Chapter-12 Extraoral Radiographs and Other Specialized Imaging TechniquesBOOK TITLE: Essentials of Oral & Maxillofacial Radiology Show Author 1. Karjodkar Freny R ISBN 9789351522294 DOI 10.5005/jp/books/12300_12 Edition 1/e Publishing Year 2014 Pages 32 Author Affiliations 1. Nair Hospital Dental College, Mumbai, Maharashtra, India Chapter keywords Landmarks, Caldwell Projection, PA Water’s, PA Mandible, Rotated PA Mandible, Lateral Oblique, Anterior Body, Posterior Body, Ramus of Mandible, Submento-Vertex Projection, Jughandle View, Transcranial Projection, Transpharyngeal Projection, Transorbital Projection, Reverse Towne’s Projection, Lateral Cephalogram, True Lateral, PA Cephalogram, PA Skull, Towne’s Projection, Nuclear Medicine, Radio Isotope, Tomography, Denta Scan, Contrast Media 1 In the shoulder diagram to the right, the letter "X" is located next to which scapular border? D. Medial border -The scapula has three borders, superior, lateral (axillary), and medial (vertebral)
2 The red arrow is pointing to which part of the femur? D. Medial condyle -Remember, the head of the femur is medial and fits into the acetabulum. Therefore, the red arrow is pointing toward 3 Which of the following could be considered a reservoir for infection? D. 1, 2 & 3 4 While imaging a patient with chest tube drainage, which of the following actions must be taken? B. Keep drainage tube below chest -When a patient has chest tube drainage it is imperative that the tubing be kept below the level of the chest. This way the material being 5 The brightness of a digital image affects which of the following? B. Visibility of detail -The image must be a certain brightness to make the details visible. A digital image can be too light or too dark. 6 What separates the head of the humerus from the body (shaft) of the humerus? A. Anatomical neck -Directly below the head of the humerus is a narrowed area called the anatomical neck 7 Where would the CR enter for a cross-table (horizontal beam) lateral on a patient with a suspected hip fracture? D. Femoral neck 8 Oxygenated blood returns from the lungs,
through the pulmonary veins, to which chamber of the heart? B. Left atrium -The blood then passes through the mitral valve, into the left ventricle and then out the aortic valve into the ascending aorta 9 What position is the patient's right arm in when radiographing the upper right posterior ribs in the RPO position? C. Abducted and elevated -This brings the right scapula away from the rib cage 10 Which of the following exposure indicator optimal value ranges is/are correct? D. 1,
2 & 3 11 Which of the following sequences of examinations is correct? C. Gallbladder Sonography, Barium Enema, Upper GI -The gallbladder sonography and nuclear medicine scans need to be done before any barium is placed in the body. Then the B.E., because that barium won't interfere with the UGI the following day. 12 How many half value layers (HVL) are required to reduce an x-ray beam from 10 mR/mAs to 5 mR/mAs? A. 1 -A half value layer is the amount of material that will reduce the intensity of an x-ray beam in half. Therefore, 1 HVL will reduce 10 mR to 5mR. 13 Long bone measurements are taken radiographically for which of the following reasons? B. Length differences between two sides -A special metal ruler is used to measure the length of long bones on patients who have different bone lengths 14 Which
of the following will cause a loss in spatial resolution? C. Motion -Motion can cause a loss of spatial resolution because the area of interest will be blurred. 15 According to the Code of Federal Regulations Title 21 (21 CFR) for fluoroscopic equipment manufactured after June 10, 2006, the AKR nor the cumulative air kerma shall not deviate from the actual values by more
than _______ percent. C. 35 -Compliance shall be determined over the range of 6 mGy/min and 100 mGy to the maximum indication of AKR and cumulative air kerma. 16 During a barium enema, if the patient is supine, the CR angled 30-40 degrees cephalad, 2" inferior to the level of the ASIS and to the midsagittal plane, what anatomy is best demonstrated? C. Rectosigmoid -This is known as an AP axial projection. The rectosigmoid segment of the large intestine may also be demonstrated with a PA axial 17 Which of the following types of primary radiation CANNOT be produced at tube potentials of less than 70 keV? D. Characteristic -Primary radiation is produced with either bremsstrahlung or characteristic interactions. It takes at least 70 keV to remove the K-shell electron to produce characteristic radiation. 18 A patient with known salmonella pathogens has an "accident" on your x-ray table. What should you do with the contaminated sheets and pillow case? A. Place them with the other dirty linen as usual -All linen is considered contaminated, so this case is no different than all cases. The linen is placed in a water proof hamper and handled 19 What post-examination instructions should be given to a patient following a
myelogram? D. Elevate head 30 degrees for six hours 20 As an x-ray beam passes through a material its intensity is reduced. What is this called? D. Attenuation 21 According to the Code of Federal Regulations Title 21 (21 CFR), fluoroscopic equipment manufactured after June 10, 2006 must meet which of the following standards? D. All of the above 22 Which of the
