Anatomy/Positioning

Question 1

TRUE OR FALSE
When MCP joints are under examination and the pt cannot extend the hand enough to place its palmar surface in contact with the IR, the position of the hand can be reversed for an AP projection.

Answer 1

TRUE

Merrills 1 p. 116

Question 2

Which digits should overlap and which digits should be separated on a PA oblique hand projection?

Answer 2

Minimal overlap of 3,4,5 metacarpal shafts
slight overlap of the metacarpal bases and heads
seperation of the 2,3 metacarpals

Question 3

How would you alter the lateral projection of the hand to better demonstrate fractures of the 5th metacarpal?

Answer 3

Rotate the hand 5 degrees posterior from the true lateral

p. 121 Merrill’s 1

Question 4

TRUE OR FALSE
Re : PA projection of wrist
A 30 degree central ray angle towards the elbow will elongate the scaphoid, capitate and lunate.

Answer 4

FALSE
30 degree angle towards the elbow elongates BOTH scaphoid and capitate

p. 124 Merrills 1

Question 5

TRUE OR FALSE
The carpal interspaces are better demonstrated in the AP wrist than the PA wrist.
If false, why?

Answer 5

TRUE

Because of the oblique direction of the interspaces, they are more closely parallel with the divergence of the x-ray beam

p. 125 Merrills 1

Question 6

Which projection best demonstrates the trapezium and distal 1/2 of the scaphoid?

Answer 6

PA oblique of the wrist - lateral rotation

p. 128 Merrills 1

Question 7

Which projection best demonstrates the triquetrium, pisiform and hook of hamate?

Answer 7

AP oblique of the wrist - Medial rotation

p. 129 Merrills 1

Question 8

TRUE OR FALSE
Re : Scaphoid PA axial
The 20 degree angulation of the wrist places the scaphoid at right angles to the central ray so that it is projected without self-superimposition.

Answer 8

TRUE

p. 132 Merrill’s 1

Question 9

TRUE/FALSE

When injury to soft tissue around the elbow is suspected the joit should be flexed only 30 or 35 degrees.

Answer 9

TRUE

p. 145 Merrill’s 1

Question 10

Which projection of the elbow should be performed to best demonstrate the coronoid process?

Answer 10

AP oblique medial rotation

p. 146 Merrill’s 1

Question 11

Which projection would best demonstrate the radial head, allowing the tuberosity free of superimposition?

Answer 11

AP oblique lateral rotation
p. 127
Merrill’s 1

Question 12

TRUE OR FALSE

In the AP humerus projection of the humerus the lesser tubercle is seen in profile.

Answer 12

FALSE
The humeral head and GREATER tubercle is seen in profile
The lesser tubercle is located between the humeral head and the greater tubercle
p. 159 Merrill’s 1

Question 13

TRUE OR FALSE

Which projections would best demonstrate the lesser tubercle in profile?

Answer 13

AP lateral projection of the humerus
p. 160 Merrill's 1
AP shoulder with internal rotation
p. 176 Merrill's 1
Superoinferior p. 187 Merrill's 1
Inferosuperior axial p. 184 Merrill's 1

Question 14

Which projection of the shoulder is useful in the evaluation of suspected shoulder dislocation?

Answer 14

Scapular Y

p. 189 Merrill’s 1

Question 15

TRUE/FALSE
When performing the scapular Y, the position of the arm is not critical because it does not alter the relationship of the humeral head to the glenoid cavity.

Answer 15

TRUE

p. 189 Merrill’s 1

Question 16

Describe the appearance of an anterior and posterior shoulder dislocation in regards to the scapular Y projection

Answer 16

Anterior dislocation : humeral head beneath the coracoid process
Posterior dislocation : humeral head beneath the acromion process

Question 17

Which projection is best to demonstrate the tuberosity of the 5th metatarsal?

Answer 17

Foot - AP oblique projection - medial rotation

p. 261 Merrill’s 1

Question 18

TRUE/FALSE

In the AP projection of the ankle, the talofibular articulation should be open.

Answer 18

FALSE
Will not be open nor shown in profile
This is a positive sign, this will indicate that the patient has no ruptured ligaments or other type of separations
p. 285 Merrill’s 1

Question 19

TRUE OR FALSE

On the lateral projection of the ankle the fifth metatarsal should be seen.

Answer 19

TRUE
This will allow to check for a Jones fracture (# of the 5th metatarsal tuberosity)

p. 286 Merrill’s 1

Question 20

TRUE OR FALSE

In the AP oblique projection (45 degrees) of the ankle the talofibular joint space is in profile.

Answer 20

FALSE
Mortise projection (15-20 degrees) the talofibular joint space is in profile

Question 21

Requisition is questioning “joint mice” loose bodies. Which projection should be performed?

Answer 21

PA axial projection - Intercondylar fossa

p. 314 Merrill’s 1

Question 22

Which 3 bones join together to form the acetabulum?

