Week 6 Comprehensive Radiology Review

Front 1

Which of the following projections of the calcaneus is obtained with the leg extended, the plantar surface of the foot vertical and perpendicular to the IR, and the central ray directed 40° caudad?
A.
Axial plantodorsal projection
B.
Axial dorsoplantar projection
C.
Lateral projection
D.
Weight-bearing lateral projection

Back 1

B.
Axial dorsoplantar projection

Front 2

When the patient is recumbent and the central ray is directed horizontally, the patient is said to be in the
A.
Trendelenburg position.
B.
Fowler's position.
C.
decubitus position.
D.
Sims' position.

Back 2

C.
decubitus position.

Front 3

Which of the following influences geometric unsharpness?
1. OID
2. Source-object distance
3. SID

Back 3

1, 2, and 3

Front 4

Which of the following is (are) recommended when positioning the patient for a lateral projection of the chest?
1. The patient should be examined upright.
2. The shoulders should be depressed.
3. The shoulders should be rolled forward.

Back 4

1 only

Front 5

To make the 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 to 105°F) to aid in retention.

Back 5

1 and 2 only

Front 6

Cassette front material can be made of which of the following?
1. Carbon fiber
2. Magnesium
3. Lead

Back 6

1 and 2 only

Front 7

Which of the following is most likely to produce a radiograph with a long scale of contrast?
A.
Increased photon energy
B.
Increased screen speed
C.
Increased mAs
D.
Increased SID

Back 7

The answer is A.

EXPLANATION: An increase in photon energy accompanies an increase in kilovoltage. Kilovoltage regulates the penetrability of x-ray photons; it regulates their wavelength—the amount of energy with which they are associated. The higher the related energy of an x-ray beam, the greater its penetrability (kilovoltage and photon energy are directly related; kilovoltage and wavelength are inversely related). Adjustments in kilovoltage have a big impact on radiographic contrast: As kilovoltage (photon energy) is increased, the number of grays increases, thereby producing a longer scale of contrast. In general, as screen speed increases, so does contrast (resulting in a shorter scale of contrast). An increase in mAs is frequently accompanied by an appropriate decrease in kilovoltage, which would also shorten the contrast scale. SID and radiographic contrast are unrelated.

Front 8

To obtain an exact axial projection of the clavicle, place the patient
A.
supine and angle the central ray 30° caudally.
B.
prone and angle the central ray 30° cephalad.
C.
supine and angle the central ray 15° cephalad.
D.
in a lordotic position and direct the central ray at right angles to the coronal plane of the clavicle.

Back 8

The answer is D.

EXPLANATION: The exact axial projection is performed by placing the patient in a lordotic position, leaning against the vertical grid device. This places the clavicle at right angles, or nearly so, to the plane of the IR. The central ray is directed to enter the inferior border of the clavicle, at right angles to its coronal plane. Other axial projections may include a prone position with a 25° to 30° caudal angle. However, none of these produce an exact axial projection of the clavicle.

Front 9

Physical changes characteristic of gerontologic patients usually include
1. loss of bone calcium.
2. loss of hearing.
3. loss of mental alertness.

Back 9

1 only

Front 10

Which of the following positions demonstrates all the paranasal sinuses?
A.
Parietoacanthial
B.
PA axial
C.
Lateral
D.
True PA

Back 10

The answer is C.

EXPLANATION: The parietoacanthial (Waters' method) projection demonstrates the maxillary sinuses. The PA axial with a caudal central ray (Caldwell) demonstrates the frontal and ethmoidal sinus groups. The lateral projection, with the central ray entering 1 inch posterior to the outer canthus, demonstrates all the paranasal sinuses. X-ray examinations of the sinuses should always be performed erect, to demonstrate leveling of any fluid present.

Front 11

Recorded detail is directly related to
1. source-image distance (SID).
2. tube current.
3. focal spot size.

Back 11

1 only

Front 12

Which of the following will result if developer replenishment is inadequate?
A.
Images with excessively high contrast
B.
Images with excessively low contrast
C.
Images with excessively high density
D.
Dry, brittle films

Back 12

B.
Images with excessively low contrast

Front 13

The ARRT Rules of Ethics are

1. aspirational.

2. mandatory.

3. minimally acceptable standards.

Back 13

2 and 3 only

Front 14

All the following are posterior structures except
A.
the linea aspera.
B.
the intertrochanteric line.
C.
the popliteal surface.
D.
the intercondyloid fossa.