following describes the x-ray beam after it has passed through the patient? A. Remnant (exit) -Remnant means remaining. Remnant (exit) radiation is what is remaining in the beam after it has passed through the patient 23 A scoliosis series involves PA projections of which of the following areas? B. Thoracic and lumbar spines -The thoracic and lumbar vertebrae must be shown along with 1 - 2 inches of the iliac crest 24 Accurate centering of the central ray is critical for which type of grid? C. Focused -Off-center grid cut-off is more likely with a focused grid 25 Which of the
following is the major source of exposure to the radiographer? B. Scatter x rays Scatter radiation from the patient produces the greatest risk to the radiographer, but "backscatter" from the floor and walls, and leakage radiation cannot be ignored. The radiographer should never be in the path of the primary beam. 26 Which of the following technical
factors will cause receptor exposure to decrease when it is increased? C. SID -According to the inverse square law, intensity of the x-ray beam decreases when distance increases. 27 The quality assurance test at the right helps determine which of the
following? D. Beam alignment 28 Which of the following is a postprocessing option to increase the contrast along the borders of a digital image? B. Edge enhancement -Edge enhancement improves the visibility of details. 29 When using anatomically programmed technique (APT) with a digital system and an average size patient, the radiographer changes the density control to -2. Which of the following would result? D. 2 & 3 only 30 When the x-ray beam is traveling in an anterior to posterior direction through a patient, with the image receptor touching his back, which of the D. 1 & 3 only 31 Medical asepsis is defined as the _______ of pathogens in the environment? C. reduction in the number -Medical asepsis is reducing the number of pathogens by washing and cleaning objects that come in contact with patients. 32 For an AP projection of the sacroilliac joints, the central ray enters on the midsagital plane at what angle? D. 30 to 35 degrees cephalad 33 What is the name of the largest blood vessel in the abdomen? C. Aorta -The aorta leaves the heart and is referred to as the thoracic aorta above the diaphragm and the abdominal aorta below the diaphragm. 34 Which of the
following primary beam sizes would produce the greatest radiation exposure to the patient? D. 14 x 17 35 Which of the following oxygen delivery systems would indicate the patient needs a high rate of oxygen supply? C. Nonrebreathing mask -This high flow system has a reservoir bag attached and prevents rebreathing exhaled air 36 Which of the following would describe a hemiplegic? C. Paralyzed on one side -Hemiplegia indicates paralysis (-plegia) of half (hemi-) of the body, in this case, one side. 37 If the mAs is 40 and the time is .1 second, the mA setting must be what? D. 400 mA 38 During fluoroscopy, where is an acceptable position for the
radiographer to stand? C. In the room, as far from the patient as practical -The patient is the primary source of radiation exposure to the radiographer. Take a step back away from the fluoroscopy unit whenever possible. 39 The American Heart Association's guidelines for CPR
recommends which of the following sequences? B. Compressions, airway, breathing -By changing the sequence from ABC to CAB, compressions will be initiated sooner and starting with compressions may encourage more bystanders to begin CPR. 40 In digital imaging, even though mAs is the
controlling factor for receptor exposure, what advantage does the kVp 15% rule have in the adjustment D. 1, 2 & 3 41 Cystography is a radiographic examination of which anatomical part? A. Bladder -Cystography is done by injecting contrast media through a urethral catheter into the urinary bladder 42 Which of the following is necessary for a true lateral
position of the forearm? D. 1, 2 & 3 43 If an unattended patient is injured by falling off the x-ray table, why could the radiographer be sued? D. Negligence 44 How long should a patient remain in the upright or lateral decubitus position before an exposure is made to
demonstrate free air in the C. 5 minutes -5 minutes is the recommended time to leave a patient in the upright or lateral decubitus position so the free air and fluid have time to move 45 Which manufacturer refers to its exposure indicator as a log median number? A. Agfa -Agfa uses a logarithmic number to indicate its imaging plate exposure. 46 Which of the following anatomical areas should be covered with protective shielding when they are in or near a properly collimated beam? D. 1, 2 & 3 47 An AP axial sacrum requires the patient to be supine, the CR angled 15-25 degrees cephalad, and entering a point: B. 2" superior to the symphysis pubis. -The CR is angled 15-25 degrees cephalad to enter at a point 2" superior to the symphysis pubis 48 Which of the following combinations will reduce patient exposure the most? C. Increase kVp and decrease mAs -By increasing kVp and decreasing mAs, the amount of radiation can be reduced while maintaining radiographic brightness 49 First-stage entrance-shutters of a variable-aperture collimator are designed to reduce which of the following? D. Off-focus radiation 50 Bone marrow is the largest producer of blood cells in the human body. Which of the following bone types contain the most bone marrow? A. Flat bones -The pelvis, skull, ribs, and sacrum are flat bones that contain blood producing marrow and should be avoided or shielded when imaging a patient if possible. 51 Which of
