Al-Azher University - Gaza

Faculty of Applied Medical Sciences

Department of Radiography Time allowed: 120 min

Final Exam Model B

Radiographic Position and Radiologic Procedures
---------------------------- / Name Student's No / --------------

.Q I: Select the ONE lettered answer that is BEST in each case

Read the questions carefully so that you don't misinterpret them (e.g. by missing a word
.such as "Except")

For what type of the body habitus will the diaphragm be at the highest -1
?position
a- sthenic
b- asthenic
c- hypersthenic
d- hyposthenic
e- b and c

When examining the pelvis in AP projection, the feet should be placed in -2

?which of the following positions
a- eversion
b- inversion
c- perfectly straight
d- oblique
e- none the above

Which one of the following projection is used to radiograph the right axillary -3
?portion of the ribs
a- AP oblique projection ( RPO position )
b- PA oblique projection ( RAO position )
c- AP projection
d- PA projection
e- lateral projection ( right lateral position )

Which one of the following technical factors is essential when performing AP -4

?projection Ottonello method
a- short exposure time and low milliamperage
b- long exposure time and high milliamperage
c- short exposure time and high milliamperage
d- long exposure time low milliamperage
e- none of the above

The mastoid tip corresponds to the level of:5 -

a- atlas
b- 1 inch below the level of EAM
c- atlanto- occipital articulation
d- a and b
e- all of the above
Which one of the following is false when performing PA projection for -6
?sternoclavicular articulations
a- center the cassette at the level of spinous process of the third thoracic vertebra
b- place the patient's palms facing upward
c- turn the head to face the unaffected side for unilateral examination
d- rest the patient's head on chin for bilateral examination
e- place the patient in recumbent or upright position

Which of the following is the preferred distance for radiography of the -7

?sternum in AP oblique projection for patient with trauma
a- 30 inches
b- 40 inches
c- 60 inches
d- 72 inches
e- none the above

8- Which of the following is at the level of the highest point of greater

trochanter?
a- pubic symphysis
b- ASIS
c- ischial tuberosity
d- tip of coccyx
e- none of the above

9- Which one of the following topographic landmarks is found at the level of L3?
a- iliac crest
b- 2.5" above the ASIS
c- ASIS
d- 2.5" above iliac crest
e- none of the above

Which one of the following projections is the best to demonstrate the right -10
?thoracic intervertebral foramina
a- lateral projection ( left lateral position )
b- lateral projection ( right lateral position )
c- RAO position
d- RPO position
e- a and b

11- AP axial oblique projection, RPO position, is used to demonstrate:

a- left cervical intervertebral foramina
b- right cervical intervertebral foramina
c- left thoracic zygapophyseal facet joints
d- right thoracic zygapophyseal facet joints
e- none of the above
12- Regarding the thoracic and pelvic curves:
a- both of them are primary curves
b- both of them are present at birth
c- both of them are convex posteriorly
b- a and b
e- all of the above

In order to demonstrate the anterior pelvic bones, the following projections -13
:are used for this purpose except
a- AP axial projection ( Bridgman method )
b- PA projection
c- AP Axial projection ( Taylor method )
d- b and c
e- all of the above

The resulting image of AP projection of the pelvis and upper femora shows -14
:the following structures shown except
a- entire pelvis along proximal femora
b- lesser trochanter in profile
c- greater trochanter if seen, demonstrated on medial border of the femora
d- femoral necks in their full extent without superimposition
e- ischial spines equally demonstrated

Which one of the following is true regarding the intervertebral disc between -15
?C1 and C2 vertebrae
a- Its annulus fibrosus is composed of concentric lamellae of fibrocartilage
b- It does not contain a nucleus pulposus as other intervertebral discs do
c- It is thicker than other intervertebral discs
d- It acts like a shock absorber in response to axial forces
e- There is no intervertebral disc between the C1 and C2 vertebrae

The following projections are used to demonstrate the right sacroiliac joint -16
:except
a- AP axial projection
b- PA axial projection
c- AP oblique projection (RPO position)
d- PA oblique projection (RAO position)
e- b and d

