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Radiology courses > Image Analysis > Flashcards

Image Analysis Flashcards

1
Q

PA Chest Evaluation Criteria

A
  • Proper collimation
  • Entire lung field from apices to costrophrenic angles
  • Manubrium superimposed over T-4
  • 1” of apices over clavicle
  • No rotation
  • Sternal ends of clavicles equidistant from vetebral column
  • Trachea visible in midline
  • Equal distance from the vertebral column to the lateral border of the ribs on each side
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2
Q

PA chest should also have

A
  • Proper shoulder rotation demonstrated by scapulae projected outside of the ribs
  • Proper inspiration
  • Ten posterior ribs
  • Sharp outlines of heart and Diaphragm
  • Faint shadows of the ribs and superior thoracic vertebrae visible through heart shadow
  • Lung markings visible from the hilum to the periphery of the lung
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3
Q

Lateral Chest X-Ray

A

-Proper collimation
Arm or soft tissue not overlapping the superior lung field
-Entire lung field; apices, angles, posterior ribs are included
-Hilum in the approximate center of the radiograph
-Superimposition of the ribs posterior to the vetebral column (<1/2” space)
-Hemidiaphragm inferior to T-11

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4
Q

Lateral chest x-ray should also have

A
  • Lateral sternum with no rotation
  • Long axis of the lung fields shown in vertical position, without forward or backward leaning
  • Open thoracic intervetebral spaces and intervertebral foramina except in patients with scoliosis
  • Penetration of the lung fields and heart
  • Sharp outlines of heart and diaphragm
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5
Q

AP chest with a portable should include

A
  • Thoracic veterbrae, posterior ribs faintly shown through heart shadow
  • Check rotation, make sure SC ends to vetebral column, and the length of L and R posterior ribs are equal
  • Chest is not forshortened
  • Manubrium at T-4
  • 1” of apices above clavicle
  • Mandible not in exposure field
  • Clavicles on same horizontal plane
  • Entire lung field
  • Minimum of 9 posterior ribs above diaphragm
  • Not artifacts
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6
Q

AP/PA lateral decubitus should have

A
  • Proper collimation
  • Affected side in its entirety, from apex to costophrenic angle
  • Not rotation from true frontal position
  • Sternal ends of clavicles equidistant from spine
  • Patients arms not visible in the field of interest
  • Proper identification visible to indicate the decubitus postion
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7
Q

AP axial lordotic should have

A
  • Proper collimation
  • Entire apices and appropriate portion of the lungs
  • Clavicles located superior to the apices
  • Sternal ends of the clavicles equidistant from vertebral column
  • Clavicles lying horizontally with their sternal ends overlapping only the first or second ribs
  • Ribs distorted with their anterior and posterior portions superimposed
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8
Q

Pa oblique projection RAO and LAO positions

A
  • 45 degree PA oblique angle
  • Trachea should be seen going into lungs
  • Heart and mediastinum on elevated side
  • SC joints should be free of spine
  • If you do a 60 degree angle you will see the heart more
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9
Q

A PA chest projection (lateral decubitus position) demonstrates

A

The manubrium superimposed over the fourth vertebral body.

A closed C6-C7 intervertebral disk space.

Clearly shown C6-C7 spinous processes and laminae.

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10
Q

A left lateral chest projection with poor positioning demonstrates the humeri soft tissue superimposed over the anterior lung apices. How was the patient positioned for such an image to be obtained?

A

The humeri were positioned at a 90-degree angle with the body.

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11
Q

For an AP axial chest projection (lordotic position)

A

The shoulders are positioned at equal distances from the IR.

The patient’s back is arched until the midcoronal plane and IR form a 45-degree angle.

The elbows and shoulders are rotated anteriorly.

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12
Q

A mobile AP chest projection obtained with the central ray angled caudally demonstrates

A

Vertically contoured ribs.

Vertical clavicles.

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13
Q

A PA chest projection with accurate positioning demonstrates

A

10 or 11 posterior ribs above the diaphragm.

Equal posterior rib length on both sides of the chest.