the following is/are necessary for a patient with contact precautions? D. 1, 2 & 3 52 Which of the following is a recumbent position in which the patient's head is higher than his/her feet? D. Fowler's 53 What caused the artifact that is demonstrated on this radiograph? B. Double exposure -This is a common mistake while doing several mobile chest radiographs. The radiographer forgot which cassette had already been exposed and created this double exposure. 54 How are the electrons focused toward the anode of a typical x-ray tube during an exposure? D. Focusing cup 55 Which of the following terms describes the intensity of the x-ray beam? B. Quantity -Intensity is the number of x rays per area. Quantity refers to the number of x rays 56 What is a major benefit of a fixed kVp technique chart? C. Consistent radiographic contrast -A fixed kVp chart has the kVp set higher than necessary, which produces a more consistent long scale of contrast. 57 Which of the following can be used to clean the outside of a CR cassette? D. All of the above 58 How does the SNR (signal to noise ratio) affect the quality of a digital image? D. The higher the SNR the better the quality of the image 59 In the
radiograph to the right, the red arrow is pointing to which of the following anatomical parts? A. Medial malleolus -The medial malleolus is at the distal end of the tibia and helps form the ankle joint 60 From a radiograph, how does one tell if a PA axial (Caldwell) projection of the skull was correctly positioned? D. The petrous ridges are projected into the lower 1/3 of the orbits 61 Which of the
following is NOT necessary for the production of x rays? C. Magnetic field -Whenever high speed electrons are suddenly stopped or change direction, some or all of their kinetic energy is given up in the form of 62 f a dynamic recording of a fluoroscopic image is required, how many frames per second
must be recorded? C. 30 -In order to perceive a dynamic image, at least 30 frames per second must be recorded. The new flat panel detectors used for digital fluoroscopy can record 30 fps. 63 A lead apron is designed to protect the
radiographer from scatter radiation. A protective apron must have a lead equivalency of at least: B. .50 mm. -The NCRP changed their recommendation from .25 mm Pb to .50 mm Pb equivalent for lead aprons. Lead gloves changed from .50 mm Pb to .25 mm Pb. 64 Which of the following must be taken into consideration when determining the thickness of a protective barrier? D. All of the above 65 While doing an erect abdomen image, the patient warns you that he/she is about to faint. What should be your first reaction? D. Carefully lower the patient to the floor and have him/her lie down 66 Which of the following would NOT be considered ambient light in a radiologist's reading room? A. Light from the display monitor -Light from the display monitor is referred to as luminance 67 Which of the following are considered ways of assessing a patient's
condition? D. 1, 2 & 3 68 Which of the following must be done
when checking a patient for radiopaque objects? D. 1, 2 & 3 69 Which of the
following prefixes means "below"? C. Infra -"infra" is the prefix that means "below", as used in the term "inframammary" (below the breast). 70 Edema describes which of the following conditions? B. Swelling -Edema is an accumulation of fluid in tissues and is commonly seen in patients with a sprained ankle 71 What position/projection is demonstrated on this radiograph? B. Right lateral -The lateral vertebrae help to identify this as a right lateral stomach 72 When a patient is being registered, that person's information is being typed into which of the following? A. HIS -When a patient is registered, that information is put into the hospital information system (HIS). The radiology information system (RIS) and other hospital intranets then have access to that information. 73 Which of the following must be done to
correct a saturated digital image? D. The image must be repeated. 74 Which of the following is an appropriate way to make sure you have the correct patient and are doing the correct procedure? C. Check wrist band and ask the patient for his/her date of birth -Checking the wrist band and asking for date of birth are the two accepted means of assuring you have the correct patient. 75 Which of the following people have the authority to restrain a patient? D. Patient's physician 76 If ureteral reflux is suspected during cystography, which of the following radiographs is necessary? C. Voiding -Ureteral reflux is the backward flow of urine up the ureter during urination. 77 What is the proper way to move a heavy object? A. Push it -Trying to lift or pull a heavy object puts undue stress on your shoulders and lower back. Pushing allows you to get your weight behind the object.
