The hip joint is what type of joint?
The ischium makes up about how much of the acetabulum?
The term pelvic girdle refers to the combination of which of the following bones?
Approximately how much angulation is present between the neck and shaft of the femur?
Which statement is correct concerning gonadal shielding for hip/pelvic projections?
Small contact shields can be used on all male pts
Gonadal shielding should be used for all pts whenever possible
Shielding isn't possible on any hip/pelvic exams
Only pediatric pts need to be shielded
Gonadal shielding should be used for all pts whenever possible
Where is the film centered for an AP pelvis?
Midway between ASIS and symphysis pubis
When an AP pelvis projection is centered correctly, the top of the film will extend above the crest by _____ inch(s).
The CR angulation for an AP pelvis is ______.
A bilateral "frog leg" projection is also known as a ______ method.
On an image of an AP pelvis, the right ala of the ilium is wider than the left. What positioning error led to this result?
The pts hips were rotated to the right
On an image of a unilateral left AP hip, the left obturator foramen is narrowed. What positioning error led to this result?
The pts hips were rotated to the left
On an image of a non-trauma AP pelvis, the lesser trochanters are visualized in profile. What positioning error led to this result?
The pts legs are not inwardly rotated 15 to 20 degrees
On an image of a unilateral right frog-leg hip, the sacrum and coccyx are pointing to an area to the left of the symphysis pubis. What positioning error led to this result?
The pts hips are rotated to the right
Which one of the following conditions is a common clinical indication for performing pelvic and hip exams on a pediatric pt?
Developmental dysplasia of hip (DDH)
Osteoarthritis
Metastatic carcinoma
Legg-Calve-Perthes disease
An AP axial (taylor) projection requires a CR angulation of _____ for mans and ______ for females.
20 to 35 degrees cephalic/ 30 to 45 degrees cephalic
An axiolateral projection of the hip. Also known as the Danelius- Miller method, requires the CR ______ to the femoral neck.
An axiolateral projection of the hip, also known as the Danelius-Miller method, requires the collimator to be ______ to the cassette.
A judet pelvis requires an angulation of the part ____ and the tube _____.
45 degrees/ 0 degree angulation
Which lateral projection of the proximal femur allows pts with bilateral hip fractures to be imaged?
Clements- Nakayama method
A pt is brought to the ER who has been in a sledding accident. The ER doctor orders a femur exam. You notice redness and deformity of the femur. What projections will you do to complete this exam?
AP distal femur, AP proximal femur, x-table lateromedial distal femur, x-table lateral proximal femur
An AP axial "inlet" projection is centered at _____ and the CR is angled ____ degrees _____.
A PA axial oblique (Teufel) projection of the acetabulum is especially good for demonstrating the following structure.
The superoposterior wall of the downside acetabulum
A unilateral frog-leg projection demonstrates foreshortening of the femoral necks. The ER doctor is unsure if there is a defect within the anatomical neck. What can be done to minimize distortion of the neck during the repeat image?
Position the pts leg so that it is abducted about 20 degrees from vertical
A radiograph of non-trauma AP pelvis reveals the lesser trochanters are not visualized. What should the tech do to correct the problem?
Nothing. Accept the radiograph and don't repeat it
A radiograph of an axiolateral hip reveals soft tissue superimposing the affected hip. This prevents a clear view of the femoral head and neck. What should you do?
Increase the elevation and flexion of the unaffected leg
An ER pt has fallen and sustained an injury to her left hip. X-rays reveal a possible fracture to the inferior rami of the pubic bone. What projection might one be asked to do to rule the fracture out?
A trauma pt arrives at your facility with a possible fracture to the acetabulum. You complete an AP pelvis as ordered by the trauma doctor. While assessing the pt lying on the cart supine, the trauma doctor asks for additional films. What projection do you think he will ask for?
An outpatient arrives at your facility for a routine right hip x-ray. While attempting to perform the lateral "frog-leg" view of the hip, the pt complains of pain. What should you do?