Answer 22

ilium, pubis, ischium

p. 335 Merrill’s 1

Question 23

TRUE OR FALSE

The ilium, pubis, ischium are separated by cartilage in youth and become fused into one bone in adulthood.

Answer 23

TRUE

p. 335 Merrill’s 1

Question 24

TRUE/FALSE

The male pelvis is normally wide and shallow.

Answer 24

FALSE
the female patient is wide and shallow
the male patient is narrow and deep

• **see differences between male and female pelvis
  p. 340 Merrill’s 1

Question 25

TRUE OR FALSE

The zygapophyseal joints are demonstrated on an AP lumbar spine

Answer 25

False

p.412,420-423 Merrill’s 1

Question 26

TRUE OR FALSE

A PA Lumbar spine further reduces dose compared to AP lumbar spine.

Answer 26

TRUE

p. 424 Merrill’s 1

Question 27

What is the recommended SID for a lumbar spine and why?

Answer 27

48 inces (122 cm) - reduce distortion, more completely opens the intervertebral joint spaces 
p. 425 Merrill's 1

Question 28

Where is the central ray directed for a lumbosaccral exam and for a lumbar exam?

Answer 28

Lumbosaccral : L4

Lumbar : 3.8 cm above iliac crest (L3)

Question 29

Why is the last lumbar joint space (lumbosacral) disk space not well demonstrated in an AP L-spine?

Answer 29

Because of the angle at which the last lumbar segment joins the sacrum
p. 426 Merrill’s 1

Question 30

Where are the pedicles located on a true AP L-spine?

Answer 30

See p. 414 Martensen

Question 31

Where are the lamina located on a true AP L-spine?

Answer 31

see p. 414 Martensen

Question 32

What is the angle of rotation for an esophagus RAO?

Answer 32

35-40 degrees

Question 33

What is the degree of rotation when questioning visualization of the L5-S1 joint for LPO of the L-spine?

Answer 33

60 degrees

Merill’s 1 pg 420

Question 34

What is the degree of rotation to visualize the kidneys, RPO?

Answer 34

30 degrees

Merill’s 2 pg 208

Question 35

Give examples of what is considered part of the “low residue diet”.

Answer 35

clear liquid diet: bouillon, apple juice, gelatin, light coloured tea, lots of water
Low residue diet: white rice, pasta, well cooked veggies, meat/fish, eggs

Question 36

Dr on call asks you to centre at T2-T3 for upper T-spine x-ray. The patient is on a backboard. How would you find proper position for this x-ray?

Answer 36

Jugular notch

Question 37

Which of the following structures is NOT usually demonstrated on a post-op t-tube cholangiogram?

a) right and left hepatic ducts
b) sphincter of Oddi
c) pancreatic duct
d) common bile duct

Answer 37

c) pancreatic duct
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Question 38

The purpose of compression devices during excretory urography is to:

a) restrict involuntary movement
b) obtain filling of the calyces and pelves
c) delineate the ureters and bladder
d) demonstrate hidden calculi

Answer 38

b) obtain filling of the calyces and pelves

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Question 39

What is the name of the method used to catheterize the femoral artery during angiography?

a) direct puncture method
b) Sweet’s technique
c) cutdown method
d) Seldinger method

Answer 39

d) Seldinger

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Question 40

At which level is the suprasternal notch located?

Answer 40

T2-T3

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Question 1

Question 41

Which of the following bones are formed by intramembranous ossification?

a) carpal bones
b) humerus
c) scapula
d) clavicle

Answer 41

d) clavicle

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Question 42

Which of the following arteries branch from the aortic arch?

1. brachiocephalic
2. right common carotid
3. left common carotid
4. right subclavian
5. left subclavian
6. left coronary

Answer 42

1) bradiocephalic
3) left common carotid
5) left subclavian

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Question 25

Question 43

The trachea bifurcates at the level of?

Answer 43

T4-T5

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Question 30

Question 44

The upper part of the oblique fissure of the right lung separates the

a) superior and middle lobes
b) middle and inferior lobes
c) superior lobe and the lingula
d) superior and inferior lobes

Answer 44

d) superior and inferior lobes

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Question 31

Question 45

Where are the adenoids located?

Answer 45

Nasopharynx

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Question 33

Question 46

Where is the esophagus located within the thoracic cavity?

a) in the posterior mediastinum
b) in the middle mediastinum
c) anterior and to the right of the descending aorta
d) posterior and to the right of the descending aorta

Answer 46

a) posterior mediastinum,
c) anterior and to the right of the descending aorta

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Question 37

Question 47

Which of the following parts of the nephron are found in the medulla of the kidney?

a) bowman’s capsule
b) renal pyramids
c) glomerulus
d) loop of Henle

Answer 47

d) loop of Henle
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Question 38