projection to best demonstrate a possible Hill-Sachs defect?

Perform exaggerated external rotation of the affected upper limb.

Which of the following shoulder projections best demonstrates the glenoid cavity in profile?

Grashey method

A radiograph of the inferosuperior axial projection (Lawrence method) demonstrates the acromion process of the shoulder to be located most superiorly (anteriorly).

False

For a Grashey method projection of the shoulder, the CR is centered to the acromion.

False

How much posterior CR angulation is required for the supine version of the tangential projection for the intertubercular (bicipital) groove?

10 to 15

Which ionization chamber(s) for the AEC should be used for a tangential projection for an intertubercular groove?

Cannot use AEC with this projection

Which of the following projections can be performed using a breathing technique?

AP scapula

How much CR angulation should be used for a scapular Y projection?

No CR angle should be used.

Where is the CR centered for a transthoracic lateral projection for proximal humerus?

Level of surgical neck

Which projection of the shoulder requires that the patient be rotated 45 to 60 toward the IR from a PA position?

Lateral scapula projection

The inferosuperior axial projection (Clements modification) requires a CR angle of ____ toward axilla if a patient cannot fully abduct extremity 90.

5 to 15

How much CR angulation is required for an asthenic patient for an AP axial projection of the clavicle?

30

Where is the CR centered for the bilateral acromioclavicular (AC) joint projection on a single 14-  17-inch (35  43 cm) image receptor?

1 inch (2.5 cm) above jugular notch

49. The recommended SID for AC joints is 72 inches (183 cm).

True

The arm should be abducted about 45 for an AP scapula.

False

An orthostatic (breathing) technique can be performed for the AP projection of the scapula.

True

The AP humerus requires that the humeral epicondyles are _____ to the IR.

parallel

What type of CR angle is required for the superoinferior axial projection (Hobbs modification)?

CR is perpendicular to IR

Where is the CR centered for the posterior oblique position for the glenoid cavity?

2 inches (5 cm) medial and inferior to the superolateral border of shoulder

How much central ray (CR) angulation (if any) should be used for an AP projection of the toes?

10 to 15 toward calcaneus

Which of the following routines should be performed for a study of the second toe?

AP, AP oblique with medial rotation, lateromedial projection

How much is the foot dorsiflexed with the tangential projection for the sesamoid bones if the CR remains perpendicular to the image receptor?

15 to 20 from vertical

A correctly positioned AP 45 medial oblique ankle projection frequently may also demonstrate a fracture of the base of the fifth metatarsal if present.

True

Which position of the foot will best demonstrate the lateral (third) cuneiform?

AP oblique with medial rotation

What is one advantage of the lateromedial projection of the foot?

The foot assumes a more true lateral position.

What CR angulation is required for the AP oblique projection of the foot?

CR is perpendicular to the image receptor.

How much CR angulation to the long axis of the foot is required for the plantodorsal (axial) projection of the calcaneus?

40

Where is the CR placed for a mediolateral projection of the calcaneus?

1 inch (2.5 cm) inferior to medial malleolus

How much rotation from an AP position of the ankle will typically produce an AP mortise projection?

15 to 20

Which of the following projections of the ankle will best demonstrate the open joint space of the lateral aspect of the ankle joint?

AP mortise projection

To ensure that both joints are included on an AP projection of the tibia and fibula on an adult, the technologist should:

turn the image receptor diagonally.

What CR angulation is required for an AP projection of the knee on a patient with an ASIS-to-tabletop measurement of 18 cm?

3 to 5 caudad

What CR angle should be used for a lateral projection of the knee on a short, wide-pelvis patient?

7 to 10 cephalad

The superoinferior, tangential (Hobbs modification) projection requires a CR angle of 5to 10 posterior.

False

The AP mortise projection of the ankle is commonly taken in surgery during open reductions.

True

What type of CR angle is required for the PA axial weight-bearing bilateral knee projection (Rosenberg method)?

10 caudad

How much flexion of the knee is recommended for the lateral projection of the patella?

5 to 10 or less

A radiograph of an AP projection of the second toe reveals that the interphalangeal joints are not open. What is the most likely cause for this radiographic outcome?