78 Which of the following structures should be filled with air for a soft tissue neck radiograph? D. 1, 2 & 3 79 When should a grid be used? D. 1, 2 & 3 80 How would a crack in an imaging plate appear in a digital image? A. White -If there is a crack in the imaging plate, no light would be produced in that area. Therefore, the pixel value would be 0, so it would appear white. 81 What criteria should be used to make sure a lateral position of the wrist is of optimum quality? A. The ulnar head and radius should be superimposed -In order to get a true lateral of the wrist, the patient's arm and forearm must be resting on the table, the elbow flexed 90 degrees and the ulnar head and radius superimposed. 82 You and a co-worker are on the weekend shift. It is a busy department for a small hospital and it demands a great deal of effort from both of you. Your co-worker frequently leaves the department to
deal with his personal problems. You do not know much about the circumstances, nor have you known him for long. Some days your co-worker helps very little, and, as a result, you are putting in an excessive amount of overtime to get the patients done. You feel that your health may begin to suffer because of the stress and the overtime. Which of the following is the appropriate response? A. Raise the issue with your department manager. Explain that the patients are not being done in a reasonable time because -It is your manager's job to solve this problem. Overworking yourself or lying to your manager is not the solution. 83 Which of the following will cause magnification? D. Increased OID 84 The capitullum of the humerus articulates with which of the following anatomical structures? B. Head of the radius -A good way to remember this is that a cap fits on your head. The capitullum articulates with the head of the radius! 85 What is an imaging contrast agent called that absorbs more x rays than the surrounding tissue? C. Positive contrast agent -A positive contrast agent has a high atomic number, either barium sulphate or iodine 86 Which of the following will reduce patient exposure during fluoroscopy? A. 1 & 2 only -Newer digital, fluoroscopic units use a pulsed beam instead of a continuous beam to produce the images, reducing patient exposure. A radiologist can use an intermittent beam instead of a continuous beam to reduce patient exposure. 87 What is the name of the spongy pad that lies between the vertebrae? B. Intervertebral disk -Intervertebral disks are found between the bodies of the vertebrae. They act as shock absorbers 88 Inspiration and expiration PA projections of the chest may be used to demonstrate which of the following? B. Pneumothorax -Other indications for inspiration and expiration views of the chest are foreign body localization, diaphragm movement or to distinguish between an opacity in the rib or lung. 89 Which of the following positions would be best when
radiographing the sternum of a trauma patient? A. LPO -Even though the sternum is further from the image receptor in this position, it is easier on the patient and reduces the risk of further injury 90 When should the timing for a small bowel series begin? B. When the patient swallows the barium -Since fluoroscopy time varies with patients and radiologists, to maintain consistency, the timing of a small bowel series should begin when the patient first swallows the barium 91 If you were alone with a patient that you felt was going into cardiogenic shock, which of the following should you do while you are waiting for help A. Put a blanket on the patient and elevate his feet -Shock is a result of poor blood supply to the vital organs. If you feel your patient may be going into shock because he is restless, has a rapid heart rate, lacks color, and has cold, clammy skin. Your first response is to call for help. Then you should cover him, elevate his feet and reassure him that help is coming soon. 92 Which of the following postprocessing techniques could be used while evaluating a digital image for central line placement within the D. Invert the image 93 When a residual latent image appears on a subsequent CR digital image it is known as what? C. Ghost image -A ghost image can be caused by overexposing the original image or by inadequate erasing of the original imaging plate 94 A sampling frequency of 5 pixels per millimeter would
produce how much spatial resolution? A. 2.5 line pairs per millimeter -It takes 2 pixels to make a line pair, therefore, 5 pixels would produce 2.5 line pairs per millimeter. 95 In the image to the right, the red arrow is pointing to which of the following anatomical parts? D. Coracoid process 96 Which of the following positions/projections will produce the least exposure to the thyroid gland during a cervical spine
radiographic series? B. PA -A PA projection of the cervical spine will cause the lower energy x-rays to be absorbed before they ever reach the thyroid gland. 97 Which of the following can be detrimental to viewing digital images on a monitor? C. Ambient light -Ambient light refers to the overall illumination of a room. It consists of natural light, fluorescent lights and lamps. Ambient light is reflected off the monitor and can reduce the contrast of an image. 98 What is the function of the National Council on Radiation Protection and Measurement (NCRP)? A. Set standards for using radiation -The National Council on Radiation Protection and Measurements (NCRP) sets standards for the measurement of and the protection from 99 Which of the following will result in an underexposed radiograph while using automatic exposure control (AEC)? A. Insufficient backup time set -When the backup time is reached, it will terminate the exposure even though the AEC would require more x rays to terminate the exposure 100 Which of the following will put the humerus in a true AP projection? D. AP external rotation 101 Which of the following can be done to reduce the patient's skin dose during prolonged fluoroscopic examinations? D. All of the above 102 Which of the following positions/projections will best demonstrate the coronoid process of the elbow? B. Medial oblique -The medial oblique shows the coronoid process free from superimposition. The lateral oblique shows the radial head. 103 Managing patient