Perform axiolateral instead
An ER pt comes in by ambulance after sustaining a fall. When you go to retrieve your pt for an x-ray, you notice severe foreshortening and external rotation of the left hip. What projection will you perform?
AP pelvis without inversion and an axiolateral projection of the hip
This condition is also known as a degenerative joint disease. It is characterized by degeneration of joint cartilage and adjacent bone causing pain and stiffness
Which one of the following projections provides the greatest amount of gonadal dose for a male pt (without the use of shielding)?
Axiolateral (inferosuperior) projection
How many bones make up the adult vertebral column?
The spinal cord tapers off to a point distally at the level of:
Which of the following curves is classified as being compensatory?
Scoliosis is defined as abnormal or exaggerated:
Abnormal thoracic curvature with increased convexity
The joints between articular processes of vertebra are termed:
Which aspect of the intervertebral disk is composed of semigelatinous material?
Which of the following statements is true?
All adult vertebra are separated by intervertebral disks
All thoracic vertebrae have at least one facet for rib articulation
The intervertebral disks are tightly bound to the vertebral bodies to prevent movement within the vertebral column
All of the above
Where is the articular pillar located on a cervical vertebra?
Between the superior and inferior articular processes
Which of the following thoracic vertebra(e) possess on facets for costoransverse joints?
The zygapophyseal joints for the typical cervical vertebra lie at an angle of ____ in relation to the midsagittal plane.
The thyroid cartilage generally corresponds to the level of:
The zygapophyseal joints for the thoracic spine lie at an angle of ____ relation to the midsagittal plane.
T2-3 disk space is found at the level of the:
The gonion corresponds to the level of:
Which of the following pathologic conditions is defined as "a condition of the spine characterized by rigidity of a vertebral joint"?
Which factor is most important to open up the intervertebral joint spaces for a lateral thoracic spine projection?
Keep vertebral column parallel to the tabletop
Which projection of the cervical spine will best demonstrate the zygapophyseal joint spaces between C1 and C2?
Along with the upper incisors, what other bony landmark must be aligned for the AP open mouth projection?
How much CR angulation is required for the AP axial projection for the cervical spine?
15 to 20 degrees cephalad
Why are the anterior oblique's (RAO/LAO) preferred over the posterior oblique's of the cervical spine?
Less thyroid and breast dose
Which of the following positions will demonstrate the left intervertebral foramina of the cervical spine?
Which of the following is not a correct criterion for the AP axial C spine projection?
C3 to T2 or T3 vertebral bodies should be visible
Spinous processes are seen to be equal distances from the vertebral body lateral borders
Center of the collimation field is at C4
All of the above
Which of the following factors does not apply to a lateral projection of the cervical spine?
Use a 72" SID
Suspend respiration upon full inspiration
Perform horizontal beam lateral projection if trauma is suspected
Center CR to thyroid cartilage
Suspend respiration upon full inspiration (should be on full expiration)
Why is the chin extended for a lateral projection of the cervical spine?
to prevent superimposition of the mandible upon the spine
What type of CR angle is required for posterior oblique positions of the cervical spine?
Which of the following factors will enhance the visibility of the vertebral bodies during a lateral projection of the thoracic spine?
Use a high kVp
Increase the SID
Use a breathing technique
Flex the spine
Use a breathing technique
Which of the following projections will project the dens within the shadow of the foramen magnum?
AP open mouth
Fuchs method
Twining method
None of the above
A radiograph of an open mouth projection of the cervical spine reveals that the zygapophyseal joints are not symmetric. What positioning error can lead to this radiographic outcome?
A radiograph of an AP axial projection of the cervical spine reveals that the intervertebral joints are not open. The following factors were used for this projection: 5 degree cephalad angle, 40" SID, grid, slight extension of the skull and the CR centered to the thyroid cartilage. Which alteration should be made for the repeat exposure?
Increase the cephalad angle of the CR
A radiograph of an AP thoracic spine projection reveals that the upper thoracic spine is overexposed. The lower vertebrae have acceptable density and contrast. Which of the following modifications will improve the visibility of the upper thoracic spine?