Back 14

B.
the intertrochanteric line.

Front 15

Which of the following groups of technical factors will produce the greatest radiographic density?
A.
400 mA, 0.010 second, 94 kVp, 100-speed screens
B.
500 mA, 0.008 second, 94 kVp, 200-speed screens
C.
200 mA, 0.040 second, 94 kVp, 50-speed screens
D.
100 mA, 0.020 second, 80 kVp, 200-speed screens

Back 15

The answer is B.
EXPLANATION: Each mAs is determined (A = 4; B = 4; C = 8; D = 2) and numbered in order of greatest to least density (C = 1; A and B = 2; D = 3). Then the kilovoltages are reviewed and also numbered in order of greatest to least density (A, B, and C = 1; D = 2). Next, screen speeds are numbered from greatest-density-producing to least-density-producing (D and B = 1; A = 2; C = 3). Finally, the numbers assigned to the mAs, kVp, and screen speed are added up for each of the four groups (B = 4; A and C = 5; D = 6); the lowest total (B) indicates the group of factors that will produce the greatest radiographic density. This process is illustrated as follows:
A. 4 mAs (2) + 94 kVp (1) + 100 screens (2) = 5
B. 4 mAs (2) + 94 kVp (1) + 200 screens (1) =4
C. 8 mAs (1) + 94 kVp (1) + 50 screens (3) = 5
D. 2 mAs (3) + 80 kVp (2) + 200 screens (1) = 6

Front 16

The first carpometacarpal joint is formed by the articulation of the base of the first metacarpal and the
A.
distal radius.
B.
distal ulna.
C.
scaphoid.
D.
trapezium.

Back 16

D.
trapezium.

Front 17

The exposure factors used for a particular nongrid radiograph were 400 mA, 0.02 second, and 90 kVp. Another radiograph using an 8:1 grid is requested. Which of the following groups of factors is most appropriate?
A.
400 mA, 0.02 second, 110 kVp
B.
200 mA, 0.08 second, 90 kVp
C.
300 mA, 0.05 second, 100 kVp
D.
400 mA, 0.08 second, 90 kVp

Back 17

The answer is D.
EXPLANATION: The addition of a grid will help clean up the scattered radiation produced by higher kVp, but it requires an mAs adjustment. According to the grid conversion factors listed here, the addition of an 8:1 grid requires that the original mAs be multiplied by a factor of 4:

No grid = 1 x the original mAs

5:1 grid = 2 x the original mAs

6:1 grid = 3 x the original mAs

8:1 grid = 4 x the original mAs

12:1 (or 10:1) grid = 5 x the original mAs

16:1 grid = 6 x the original mAs

The adjustment therefore requires 32 mAs at 90 kVp

Front 18

Arthrography requires the use of
1. general anesthesia.
2. sterile technique.
3. fluoroscopy.

Back 18

2 and 3 only

Front 19

In the parietoorbital projection (Rhese method) of the optic canal, the median sagittal plane and central ray form what angle?
A.
90°
B.
37°
C.
53°
D.
45°

Back 19

B.
37°

Front 20

In radiography of a large abdomen, which of the following is (are) effective way(s) to minimize the amount of scattered radiation reaching the IR?
1. Use of close collimation
2. Use of compression devices
3. Use of a low-ratio grid

Back 20

1 and 2 only

Front 21

In which of the following positions can the sesamoid bones of the foot be demonstrated free of superimposition with the metatarsals or phalanges?
A.
dorsoplantar metatarsals/toes
B.
tangential metatarsals/toes
C.
30° medial oblique foot
D.
30° lateral oblique foot

Back 21

B.
tangential metatarsals/toes

Front 22

Which of the following structures will usually contain air, in the PA position on a sthenic patient, during a double-contrast upper GI (UGI) examination?
A.
Duodenal bulb
B.
Descending duodenum
C.
Pyloric vestibule
D.
Gastric fundus

Back 22

D.
Gastric fundus

Front 23

The AP axial projection, or "frog leg" position, of the femoral neck places the patient in a supine position with the affected thigh
A.
adducted 25° from the horizontal.
B.
abducted 25° from the vertical.
C.
adducted 40° from the horizontal.
D.
abducted 40° from the vertical.

Back 23

D.
abducted 40° from the vertical.

Front 24

All of the following are related to recorded detail except
A.
mA.
B.
focal spot size.
C.
screen speed.
D.
OID.

Back 24

The answer is A.

EXPLANATION: The focal spot size selected will determine the amount of focal spot, or geometric, blur produced in the image. Different screen speeds will create differing degrees of fluorescent light diffusion, affecting recorded detail. OID is responsible for image magnification, and hence recorded detail. The milliamperage is unrelated to recorded detail; it affects only the quantity of x-ray photons produced and thus the radiographic density.

Front 25

Improper spectral matching between rare earth intensifying screens and film emulsion results in
A.
longer-scale contrast.
B.
insufficient density.
C.
decreased recorded detail.
D.
excessive density.

Back 25

B.
insufficient density.

Front 26

Which of the following is (are) method(s) that would enable the radiographer to reduce the exposure time required for a particular radiograph?
1. Use higher mA.
2. Use higher kVp.
3. Use faster film-screen combination.

Back 26

1, 2, and 3

Front 27

Which of the following positions will demonstrate the lumbosacral apophyseal articulation?
A.
AP
B.
Lateral
C.
30° RPO
D.
45° LPO

Back 27

C. 30° RPO
The articular facets (apophyseal joints) of the L5–S1 articulation form a 30° angle with the MSP; they are therefore well demonstrated in a 30° oblique position. The 45° oblique demonstrates the apophyseal joints of L1 through L4.

