Chapter 19: Special Radiographic Procedures Multiple Choice

a. A common nontrauma clinical indication is a Baker's cyst.

Which of the following is generally true for knee arthrography?

a. A common nontrauma clinical indication is a Baker's cyst.

b. A minimum of 20 mL of positive contrast media is introduced into joint.

c. During fluoroscopy, views are taken of each meniscus with the knee rotated 30°

between exposures.

d. The amount of aspirated joint (synovial) fluid should equal the amount of injected

contrast media.

b. Magnetic resonance imaging (MRI)

What imaging modality is most frequently used to study the soft tissue structures of the

temporomandibular joint?

a. Computed tomography (CT)

b. Magnetic resonance imaging (MRI)

c. Conventional radiography

d. Ultrasound

d. Arthroscope

Which of the following instruments is not required during a knee arthrogram?

a. Sterile gauze

b. 10-mL syringe

c. 20-gauge needle

d. Arthroscope

c. To coat the soft tissue structures with contrast media

During an arthrogram, why is the knee flexed following injection of contrast media

before imaging?

a. To reduce the viscosity of the contrast media

b. To force the contrast media outside of the joint if there is a tear

c. To coat the soft tissue structures with contrast media

d. None of the above; the knee should not be flexed during an arthrogram after

injection of contrast media.

a. nine views of each meniscus rotated 20° between exposures.

A common fluoroscopy routine for knee arthrography is:

a. nine views of each meniscus rotated 20° between exposures.

b. nine views total of each knee rotated 20° between exposures.

c. six views each of lateral and medial menisci rotated 20° between exposures.

d. horizontal beam projections, six exposures per knee.

a. Injury or tears to rotator cuff

Which of the following is not an indication for knee arthrography?

a. Injury or tears to rotator cuff

b. Evaluate for Baker's cyst

c. Injury or tears to collateral or cruciate ligaments

d. Injury or tears to menisci

d. 2 3/4- to 3 1/2-inch spinal needle

What size needle is used to introduce the contrast media during a shoulder arthrogram?

a. 2 inches, 16 gauge

b. 1 1/2 inches, 18 gauge

c. 2 inches, 25 gauge

d. 2 3/4- to 3 1/2-inch spinal needle

b. Scapular Y projection

Which of the following projections would NOT be commonly performed during a

shoulder arthrogram?

a. Anteroposterior external/internal rotation projections

b. Scapular Y projection

c. Glenoid fossa projection

d. Transaxillary projection

d. Residual calculi

What is the most common clinical indication for a postoperative (T-tube)

cholangiogram?

a. Jaundice

b. Pancreatitis

c. Chronic cholecystitis

d. Residual calculi

c. 8

The patient must be NPO ____ hours (minimum) before a postoperative (T-tube)

cholangiogram.

a. 4

b. 6

c. 8

d. 12

c. gastroenterologist.

The majority of ERCP procedures are performed by a:

a. radiologist.

b. radiologic technologist.

c. gastroenterologist.

d. surgeon.

a. Pseudocyst

Which of the following conditions is often a contraindication for an ERCP?

a. Pseudocyst

b. Biliary stenosis

c. Hepatitis

d. Cirrhosis

b. Corpus (body)

Which of the four divisions of the uterus is the largest?

a. Fundus

b. Corpus (body)

c. Isthmus

d. Cervix

c. 10 to 12

The uterine (fallopian) tubes are approximately ____ cm in length.

a. 3 to 4

b. 6 to 8

c. 10 to 12

d. 15 to 18

a. Interstitial

Which of the four segments of the uterine tube communicates with the uterine cavity?

a. Interstitial

b. Isthmus

c. Ampulla

d. Infundibulum

d. Infundibulum

The fingerlike extensions termed fimbriae connect to which part of the uterine tube?

a. Interstitial

b. Isthmus

c. Ampulla

d. Infundibulum

c. Infundibulum

Which part of the uterine tube opens into the peritoneal cavity?

a. Isthmus

b. Interstitial

c. Infundibulum

d. None of the above

c. uterine cavity and the patency of the uterine tubes.

The purpose of the hysterosalpingography is to demonstrate the:

a. interior of the cervix, uterus, uterine tubes, and ovaries.

b. interior of the uterus for neoplasms or other abnormalities.

c. uterine cavity and the patency of the uterine tubes.

d. degree of openness of the cornu between the uterus and uterine tubes.

d. All of the above

Which of the following is a contraindication to hysterosalpingography?

a. Pregnancy

b. Active uterine bleeding

c. Pelvic inflammatory disease

d. All of the above

b. positive, nonionic, water soluble.