Which of the following projection/s is/are the best to demonstrate the upper -17
?shaft of the dens
a- AP projection Fuchs method
b- PA projection Judd method
c- AP projection open mouth method
d- a and b
e- all of the above
 18- The thoracic vertebrae would differ from the cervical and lumber due to:
a- foramina located in the transverse process
b- bifid spinous process
c- demifacets located on the bodies
d- location of the pedicales parallel to midsagittal plane
e- none of the above
19- The intervertebral foramina of the lumber region are situated:
a- at right angles to the MSP
b- slightly anteriorly to the midcoronal plane
c- at 30-50 degrees anteriorly to MSP
d- at 30-50 degrees posteriorly to the MSP
e- none of the above
The right zygapophyseal joint between first and second cervical vertebral -20
:demonstrates in
a- AP projection
b- lateral projection
c- LPO position
d- LAO position
e- none of the above
Regarding the structures shown of the AP axial projection of the cervical -21
:vertebrae, which of following is true
a- upper five cervical bodies are demonstrated
b- all cervical bodies except atlas are demonstrated
c- lower five cervical vertebrae are demonstrated
d- lower five cervical bodies and upper two or three thoracic bodies are demonstrate
e- none of the above
22- All of the following are true regarding the AP axial projection of the sacrum
except:
a- the colon should be free of gas and fecal material
b- the central ray 15 degrees caudad
c- the central ray 15 degrees cephalad
d- the central ray directed to pubic symphysis
e- b and d
Normally, the patient is asked to stand and inhale deeply when having the -23
?chest radiograph, which of the following is true
a- to move the diaphragm inferiorly
b- to demonstrate free air or air-fluid level, if present
c- to prevent engorgement of pulmonary vessels
d- a and b
e- all the above
In properly position of posterior ribs under diaphragm in AP projection, the -24
: lower edge of the cassette should be at the level of
a- iliac crest
b- ASIS
c- inferior costal margin
d- xiphoid
e- none of the above
A radiograph of AP projection of the pelvis reveals that right iliac wing is -25
?wider than the left. What type of the positioning error was involved
a- rotation toward the left
b- tilt toward the left
c- rotation toward the right
d- tilt toward the right
e- none of the above
The palpable tip of each spinous processes of .. . corresponds in -26
:position to the interspace below the vertebra from which it projects
a- the fifth to ninth thoracic vertebrae
b- the second to ninth thoracic vertebrae
c- the third to ninth thoracic vertebrae
d- the fourth to ninth thoracic vertebrae
e- none of the above
Regarding the AP axial projection of the cervical vertebrae, patient in supine -27
:position, the central ray directed through C4 at an angle
a- 15 degrees cephalad
b- 20 degrees cephalad
c- 15 degrees caudad
d- 20 degrees caudad
e- none of the above
In order to demonstrate the upper anterior ribs all of the following are true -28
:except
a- patient in upright position
b- patient in PA projection
c- respiration should be suspended at full inspiration to elevate the diaphragm
d- central ray perpendicular to the level of T7
e- rest the patients hands against the hips with the palms turned outward
Regarding the AP oblique projection of the atlanto-occipital articulation, the -29
:central ray 1" anterior to the right EAM to demonstrate
a- the dens
b- left atlanto-occipital articulation
c- Right atlanto-occipital articulation
d- A and B
e- A and c
Which of the following is true regarding the lateral projection of the cervical -30
?vertebrae( Grandy method )
a- suspend respiration
b- suspend respiration at end of full expiration
c- suspend respiration at end of full inspiration
d- shallow breathing technique
e- a and d
The resulting image of lateral projection of lumber vertebrae shows the -31
:following structures shown except
a- intervertebral foramina of L1 to L5
b- lumber bodies and their interspaces
c- spinous processes
d- lumbosacral junction
e- c and d
Which specific positioning error is present if the femoral necks were -32
completely overlapped by greater trochanters in AP oblique projection
?( modified cleveas method )
a- abduction of the thighs more than 45 degrees
b- abduction of the thighs less than 45 degrees
c- rotation of pelvis
d- a and c
e- b and b