Place the upper spine under the cathode side of the tube
Use a compensating filter
Increase the kVp to decrease the contrast of the upper spine
Use a breathing technique
Use a compensating filter
A radiograph of a lateral thoracic spine reveals that there is excessive density along the posterior aspect of the spine. Even with good collimation, the scatter radiation reaching the IR obscures the spinous processes. What can the tech do to improve the visibility of the posterior elements of the spine?
Place a lead blocker on the tabletop posterior to the pt
A radiograph of an AP open mouth projection reveals that the base of the skull is superimposed over the dens. What positioning error led to this radiographic outcome?
Excessive extension of the skull
A radiograph of an RAO of the cervical spine reveals that the lower intervertebral foramina are not open. The upper vertebral foramina are well visualized. Which positioning error may have lead to this radiographic outcome?
Insufficient rotation of the upper body
A pt comes to the radiology department for a cervical spine exam. The study is ordered for notraumatic reasons. The AP open mouth projection reveals that the base of the skull and upper incisors are superimposed, but they re obscuring the upper portion of the dens. On the repeat exposure, what should the tech do to demonstrate the entire dens?
Perform the fuchs or judd method
A pt enters the ED due to a MVC. The pt is on a backboard and wearing a C collar. The tech is concerned about the artifacts that the collar will project on the spine during the horizontal beam lateral projection. What should he do in the situation?
Leave the collar on during the exposure
A lateral projection of the thoracic spine reveals that the pts shoulders obscure the upper aspect, which a primary area of interest on this pt. Which of the following changes will best demonstrate this region of the spine?
Use a wedge filter and repeat the exposure with increased kVp
Angle the CR 10 to 15 degrees cephalad
Perform the projection with the pt erect and holding weights in hand during exposure
Perform swimmers lateral position
Perform swimmers lateral projection
For an average size pt, which of the following would receive the highest skin dose?
AP "wagging jaw" cervical spine, 3 sec. exposure time
AP thoracic spine
Lateral cervical spine 72" SID
Lateral thoracic spine
The thyroid dose for a posterior cervical oblique is ____ greater than that of the anterior oblique.
Which of the following projections will best demonstrate a compression fracture of the thoracic spine?
AP projection
Lateral projection
Posterior oblique position
Anterior oblique position
A pt enters the ED due to a MVA. He is on a backboard and in a C collar. The initial lateral cervical spine projection demonstrates C1-6. The pt has broad and thick shoulders. Because the hospital is in a rural setting, no CT scanner is available. What should the tech do next?
Perform a horizontal beam swimmer's lateral position
Which of the following is considered a "functional study" of the C spine?
AP "Chewing" projection
AP open mouth projection
Fuchs method
Flexion and extension lateral projection
Flexion and extension lateral projections
T/F. The zygapophyseal joints of all cervical vertebrae are shown in a true 90 degree lateral projection.
Herniated nucleous pulposus is:
Sometimes called a "slipped disk"
When the soft inner part of an intervertebral disk protrudes through the fibrous cartilage outer layer
A frequent cause of pain and numbness in the extremities
The spinous process of C7
Subluxation is defined as:
A partial abnormal separation of the articular surfaces of a joint
The structure known as the Cauda equina is located:
At the end of the spinal cord
A compression fracture is:
Anterior wedging of a vertebral body
A fracture that extends through the pedicles of C2 with or without subluxation of C2 upon C3
The anterior projecting bony process of the sacrum that forms part of the inlet of the true pelvis is the:
The small section of bone found between the superior and inferior articular processes of the lumbar spine is termed:
The zygapophyseal joints of the upper lumbar vertebrae are _____ in relation to the midsagittal plane.
The intervertebral foramina of the lumbar spine are located at an angle of ___ in relation to the midsagittal plane.
Another term for the sacral horns is the:
What type of joint movement occurs with the zygapophyseal joints?
What is the term for the superior aspect of the coccyx?
What is the joint classification of the zygapophyseal joints?
