Citation, DOI & article data
Citation:
Murphy, A., Fahrenhorst-Jones, T. Elbow (internal oblique view). Reference article, Radiopaedia.org. (accessed on 26 Oct 2022) //doi.org/10.53347/rID-59930
The elbow internal oblique view is a specialized projection, utilized to demonstrate both the coronoid process in profile and the olecranon process sitting within the olecranon fossa of the humerus. The affected limb is pronated.
On this page:
The medial oblique view is not a standard projection of the elbow, however helpful when occult fractures of the coronoid process are suspected.
- the patient is seated alongside the table
- fully extended arm and forearm, in a pronated position
- ensure the anterior portion of the elbow is roughly 45 degrees from the IR
- anteroposterior medial oblique projection
- centering point
- mid elbow joint
- collimation
- superior to the distal third of the humerus
- inferior to include one-third of the proximal radius and ulna
- lateral to include the skin margin
- medial to include medial skin margin
- orientation
- portrait
- detector size
- 18 cm x 24 cm
- exposure
- 50-60 kVp
- 2-5 mAs
- SID
- 100 cm
- grid
- no
- the coronoid process should be seen in profile
- a clear visualization of the olecranon sitting in the olecranon fossa
- the radial head and proximal ulna are superimposed
Keep in mind patient comfort when performing this examination.
References
Related articles: Imaging in practice
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Where will the fibula be located on a properly positioned lateral radiograph of the ankle?
over the posterior half of the tibia
The distal of the gallbladder is the:
fundus
The lumbar lamina is represented by what part of the "scotty dog" seen in a correctly positioned oblique lumbar spine view?
body
The valve that separates the right atrium from the right ventricle is called the:
tricuspid valve
T9 and T10 are located at the level of the:
xyphoid process
Ideally, the cathode end of an x-ray tube should be positioned to take advantage of the "heel effect" of the tube. Where should the cathode be placed for an AP thoracic spine?
toward the feet
The secondary center of ossification in long bones is the:
epiphysis
-
Some synovial joints contain synovial-fluid filled sacs outside the main joint cavity called:
bursae
A malformation of the acetabulum causing displacement of the femoral head is known as:
congenital hip dysplasia
Which of the following best describes the position of the thymus gland?
behind the manubrium
Which specific type of joint allows multiaxial movement?
ball and socket
The central-ray angulation for a lateral projection of the knee is:
5 to 7 degrees cephalad
The body is placed at what angle for the AP oblique projection (Judet method) of the acetabulum?
45 degrees
Which of the following will be directly superimposed over the junction of the "Y" on the PA oblique (scapula Y) projection?
humeral head
For an AP projection of the shoulder with the humerus in internal rotation, the epicondyles of the humerus should be:
perpendicular to the plane of the IR
The only saddle joint in the human body is the:
first digit, carpometacarpal joint
Diverticula are most common seen in which part of the colon?
sigmoid colon
Where is the center of the IR positioned for an AP abdominal radiograph done in the upright position?
2 inches above the iliac crest
What is the longest segment of the small intestine?
iliem
Where is the IR centered for a hyperflexion or hyperextension lateral projection of the cervical spine?
fourth cervical vertebra
Which structure carries oxygenated blood to the left atrium?
pulmonary veins
Which aspect of the large intestine is best demonstrated with a RAO position?
right colic flexure
If the lateral decubitus position is used to demonstrate fluid in the pleural cavity, which side must the patient lie on?
affected side
What is the term for a bending motion of an articulation, decreasing the angle between associated bones?
flexion
Where should the center of the IR be positioned for a transthoracic lateral projection of the proximal humerus?
surgical neck
Which of the following describes the central ray centering point for the L5-S1 lateral projection?
2 inches posterior to the ASIS and inches below the iliac crest
Where is the central ray directed for a lateral projection of the humerus?
midpoint of the humerus
S1 and S2 are located at the level of the:
anterior superior iliac spines (ASIS)
Where is the central ray directed for a lateral thoracic spine"
level of T7
What is the name of the condition that results in the forward slipping of one vertebra on the one below it?
spondyloidthesis
For the PA oblique projection (scapula Y) of the shoulder, the body is rotated so that the midcoronal plane is how many degrees from the IR?
45 to 60 degrees
At what level is the sternal angle?
T4/T5
Symphysis pubis is located at the level of:
greater trochanters
Which line is placed perpendicular to the IR for the parietoorbital (Rhese) projection of the optic canal?
acanthiomeatal line
For a lateral projection of the wrist, the elbow must be flexed:
90 degrees
Which joint is an example of a amphiarthroidal joint?
intervertebral joint
The superior and inferior vena cava empty returning blood into which part of the heart?
right atrium
For an AP projection of the toes, the central ray is directed to the:
third MTP joint
How many feet make up the small intestine?
23
A fracture of the distal radius with posterior displacement is known as a ____ fracture.
Collie's
Which of the following passes through the carpal "tunnel"?
median nerve
When viewed from the side, the vertebral column presents how many curves?
4
The first cervical vertebra is called the:
atlas
A chronic condition with persistent obstruction of the bronchial airflow is termed:
chronic obstructive pulmonary disease (COPD)
L4 and L5 are located at the level of the:
superior aspect of the iliac crests
What quadrant is the liver located?
RUQ
If the patient cannot be placed in the lordotic position for radiography of the pulmonary apices, what is the central-ray angle that can be used to project the clavicles above the apices?
15-20 degrees cephalad
Which ligament is part of the knee?
posterior inferior tibiotalar ligament
Which intervertebral foramina are demonstrated on the PA axial projection of the cervical spine?
those closest to the IR
Which of the following positions would best demonstrate the proximal tibifibular articulation?
45 degree internal rotation
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?