information, patient orders, and scheduling information in the Imaging Department is done on computers using RIS. What does RIS stand for? A. Radiology information system -The software that is used for these purposes in the Imaging Department is referred to as the radiology information system. 104 Children have a
greater sensitivity to radiation than adults. Which of the following should be done to keep radiation exposure to children to a minimum? D. All of the above 105 Which of the following
positions/projections would best demonstrate a right pleural effusion? B. Right lateral decubitus -Pleural effusion is an accumulation of fluid in the pleural cavity (a double-walled membrane that surrounds the lungs). It is best demonstrated 106 Tube
angulation will produce which type of shape distortion? C. Elongation -Elongation makes the object to appear longer that it actually is. It occurs when the tube is angled or when the tube and image receptor are not properly aligned. 107 Which of the following interactions with matter leaves an atom ionized? B. Compton effect and photoelectric absorption -Both of these interactions results in an incoming photon striking an electron and ejecting it from its energy shell, thereby, leaving the atom with more positive charges than negative charges (ionized). 108 Which of the following positions/projections
clearly demonstrate all four paranasal sinuses? D. Lateral (horizontal beam) 109 What is the
definition of amorphous? A. A noncrystalline state of an otherwise crystalline material -Amorphous is defined as a noncrystalline state of an otherwise crystalline material. 110 What instructions could a radiographer give to a
patient following a small bowel series? A. Drink plenty of liquids -Since barium can become hardened in the large bowel, the radiographer can tell the patient to drink plenty of liquids. It is not appropriate for a radiographer to instruct the patient to take a laxative. It may be contraindicated for some patients. 111 What do the letters RBE stand for? C. Relative biological effect -RBE describes the capability of various radiations to produce a particular biological effect. 112 What part of the CR imaging plate is used to match the imaging plate to a particular patient/examination? B. Barcode -A barcode is printed on the back of the plate which is read by a barcode reader to match the imaging plate to a patient/examination. 113 Which of the following would best demonstrate a blow-out fracture of the orbit? C. Modified parietoacanthial (modified Waters) -The difference between a Waters and modified Waters is that the modified Waters has the chin and nose resting on the tabletop, which makes the OML form a 55 degree angle with the image receptor. A Waters forms a 37 degree angle when the nose does not touch the tabletop. 114 The body part _______ the image receptor is referenced when describing the term "position".
C. nearest -The term position refers to a specific body position, oblique or decubitus, in which the body part nearest the image receptor describes the position. For example, a right anterior oblique would have the right anterior side nearest the image receptor. 115 At a 40" SID, the collimator light-to-x-ray field must be accurate to within how many inches? B. 0.8" -2% of 40" equals 0.8" 116 Going from the easiest to penetrate to the hardest to penetrate, which of the following is in the correct order? B. Gas, fat, muscle, bone -The less the tissue density, the easier to penetrate 117 What is the name of the organ that lies within the duodenal
loop? B. Pancreas -The pancreas lies within the duodenal loop and the main pancreatic duct empties into the duodenum through the sphincter of Oddi. 118 Which of the following terms describes the horizontal portion of the mandible? C. Body -The mandible has a curved, horizontal portion called the body. 119 Which of the following tarsal bones articulates with the talus anteriorly? D. Navicular 120 Which of the following image matrix sizes is necessary to produce adequate spatial resolution for digital chest radiography? D. 2048 x 2048 121 Which of the following automatic exposure control (AEC) functions will prevent overexposing the patient in the event of a malfunction or C. Back-up timer -The back-up timer or back-up mAs should be set to approximately 150% of the expected value. 122 Where should the central ray enter for an AP axial projection of the foot? B. Base of the 3rd metatarsal -The base of the 3rd metatarsal is the proximal end of the metatarsal, which is in the center of the foot. 123 The histogram is used to automatically rescale the image to the proper brightness. Which of the following could cause an error with the D. 1, 2 & 3 124 What is the definition of a fomite? D. An item to which microorganisms cling 125 You received the requests for the following procedures all at the same time. In what sequence would you perform these procedures? B. 2, 1 then 3 -Emergency patients are always first. Then pediatric and geriatric patients who are fasting. Followed by routine imaging procedures. 126 Which of the following hospital personnel is considered "qualified" to interpret radiation monitoring reports? C. Certified medical physicist -Radiation monitoring reports must be interpreted by a "qualified expert", a certified medical physicist. 127 A test pattern should be used to evaluate which of the following monitor qualities? D. All of the above 128 You are imaging a patient with head trauma in the emergency room and he suddenly appears drowsy and