How should the patient's hands be positioned for an erect lateral projection -33
? of the sternum
a- raised over the head
b- released at the patient's side
c- clasped behind the patient's back
d- held at a 90 degree angle straight out in front the patient
e- none of the above
Which of the following is at the level of T4-5? 34 -
a- sternal angle
b- manubrial notch
c- xiphoid process
d- mid of the sternum
e- none of the above
35- Regarding the AP axial projection lordotic position, which one of the
following is false?
a- the upper margin of IR should be about 3" above the shoulder.
b- the exposure is made after the second full inspiration.
c- the projection is performed primarily to demonstrate pleura fusion.
d- CR perpendicular, directed to midsternum.
e- none of the above
36- The following statements are true regarding the Twinning method except:
a- used to demonstrate the lower cervical and upper thoracic vertebrae
b- CR perpendicular, directed to interspace of C7 and T1
c- respiration is suspended at end of expiration
d- if the patient can cooperate, short exposure time should be used while the patient
takes shallow breaths
e- none of the above
37- Regarding the PA oblique projection of chest RAO position, which one of
the following is true?
a- the anatomy of interest is farther from IR
b- the maximum area of the right lung field is demonstrated
c- have the patient turn approximately 45 for heart study
d- CR perpendicular, directed to midline point 7-8" below level of vertebrae
prominence
e- all of the
?Which of the following projections demonstrate of dens -38
a- Kasabash method
b- Judd method
c- AP projection open mouth
d- a and c
e- all of the above
39- Regarding the Taylor method, which one of the following is false?
a- CR directed 20 to 35 cephalad for male and 30 to 45 for female
b- CR directed to a midline point 1 to 2 " distal to symphysis pubis
c- known as AP axial " inlet " projection
d- presents excellent view of pubis and ischia
e- none of the above
40- Regarding the AP projection open mouth, the following statements are
true except:
a- the resulting image demonstrates atlas and axis through the open mouth
b- adjust the patient's head so that the line from lower edge of upper incisors to
mastoid tip is perpendicular to IR
c- used to reveal the atlanto-ocipital articulation
d- CR parallel to the line in the option b, directed to midpoint of the open mouth
e- a and d
41- Which one of the following projections provides lateral view of
acetabulum and femoral head and neck?
a- Danelius-Miller method
b- unilateral frog leg position modified cleaves method
c- Lauenstein and Hickey method
d- a and c
e- all of the above
42- To radiographically demonstrate the RT side cervical zygapophyseal
joints, the patient should be:
a- AP oblique projection LPO position
b- PA oblique projection LAO position
c- AP axial oblique projection LPO position
d- PA axial oblique projection LAO position
e- none of the above
43- Which of the following is true regarding the AP oblique projection of iliac
bone?
a- the anatomy of interest is upside
b- elevate the unaffected side about 60
c- CR perpendicular, directed to 2" medial the affected ASIS
d- all of the above
e- none of the above
44- Which of the following is false regarding the AP oblique projection of lumber
vertebrae?
a- used to demonstrate the defects of the pars interaticularis
b- the anatomy of interest is downside
c- CR perpendicular to L3 at the level of lower costal margin
d- the degree of body rotation is 50 for best demonstration of the zygapophyseal joints
at L1-L2
e- none of the above
45- Which one of the following is the best for demonstration of neck of femur
with least foreshortening?
a- AP bilateral frog leg position, abduction both femurs about 40-45 form the vertical
b- AP bilateral frog leg position, abduction both femurs about 50-60 form the
vertical
c- AP pelvis projection, rotation of both leg externally 15-20.
d- c and d
e- none of the above
46- which one of the following is false regarding the AP axial projection of
lumbosacral junction?
a- used as a part of basic projections of SI joints
b- CR directed to midline point 2" above the ASIS at cephalad angle 30 for male and
35 for female
c- correct alignment of CR and L5-S1 is evidenced by closed joint space
d- SI joints demonstrate equal distance from spine, indicating pelvis rotation
e- all of the above except a