37 degrees caudad
Blunting of the costophrenic angles on a PA projection of the chest can be an indication of:
pleural effusion
Which type of body habitus has a high and transverse stomach?
hypersthenic
All of the following statements regarding respiratory structures are true, except:
the lobes of the left lung are separated by the horizontal fissure
The largest and strongest bone in the body is the:
femur
Some synovial joints contain a thick cushioning pad of fibrocartilage called the:
meniscus
If the IR and wrist are placed flat on the table for the PA axial projection of the wrist (Stecher method), the central ray must be angled:
20 degrees
An abnormal increase in the convexity of the thoracic spine is termed:
kyphosis
Which sinus is projected through the mouth on the open-mouth modification of the Waters method?
sphenoidal
What bone articulates with the semi-lunar notch of the ulna?
trochlea
Often, the leg is to long to fit on one IR for radiographs. Which joint or joints should be included on the IR when the site of a lesion is known?
the joint closest to the lesion
What skull type is narrow from side to side?
dolichocephalic
What is the respiration phase for an AP abdominal radiograph done in the left lateral decubitus position?
expiration
How many bones make up the appendicular skeleton?
126
What is the recommended SID for a supine AP chest radiograph?
72 inches
Which structure is the most superior?
laryngopharynx
Oxygen and carbon dioxide are exchanges by diffusion within the:
alveoli
For a transthoracic lateral projection of the shoulder, lung detail may be blurred to better visualize the shoulder area. Which exposure time is recommended to blur the lung structures?
minimum of 3 seconds
What angle would be utilized on an AP axial (lordotic) chest?
15-20 degrees cephalad
In which region is the splenic flexure?
left hypochondrium
At which level should the central ray enter the base of the skull for the SMV projection of the sinuses?
3/4 inch below the mental protuberance
Which of the following is located in the internal ear?
transverse foramen
The outermost layer of the pleura is referred to as the:
parietal pleura
To prevent lateral rotation, how should the foot be positioned for a lateral projection of the ankle?
in dorsiflexion
For a lateral projection of the hand, the central ray is directed to the:
second digit of MCP joint
Which of the following positions is most likely to place the right kidney parallel to the IR?
LPO
The term varus refers to
turned inward
Demonstration of the posterior fat pad on the lateral projection of the adult elbow can be caused by
1. trauma or other pathology
2. greater than 90-degree flexion
3. less than 90-degree flexion1 and 3 only
The coronoid process should be visualized in profile in which of the following positions?
Medial oblique elbow
The male bony pelvis differs from the female bony pelvis in which of the following way(s)?
1. The male pelvis has a larger pelvic inlet.
2. The female pubic arch is greater than 90 degrees.
3. The male ilium is more vertical.2 and 3 only
Which of the following techniques would provide a posteroanterior (PA) projection of the gastroduodenal surfaces of a barium-filled high and transverse stomach?
Angle the CR 35 to 45 degrees cephalad.
-
With the patient and the x-ray tube positioned as illustrated in Figure 2-2, which of the following will be visualized?
1. Intercondyloid fossa
2. Patellofemoral articulation
3. Tangential patella2 and 3 only
All of the following statements regarding respiratory structures are true except
the inferior portion of the lung is the apex.
All the following statement regarding an exact PA projection of the skull are true except
the midsagittal plane (MSP) is parallel to the IR.
What could be done to improve the mediolateral projection of the knee seen in Figure 2-3?
Rotate the pelvis slightly backward.
Pacemaker electrodes can be introduced through a vein in the chest or upper extremity, from where they are advanced to the
right ventricle
Widening of the intercostal spaces is characteristic of which of the following conditions?
Emphysema
Which of the following structures is (are) located in the right upper quadrant (RUQ)?
1. Hepatic flexure
2. Gallbladder
3. Ileocecal valve1 and 2 only
Which of the following statements regarding the image in Figure 2-4 is correct?
The left kidney is more parallel to the IR.
During the 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 mostly likely
LPO
Which of the following articulations participate(s) in formation of the ankle mortise?
1. Talotibial
2. Talocalcaneal
3. Talofibular1 and 3 only
Which projection of the foot will best demonstrate the longitudinal arch?
Lateral weight-bearing
Graves disease is associated with
thyroid overactivity
To best visualize the lower ribs, the exposure should be made
on expiration
In an AP axial projection (Towne method) of the skull, with the CR directed 30 degrees caudad to the orbitomeatal line (OML) and passing midway between the external auditory meati, which of the following is best demonstrated?
Occipital bone
The right posterior oblique position (Judet method) of the right acetabulum will demonstrate the
1. anterior rim of the right acetabulum
2. right iliac wing
3. right anterior iliopubic column1 and 2 only
Figure 2-5 demonstrates which of the following conditions?
dextrocardia
A frontal view of the sternum is best accomplished in which of the following positions?
RAO
What is the name of the condition that results in the forward slipping of one vertebra on the one below it?
spondylolisthesis
During atrial systole, blood flows into the
1. right ventricle via the mitral valve
2. left ventricle via the bicuspid valve
3. right ventricle via the tricuspid valve2 and 3 only
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.
All of the following statements regarding the use of iodinated contrast agents with patients taking metformin hydrochloride are true except
metformin should be with held for 48 hours before IV iodinated contrast studies.
Which of the following methods was used to obtain the image seen in Figure 2-6?
Erect PA, chin extended, OML 15 degree from horizontal
Which of the following statements regarding the radiograph in Figure 2-6 is (are) true?
1. The position is used to demonstrate the frontal and ethmoid sinuses.
2. The ethmoid sinuses are seen near the medial aspect of the orbits.
3. The perpendicular plate is visualized in midline of the nasal cavity.1,2, and 3
Which of the following is an important consideration to avoid excessive metacarpophalangeal joint overlap on the oblique projection of the hand?
Oblique the hand no more than 45 degrees.
All of the following positions are used frequently to demonstrate the sternoclaviclar articulations except
weight-bearing
Which of the following positions is most likely to place the right kidney parallel to the IR?