The manubrium superimposed by the fourth thoracic vertebra.

The scapulae outside the lung field.

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14
Q

Air-fluid levels on an AP chest projection

A

Are formed when air and fluid separate.

Are precisely demonstrated when the central ray is horizontal.

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15
Q

An AP-PA chest projection (lateral decubitus position) with accurate positioning demonstrates

A

Equal posterior rib length on both sides of the chest.

Nine or ten posterior ribs above the diaphragm.

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16
Q

Which positioning problem(s) listed result(s) in an AP-PA chest projection (lateral decubitus position) with the manubrium and the fifth thoracic vertebra located at the same level?

A

An AP projection obtained with the upper midcoronal plane tilted away from the IR

A PA projection obtained with the upper midcoronal plane tilted toward the IR

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17
Q

A left lateral chest projection obtained with the patient’s left side rotated anteriorly demonstrates the

A

Anterior and posterior ribs with more than 0.5 inch (1 cm) of superimposition.

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18
Q

A PA chest projection with poor positioning demonstrates the scapulae in the lung field and elevated lateral clavicular ends. How should the patient be repositioned for an optimal projection to be obtained?

A

Depress the shoulders.

Anteriorly rotate the shoulders and elbows.

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19
Q

An AP axial chest projection (lordotic position) with poor positioning demonstrates the clavicles within the lung apices. How should the positioning setup be adjusted for an optimal image to be obtained?

A

Increase the degree of cephalic central ray angulation.

Arch the patient’s back more, increasing the midcoronal plane to IR angle.

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20
Q

The IR is positioned ____ for a PA chest projection of a hypersthenic patient.

A

Crosswise

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21
Q

For a PA oblique chest projection

A

There is twice as much lung field demonstrated on one side of the vertebral column as on the opposite side.

10 or 11 posterior ribs are demonstrated above the hemidiaphragm.

The apices, costophrenic angles, and lateral chest walls are included on the image.

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22
Q

A PA chest projection with poor positioning demonstrates vertical clavicles and the manubrium at the same level as the fifth thoracic vertebra. How was the patient positioned for such an image to be obtained?

A

The patient’s upper midcoronal plane was tilted toward the IR.

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23
Q

Which side of the patient is positioned on the imaging table for an AP-PA chest projection (lateral decubitus position) to rule out a right side pneumothorax?

A

Left

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24
Q

The last rib is attached to the ____ vertebra.

A

Twelfth

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25
Q

On inhalation, the lungs expand

A

Vertically

Transversely

Anteroposteriorly

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26
Q

An AP chest projection (lateral decubitus position) obtained with the patient in an RPO position demonstrates

A

The right SC joint without vertebral column superimposition.

9 or 10 posterior ribs above the diaphragm.

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27
Q

For a PA chest projection with accurate positioning, the

A

SID is set at 72 inches (183 cm).

Shoulders are positioned at equal distances from the IR.

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28
Q

For a left lateral chest projection with accurate positioning, the

A

Humeri are positioned vertically.

Shoulders, posterior ribs, and posterior pelvic wings are aligned perpendicular to the image receptor (IR).

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29
Q

Which of the following pertains to a lateral chest projection with accurate positioning that was obtained with the right side positioned adjacent to the IR?

A

The heart shadow demonstrates increased magnification over a left lateral projection.

The left hemidiaphragm is demonstrated inferior to the right hemidiaphragm.

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30
Q

Heart penetration on an AP chest projection

A

Is obtained by increasing the kVp.

Results in a lower contrast image.

Is required when apparatuses located at the mediastinal region are of interest.

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31
Q

Which side of the patient is positioned on the imaging table for an AP-PA chest projection (lateral decubitus position) to rule out a left side pleural effusion?

A

Left

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32
Q

An AP axial chest projection (lordotic position) with accurate positioning demonstrates

A

The medial ends of the clavicles projected superior to the lung apices.

Equal distances from the vertebral column to the SC joints.

Almost horizontal posterior and anterior portions of the first through fourth ribs.