confused. What is your immediate B. Notify the ER physician or ER nurse -Always be aware of a patient's clinical symptoms and get help immediately if they change for the worse 129 What must be done to correct this radiograph of the dens? B. Flex the chin -With the mouth open, flexing the chin will keep the base of the skull from superimposing the dens. The position calls for the upper incisors and the base of the skull to be superimposed. 130 The speed at which the projectile electrons are accelerated across the x-ray tube is determined by which of the following? B. kVp -As kVp increases, the projectile electrons increase in speed. This increase in kinetic energy increases the energy of the resultant x rays. 131 Which of the following describes the part of the
fluoroscopic system designed to maintain a constant image brightness? A. Automatic exposure rate control (AERC) -Automatic exposure rate control (ABC) is designed to compensate for changes in patient positioning and/or tube movement during fluoroscopy. 132 Which of the following methods uses light
to imprint information onto an image? A. Photographic -This method is used to record patient demographics onto an image 133 Which type of radiation has a greater biological effect on a tissue when its cells are well oxygenated? A. X or gamma radiation -The oxygen effect is important for low LET radiation (x or gamma), but less important for higher LET radiation (alpha particles). Low LET radiation penetrates deeper making a more uniform distribution throughout the cell. 134 Which of the following anatomical structures is at the level of the iliac crest? D. L4-5 interspace 135 Personnel monitoring is required when there is a chance that an employee will be exposed to: B. 1/10 or more of the annual effective dose limits of 50 mSv in any one year -The NCRP #116 requires individuals for whom there is a reasonable probability of exceeding 10% of the occupational effective dose limit (50 mSv/year) in the course of their work to wear a radiation monitor. 136 Digital imaging has created which of the following poor radiation practices? D. All of the above 137 What is the suture between the parietal bones and the occipital bone called? C. Lambdoidal -The sagittal is between the parietals, the coronal is between the parietals and frontal, and the squasmosal is between the parietal and temporal. 138 Which projection of the knee will show the proximal tibiofibular articulation free from superimposition? D. Medial oblique 139 What is the
purpose of the photodetector in a CR reader? D. It converts photostimulable luminescence into an electric current 140 Quantum noise in a digital image is the result of which of the following? D. Underexposure 141 When a patient is transported to the imaging department, their chart is brought with them. Why is their chart brought? D. To determine the patient's risk factors 142 When using automatic exposure control (AEC), how can the radiographer decrease the time of the exposure and still maintain a satisfactory B. Increase the mA -The same principles are true with AEC as they are with manual exposures. An increase in mA or kVp will allow the exposure time to be reduced. 143 What is the name of the plane that divides the body into anterior and posterior halves? D. Midcoronal plane 144 Which of the following documents describes the treatment that is due a patient? C. AHA Patient Care Partnership (Patient's Bill of Rights) -The AHA Patient Care Partnership (Patient's Bill of Rights) lists a number of rights of a patient. Everything from the right to know your name 145 What is the shortest portion of the small intestine? D. Duodenum 146 Immobilization methods used in radiology: A. 1 & 2 only -Immobilization includes temporary methods to help the patient stay still during the x-ray exposure and include tape and sandbags. Unlike restraints, which help protect the patient, these are used only for the procedure 147 The dynamic range of an image display monitor is: A. the range of intensities that can be display. -The dynamic range is from the smallest to largest input intensities that can be displayed 148 A
flat-panel detector is exposed with nothing between the x-ray tube and detector. 5 images were acquired on 5 different days using the same exposure. The pixel readings within a region of interest (ROI) are compared. What quality control test was performed? C. Repeatability -Repeatability checks the stability of the pixel readings over time. 149 Why was this IVU radiograph repeated? B. Motion -Motion is seen in the left kidney area 150 Which of the following is a postprocessing option to remove white areas from the final digital image that is caused by tight collimation? B. Masking -Digital images that are tightly collimated have clear white areas that can fatigue a radiologist's eyes. Blocking this white light is called masking and it can be done manually or automatically 151 When should a water soluble contrast agent, such as Gastrografin, be used instead of barium? B. 1 & 3 only -Barium sulfate will not be absorbed by the body. Therefore, if there is a "hole" in the gastrointestinal tract, barium would leak into the abdomen and cause infection. Barium would be indicated for children. 152 According to the law of Bergonie and Tribondeau, which of the following will have the greatest effect on