Front 28

Which of the following combinations will result in the most scattered radiation reaching the image receptor?
A.
Using more mAs and compressing the part
B.
Using more mAs and a higher ratio grid
C.
Using fewer mAs and more kVp
D.
Using more mAs and less kVp

Back 28

C. Using fewer mAs and more kVp
As x-ray photons travel through a part, they either pass all the way through to expose the film/image receptor, or they undergo interaction(s) that may result in their being absorbed by the part or deviated in direction. It is those that change direction (scattered radiation) that undermine the image. With respect to the radiographic image, it is responsible for the scattered radiation that reaches the film/image receptor. Scattered radiation adds unwanted, degrading densities to the radiographic image.

The single most important way to reduce the production of scattered radiation is to collimate. Although collimation, use of lower kVp (with appropriately higher mAs), and compression can be used, a large amount of scattered radiation is still generated within the part being radiographed and, because it adds unwanted noninformation-carrying densities, it can have a severely degrading effect on image quality, thus the need for grids. (

Front 29

To better demonstrate the mandibular rami in the PA position, the
A.
skull is obliqued toward the affected side.
B.
skull is obliqued away from the affected side.
C.
central ray is angled cephalad.
D.
central ray is angled caudad.

Back 29

C.
central ray is angled cephalad.

Front 30

Stomach structures from superior to inferior

Back 30

(A) Fundus

(B) Gastroesophageal junction

(C) Incisure angularis

(D) Pylorus

Front 31

apophyseal articulations of the thoracic spine are demonstrated with the
A.
coronal plane 45° to the IR.
B.
midsagittal plane 45° to the IR.
C.
coronal plane 70° to the IR.
D.
midsagittal plane 70° to the IR.

Back 31

C.
coronal plane 70° to the IR.

Front 32

How is the mAs adjusted in an AEC system as the film–screen speed combination is decreased?
A.
The mAs increases as film–screen speed decreases.
B.
Both the mAs and the kVp increase as film–screen speed decreases.
C.
The mAs decreases as film–screen speed decreases.
D.
The mAs remains unchanged as film–screen speed decreases.

Back 32

D.
The mAs remains unchanged as film–screen speed decreases.

Front 33

The term latitude describes
1. an emulsion's ability to record a range of densities.
2. the degree of error tolerated with given exposure factors.
3. the conversion efficiency of a given intensifying screen.

Back 33

1 and 2 only

Front 34

Base-plus fog is a result of
1. blue-tinted film base.
2. chemical development.
3. the manufacturing process.

Back 34

1. blue-tinted film base.
2. chemical development.
3. the manufacturing process.

Front 35

A shoulder was imaged using 300 mA, 7 ms, 70 kVp, 40-inch SID, 1.2-mm focal spot, and 100 speed screen/film combination. Which of the following changes, made to compensate for changes in optical density, would result in decreased production/visualization of blur?

1. Use of a 0.6-mm focal spot

2. Use of a 50-inch SID

3. Screens with higher intensification factor

Back 35

1 and 2 only
Blur impairs recorded detail. The factors that affect the recorded detail of traditional screen/film imaging are focal-spot size, source-to-image distance (SID), object-to-image distance (OID), film/screen speed, and motion. Recorded detail is improved using a small focal-spot size, largest practical SID, shortest possible OID, and slowest practical screen/film combination and avoiding motion of the part being imaged. Therefore, reducing the focal spot to 0.6 mm and increasing the SID to 50 inches will result in decreased production/visualization of blur and improved recorded detail.

Front 36

Which of the following factors affect(s) both radiographic density and intensifying screen speed?
1. Thickness of phosphor layer
2. Type of phosphors used
3. Thickness of spongy screen support

Back 36

1 and 2 only

Front 37

If the quantity of black metallic silver on a particular radiograph is such that it allows 1% of the illuminator light to pass through the x-ray image, that image has a density of
A.
0.01.
B.
0.1.
C.
1.0.
D.
2.0.

Back 37

2.0.

Front 38

Double-contrast examinations of the stomach or large bowel are performed to better visualize the
A.
position of the organ.
B.
size and shape of the organ.
C.
diverticula.
D.
gastric or bowel mucosa.

Back 38

D.
gastric or bowel mucosa.

Front 39

An increase in kVp will have which of the following effects?
1. More scattered radiation will be produced.
2. The exposure rate will increase.
3. Radiographic contrast will increase.

Back 39

1 and 2 only An increase in kilovoltage (photon energy) will result in a greater number (ie, exposure rate) of scattered photons (Compton interaction). These scattered photons carry no useful information and contribute to radiation fog, thus decreasing radiographic contrast.

Front 40

The clearing agent is found in the
A.
developer.
B.
fixer.
C.
wash.
D.
dryer.

Back 40

B.
fixer.