LPO
When examining a patient whose elbow is in partial flexion, how should an AP projection be obtained?
1. with humerus parallel to IR, CR perpendicular
2. with forearm parallel to IR, CR perpendicular
3. through the partially flexed elbow, resting on the olecranon process, CR perpendicular1 and 2 only
Which of the following positions is required to demonstrate small amounts of air in the peritoneal cavity?
lateral decubitus, affected side up
Which of the anatomic structures listed below is seen most anteriorly in a lateral projection of the chest?
cardiac apex
For an AP projection of the knee on a patient whose measurement from ASIS to tabletop is 21 cm, which CR direction will best demonstrate the knee joint?
0 degrees (perpendicular)
In which of the following projections was the image in Figure 2-7 made?
medial oblique
Which of the following anatomic structures is indicated by the number 2 in Figure 2-7?
olecranon process
Which of the following is (are) well demonstrated in the lumbar spine pictures in Figure 2-8?
1. apophyseal articulations
2. intervertebral foramina
3. pedicles2 and 3 only
In which of the following tangential axial projections of the patella is complete relaxation of the quadriceps femoris requires for an accurate diagnosis?
1. supine flexion 45 degrees (Merchant)
2. prone flexion 90 degrees (Settegast)
3. prone flexion 55 degrees (Hughston)1 only
Which of the following projections can be used to supplement the traditional "open-mouth" projection when the upper portion of the odontoid process cannot be well demonstrated?
AP or PA through the foramen magnum
The floor of the cranium includes all of the following bones except
the occipital bone
A lateral projection of the hand in extension often recommended to evaluate
1. a fracture
2. a foreign body
3. soft tissue2 and 3 only
in which of the following positions was the radiograph in Figure 2-9 taken
RPO
The structure indicated as number 4 in Figure 2-9 is the
cecum
The condition that results from a persistent fetal foramen ovale is
an atrial septal defect
Which of the following projections or positions will best demonstrate subacromial or subcoracoid dislocation?
PA oblique scapular Y
With the patient recumbent on the x-ray table with the head lower than the feel, the patient is said to be in the
Trendelenberg position
Which of the following positions can be used to demonstrate the axillary ribs of the right thorax?
1. RAO
2. LAO
3. RPO2 and 3 only
In which projection of the foot are the interspaces between the first and second cuniforms best demonstrated?
lateral oblique foot
The sternal angle is at approximately the same level as the
T5
Which of the following structures is (are) located in the right upper quadrant (RUQ)?
1. spleen
2. gallbladder
3. hepatic flexure2 and 3 only
To demonstrate esophageal varices, the patient must be examined in
the recumbent position
Which of the following statements regarding Figure 2-10 is (are) true?
1. correct degree of rotation is present
2. midphalanges are foreshortened
3. fingers are parallel to the IR1 and 2 only
The tissue that occupies the central cavity within the shaft of a long in an adult is
yellow marrow
All the following structures are associated with the posterior femur except
intertrochanteric line
Which of the following projections of the ankle would best demonstrate the mortise?
Medial oblique 15 to 20 degrees
Which of the following statements with respect to the PA chest seen in Figure 2-11 is (are) correct?
1. adequate inspiration is demonstrated
2. the shoulders are rolled forward adequately
3. rotation is demonstrated1,2, and 3
Which of the following bony landmarks is in the same transverse plane as the symphysis pubis?
Prominence of the greater trochanter
A radiolucent sponge can be placed under the patient's waist for a lateral projection of the lumbosacral spine to
1. make the vertebral column parallel with the IR
2. place the intervertebral disk spaces perpendicular to the IR
3. decrease the amount of SR reaching the IR1 and 2 only
To reduce the amount of scattered radiation reaching the IR in CR/DR imaging of the lumbosacral region, which of the following is (are) recommended?
1. close collimation
2. lead mat on table posterior to the patient
3. decreased SID1 and 2 only
Which of the following is (are) distal to the tibial plateau?
1. intercondyloid fossa
2. tibial condyles
3. tibial tuberosity2 and 3 only
Evaluation criteria for a lateral projection of the humerus include
1. epicondyles parallel to the IR
2. lesser tubercle in profile
3. superimposed epicondyles2 and 3 only
Which position of the shoulder demonstrates the lesser tubercle in profile medially?
Internal rotation
With the patient in the PA position, which of the following tube angle and direction combinations is correct for an axial projection of the clavicle?
15 to 30 degrees caudad
Which of the following fracture classifications describes a small bony fragment pulled from a bony process?
avulsion fracture
What portion of the humerus articulates with the ulna to help form the elbow joint?
trochlea
Movement of a part toward the midline of the body is termed
adduction
During myelography, contrast medium is introduced into the
subarachnoid space
The junction of the sagittal and coronal sutures is the
bregma
Which of the following statements is (are) true regarding the radiograph in Figure 2-12?
1. The patient is placed in an RAO position.
2. The midcoronal plane is about 60 degrees to the IR.
3. The acromion process is free of superimposition.1,2, and 3
Examples of synovial pivot articulations in the
1. atlantoaxial joint
2. radioulnar joint
3. temporomandibular joint1 and 2 only
The lumbar transverse process is represented by what part of the "scotty dog" seen in a correctly positioned oblique lumbar spine?
nose
An injury to a structure located on the side opposite that of the primary injury is referred to as
contrecoup
In which of the following positions can the sesamoid bones of the foot be demonstrated to be free of superimposition with the metatarsals or phalanges?
Tangential metatarsals/toes
Which of the following conditions is limited specifically to the tibial tuberosity?
Osgood-Schlatter disease
AP stress studies of the ankle may be performed
1. to demonstrated fractures of the distal tibia and fibula
2. following inversion or eversion injuries
3. to demonstrate a ligament tear2 and 3 only
Which of the following is (are) part of the bony thorax?