The preferred contrast medium for hysterosalpingography is:

a. positive, ionic, oil based.

b. positive, nonionic, water soluble.

c. negative carbon dioxide gas.

d. thin barium sulfate.

d. 2 inches (5 cm) superior to the symphysis pubis.

Imaging for a hysterosalpingography includes centering of the CR and image receptor

(IR) to:

a. 4 inches (10 cm) superior to the symphysis pubis.

b. the symphysis pubis.

c. the level of the ASIS.

d. 2 inches (5 cm) superior to the symphysis pubis.

b. Ovaries should be opacified and well demonstrated.

Which of the following is NOT a valid radiographic criterion for

hysterosalpingography?

a. Cannula or balloon catheter should be seen within the cervix.

b. Ovaries should be opacified and well demonstrated.

c. Contrast medium should be seen within the peritoneum.

d. The pelvic ring should be centered within the collimation field.

a. Subarachnoid space

Where is the contrast media instilled during a myelogram?

a. Subarachnoid space

b. Epidural space

c. Subdural space

d. Spinal cord

c. Herniated nucleus pulposus

What is the most common clinical indication for a myelogram?

a. Benign tumors

b. Malignant tumors

c. Herniated nucleus pulposus

d. Increased intracranial pressure

a. 2 weeks.

Myelography is often contraindicated if a lumbar puncture has been performed within

the previous:

a. 2 weeks.

b. 3 weeks.

c. 30 days.

d. 6 months.

d. All of the above

Which of the following is a contraindication for myelography?

a. Arachnoiditis

b. Blood in the CSF

c. Increased intracranial pressure

d. All of the above

d. L3-4

What is the most common injection site for a myelogram?

a. C1-2

b. T12

c. L4-5

d. L3-4

c. To widen the interspinous spaces

During a myelogram performed with the patient prone, why is a positioning block

(bolster) placed under the abdomen for the lumbar puncture?

a. To force the contrast media toward the head

b. For patient comfort

c. To widen the interspinous spaces

d. To prevent reflux of contrast media back into the syringe

a. Erect-seated

Other than prone, what additional position is recommended for a cisternal puncture?

a. Erect-seated

b. Left lateral decubitus

c. Right lateral decubitus

d. Trendelenburg

c. Excreted by the kidneys

How is the water-soluble contrast media eliminated following a myelogram?

a. Withdrawn through a needle/syringe

b. Remains in the spinal canal

c. Excreted by the kidneys

d. Excreted by the lungs

c. 9 to 15 mL

What is an average dosage of contrast media given during a myelogram?

a. 1 to 2 mL

b. 3 to 4 mL

c. 9 to 15 mL

d. 20 to 24 mL

d. Nonionic, water soluble

What is the most common type of contrast media given during a myelogram?

a. Iodinated, oil based

b. Room air

c. Carbon dioxide

d. Nonionic, water soluble

c. patient prone: semierect horizontal beam lateral.

The suggested positioning routine for lumbar myelography is:

a. patient prone: semierect horizontal beam lateral, left and right lateral decubitus (AP

and PA), and PA projection.

b. patient on side: right lateral decubitus (AP) and left lateral decubitus (PA).

c. patient prone: semierect horizontal beam lateral.

d. patient supine: semierect AP and horizontal beam lateral.

c. Contrast media tend to pool near the midthoracic region

Why is the supine AP projection rarely taken during a thoracic spine myelogram?

a. Patient discomfort at puncture site

b. Contrast media may leak from puncture site

c. Contrast media tend to pool near the midthoracic region

d. Excessive radiation exposure to anterior chest structures

d. Patient prone: horizontal beam lateral (centered to C4-5) and swimmer's horizontal

beam lateral (centered to C7)

Which of the following is a suggested conventional positioning routine for cervical

myelography following fluoroscopy and spot imaging?

a. Patient prone: PA lateral, swimmer's lateral, and one lateral decubitus-horizontal

beam

b. Patient on side: right lateral decubitus (AP) and left lateral decubitus (PA)

c. Patient prone: PA horizontal beam and swimmer's lateral of C6 or C7

d. Patient prone: horizontal beam lateral (centered to C4-5) and swimmer's horizontal

beam lateral (centered to C7)

b. straight or right angle to radiography.

