Final Exam Review – Abdomen, Skull, GI & Urinary Radiography

How many chapters are covered on the final exam and which chapter has the most questions?

Five chapters are covered; Chapter 11 (Skull) has the most questions with 45.

Which two abdominal quadrants are used on the exam (four-quadrant system or nine-region system)?

The four-quadrant system only; no questions on the nine-region system.

What are the three sections of the pharynx?

Nasopharynx, oropharynx, and laryngopharynx.

Which pharyngeal sections belong to both the respiratory and digestive systems?

Oropharynx and laryngopharynx.

If barium fills the fundus of the stomach on a radiograph, what projection is most likely shown?

An AP projection with the patient supine.

Which portion of the small intestine is the shortest? The longest?

Shortest: duodenum; Longest: ileum.

Which segment of the small intestine displays a feathery appearance on barium studies?

The jejunum.

Correctly spell the intestinal portion that ends at the ileocecal valve.

I-l-e-u-m (ileum).

What are the iliac ‘wings’ of the pelvis spelled?

I-l-i-u-m (ilium).

Name the two layers of the peritoneum and indicate which is outer vs. inner.

Parietal (outer) and visceral (inner) peritoneum.

What is the double-fold of peritoneum that attaches small intestine loops to the posterior abdominal wall?

The mesentery.

What peritoneal fold drapes over the anterior abdomen and is nicknamed the ‘fatty apron’?

The greater omentum (also has a lesser omentum).

Define ascites.

Accumulation of free fluid in the peritoneal cavity.

Define ileus and distinguish mechanical from adynamic (paralytic) types.

Ileus = bowel obstruction; mechanical (physical blockage such as volvulus or intussusception) vs. adynamic (loss of peristalsis, often post-surgery).

Give two classic mechanical obstructions discussed in class.

Intussusception (telescoping) and volvulus (twisting).

Where is the CR centered for a routine KUB abdomen?

At the level of the iliac crest.

Which anatomical landmarks must be included on a KUB image?

Kidneys superiorly and symphysis pubis inferiorly.

How is a hypersthenic patient handled for a KUB?

Take two cross-wise (landscape) images to include all anatomy.

Which single decubitus position is performed to demonstrate intraperitoneal air in an abdomen?

Left lateral decubitus (air rises up along the liver side).

Why is the left lateral decubitus preferred over the right for abdominal air-fluid studies?

Avoids confusion with the gastric air bubble that sits on the left side.

Which structure is palpated to ensure the symphysis pubis will appear on an abdomen radiograph?

The greater trochanter.

On an AP abdomen, if the right iliac wing appears elongated which direction is the patient rotated?

Rotated toward the right side.

List one advantage and one disadvantage of a PA abdomen compared to an AP.

Advantage: less tissue thickness (dose); Disadvantage: increased OID for kidneys, possible magnification.

What are the four bones of the skull cap (calvarium)?

Frontal, occipital, right parietal, left parietal.

How many bones form the adult cranium?

Eight.

Name the three portions of the temporal bone.

Squamous, mastoid, and petrous portions.

Which portion of the temporal bone contains the organs of hearing and equilibrium?

The petrous portion (petrous pyramids).

Which air-filled cells occupy the mastoid portion?

Mastoid air cells.

What two processes unite to form the zygomatic arch?

Zygomatic process of the temporal bone & temporal process of the zygomatic bone.

Which projection best demonstrates maxillary sinuses?

Parietoacanthial (Waters) projection.

Which projection best demonstrates the frontal sinuses?

PA axial (Caldwell) projection.

Which single projection shows all paranasal sinuses simultaneously?

Lateral skull.

For CRANIUM AP/PA rotation, what separation do you inspect?

Equal distance from the lateral orbital margins to cranial cortex (or mandibular rami to cortex).

For skull TILT on an AP/PA, what indicator is used?

Vertex (top) shift; compare vertical distance from mandibular rami to cranial cortex—larger side indicates tilt toward that side.

In the Towne (AP axial) skull, which structure must appear within the foramen magnum?

The dorsum sellae and posterior clinoids.

What CR angle is used for a Towne projection referencing the OML?

30° caudad to OML (37° to IOML).

If the dorsum sellae is projected above (high) the foramen magnum on a Towne view, what is the positioning error?

Insufficient CR angulation or inadequate chin tuck (not enough flexion).

Caldwell projection: what CR angle and petrous-ridge placement indicate correct positioning?

15° caudad; petrous ridges in the lower one-third of the orbits.

Waters projection: which line is perpendicular and where should the petrous ridges appear?

MML perpendicular; petrous ridges just inferior to the maxillary sinuses.

Modified Waters: list three differences from standard Waters.

LML perpendicular, OML forms ~55° angle to IR, petrous ridges in lower half of maxillary sinuses.

For the SMV (submentovertical) projection which positioning line is parallel to the IR?

IOML (infraorbitomeatal line).

Name the projections used to survey orbits: overall orbit, infra-orbital rim, and supra-orbital rim.

Overall orbit: Waters; Infra-orbital rim: Modified Waters; Supra-orbital rim: Caldwell.

Axiolateral oblique mandible: what head rotation visualizes ramus, body, and mentum?

0° = ramus; 30° = body; 45° = mentum (chin); 15° = general survey.

What is the maximum combined CR angle and head tilt for axiolateral mandible projections?

25° total.

Centering for lateral skull vs. lateral facial bones?

Lateral skull: 2 inches (5 cm) superior to EAM; Lateral facial bones: at zygoma (midway outer canthus–EAM).

List three functions of the paranasal sinuses.

Lighten the skull, warm and moisten inhaled air, act as resonating chambers for voice.

Largest movable bone of the face? Largest immovable?

Movable: mandible; Immovable: maxilla.

Which facial bone is associated with the lacrimal (tear) ducts?

The lacrimal bone.

What is the basic patient NPO preparation time for an upper-GI series?

NPO for 8 hours prior to the exam.

What does the liver produce and what does the gallbladder do with it?

Liver produces bile; gallbladder stores and concentrates bile.

Name the enlarged chamber where the common bile duct and pancreatic