cell radiosensitivity? A. Increased proliferation, immature cell, high metabolic rate -An increased proliferation (reproduction) rate means cells are in the metaphase stage of mitosis more often and therefore, more radiosensitive. An immature cell cannot repair itself from radiation damage as well as a mature cell. A high metabolic rate increases the radiosensitivity of cells. 153 Which of the following primary factors has the greatest effect on subject contrast? C. kVp -Subject contrast is affected by tissue thickness, tissue density and x-ray beam energy (kVp). 154 A
female gonadal shield should be placed with: C. the lower margin at the symphysis pubis and the upper margin on the pelvic inlet. -Gonadal shields are only used when they will not interfere with the examination. 155 In the case of an electrical emergency, which of the following should be done immediately? C. Turn off the main breaker switch -The main breaker switch turns off the electrical current to the entire radiographic room. A quick response may prevent serious injury. 156 What is another name for the second cervical vertebra? A. Axis -The 1st cervical vertebra (atlas) rotates around the axis (second cervical vertebra). 157 Which of the following would be found in a thermoluminescent dosimeter (TLD)? C. Lithium fluoride crystal -When exposed to radiation, the TLD absorbs energy and stores it in the form of excited electrons in the lithium fluoride crystalline lattice. When heated, these excited electrons fall back to their normal orbital state with emission of visible light. The intensity of light is proportional to the radiation dose received. 158 Which of the following complications of diabetes results when a
patient has an excess amount of insulin in his/her bloodstream? A. Hypoglycemia -The radiographer's response would be to get the patient something with sugar in it immediately? 159 Which of the following anatomical structures are part of the sternum? C. 1 & 3 only -A tubercle would be found on a rib, where it articulates with the transverse process of a thoracic vertebra. 160 Which of the following grid ratios will result in the greatest increase in patient exposure? D. 12:1 grid 161 Which of the following positions/projections are required when the determination of the alignment of fractures is necessary? B. AP and lateral -There always has to be two projections, 90 degrees from each other, in order to determine the alignment of fractures. AP and lateral are the required views. 162 Automatic exposure control (AEC) was used for an erect abdomen but the SID was left at 72" SID instead of moving it to 40". The image will be: C. properly exposed. -The AEC will remain on until the proper number of x rays have struck the ionization chamber. or until the backup time is reached. In most cases, the result would be a properly exposed image. 163 To introduce contrast medium for myelography, the subarachnoid space is punctured at which of the following sites? D. L3-4 164 Since imaging plates and flat-panel detectors are sensitive to scatter radiation, which of the
following are necessary? D. 1, 2 & 3 165 Which vertebrae have costovertebral joints? B. Thoracic -A costovertebral joint is where the head of a rib articulates with the facet of a thoracic vertebra. 166 Which of the following needles has the smallest lumen?
D. 25 gauge 167 To reduce occupational exposure, the radiographer should consider which of the following before each exposure? D. 1, 2 & 3 168 Lead aprons CANNOT protect the radiographer from which of the following types of radiation? A. Primary -Lead aprons are designed to protect the radiographer from scatter radiation
169 Flat-panel detectors are sensitive to low intensity background radiation because of their wide dynamic range and high detective quantum D. The flat-panel is discharged electronically every 35 seconds 170 In the drawing to the right, the red arrow is pointing to which of the following
structures? A. Common bile duct -The hepatic duct (leaving the liver) and the cystic duct (leaving the gallbladder) join together to form the common bile duct which empties bile into the duodenum. 171 A digital image receptor exposed to 50% less radiation than optimal will display which of the following? B. Quantum noise -An insufficient number of x rays will cause a grainy image. This grainy appearance is called quantum noise. 172 Which of the following speed classes will produce the longest time to process an image? D. 400 173 How many milliseconds are
in .10 seconds? C. 100 -The prefix "milli" stands for 1/1000 (one thousandth). There are 1000 milliseconds in 1 second or 100 milliseconds in .1 seconds 174 What is the greatest advantage of digital imaging? A. Contrast resolution -Digital imaging's exceptional ability to differentiate between the slight differences in subject contrast is its greatest advantage 175 How much should the patient be obliqued for a scapular Y position of the shoulder? C. 45 degrees -The scapular Y position is used to rule out dislocation or fractures of the proximal humerus. 176 When does foreshortening occur? A. When the object is angled and the CR and image receptor are perpendicular -Foreshortening only occurs when the object is angled. 177 Which of the following defines the ability of an image receptor to record