The literal definition of orthoroentgenography is:

a. long bone measurement.

b. straight or right angle to radiography.

c. joint radiography.

d. extremity study.

c. CT involves high cost and specialized equipment.

The chief disadvantage of CT scanograms as compared with orthoroentgenography is:

a. distortion of joints due to penumbra.

b. artifacts from special ruler placed in gantry.

c. CT involves high cost and specialized equipment.

d. CT produces a poor image of bones.

a. epiphysiodesis.

A limb-shortening surgical procedure is termed:

a. epiphysiodesis.

b. limbectomy.

c. epiphysioectomy.

d. diaphysiodeses.

c. Bell-Thompson ruler

What is the name of the special ruler used in orthoroentgenography?

a. Long bone ruler

b. Shepard-Logan ruler

c. Bell-Thompson ruler

d. Myer-Smith ruler

a. The patient should not move between exposures.

Which of the following factors is most critical when performing

orthoroentgenography?

a. The patient should not move between exposures.

b. Short exposure time techniques must be used.

c. A long source IR distance (SID) must be used for less beam divergence.

d. Both right and left limbs must be examined at the same time for length

comparisons.

a. Size of anatomy

Which one of the following is not a factor that directly controls or influences the

amount of tomographic blurring?

a. Size of anatomy

b. Tomographic angle

c. Object-IR distance

d. Exposure angle

b. fulcrum.

The pivot point between the x-ray tube and IR in a tomographic system is termed:

a. amplitude.

b. fulcrum.

c. tube trajectory.

d. objective plane.

a. tomographic angle.

The total distance the x-ray tube travels is termed:

a. tomographic angle.

b. fulcrum.

c. objective plane.

d. fulcrum level.

d. both A and B.

Objects within the body that are farther from the objective plane have:

a. greater movement.

b. increased blurring.

c. less blurring.

d. both A and B.

a. Intravenous urography

Which of the following procedures is the most common application of conventional

tomography?'

a. Intravenous urography

b. Long bone studies

c. Sternum studies

d. Vertebral column studies

b. sharper and in relative focus.

Objects within the objective plane will appear:

a. blurred.

b. sharper and in relative focus.

c. as radiolucent densities.

d. as streaks.

d. 40°

Which of the following exposure angles will produce the thinnest sectional thickness?

a. 10°

b. 20°

c. 30°

d. 40°

b. their images move from one part of the IR to another as the tube and IR move through their travel during the exposure.

Objects within the body above and below the focal plane appear blurred because:

a. they are not placed parallel to the direction of tube travel.

b. their images move from one part of the IR to another as the tube and IR move through their travel during the exposure.

c. they are situated too close to the focal plane.

d. the body part is too large for sufficient penetration of x-rays.

c. body section radiography.

Another term for tomography is:

a. computed tomography.

b. orthoroentgenography.

c. body section radiography.

d. orthostatic radiography.

Blur

Distortion of objects outside the object plane

Tomographic angle

The total distance the x-ray tube travels

Tomogram

Radiograph produced by a tomographic unit

Object plane

The plane where the target anatomy is clear

Fulcrum

The pivot point between tube and IR

Exposure angle

The factor that determines slice thickness

False

T/F: Intercondylar fossa projections are often required during a conventional knee

arthrogram.

True

T/F: CT and MRI arthrography has significantly reduced the number of radiographic

arthrograms performed.

True

T/F: An endoscopic retrograde cholangiopancreatography (ERCP) can either be a diagnostic or a therapeutic procedure.

True

T/F: The technologist must follow standard precautions when handling bile.

False

T/F: The patient must remain NPO (nothing by mouth) a minimum of 8 hours following an

ERCP.

False

T/F: Arachnoiditis is a clinical indication for a myelogram procedure.

True

T/F: Most disk pathology of the spine occurs in the cervical and lumbar regions.

False

T/F: Long bone measurement of the lower limb requires that the entire lower limb be

included on a single radiograph.

False

T/F: Gonadal shielding cannot be used for long bone measurement of the lower limb for

males or females.

False

T/F: The wrist should be placed into the pronated PA position for a long bone study of the

upper limb.

False

T/F: Lower limb orthoroentgenograms should be performed nongrid.

False

T/F: Linear tomography is primarily used for studies of the temporal bones.

True

T/F: The primary factor affecting the sectional thickness, as controlled by the operator, is

exposure angle.

False

T/F: More blurring occurs with a shorter exposure angle.