The intervertebral joints in the lumbar spine are classified as:
Cartilaginous/ amphiarthrodial
Which specific aspect of the sacrum articulates with the ilium to form the sacroiliac joint?
Which of the following topographic landmarks corresponds with the L4-5 vertebral level?
Xiphoid process, lower costal margin, ASIS, iliac crest
Which of the following structures is located at the level of the ASIS?
S1-2, tip of coccyx, promontory of sacrum, L4-5
Why should the hips and knees be flexed for an AP projection of the lumbar spine?
To reduce the amount of lumbar curvature
Which position will demonstrate the left zygapophyseal joints of the lumbar spine?
The average degree of rotation required to demonstrate the L3-4 zygapophyseal joints is:
Which of the following should be done to reduce scatter radiation from reaching the IR for the lateral lumbar, sacrum and coccyx projections?
Use lower kVp, Place a lead mat on the tabletop behind pt, increase SID to 44", Use a smaller IR
Place lead mat on the table top behind the pt
An average of ___ segments makes up the adult coccyx.
Which of the following statements is not true about the lateral L5-S1 projection?
If the waist is not supported, the CR must be angled 5-10 degrees caudal, a lead mat should be placed on tabletop behind pt, and there should be close collimation to improve image quality, a 14x17 cassette should be used, The CR is centered 1.5" inferior to the iliac crest and 2" posterior to the ASIS
A 14x17 cassette should be used
What CR angulation should be used for an AP axial projection of the L5-S1 joint space on a male pt?
An anterior wedging of vertebrae with a loss of body height but rarely causing neurologic symptoms is called:
Where is the CR centered for an AP projection of the sacrum?
Midway between the symphysis pubis and the ASIS
What type of CR angulation is required for an AP axial projection of the coccyx?
The radiographic appearance on an oblique lumbar spine in which the neck of the Scotty dog appears broken suggests the presence of ____.
A fracture through the vertebral body and posterior elements caused by lap seat belts during an auto accident involving sudden deceleration is a _____ fracture.
Which of the following is a condition characterized by proliferative bony lesions of increased density?
Scheumermann's disease
Ankylosing spondylitits
Spondylolisthises
Osteoblastic type metastases
What CR angle should be used for a lateral sacrum/coccyx projection?
None. CR is perpendicular to the IR
A radiograph of an LPO projection of the lumbar spine reveals that the downside pedicle is projected too far posterior in the vertebral body. What specific positioning error is present on this radiograph?
Over rotation of the spine
A radiograph of the AP axial sacrum reveals that it is foreshortened and the sacral foramina are not clearly seen. What specific positioning error is present on the radiograph?
Insufficient CR angulation
A radiograph of an AP axial coccyx reveals that the symphysis pubis is superimposed over the distal end of the coccyx. Which of the following modifications will correct this problem during the repeat exposure?
Increase the CR angulation
A radiograph of an AP axial L5-S1 projection reveals that the joint space is not open. The following factors were used of this female pt: 80 kVp, 40" SID, grid, 35 degree caudad angle and CR centered to the ASIS. Which of the following factors needs to be modified to produce a more diagnostic image?
Change the direction of the CR angulation
Situation: A pt comes to radiology for a study of the lumbar spine. The initial radiographs demonstrate potential pathology involving the L5- S1 zygapophyseal joint. Which of the following positions/ projections would best demonstrate this joint space?
Right and left 30 degree obliques
Situation: A young female pt comes to radiology for a scoliosis study. The pt has had this series performed frequently. How much will the breast dose be decreased if a PA rather that an AP projection is taken?
Situation: A pt comes in with a possible compression fracture of L3. Which of the following positioning routines would best demonstrate the body of L3 and the intervertebral joint spaces above and below it?
Collimated AP and lateral projections
The female gonadal dose is approx. ____ for an AP projection of the lumbar spine as compared with a PA projection with the same centering and collimation size.
A radiograph of a lateral projection of the lumbar spine reveals that the mid to lower intervertebral joint spaces are not open. The pts waist was supported. Which of the following modifications will help open these joint spaces during the repeat exposure?