a wide range of exposures? C. Latitude -Latitude is the image receptor's ability to record a range of exposures that fall within the diagnostic range 178 Which of the following are reasons for nasogastric tubes? A. 1 & 2 only -Central venous catheters like the Hickman and PIC are used for measuring central venous pressure 179 Which of the following exposure indicator numbers indicates that the patient was overexposed? A. 2.5 -Agfa's perfect log median number is 2.2. Anything above that would indicate an overexposure. 2.5 indicates the patient received twice the necessary exposure. 180 Which of the digital radiography systems use exposure indicators (e.g., S-number) to express the radiation dose received by the image receptor? C. Computed radiography -Fuji calls it the S-number, Carestream calls it an exposure index (EI), and Agfa refers to it as log-median 181 Why is a small focal spot valuable to radiographic quality? A. Improves spatial resolution -The smaller the focal spot size, the less unsharpness and the better the spatial resolution. 182 Radiation that passes through the tube housing in directions other than
that of the useful beam is termed what? C. Leakage -Ideally, any radiation other than the primary beam, will get absorbed by the lead impregnated glass tube or tube housing 183 Epinephrine (Adrenalin) would be the drug needed for which of the following symptoms? C. Bronchospasms -Epinephrine (Adrenalin) is classified as a bronchodilator. It increases the size of the bronchioles 184 Data corruption can occur during: D. all of the above 185 Which of the following statements concerning mobile imaging is/are true? D. 1, 2 & 3 186 Where does the CR enter for a PA finger only projection of the 3rd digit? B. 3rd proximal interphalangeal joint -The CR is perpendicular, and enters at the 3rd proximal interphalangeal joint 187 The red X is lying directly over which anatomical part of the kidney? C. Major calyx -The major calyces drain into the renal pelvis 188 Which of the following positions will best demonstrate the right colic flexure of the colon? C. RAO -The RAO (right anterior oblique) position best demonstrates the right colic flexure and the LAO (left anterior oblique) best demonstrates the left colic flexure. 189 What is the average pulse rate for an adult? C. 70-80 beats per minute -An adult's pulse rate under normal conditions would be 70 beats per minute; higher when active or under stress 190 The hematopoietic system includes which of the following? A. Bone marrow -The hematopoietic system includes bone marrow, circulating blood, lymph nodes, and spleen. 191 Pneumonia is described by which of the following? A. An acute inflammation of the lung -An acute inflammation (-itis) of the lungs describes pneumonia, which is caused primarily by bacteria, viruses, and chemical irritants 192 In opening a wrapped sterile package, how should the first outer corner of the wrap be opened? C. Away from you -The first wrap should be opened away from you so you won't have to reach over the sterile area to open the other three corners. 193 Digital imaging systems with high detective quantum efficiency (DQE) can produce _______ quality images at ______ patient doses. C. higher, lower -The better the system can detect the radiation, the better the image at a lower dose to the patient 194 Which of the following positions will best demonstrate the scaphoid bone in the wrist? A. PA - ulnar deviation -The scaphoid is near the radius. PA - ulnar deviation (moving the hand toward the ulna) opens the joints between the adjacent carpal bones
195 A zygapophyseal joint is an articulation between which two vertebral structures? C. Inferior and superior articular processes -The cervical zygapophyseal joints are best demonstrated in a lateral position, the thoracic zygapophyseal joints are best demonstrated in a 196 During which time period is the fetus most susceptible to the effects of radiation? A. First trimester -According to the Law of Bergone and Tribondeau, the younger the tissues and organs are the more radiosensitive they are. Therefore, elective radiologic examinations should not be conducted during the first trimester 197 Which of the following anatomical structures is (are) demonstrated in a 45 degree oblique view of the cervical spine? C. 1 & 3 only -The zygapophyseal joints will be best demonstrated in the lateral position of the cervical spine 198 How many phalanges are there in each foot? C. 14 -Phalanges are the small bones that make up the digits (toes) of the foot. There are two phalanges in the 1st digit and three phalanges in the 199 Which of the following is correct for an AP projection of the upper airway? A. The acanthiomeatal line is perpendicular to the image receptor -The chin must be raised to get an unobstructed view of the upper airway. 200 The allowable radiation dosage that is assumed to result in an average nominal lifetime risk is known as
what? B. Equivalent dose limits -Even though any radiation exposure is considered potentially harmful, anyone receiving less than the equivalent dose limits is considered to be in a safe environment. What is the degree difference between the Orbitomeatal line and the Infraorbitomeatal line?Describe the infraorbitomeatal base line (IOML). - Extends from the infraorbital margin to the EAM. - There are 7 degrees difference between the IOML & the OML.
What is the degree difference between IOML and GML?Procedures 2. Skull landmarks, planes, lines. What is the OML line?Orbitomeatal line is a positioning line used in radiography of the skull. It passes through the outer canthus of the eye and the center of the external auditory meatus. It is used for positioning the patient for different radiographic views including Water's view, Perorbital view, Lateral view, and others.
Where is the Infraorbitomeatal line?The orbitomeatal line (OML) runs from the nasion through the outer canthus of the eye to the center of the external auditory meatus. The infraorbitomeatal line (IOML) runs from the inferior orbital margin to the upper border of the external auditory meatus.
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