1. Manubrium
2. Clavicles
3. 24 ribs1 and 3 only
Aspirated foreign bodies in older children and adults are most likely to lodge in the
right main stem bronchus
The PA chest radiograph shown in Figure 2-13 demonstrates
1. rotation
2. scapulae removed from lung fields
3. adequate inspiration1,2, and 3
The letter B in Figure 2-13 indicates
a left anterior rib
With the patient seated at the end of the x-ray table, elbow flexed 80 degrees, and the CR directed 45 degrees laterally from the shoulder to the elbow joint, which of the following structures will be demonstrated best?
coronoid process
The structures forming the brain stem include
1. the pons
2. the medulla oblongata
3. the midbrain1,2, and 3
The CR will parallel the intervertebral foramina in which if the following projections?
1. lateral cervical spine
2. lateral thoracic spine
3. lateral lumbar spine2 and 3 only
What structure can be located midway between the anterosuperior iliac spine (ASIS) and pubic symphysis?
dome of the acetabulum
The structure labeled 3 in Figure 2-14 is the
spenoidal sinus
Which of the following would best evaluate the structure labeled 4 in Figure 2-14?
parietoacanthal projection (Waters method)
Which of the following positions demonstrates the sphenoid sinuses?
1. modified Waters (mouth open)
2. lateral
3. PA axial1 and 2 only
The radiograph shown in Figure 2-15 demonstrates the articulation between the
1. talus and the calcaneus
2. calcaneus and the cuboid
3. talus and the navicular2 and 3 only
Identify the structure labeled 1 in the AP projection of the knee shown in Figure 2-16.
medial epicondyle
The articular facets of L5-S1 are best demonstrated in a(n)
30-degree oblique
The patient's chin should be elevated during a chest radiography to
avoid superimposition on the apices
The secondary center of ossification in long bones is the
epiphysis
Medial displacement of a tibial fracture would be best demonstrated in the
AP projection
The lumbar lamina is represented by what part of the "scotty dog" seen in correctly positioned oblique lumbar spine view?
body
All of the following statements regarding the position shown in Figure 2-17 are true except
the CR is directed vertically to the level of T7.
Which of the following positions would best demonstrate the proximal tibiofibular articulation?
45-degree internal rotation
At what level do the carotid arteries bifurcate?
C4
During a double-contrast BE, which of the following positions would afford the best double-contrast visualization of the lateral wall of the descending colon and the medial wall of the ascending colon?
right lateral decubitus
What is the structure indicated by the number 8 in Figure 2-18?
common bile duct
What is the structure indicated by the number 7 in Figure 2-18?
cystic duct
Which of the following conditions is often the result of ureteral obstruction or stricture?
Hydronephrosis
Which of the following examinations involves the introduction of a radiopaque contrast medium through a uterine cannula?
Hysterosalpingogram
All of the following statements regarding large bowel radiography are true except
single-contrast studies help to demonstrate intraluminal lesions
In a lateral projection of the normal knee, the
1. fibular head should be somewhat superimposed on the proximal tibia.
2. patellofemoral joint should be visualized.
3. femoral condyles should be superimposed.1,2, and 3
All elbow fat pads are best demonstrated in which position?
lateral
The term used to describe expectoration of blood from the bronchi is
hemoptysis
Double-contrast examinations of the stomach or large bowel are performed to better visualize the
gastric or bowel mucosa
Which of the following are mediastinal structures?
1. Heart
2. Trachea
3. Esophagus1, 2, and 3
Which of the following statements is (are) true regarding the position illustrated in Figure 2-19?
1. The right (adjacent to the table) ureter is parallel to the IR
2. The left (elevated) kidney is parallel to the IR
3. The degree of obliquity should be about 30 degrees1,2, and 3
In which position of the shoulder is the greater tubercle seen superimposed on the humeral head?
Internal rotation
With the patient positioned as illustrated in Figure 2-20, which of the following structures is best demonstrated?
intercondyloid fossa
Which of the following structures is illustrated by the number 2 in Figure 2-21?
Zygomatic arch
Which of the following articulations may be described as diarthrotic?
1. knee
2. intervertebral joints
3. Temporomandibular joint (TMJ)1 and 3 only
Ulnar flexion/deviation will best demonstrate which carpal(s)?
2 and 3 only
What should be done to better demonstrate the coracoid process shown in Figure 2-22?
Angle the CR about 30 degrees cephalad
Structures comprising the neural, or vertebral, arch include
1. pedicles
2. lamina
3. body1 and 2 only
In which type of fracture are the splintered ends of bone forced through the skin?
compound
The thoracic apophyseal joints are demonstrated with the
midsagittal plane 20 degrees to the IR
Which of the following may be used to evaluate the glenohumeral joint?
1. scapular Y projection
2. inferosuperior axial
3. transthoracic lateral1,2, and 3
The long, flat structures that project posteromedially from the pedicles are the
laminae
The type of ileus characterized by cessation of peristalsis is termed
paralytic
Radiography of which if the following structure(s) in the AP or PA position will inherently result in an image demonstrating shape distortion of the anatomic part?
1. kidney
2. scapula
3. sigmoid1,2, and 3
Which of the following procedures will best demonstrate the cephalic, basilica, and subclavian veins?
upper-limb venogram
-
Which of the following statements is (are) correct with respect to the images shown in Figure 2-23?
1. Image A was made with cephalad angulation
2. Image B was made with cephalad angulation
3. Image A and B were made with CR directed 15 degrees cephalad1 only
The bony habitus characterized by a long and narrow thoracic cavity and low midline stomach and gallbladder is the
asthenic
Which of the following should be performed to rule out subluxation or fracture of the cervical spine?
Horizontal beam lateral
Which of the following is proximal to the carpal bones?