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33
Q

A supine AP abdomen projection with accurate positioning demonstrates the

A

Outline of the psoas muscles and kidneys

Symphysis pubis

Spinous process aligned with the midline of the vertebral bodies

Long axis of the vertebral column aligned with the long axis of the collimated field.

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34
Q

How should the technique be adjusted from the routine for an AP abdomen projection (lateral decubitus position) in a patient with ascites or a bowel obstruction

A

Increase the mAs 30-50%

Increase the kVp 5-8%

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35
Q

How should the technique be adjusted from the routine for an AP abdomen projection in a patient who has a large amount of bowel gas

A

Decrease the mAs 30-50%

Decrease the kVp 5-8%

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36
Q

For an upright AP abdomen projection, the

A

ASIS’s are positioned at equal distances from the IR

Patient remains in an upright position at least 5 to 20 minutes before the image is obtained.

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37
Q

An AP abdomen projection demonstrates greater distances from the left lumbar vertebral pedicle to the spinous process than the right pedicles to the spinous process. How was the projection taken

A

The patient was in the LPO position

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38
Q

Voluntary motion can

A

Result from a patient breathing

Be controlled by using a short exposure time.

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39
Q

To best demonstrate intraperitoneal air

A

Allow the patient to be positioned upright for 5 to 20 minutes before obtaining the exposure for an AP abdomen projection.

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40
Q

To reposition a decubitus abdomen projection that demonstrates longer right posterior ribs and a wider right iliac wing

A

Rotate the right side of the patient away from the IR

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41
Q

A supine AP abdomen projection obtained with the patient in an LPO position demonstrates

A

A distance from the pedicles to the spinous processes that is narrower on the right side than on the left side.

The sacrum rotated toward the patient’s right side.

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42
Q

Optimal contrast, density, and penetration have been achieved on AP abdominal projections when which anatomic structures are demonstrated.

A

Psoas major muscles, kidneys, inferior ribs, and lumbar transverse processes.

43
Q

For an AP abdominal projection (lateral decubitus position) you need these things

A

The right hemidiaphragm and iliac wing must be included to demonstrate intraperitoneal air

Position the shoulders and the ASIS’s at equal distances from the IR

Obtain the exposure on expiration

44
Q

Which of the technical factors should be chosen when 20 mAs is desired and the patient being imaged has difficulty remaining still

A

400 mA at 0.05 sec. This is the lowest exposure time

45
Q

Which side of the arm is positioned against the IR for the lateral second finger projection

A

Radial

46
Q

A lateral finger projection obtained with the finger in a 45 degree PA oblique projection demonstrates

A

More midshaft concavity on one side of the phalanges than on the opposite side

Twice as much soft tissue on one side of the phalanges as on the opposite side

47
Q

A right lateral fourth finger projection obtained with the hand internally rotated to 20 degrees demonstrates

A

Greater phalangeal midshaft concavity on the side facing the third finger

48
Q

What is the projection for the PA oblique finger

A

Phalanges demonstrate more concavity on one side than on the other

49
Q

A lateral hand projection obtained with the hand in slight external rotation demonstrates the

A

Shortest of the second through fourth metacarpals anteriorly situated

Radius posterior to the ulna

Second metacarpal posterior to the other metacarpals

50
Q

The IP joint spaces on finger projections are open and demonstrated without distortion when

A

Central ray is aligned parallel with the IP joint spaces

IP joints are aligned perpendicular to the IR

51
Q

A PA hand projection obtained with the hand flexed demonstrates

A

Foreshortened phalanges

The thumb is a lateral projection

Closed IP joint spaces

Foreshortened metacarpals

52
Q

What is the projection for the lateral finger

A

Phalanges demonstrate concavity on one side and convexity on the other

53
Q

What is the projection for the PA finger

A

Phalanges demonstrate equal concavity

54
Q

A less than optimal lateral hand projection demonstrating the longest of the second through fifth metacarpal midshafts situated anterior to the others

A

Was obtained with the hand internally rotated

55
Q

Which side of the arm is positioned against the IR for the lateral fourth finger projection