47- Which one of the following is true regarding the Judet method?
a- when the anatomy of interest is downside, anterior rim and posterior iliopubic
column are demonstrated
b- when the anatomy of interest is upside, CP perpendicular and directed to 2" distal
and 2" medial to affected ASIS
c- when the anatomy of interest is upside, posterior rim and anterior iliopubic column
are demonstrated
b- when the anatomy of interest is downside, CP perpendicular and directed to 2"
distal to affected ASIS
e- none of the above

48- Regarding the AP pelvis projection, the following statements are true except:
a- shield gonads for both male and female
b- IR size 35x45 cm
c- ensure that the pelvis is not rotated
d- rotate the long axes of feet and lower limbs about 15 to 20
e- CR directed to midway between level of ASIS and symphysis pubis
49- Regarding the lateral projection of sacrum, which of the following is
false?
a- IR size 24x30 cm
b- lead rubber placed in front of patient to reduce scatter radiation to IR
c- align long axis of sacrum to CR and to midline of table
b- CR perpendicular, directed to 3-4" posterior and 2" distal to ASIS
e- b and d

50- Inspiration and expiration projections of the chest may be performed to

demonstrate:
a- pneumothorax
b- foreign body
c- pleura fusion
d- a and b
e- all of the above
:The organ most radiosensitive from radiation during radiograph the skull is -1
.a- the pituitary gland
.b- the lenses of eyes
.c- the thyroid
.d- the skin
Which topographic landmark corresponds to the inferior margin of the -2
?abdomen
.a- ASIS
.b- iliac crest
.c- symphysis pubis
.d- ischial tuberosity
.e- c & d
Which of the following technical factors is essential when performing -3
?abdomen studies on a pediatric patient
.a- high mA
.b- short exposure time
.c- high-speed image receptor
.d- all of the above
:The bony landmark in the MSP at the root of the nose is called -4
.a- Gonion
.b- Glabella
.c- Nasion
.d- Symphysis menti
Which one of the following abdominal structures is not visible on a well- -5
?exposed KUB
.a- kidneys
.b- margin of liver
.c- lumber transverse processes
.d- pancreas
In radiographing the sella turcica, many views may be taken. Which of the -6
?following is absolutely necessary
.a- true lateral
.b- SMV
.c- Towne method
.d- Caldwell method
With the patient head in PA position and the central ray directed 20 degree
cephaled, which part of the mandible will be best visualized?
a- symphysis.
b- rami.
c- body.
d- angle of mandible.
Which projection of the nasal bones will demonstrate medial or lateral -8
?displacement of fragment
.a- oblique projection
.b- lateral projection
.c- AP axial projection
d- tangential projection

.
A patient with a history of ascites comes to the radiology department. -9
?Which one of the following projections best demonstrate this condition
.a- erect AP abdomen
.b- erect PA chest
.c- supine KUB
.d- prone KUB
:Angulation of the central ray may be required -10
.a- to avoid superimposition of overlaying structures
.b- to avoid foreshortening or self-superimposition
.c- in order to project through certain articulations
.d- all of the above
A properly positioned AP axial ( Towne ) projection should place the -11
:dorsum sellae into the middle aspect of the
.a- orbit
.b- clivus
.c- anterior arch of C1
.d- foramen magnum
Paranasal sinuses should always be taken with the central ray -12
:horizontal and the film vertical because
.a- its more comfortable to the patient
.b- the sinuses are demonstrated better
.c- fluid levels will be shown if present
.d- any infection will have drained from the sinuses
A lack of symmetry of the petrous ridges indicates which of the -13
?following problems with a radiograph of an AP axial projectioin
.a- tilt
.b- central ray angle
.c- flexion or extension
.d- rotation
When the patient is positioned so that the MSP is parallel to, and the -14
?interpupillary line is perpendicular to the film, the skull projection is
.a- SMV projection
.b- Lateral projection
.c- AP projection
.d- Axiolateral projection
,Which of one the following projections provides a comparative -15
?bilateral view of both mastoids with single exposure
.a- AP axial
.b- Axiolateral oblique posterior profile
.c- Axiolateral oblique
.d- Axiolateral oblique anterior profile
For the PA projection of the mandible with the patient in the erect, the -16
:CR is
.a- horizontal
.b- 10 degrees down from horizontal
.c- 10 degrees up from horizontal
d- none of the above