Radial styloid process
Which of the following statements regarding the scapular Y projection of the shoulder is (are) true?
1. The midsagittal plane should be about 60 degrees to the IR
2. The scapular borders should be superimposed on humeral shaft
3. An oblique projection of the shoulder is obtained2 and 3 only
Which of the following are characteristics of the hypersthenic body type?
1. short, wide, transverse heart
2. high and peripheral large bowel
3. diaphragm positioned low1 and 2 only
Glossitis refers to inflammation of the
tongue
With the patient's head in a PA position and the CR directed 20 degrees cephalad, which part of the mandible will be best visualized?
Rami
During IV urography, the prone position generally is recommended to demonstrate
1. the filling of the ureters
2. the renal pelvis
3. the superior calyces1 and 2 only
The plane that passes vertically through the body, dividing it into anterior and posterior halves, is termed the
midcoronal plane
To demonstrate a profile view of the glenoid fossa, the patient is AP recumbent and oblique 45 degrees
toward the affected side
Which of the following anatomic structures is indicated by the number 1 in Figure 2-24?
spinous process
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
Central ray angulation may be required for
1. magnification of anatomic structures
2. foreshortening or self-superimposition
3. superimposition of overlaying structures2 and 3 only
Which of the following is recommended to better demonstrate the tarsmetatarsal joints in a dorsoplantar projection of the foot?
Angle the CR 10 degrees posteriorly
Valid evaluation criteria for a lateral projection of the forearm requires that
1. the epicondyles be parallel to the IR
2. the radius and ulna be superimposed distally
3. the radial tuberosity should face anteriorly2 and 3 only
Which of the following positions will provide an AP projection of the L5-S1 interspace?
Patient AP with 30- to 35- degree angle cephalad
Subject/object unsharpness can result from all of the following except when
anatomic object(s) of interest is/are in the path of the CR
Patients are instructed to remove all jewelry, hair clips, metal prostheses, coins, and credit cards before entering the room for an examination in
magnetic resonance imaging (MRI)
The true lateral position of the skull uses which of the following principles?
1. interpupillary line perpendicular to the IR
2. MSP perpendicular to the IR
3. infraorbitomeatal line (OML) parallel to the transverse axis of the IR1 and 3 only
In which of the following positions was the radiograph shown in Figure 2-25 probably made?
prone recumbent
A kyphotic curve is formed by which of the following?
1. sacral vertebrae
2. thoracic vertebrae
3. lumbar vertebrae1 and 2 only
Which of the following is (are) required for a lateral projection of the skull?
1. the IOML is parallel to the IR
2. the MSP is parallel to the IR
3. the CR enters 3/4 inch superior and anterior to the EAM1 and 2 only
That ossified portion of a long bone where cartilage has been replaced by bone is known as the
metaphysis
Which of the following positions will most effectively move the gallbladder away from the vertebrae in an asthenic patient?
LAO
The ileocecal valve normally is located in which of the following body regions?
right iliac
Which of the following is (are) true regarding radiographic examination of the acromioclavicular joints?
1. the procedure is performed in the erect position
2. use of weights can improve demonstration of the joints
3. the procedure should be avoided if dislocation or separation is suspected1 and 2 only
A type of cancerous bone tumor occurring in children and young adults and arising from bone marrow is
Ewing sarcoma
Arteries and veins enter and exit the medial aspect of each lung at the
hilus
Which of the following skull positions will demonstrate the cranial base, sphenoidal sinuses, atlas, and odontoid process?
submentovertical (SMV)
Which of the following is (are) located on the anterior aspect of the femur?
1. patellar surface
2. intertrochanteric crest
3. linea aspera1 only
An intrathecal injection is associated with which of the following examinations?
myelogram
In figure 2-27, the structure indicated as number 7 is which of the following?
head of rib
Which of the following statements is (are) correct with respect to evaluation criteria for a PA projection of the chest for lungs?
1. sternal extremities of clavicles are equidistant from vertebral borders
2. ten posterior ribs are demonstrated above the diaphragm
3. the esophagus is visible in the midline1 and 2 only
In which of the following positions/projections will the talocalcaneal joint be visualized?
plantodorsal projection of the os calcis
In the lateral projection of the ankle, the
1. talotibial joint is visualized
2. talofibular joint is visualized
3. tibia and fibula are superimposed1 and 3 only
The position illustrated in the radiograph in Figure 2-28 may be obtained with the patient
1. supine and the CR angled 30 degrees caudad
2. supine and the CR angled 30 degrees cephalad
3. prone and the CR angled 30 degrees cephalad2 only
All of the following positions are likely to be employed for both single- and double-contrast examinations of the large bowel except
right and left lateral decubitus abdomen
Which of the following statements regarding the Norgaad method, "Ball-Catcher's position, "is (are) correct?
1. bilateral AP oblique hands are obtained
2. it is used for early detection of rheumatoid arthritis
3. the hands are oblique about 45 degrees palm up1,2, and 3
Which of the following can be used to demonstrate the intercondyloid fossa?
1. prone, knee flexed 40 degrees, CR directed caudad 40 degrees to the popliteal fossa
2. supine, IR under flexed knee, perpendicular to tibia
3. prone, patella parallel to IR, heel rotated 5 to 10 degrees lateral, CR perpendicular to knee joint1 and 2 only
The scapula shown in Figure 2-29 demonstrates
1. its posterior aspect
2. its costal surface
3. its sternal articular surface1 only
In Figure 2-29, which of the following is represented by the number 3?