A

Ulnar

56
Q

A PA wrist projection with accurate positioning demonstrates

A

An open radioulnar articulation

The radial styloid in profile

The long axes of the third metacarpal aligned with the mid forearm

Open second through fifth MC joint spaces

57
Q

A lateral wrist projection obtained with the elbow flexed 90 degrees and the humerus placed parallel with the IR demonstrates

A

Superimposition of the radius and ulna

Trapezium without superimposition of the first proximal metacarpal

The ulnar styloid in profile

58
Q

A PA oblique wrist projection with poor positioning demonstrates an obscured trapezoidal joint space and superimposition of the 4th and 5th metacarpal shafts. How should the positioning setup be adjusted for an optimal image to be obtained

A

Internally rotate the wrist

59
Q

A PA wrist projection obtained with the wrist in a neutral position demonstrates

A

Radial styloid in profile laterally

Open radioulnar articulation

Alignment of the long axis of the third metacarpal and radius

60
Q

The trapezium is demonstrated without superimposition of other anatomy on a lateral wrist projection when the patient

A

Depresses the distal first metacarpal

61
Q

An externally rotated PA oblique wrist projection with accurate positioning demonstrates

A

The trapezoidand trapezium without superimposition

The ulnar styloid in profile

Small separation between the 4th and 5th metacarpal midshafts

62
Q

A poorly positioned PA oblique wrist projection demonstrates superimposition of the trapezoid and trapezium. How should the positioning setup be adjusted to obtain an optimal projection

A

Decrease the degree of medial rotation

63
Q

A tangential, inferosuperior carpal canal wrist projection with poor positioning demonstrates superimposition of the pisiform and hamulus of the hamate. How should the positioning setup be adjusted for an optimal image to be obtained?

A

Internally rotate the hand towards the radius

64
Q

A PA axial, ulnar deviated wrist projection with poor positioning demonstrates a closed scaphocapitate joint and an open hamate-capitate joint. How should the positioning setup be adjusted for an optimal image to be obtained?

A

Decrease the degree of external wrist rotation

65
Q

A less than optimal lateral wrist projection demonstrating the distal scaphoid anterior to the pisiform

A

Was obtained with the wrist internally rotated

66
Q

For a carpal canal wrist image, the

A

Wrist is hyperextended until the long axis of the metacarpals are vertical

Hand is rotated 10 degrees internally until the fifth metacarpal is perpendicular to the IR

Central ray is angled 25 to 30 degrees proximally

Central ray is centered to the palm of the hand

67
Q

A PA wrist projection obtained in slight external rotation demonstrates

A

A closed radioulnar articulation

Too much superimposition of proximal metacarpals

68
Q

A lateral wrist projection obtained with the wrist in slight internal rotation demonstrates the

A

Radius anterior to the ulna

69
Q

A less than optimal PA wrist projection demonstrates the second through fourth metacarpals superimposing the CM joint spaces. What is true about the projection

A

The hand was over flexed

70
Q

An optimally positioned PA wrist projection demonstrates all of the following

A

Alignment of the long axis of the third metacarpal and mid-forearm

Open second through fifth MC joint spaces

An open radioulnar articulation

71
Q

A lateral forearm projection obtained in a patient with the proximal humerus elevated and the wrist internally rotated demonstrates the

A

Radial head posterior to the coronoid process

Distal radius anterior to the ulna

72
Q

An AP forearm projection with accurate positioning demonstrates the

A

Radial styloid in profile laterally

Radial tuberosity in profile medially

Humeral epicondyles in profile

73
Q

Which of the following projections is used to prevent the crossing of the forearm bones?

A

AP projection

74
Q

An IR that is large enough to extend at least 2 inches beyond the elbow and wrist joints for a forearm projection is

A

Needed in order to record the elbow and wrist on the image

75
Q

The olecranon process is situated directly in the fossa for an AP forearm (T/F)

A

True

76
Q

A lateral forearm projecion with accurate positioning demonstrates

A

Superimposition of the distal radius and ulna

The ulnar styloid in profile

An open elbow joint space

77
Q

To take advantage of the anode heel effect when imaging a forearm

A

The wrist is positioned at the anode of the x-ray tube

78
Q

Only one joint needs to be included on the lateral forearm if both joints are included on the AP forearm (T/F)

A

False

79
Q

The radial tuberosity is demonstrated in profile on a lateral forearm projection (T/F)

A

False

80
Q

An AP forearm projection obtained with the wrist and elbow in lateral rotation demonstrates

A

Superimposed fourth and fifth metacarpal bases

The proximal radius and ulna without superimposition.

