LRA 218-Radiographic Position

The bending or forcing of the hand laterally with the hand pronated in a posteroanterior (PA) projection is known as:

radial deviation.

ulnar deviation.

radial abduction.

ulnar extension.

ulnar deviation.

What is the distance between the tabletop and Bucky tray on most floating tabletop type of tables?

1/2 to 1 inch (1.3 to 2.5 cm)

1 to 2 inches (2.5 to 5.1 cm)

2 to 3 inches (5 to 7.6 cm)

3 to 4 inches (8 to 10 cm)

3 to 4 inches (8 to 10 cm)

Which special projection of the wrist will open up the interspaces on the ulnar side of the wrist?

Radial deviation

Ulnar deviation

Carpal canal

Carpal bridge

Radial deviation

How much CR angulation to the long axis of the hand is required for the tangential, inferosuperior projection to demonstrate the carpal sulcus (canal)?

10° to 15°

25° to 30°

35° to 45°

5° to 10°

25° to 30°

Which special projection of the wrist is ideal for demonstrating possible calcification in the dorsal aspect of the carpals?

Carpal bridge

Carpal canal

Ulnar deviation

Lateral wrist

Carpal bridge

A patient enters the emergency department (ED) with a Smith fracture. Which region of the upper limb must be radiographed to demonstrate this injury?

Trapezium

Elbow

Wrist and forearm

Hand

Wrist and forearm

A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamate is superimposed over the pisiform. Which of the following measures will correct this problem?

Rotate the wrist and hand 10° internally.

Increase the CR angle.

Decrease the CR angle.

Increase the extension of the hand and/or wrist.

Rotate the wrist and hand 10° internally.

A patient enters the ED with a possible scaphoid fracture. The patient is unable to assume the ulnar deviation position. Which of the following positions should be performed to confirm the diagnosis?

Gaynor-Hart

Jones

Modified Stecher

Coyle

Modified Stecher

A patient with a history of carpal tunnel syndrome comes to radiology. The physician wants to rule out abnormal calcifications in the carpal sulcus. Which of the following projections would best demonstrate this region?

Coyle method

Jones method

Carpal bridge

Gaynor-Hart method

Gaynor-Hart method

How many carpal bones are found in the wrist?

8

7

5

10

8

What is the most commonly fractured carpal bone?

scaphoid

hamate

capitate

lunate

scaphoid

Which wrist ligament is attached to the styloid process of the ulna and continues to the triquetrum and pisiform?

ulnar collateral ligament

palmar radiocarpal ligament

dorsal radiocarpal ligament

radial collateral ligament

ulnar collateral ligament

The two fat stripes of the wrist demonstrated radiographically are known as the scaphoid fat stripe and the ____ fat stripe.

pronator

pisiform

abductor

anterior

pronator

A general positioning rule is to place the long axis of the part ____ to the long axis of the image receptor.

parallel

axial

perpendicular

adjacent

parallel

In which position is the following radiograph of the 1st digit (thumb) presented?

a. AP

b. PA

c. Lateral

d. Oblique

a. AP

The "Fan" lateral - lateromedial projection of the hand is the preferred lateral for the hand if phalanges are the area of interest.

True

False

True

In which position is the following radiograph of the hand presented?

a. Lateral Flexion

b. Oblique

c. Lateral Extension

d. PA

c. Lateral Extension

In which position is the following radiograph of the hand presented?

a. Lateral Flexion

b. Oblique

c. Lateral Extension

d. PA

a. Lateral Flexion

In order to obtain a PA Olique Hand image, the entire hand and wrist should be rotated _____ laterally.

a. 15 degrees

b. 25 degrees

c. 35 degrees

d. 45 degrees

d. 45 degrees

When performing a PA Finger examination, the CR (Central Ray) is perpendicular and centered to the _____ joint.

a. MCP

b. DIP

c. PIP

d. CMC

c. PIP

The minimum SID required to attain a radiograph of the second digit (mediolateral) is _____ inches.