Acromion process
In Figure 2-29, which of the following is represented by the number 7?
lateral border
With the patient in the PA position and the OML and CR perpendicular to the IR, the resulting radiograph will demonstrate the petrous pyramids
completely within the orbits
When evaluating a PA axial projection of the skull with a 15-degree caudal angle, the radiographer should see
1. petrous pyramids in the lower third of the orbits
2. equal distance from the lateral border of the skull to the lateral rim of the orbit bilaterally
3. symmetrical petrous pyramids1,2, and 3
Which of the following barium-filled anatomic structures is best demonstrated in the LPO position?
hepatic flexure
The uppermost portion of the iliac crest is at approximately the same level as the
fourth lumbar vertebra
What is the position of the stomach in a hypersthenic patient?
high and horizontal
In the anterior oblique position of the cervical spine, the structures best seen are the
intervertebral foramina nearest the IR
During chest radiography, the act of inspiration
1. elevates the diaphragm
2. raises the ribs
3. depresses the abdominal viscera2 and 3 only
In the lateral projection of the scapula, the
1. vertebral and axillary borders are superimposed
2. acromion and coracoid processes are superimposed
3. inferior angle is superimposed on the ribs1 only
Which of the following statements is (are) true regarding Figure 2-30?
1. the image was made in the LAO position
2. the CR should enter more inferiorly
3. the sternum is projected onto the left side of the thorax2 and 3 only
To better visualize the knee-joint space in the radiograph in Figure 2-31. the radiographer should
angle the CR 5 to 7 degrees cephalad
Which of the following is (are) demonstrated in an AP projection of the cervical spine?
1. intervertebral disk space
2. C3-7 cervical bodies
3. apophyseal joints1 and 2 only
With which of the following does the trapezium articulate?
first metacarpal
Which of the following statements is (are) true regarding a PA axial projection of the paranasal sinuses?
1. the OML is elevated 15 degrees from the horizontal
2. the petrous pyramids completely fill the orbits
3. the frontal and ethmoidal sinuses are visualized1 and 3 only
Tracheotomy is an effective technique used to restore breathing when there is
respiratory pathway obstruction above the larynx
To demonstrate the first two cervical vertebrae in the AP projection, the patient is positioned so that
a line between the maxillary occlusal plane and the mastoid tip is vertical
For which of the following conditions is operative cholangiography a useful tool?
1. patency of the biliary ducts
2. biliary tract calculi
3. gallbladder calculi1 and 2 only
For the average patient, the CR for a lateral projection of the barium-filled stomach should enter
midway between the midcoronal line and the anterior abdominal surface
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
Which of the following is (are) appropriate techniques(s) for imaging a patient with a possible traumatic spine injury?
1. Instruct the patient to turn slowly and stop if anything hurts.
2. Maneuver the x-ray tube instead of moving patient.
3. Call for help and use the log-rolling method to turn the patient.(C) 2 and 3 only
Which of the following positions is used to demonstrate vertical patellar fractures and the patellofemoral articulation?
(C) Tangential patella
The structure labeled 5 in Figure 2-32 is the
(D) anterior arch of C1
The structure labeled 4 in Figure 2-32 is the
(C) odontoid process
Which of the following examinations is used to demonstrate vesicoureteral reflux?
(C) Voiding cystourethrogram
Which of the following should be demonstrated in a true AP projection of the clavicle?
1. Clavicular body
2. Acromioclavicular joint
3. Sternocostal joint(B) 1 and 2 only.
In which of the following projections is the talofibular joint best demonstrated?
(C) Medical oblique
Free air in the abdominal cavity is best demonstrated in which of the following positions?
(A) AP projection, left lateral decubitus position.
Which of the following sequences correctly describes the path of blood flow as it leaves the left ventricle?
(A) Arteries, arterioles, capillaries, venules, veins.
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Which of the following projections of the elbow should demonstrate the radial head free of ulnar superimposition?
(D) Lateral oblique
Which of the following projections will best demonstrate acromioclavicular separation?
(D) AP erect, both shoulders
Which of the following statements regarding myelography is (are) correct?
1. Spinal puncture may be performed in the prone or flexed lateral position.
2. Contrast medium distribution is regulated through x-ray tube angulation.
3. The patient's neck must be in extension during Trendelenburg positions.(C) 1 and 3 only
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The term that refers to parts away from the source or beginning is
(C) distal
With the patient PA, the MSP centered to the grid, the OML forming a37- degree angle with the IR, and the CR perpendicular and exiting the acanthion, which of the following is the best demonstrated?
(C) Facial bones
The inhalation of liquid or solid particles into the nose, throat, or lungs is referred to as
(B) aspiration
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(B) 1 and 2 only
Which of the following is (are) associated with a Colles' fractures?
1. Transverse fracture of the radial head
2. Chip fracture of the ulnar styloid
3. Posterior or backward displacement(C) 2 and 3 only
The axiolateral, or horizontal beam, projection of the hip requires the IR to be placed
1. parallel to the central ray (CR)
2. parallel to the long axis of the femoral neck.
3. in contact with the lateral surface of the body(C) 2 and 3 only
Which of the following guidelines should be followed when performing radiographic examinations on pediatric patients?
(A) Use restraint only when necessary
Which of the following interventional procedures can be used to increase the diameter of a stenosed vessel?
1. Percutaneous transluminal angioplasty (PTA)
2. Stent placement
3. Peripherally inserted central catheter (PICC line)(B) 1 and 2 only
Important considerations for radiographic examinations of traumatic injuries to the upper extremity include
1. the joint closest to the injured site should be supported during movement of the limb.
2. both joints must be included in long bone studies.
3. two views, at 90 degrees to each other, are required.(C) 2 and 3 only
Correct preparation for a patient scheduled for an upper gastrointestinal (GI) series is most likely to be
(B) NPO after midnight
The contraction and expansion of arterial walls in accordance with forceful contraction and relaxation of the heart are called
(C) Pulse
AP Trendelenburg position is often used during an upper GI examination to demonstrate
(C) Hiatal hernia
Which of the following positions would be the best choice for a right shoulder examination to rule out fracture?
(D) AP and scapular Y
Which of the following projections will best demonstrate the tarsal navicular free of superimposition?