81
Q

A less than optimal lateral elbow projection demonstrating the radial head positioned posterior to the coronoid process

A

Will demonstrate the capitulum distal to the trochlea

82
Q

An internally rotated AP oblique elbow projection with accurate positioning demonstrates which of the following structures in profile

A

Coronoid Process

83
Q

An optimal internally rotated AP oblique elbow projection will demonstrate all of the following

A

Trochlea-coronoid process articulation as an open space

Radial head and neck superimposing the ulna

Coronoid process in profile

84
Q

A less than optimal lateral elbow projection demonstrating the radial head distal to the coronoid process will

A

Be obtained when the distal forearm is depressed

85
Q

Which of the statements is true as demonstrated on a lateral elbow projection

A

When the wrist is in a lateral projection, the radial tuberosity is superimposed by the radius

86
Q

A lateral elbow projection obtained with the distal forearm positioned too low and the proximal humerus positioned too high demonstrates the

A

Radial head distal and posterior to the coronoid process

The Capitulum anterior and distal to the medial trochlea

87
Q

An AP elbow projection obtained with the elbow internally rotated demonstrates

A

An open capitulum-radial joint space

More than 1/8th or radial head and ulnar superimposition

88
Q

For an externally rotated AP oblique elbow projection with accurate positioning, the

A

Capitulum is in profile

Capitulum-radial joint space is open

Ulna is demonstrated without radial head superimposition

89
Q

An AP elbow projection with accurate positioning demonstrates

A

The medial and lateral humeral epicondyles in profile

The radial tuberosity in profile medially

An open capitulum-radial joint

90
Q

An optimal AP elbow projection is obtained when

A

1/8th of the radial head superimposes the lateral aspect of the proximal ulna

91
Q

A less than optimal AP elbow projection demonstrating the ulna without radial head superimposition

A

Was obtained with the elbow in external rotation

92
Q

A lateral elbow projection with accurate positioning demonstrates

A

An open elbow joint space

The radius superimposing the radial tuberosity

The anterior fat pad

93
Q

A less than optimal lateral elbow projection demonstrating the radial head too far anterior to the coronoid process will

A

Be obtained when the proximal humerus is depressed

94
Q

A less than optimal lateral elbow projection demonstrating the radial head proximal to the coronoid process will

A

Be obtained when the distal forearm is elevated

95
Q

A lateral elbow projection demonstrates the radial head situated anterior and proximal to the coronoid process. How was the patient positioned for such an image to be obtained

A

The distal forearm was too high

The proximal humerus was too low

96
Q

To properly position a lateral humerus, place the shoulder (humeral head) at the ____end of the tube

A

Cathode

97
Q

An AP projection of the distal humerus has been obtained when this much of the radial head superimposes the ulna

A

1/4” Image analysis book says 1/8th, and about 1/4th, so who knows

98
Q

For a lateral projection of the humerus, which tubercle is demonstrated in profile medially

A

Lesser tubercle

99
Q

On an AP humerus projection, which tubercle is demonstrated in profile laterally

A

Greater tubercle

100
Q

On a lateral projection of the humerus, ____and ____ are superimposed.

A

Greater tubercle

Humeral head

101
Q

For a lateral humerus, the anterior surface of the capitulum and trochlea are nearly aligned (T/F)

A

True

102
Q

The joint farthest from the fracture should be demonstrated in true AP projection (T/F)

A

False

103
Q

To properly position an AP humerus, align the humeral condyles_____with the IR

A

Parallel

104
Q

To properly position an AP humerus, place the elbow at the _____end of the tube

A

Anode

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