.
Gonadal shielding should not be used during the abdomen radiography -17
:if
.a- it obscure essential anatomy
.b- the patient requests that is not be used
.c- the technologist dose not elect to use it
.d- the patient is 40 years or older
The axiolateral oblique projection (modified law method) of examining -18
?the mastoids uses of which of the following
.a- IOML perpendicular to front edge of IR
.b- Central ray 15 degree caudad
.c- Center ray 1 inch posterosuperior to EAM
.d- A and B
.e- all of the above
Which one of the following projections best demonstrates the -19
?clivus
.a- AP axial
.b- PA axial 15 degree caudad
.c- Lateral
.d- Tangential
The structure/s best demonstrated on AP axial projection of the -20
:skull with the central ray directed 30 degree caudally is/are
.a- petrous pyramids
.b- greater and lesser sphenoid wings
.c- superior orbital fissures
.d- all of the above
?Which one of the following is not one of the bones of the cranium -21
.a- lacrimal
.b- frontal
.c- sphenoid
.d- occipital
?The petromastoid portion is a part of which bone -22
.a- temporal
.b- occipital
.c- sphenoid
.d- ethmoid
What is the central-ray angulation for demonstration of the entire foramen magnum -23
?during an AP axial (Towne) projection
.a- 37 degrees caudad
.b- 40 degrees caudad
.c- 60 degrees caudad
.d- 40 to 60 degrees caudad
What is the average central-ray angulation for the PA axial (Haas) projection of the -24
?skull
.a- 25 degrees caudad
.b- 25 degrees cephalad
.c- 30 degrees caudad
.d- 30 degrees caudad
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
Which parts of the patient's face touch the table for a PA axial projection (Caldwell
?method)
.a- forehead
.b- nose
.c- chin
a & b (.1
a & c (.2
b & c (.3
a, b & c (.4
:Regarding the Caldwell method, the CR is angled caudally 25 to 30 degrees due to -27
a- shift the petrous pyramids below the
infraorbital margin
.b- demonstrate the superior orbital fissure
.c- demonstrate the foramen spinosum
a & b (.1
a & c (.2
a, b & c (.3
:Regarding the Caldwell method, which one of the following is true -28
.a- used to demonstrate frontal bone
.b- used as a part of basic projection of facial and cranial bones
c- the outlet of CR is
.nasion
.d- may be used as reverse Caldwell for trauma patient
a & b (.1
a & c (.2
b & c (.3
a, b, c & d (.4
Regarding the Caldwell method for paranasal sinuses, which one of the following is -29
:false
.a- the angle should be done in the CR
.b- the patient position is erect or recumbent
.c- the patient chin against the table/ bucky surface
.d- is used for maxillary sinuses
a & b (.1
a & c (.2
a & d (.3
a, b, c & d (.4
?Where is the CR centered for Lateral projection for facial bones -30
.a- outer canthus
.b- acanthion
.c- zygoma
.d- nasion
?Which projection of the TMJ requires that the skull be kept in a true lateral position
.a- modified Law method
.b- Schuller method
.c- modified Towne method
d- Axiolateral oblique projection
?How much of a difference in degrees is there between the OML and IOML -32
.a- 10 degrees
.b- 7 to 8 degrees
.c- 3 degrees
.d- none of the above
:Reid's base line is an older term for -33
.a- GML
.b- IOML
.c- OML
.d- GAL
Which one of the following positioning errors frequently results in -34
?a repeat exposure of a cranial position
.a- rotation
.b- incorrect CR placement
.c- slight flexion
.d- none of the above
During a Panorex procedure, it is important to keep the .
.positioning line parallel to the floor
.a- OML
.b- AML
.c- GAL
.d- IOML
Which one of the following projections involves a KV setting of 110 -36
?to 125
.a- erect abdomen for ascites
.b- supine abdomen for intraabdominal mass
.c- PA, erect chest for free air under diaphragm
.d- dorsal decubitus abdomen for calcified aorta
A child goes to radiology for an abdomen study. It is possible that he -37
swallowed a coin. ER physician believes it may be in the upper GI tract. Which
?of the following routines would best identify the location of the coin