Incorrect CR centering or angle

A radiograph of an AP medial oblique projection of the foot, if positioned correctly, should demonstrate:

third through fifth metatarsals free of superimposition.

A radiograph of a PA axial projection for the intercondylar fossa does not demonstrate the fossa well. It is foreshortened. The following positioning factors were used: patient prone, knee flexed 40 to 45, CR angled to be perpendicular to the femur, 40-inch SID, and no rotation of the lower limb. On the basis of the factors used, what changes need to be made to produce a more diagnostic image?

CR must be perpendicular to lower leg.

A 3 to 5 caudad CR angle should be used for an AP knee projection for patients with an ASIS-to-tabletop measurement of 20 cm.

False

The correct CR placement for an AP projection of the knee is midpatella.

False

For the AP weight-bearing feet projection, the CR should be:

angled 15 posteriorly.

For the AP weight-bearing knee projection on an average patient, the CR should be:

perpendicular to the image receptor.

A radiograph of an AP oblique foot with medial rotation demonstrates considerable superimposition of the third through fifth metatarsals. How must the original position be changed to eliminate this problem

Decrease obliquity of the foot.

Which of the following projections of the patella requires the patient to be placed in a prone position, a 55 flexion of the knee, and a 15 to 20 angle of the CR?

Hughston method

sing the hip localization method, the femoral head can be located:

1 1/2 inches (4 cm) below the midpoint of the imaginary line between the two bony landmarks.

The two bony landmarks that are palpated using the hip localization method are the:

ASIS and the symphysis pubis

Gonadal shielding of the male patient for the AP pelvis projection requires that the top of the shield is not extend above the level of the:

inferior margin of the symphysis pubis.

A radiograph of an AP axial (Taylor) “outlet” projection reveals that the obturator foramina are not symmetric. What type of positioning problem is present on this radiograph?

Rotation of the pelvis

During a repeat study of the AP axial (Taylor) outlet projection, both obturator foramina are symmetric but foreshortened. Which of the following positioning modifications must be performed to correct this error?

Increase the cephalic CR angulation.

Which of the following lateral hip projections cannot be performed on a trauma patient with a possible hip fracture?

Modified Cleaves method

Which of the following projections requires that the IR be tilted 15

Modified axiolateral projection (Clements-Nakayama method)

How much CR angle, from the horizontal, is required for the modified axiolateral (Clements-Nakayama) projection?

15

Along with increasing the source image receptor distance (SID), what other factor(s) will improve spatial resolution for lateral and oblique projections of the cervical spine?

Using a small focal spot

Which factor is most important to open up the intervertebral joint spaces for a lateral thoracic spine projection?

Keep vertebral column parallel to tabletop.

Which position or projection of the cervical spine will best demonstrate the zygapophyseal joint spaces between C1 and C2?

AP open mouth

How much CR angulation is required for the AP axial projection for the cervical spine?

15

Which of the following positions will demonstrate the left intervertebral foramina of the cervical spine?

LAO

Which of the following projections will best demonstrate the zygapophyseal joints of the cervical spine?

Lateral

Which of the following is NOT a correct evaluation criterion for the AP axial C spine projection?

C3 to T2 vertebral bodies should be visualized. b. Spinous processes are seen to be equal distances from the vertebra body lateral borders. c. Center of the collimation field is at C4. d. All of the above are correct criteria.

Which of the following factors does not apply to a lateral projection of the cervical spine?

Suspend respiration upon full inspiration.

The chin is extended for a lateral projection of the cervical spine to:

prevent superimposition of the mandible upon the spine.

The AP axial-vertebral arch projection may be performed to better demonstrate the:

articular pillars of C4-7.

What type of CR angle is recommended when performing the AP axial C spine projection erect?

20

What type of CR angle is required for posterior oblique (left posterior oblique [LPO]/right posterior oblique [RPO]) positions of the cervical spine?

15

Which of the following factors will enhance the visibility of the vertebral bodies during a lateral projection of the thoracic spine?

Use a breathing technique.