(A) AP Oblique, medical rotation
Which of the following bones participates(s) in the formation of the obturator foramen?
1. Ilium
2. Ischium
3. Pubis(C) 2 and 3 only
Which of the following radiologic procedures requires that contrast medium be injected into the renal pelvis via a catheter placed within the ureter?
(B) Retrograde urography
The AP projection of the coccyx requires that the CR be directed.
1. 15 degrees cephalad
2. 2 inches superior to the public symphysis
3. to a level midway between the ASIS and pubis symphysis(B) 2 only
Which of the following views would best demonstrate arthritic changes in the knees?
(C) AP erect
Which of the following positions will demonstrate the lumbosacral apophyseal articulation?
(C) 30-degree RPO
Which of the following statements is (are) true regarding the images shown in figure 2-33?
1. Image A is positioned in internal rotation.
2. Image B is positioned in internal rotation.
3. The greater tubercle is better demonstrated in image A(D) 2 and 3 only
Which of the following will best demonstrate the size and shape of the liver and kidneys?
(B) AP abdomen
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Correct preparation for a patient scheduled for a lower GI series is most likely to be
(C) cathartics and cleansing enemas.
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The AP axial projection, or "frog leg" position, of the femoral neck places the patient in a supine position with the affected thigh
(D) abducted 40 degrees from the vertical
Which of the following precautions should be observed when radiography a patient who has sustained a traumatic injury to the hip?
1. When a fracture is suspected, manipulation of the affective extremity should be performed by a physician.
2. The AP axiolateral projection should be avoided.
3. To evaluate the entire region, the pelvis typically is included in the initial examination.(B) 1 and 3 only
Which of the following projections require(s)
that the humeral epicondyles be perpendicular to the IR?1. AP humerus
2. Lateral forearm
3. Internal rotation shoulder(C) 2 and 3 only
Prior to the start of an IVU, which of the following procedures should be carried out?
1. Have patient empty the bladder.
2. Review the patient's allergy history.
3. Check the patient's creatinine level.1,2, and 3
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To demonstrate the entire circumference of the radial head, exposure(s) must be made with the
1. epicondyles perpendicular to the cassette
2. hand pronated and supinated as much as possible
3. hand lateral and in internal rotation1,2, and 3
The image shown in Figure 2-34 was made in what position?
right lateral decubitus
In myelography, the contrast medium generally is injected into the
subarachnoid space between the third and fourth lumbar vertebrae
To evaluate the interphalangeal joints in the oblique and lateral positions, the fingers
must be supported parallel to the IR
Which of the following is (are) effective in reducing exposure to sensitive tissues for frontal views during scoliosis examinations?
1. use of PA position
2. use of breast shields
3. use of compensating filtration1,2, and 3
Which type of articulation is evaluated in arthrography?
diarthrodial
The laryngeal prominence is formed by the
thyroid cartilage
In the AP projection of the ankle, the
1. plantar surface of the foot id vertical
2. fibula projects more distally than the tibia
3. calcaneus is well visualized1 and 2 only
Which of the following examinations most likely would be performed to diagnose Wilm's tumor?
IVU
To visualize or "open" the right sacroiliac joint, the patient is positioned
25 to 30 degrees LPO
Deoxygenated blood from the head and thorax is returned to the heart by the
superior vena cava
Which of the following women is likely to have the most homogeneous glandular breast tissue?
A postpubertal adolescent
Standard radiographic protocols may be reduced to include two views, at right angles to each other, in which of the following situations?
Emergency and trauma radiography
Which of the following is a condition in which an occluded blood vessel stops blood flow to a portion of the lungs?
Pulmonary embolism
Following the ingestion of a fatty meal, what hormone is secreted by the duodenal mucosa to stimulate contraction of the gallbladder?
cholecystokinin
Which of the following projections is most likely to demonstrate the carpal pisiform free of superimposition?
AP (medial) oblique
Myelography is a diagnostic examination used to demonstrate
1. internal disk lesions
2. posttraumatic swelling of the spinal cord
3. posterior disk herniation2 and 3 only
Which of the following blood chemistry levels must the radiographer check prior to excretory urography?
1. creatinine
2. blood urea nitrogen (BUN)
3. red blood cells (RBCs)1 and 2 only
Which of the following are components of a trimalleolar fracture?
1. fractured lateral malleolus
2. fractured medial malleolus
3. fractured posterior tibia1,2, and 3
The functions of which body system include mineral homeostasis, protection, and triglyceride storage?
skeletal
The four major arteries supplying the brain include the
1. brachiocephalic artery
2. common carotid arteries
3. vertebral arteries2 and 3 only
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 patients1, 2, and 3
Which of the following is a major cause of bowel obstruction in children?
intussusception
Which of the following is (are) well demonstrated in the lumbar spine shown in Figure 2-35?
1. apophyseal articulations
2. intervertebral foramina
3. inferior articular processes1 and 3 only
Which of the following statements is (are) correct, with respect to a left lateral projection of the chest?
1. The MSP must be perfectly vertical and parallel to the IR.
2. The right posterior ribs will be projected slightly posterior to the left posterior ribs.
3. Arms must be raised high to prevent upper-arm soft-tissue superimposition on lung field.1,2, and 3
Which of the following is represented by the number 3 in Figure 2-36?
aorta
Which of the following bones participate(s) in the formation of the knee joint?
1. femur
2. tibia
3. patella1 and 2 only
All of the following are palpable bony landmarks used in radiography of the pelvis except
the femoral neck
Lateral deviation of the nasal septum may be best demonstrated in the
parietoacantral (Waters method) projection
Which of the following structures should be visualized through the foramen magnum in an AP axial projection (Towne method) of the skull for occipital bone?