a. 36

b. 40

c. 45

d. 72

b. 40

Which of the following statements is INCORRECT when positioning for an AP Axial Thumb (Modified Roberts) view:

a. The patient can be seated or standing with hand rotated internally placing posterior surface of thumb directly on IR.

b. Align thumb to long axis of portion of IR being exposed.

c. Extend fingers and hold back with other hand to prevent superimposing base of thumb and 1st CMC joint region.

d. All statements are correct

d. All statements are correct

When performing a PA Hand radiographic examination, the central ray (CR) should be centered to the _____.

a. 2nd metacarpal shaft

b. 3rd PIP joint

c. 3rd MCP joint

d. 4th metacarpal shaft

c. 3rd MCP jointv

What radiographic image is demonstrated below?

a. AP Thumb

b. Oblique Thumb

c. Lateral Thumb

d. None of the above

b. Oblique Thumb

A patient arrives in radiology with a metal foreign body in the palm of the hand. Which of the following hand routines should be performed on this patient to confirm the location of the foreign body?

PA and lateral in extension projections

PA and lateral in flexion projections

Pa and fan lateral projections

PA and Gaynor-Hart method

PA and lateral in extension projections

A patient enters radiology with a possible Bennett's fracture. Which of the following routines should be performed to confirm the diagnosis?

thumb

finger

wrist

forearm

thumb

A radiograph of a PA projection of the hand reveals that the distal radius and ulna and the carpals were cut off. What should the technologist do to correct this problem?

Repeat the PA projection to include all the carpals and about 1 inch of the distal radius and ulna.

If the injury to the patient did not involve the carpal region and distal forearm, do not repeat it.

Make sure the carpals, distal radius, and ulna are included on the lateral projection.

Accept the radiograph. Carpals and distal radius and ulna are not part of a hand study.

Repeat the PA projection to include all the carpals and about 1 inch of the distal radius and ulna.

A radiograph of a PA oblique of the hand reveals that the midaspect of the fourth and fifth metacarpals is superimposed. What specific positioning error has been committed?

excessive rotation of the hand and/or wrist

fingers of the hand are not parallel to IR

incorrect CR angulation

insufficient rotation of the hand and/or rist

Correct Answer:excessive rotation of the hand and/or wrist

excessive rotation of the hand and/or wrist

Which of the following structures is considered to be most lateral?

capitulum

trochlea

proximal radioulnar joint

coronoid tubercle

capitulum

Which of the following structures is considered to be most proximal?

olecranon process

head of ulna

coronoid process

radial tuberosity

olecranon process

A nonvisible posterior fat pad on a well-exposed, correctly positioned lateral elbow radiograph generally suggests:

negative study for injury

fracture of one of the bones of the elbow

injury to the synovial joint

a congenital defect

negative study for injury

How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the elbow?

45°

30°

15°

55°

45°

Which of the following actions will lead to the proximal radius crossing over the ulna?

pronation of the hand

external rotation of elbow

supination of the hand

placing epicondyles parallel to image receptor

pronation of the hand

What is the purpose of performing the AP partially flexed projections of the elbow?

to provide an AP perspective if patient cannot fully extend elbow

to provide a view of the radial head and capitulum

to separate the radial head from the ulna

to demonstrate any possible elevated fat pads

to provide an AP perspective if patient cannot fully extend elbow

Which routine projection of the elbow best demonstrates the radial head and tuberosity free of superimposition?

AP oblique with lateral rotation

lateral

AP oblique with medial rotation

AP

AP oblique with lateral rotation

Which routine projection of the elbow best demonstrates the olecranon process in profile?

lateral

AP

medial rotation oblique

lateral rotation oblique

lateral

Which basic projection of the elbow best demonstrates the trochlear notch in profile?

lateral

AP

medial rotation oblique

lateral rotation oblique

lateral

A radiograph of the elbow demonstrates the radius directly superimposed over the ulna and the coronoid process in profile. Which projection of the elbow has been performed?

medial rotation oblique

AP

lateral

lateral rotation oblique

medial rotation oblique

Which routine projection of the elbow will best demonstrate an elevated or visible posterior fat pad?

true lateral with 90° flexion

true AP with no rotation

lateral rotation oblique

coyle method

true lateral with 90° flexion

A patient with a fractured forearm had the fracture reduced and a fiberglass cast placed on the extremity. The orthopedic surgeon orders a postreduction study. The original kV was 60 kV. Which one of the following kV factors should be selected for the postreduction study?