.a- KUB and left lateral decubitus
.b- acute abdominal series
.c- KUB and lateral abdomen
.d- supine and erect KUB
Which one of the following factors will prevent superimposing of the ramus -38
?on the cervical spine for the axiolateral mandible projection
.a- angle CR 10 to 15 degrees cephalad
.b- extend the chin slightly
.c- rotate head toward IR
.d- have the patient open mouth during exposure
-39
How much skull rotation (from lateral position) toward the IR is required for the
?axiolateral oblique projection of the mentum
.a- 10 to 15 degrees
.b- 45 degrees
.c- 30 degrees
d- none; keep skull in true lateral position
How much CR angulation should be used for a PA axial projection of the -40
?mandible
.a- none
.b- 10 to 15 cephalad
.c- 20 to 25 cephalad
d- cephalad 5
How to be sure that the patient is rotated 37 toward the affected side in -41
?Rhese method
.a- chin contacts with IR
.b- nose contacts with IR
.c- cheek contacts with IR
.d- AML is perpendicular to RI
a & b (.1
a & c (.2
a & d (.3
a, b & c (.4
a, b, c & d (.5
A patient comes to the radiology department with a clinical history of a -42
deviated bony nasal septum. Which facial bone projection will best demonstrate
?the degree of deviation
.a- Waters method
.b- Caldwell method
.c- modified Waters method
.d- superoinferior tangential projection
a & b (.1
a & c (.2
a, b & c (.3
a, b, c & d (.4
A radiograph of a parietoacantial projection reveals that the distance -43
between the MSP and the outer orbital margin is not equal. What positioning
?error is present on this radiograph
.a- rotation
.b- tilt
.c- CR angulation
d- a & b
.e- all of the above
A radiograph of Waters method reveals that the petrous ridges are projected -44
?just below the maxillary sinuses. What positioning error is present
.a- MML is not perpendicular to IR
.b- CR angulation
.c- there is no error
.d- none of the above
A patient with clinical history of sinusitis comes to the radiology department -45
for a sinus study. The patient is quadriplegic and cannot be placed erect. Which
?single projection will demonstrate any possible air-fluid levels in the sinuses
.a- Waters method
.b- modified transoral Waters method
.c- Caldwell method
.d- lateral projection
.e- lateral projection dorsal decubitus
Which is the minimum amount of time a patient should be upright before -46
?taking a projection to demonstrate intraabdominal free air
.a- 20 minutes
.b- 30 minutes
.c- 2 minutes
d- 5 minutes
Where are the petrous ridges projected for a properly positioned modified -46
?parietoacanthial projection
.a- petrous ridges are projected just below the inferior orbital rim
.b- petrous ridges are projected into the lower one-third of the orbits
.c- petrous ridges are projected into the upper half of the maxillary sinuses
.d- petrous ridges are projected just below the maxillary sinuses
Where should the optic foramen be located with a well- positioned Rhese -47
?method
.a- optic foramen projects into the lower outer quadrant of orbit
.b- optic foramen projects into the lower inner quadrant of orbit
.c- optic foramen projects into the upper outer quadrant of orbit
.d- optic foramen projects into the upper inner quadrant of orbit
A patient comes to radiology department with a possible tumor of the -48
pituitary gland. Which projection of the cranium best demonstrates any bony
?involvement of the sella turcica
.a- lateral projection
.b- Towne method
.c- Valdini method
.d- Haas method
A patient with a possible linear fracture of the right parietal bone enters the -49
emergency room. Which single projection of the skull best demonstrates this
?fracture
.a- right lateral position
.b- left lateral position
.c- lateral projection
.d- Towne method
which specific positioning error is present if the mandibular rami are not -50
?superimposed on a lateral skull radiograph
.a- tilt
.b- rotation
.c- incorrect CR angle
.d- overflexion of head and neck