1. posterior clinoid processes
2. dorsum sella
3. posterior arch of C11 and 2 only
What is the structure labeled number 5 in Figure 2-37?
pisiform
What is the structure labeled number 3 in Figure 2-37?
radial styloid
In the anterior oblique position of the cervical spine, the CR should be directed
15 degrees caudad to C4
Which of the following is a functional study used to demonstrate the degree of AP motion present in the cervical spine?
Flexion and extension laterals
If a patient's zygomatic arch has been traumatically depressed or the patient has flat cheekbones, the arch may be demonstrated by modifying the SMV projection and rotating the patient's head
15 degrees toward the side being examined
Which of the following factors can contribute to hypertension?
1. obesity
2. smoking
3. stress1,2, and 3
What is the degree of difference between the baseline numbered 2 and 3 in Figure 2-38 and used for various projections of the skull?
7 degrees
Referring to Figure 2-38, which of the following positions requires that baseline number 3 be parallel to the IR?
SMV
Orthoroentgenography, or radiographic measurement of long bones of an upper or lower extremity, requires which of the following accessories?
1. Bell-Thompson scale
2. Bucky tray
3. Cannula1 and 2 only
Which of the following is (are) demonstrated in a lateral projection of the cervical spine?
1. intervertebral foramina
2. apophyseal joints
3. intervertebral joints2 and 3 only
In a lateral projection of the nasal bones, the CR is directed
3/4 inch distal to the nasion
To make a patient as comfortable as possible during a single-contrast barium enema (BE), the radiographer should
1. instruct the patient to relax the abdominal muscles to prevent intra-abdominal pressure
2. instruct the patient to concentrate on breathing deeply to reduce colonic spasm
3. prepare a warm barium suspension (98-105*F) to aid in retention1 and 2 only
Which of the following positions will best demonstrate the right apophyseal articulations of the lumbar vertebrae?
RPO
Structures involved in blowout fractures include the
1. orbital floor
2. inferior rectus muscle
3. zygoma1 and 2 only
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 body1,2, and 3
Shoulder arthrography is performed to
1. evaluate humeral luxation
2. demonstrate complete or partial rotator cuff tear
3. evaluate the glenoid labrum2 and 3 only
Which of the following positions will separate the radial head, neck, and tuberosity from superimposition on the ulnar?
Lateral oblique
The most significant risk factor for breast cancer is
gender
Which of the following structures is located at the level of the interspace between the second and third thoracic vertebrae?
jugular notch
For the AP projection of the scapula, the
1. patient's arm is abducted at right angles to the body.
2. patient's elbow is flexed with the hand supinated.
3. exposure is made during quiet breathing.1,2, and 3
The innominate bone is located in the
pelvis
The sternoclavicular joints are best demonstrated with the patient PA and
in a slight oblique position, affected side adjacent to the IR
Which of the following sinus groups is demonstrated with the patient positioned as for a parietoacanthal projection (Waters method) with the CR directed through the patient's open mouth?
sphenoidal
Below-diaphragm ribs are better demonstrated when
the patient is in the recumbent position
Which of the following positions is essential in radiography of the paranasal sinuses?
erect
What projection of the os calsis is obtained with the leg extended, the plantar surface of the foot vertical and perpendicular to the IR, and the CR directed 40 degrees cephalad?
Axial plantodorsal projection
During GI radiography, the position of the stomach may vary depending on
1. the respiratory phase
2. body habitus
3. patient position1,2, and 3
With a patient in the PA position and the OML perpendicular to the table, a 15- to 20-degree caudal angulation would place the petrous ridges in the lower third of the orbit. To achieve the same result in a baby or a small child, it is necessary for the radiographer to modify the angulation to
10 to 15 degrees caudal
The structure labeled number 6 in Figure 2-39 is the
brachiocephalic artery
The structure labeled number 3 in Figure 2-39 is the
left vertebral artery
In the lateral projection of the foot, the
1. plantar surface should be perpendicular to the IR
2. metatarsals are superimposed
3. talofibular joint should be visualized1 and 2 only
Hysterosalpingography may be performed for demonstration of
1. uterine tubal patency
2. mass lesions in the uterine cavity
3. uterine position1,2, and 3
The number 2 in Figure 2-40 represents which of the following structures?
Inferior articular process
To demonstrate the mandibular body on the PA position, the
CR is directed perpendicular to the IR.
Which of the following equipment is necessary for ERCP?
1. A fluoroscopic unit with imaging device and tilt-table capabilities
2. A fiberoptic endoscope
3. Polyethylene catheters1,2, and 3
All of the following statements regarding pediatric positioning are true except
radiography of pediatric patients with a myelomeningocele defect should be performed in the supine position.
The act of expiration will cause the
1. diaphragm to move inferiorly
2. sternum and ribs to move inferiorly
3. diaphragm to move superiorly2 and 3 only
A patient unable to extend his or her arm is seated at the end of the x-ray table, elbow flexed 90 degrees. The CR is directed 45 degrees medially. Which of the following structures will be demonstrated best?1. radial head
2. capitulum
3. coronoid process1 and 2 only
Which of the following articulate(s) with the bases of the metatarsals?
1. the heads of the first row of phalanges
2. the cuboid
3. the cuneiforms2 and 3 only
Which of the following statements regarding knee x-ray arthrography is (are) true?
1. ligament tears can be demonstrated
2. sterile technique is observed
3. MRI can follow x-ray1,2, and 3
What projection was used to obtain the image seen in Figure 2 -41?
AP, external rotation
The structure labeled number 4 in Figure 2-41 is the
coracoid process
The structure labeled number 5 in Figure 2-41 is the
glenohumeral joint
Which of the following is demonstrated in a 25-degree RPO position with the CR entering 1 inch medial to the elevated ASIS?
left sacroiliac joint
The relationship between the ends of fractures long bones is referred to as
appositon
A lateral projection of the larynx is occasionally required to rule out foreign body, polyps, or tumor. The CR should be directed
to the level of the laryngeal prominence