63 kV

67 kV

70 kV

75 kV

63 kV

A patient enters the department in severe pain with a possible dislocation of the elbow. The patient has the elbow flexed more than 90°. Which one of the following routines should be performed to confirm the diagnosis?

partially flexed AP and limited lateral projections

Jones method and limited lateral projection

Coyle method and limited lateral projection

lateral elbow only

partially flexed AP and limited lateral projections

A lateral elbow radiograph demonstrates about half of the radial head superimposed by the coronoid process of the ulna. Which of the following occurred?

no positioning errors occurred

the hand was pronated rather than in a true lateral position

the hand and wrist were rotated laterally and not in a true lateral position

the shoulder was not dropped sufficiently to the tabletop level

no positioning errors occurred

A radiograph of an AP projection of the elbow reveals that there is complete seperation of the proximal radius and ulna. What positioning error has been committed?

excessive lateral rotation

excessive medial rotation

partial flexion of the joint

incorrect CR location and angle

excessive lateral rotation

Which rotation of the humerus will result in a lateral position of the proximal humerus?

A. Internal rotation (epicondyles perpendicular to image receptor)

B. Neutral rotation (epicondyles 45° to the image receptor)

C. External rotation (epicondyles parallel to the image receptor)

D. None of the above

A. Internal rotation (epicondyles perpendicular to image receptor)

Which AP projection of the shoulder and proximal humerus is created by placing the affected palm of the hand facing inward toward the thigh?

A. Internal rotation

B. Neutral rotation

C. External rotation

D. AP axial

B. Neutral rotation

Which of the following shoulder positions is considered a trauma projection (can be performed safely for a possible fracture or dislocation)?

A. AP apical oblique axial (Garth method) projection

B. Inferosuperior axial (Clements modification) projection

C. AP projection-internal rotation

D. None of the above

A. AP apical oblique axial (Garth method) projection

What medial central ray (CR) angle is required for the inferosuperior axial shoulder (Lawrence method)?

A. 5° to 10°

B. 40° to 45°

C. 25° to 30°

D. 10° to 15°

C. 25° to 30°

What additional maneuver must be added to the inferosuperior axial shoulder (Lawrence method) projection to best demonstrate a possible Hill-Sachs defect?

A. Increase medial CR angulation.

B. Angle the CR 10° to 15° downward or posteriorly in addition to the medial angle.

C. Perform exaggerated external rotation of the affected upper limb.

D. Increase abduction of the affected upper limb.

C. Perform exaggerated external rotation of the affected upper limb

Which view and projection of the proximal humerus is represented in the figure?

A. External rotation, anteroposterior (AP) projection

B. Neutral rotation, AP projection

C. Internal rotation, AP projection

D. External rotation, lateral projection

A. External rotation, anteroposterior (AP) projection

The use of a grid during shoulder radiography will result in higher patient dose over nongrid procedures.

True

False

True

A radiograph of the inferosuperior axial projection (Lawrence method) demonstrates the acromion process of the shoulder to be located most superiorly (anteriorly).

True

False

True

Where is the CR centered for a transthoracic lateral projection for proximal humerus?

A. 1 inch (2.5 cm) inferior to the acromion

B. Level of the greater tubercle

C. Level of surgical neck

D. Midaxilla

C. Level of surgical neck

A referring physician suspects that a subacromial spur may be the cause for a patient's arm numbness. She asks the technologist for a projection that would best demonstrate any possible spurs. Which of the following projections would accomplish this objective?

A. PA scapular Y lateral with 10° to 15° caudal angle

B. PA scapular Y lateral with 10° to 15° cephalad angle

C. AP oblique shoulder with 45° caudal angle

D. AP shoulder with 10° to 15° caudal angle

A. PA scapular Y lateral with 10° to 15° caudal angle