Increase waist support and/or angle 5 to 8 degrees caudal
A radiograph of an AP projection of the lumbar spine reveals that the SI joint and wings (ala) of the sacrum are not symmetrical. The right SI joint is more open than the left and the left wing (ala) appears larger. What specific positioning error is present on this radiograph?
An LPO of the lumbar spine demonstrates the pedicle in the center of the vertebral body. This would indicate:
What specific structures will be demonstrated on the right and left posterior oblique lumbar spine projections?
The downside zygapophyseal joints
What specific structures will be demonstrated on the right and left anterior oblique lumbar spine projections?
The upside zygapophyseal joints
What specific structures will be demonstrated on the lateral lumbar spine projection?
The intervertebral foramina closest to the IR
If the zygapophyseal joints of the L1-2 are of specific interest, how much should the pt be rotated?
A general survey of the right zygapophyseal joints is ordered. What criteria do you use to best demonstrate this area?
RPO, pt rotated 45 degrees
Which of the following statements is true concerning radiation protection?
Gonadal shielding should be used on all male pts for lumbar spine, sacrum, and coccyx exams
If the area of interest is the sacrum/coccyx for females, gonadal shielding will not be possible
Females of childbearing age should always be questioned about the possibility of pregnancy before beginning a lumbar spine, sacrum, or coccyx exam
All of the above are true
All of the above are true
The jugular notch corresponds to the level of:
The xiphoid process corresponds to the level of:
What is another term for the jugular notch?
Approx. at what age does the xiphoid process become ossified?
Which of the following structures connect the anterior aspect of the ribs to the sternum?
Costocartilage
Sternal tendons
Costovertebral joints
Costotransverse joints
T/F.In an erect position the posterior ends of the ribs are 3 to 5" higher or more superior that the anterior ends.
The costocartilage of which pair of ribs attach to the sternum at the level of the sternal angle:
Which of the following aspects of the rib is considered to be most posterior?
Tubercule
Costal angle
Shaft
Sternal end
Which one of the following ribs is considered to be a false rib?
7th
1st
9th
None of the above
Which one of the following statements is true about floating ribs?
They don't possess a head
They don't possess a costovertebral joint
They don't possess costocartilage
They attach to T9 and T10
They don't possess costocartilage
The widest aspect of the thorax occurs at the level of:
What is the joint classification and type of movement of the sternoclavicular joints?
Diarthodial with plane movement
What is the joint classification and type of movement for the costotransverse joint?
Diarthrial with plane movement
What is the name of the part of the rib that articulates with the thoracic vertebral body?
Which ribs are considered to be true ribs?
T/F.The degree of obliquity for RAO projection of the sternum is dependent upon the size of the thoracic cavity.
T/F. The LAO position of the sternum provides the best frontal image of the sternum with a minimal amount of distortion.
Which one of the following techniques is most effective to prevent posterior ribs from obscuring the sternum?
Use high kVp
Oblique as needed to not superimpose sternum over hilum region
Decrease SID to magnify the sternum
Use a breathing technique
Use a breathing techinque
What breathing instructions should you give your pt when doing a radiograph of ribs below the diaphragm?
Take a deep breath, blow it out and hold it
Why is the RAO sternum preferred to the LAO position?
It projects the sternum over the heart shadow
Which one of the following statements is true about radiography of ribs located above the diaphragm?
Suspend respiration upon inspiration
Which one of the following positions will best demonstrate the axillary portion of the left ribs?
T/F. The pt thyroid dose for anterior oblique ribs is approx. 1/3 of that for posterior ribs.
T/F. A right or left lead marker may be taped over the area of interest to indicate the location of the trauma to the rib.
Which one of the following conditions may occur with a trauma to the ribs?
Airway obstruction of the trachea
Pneumonia
Hemothorax
Pulmonary embolus
What is the recommended degree of obliquity for a RAO projection of the sternum for an asthenic type pt?
Which position can replace the RAO of the sternum if the pt cannot lie prone?