Question 1

For an AP chest projection obtained with a mobile x-ray unit,
1)the IR is positioned parallel with the midcoronal plane.
2)the image is obtained without the use of a grid.
3)the manubrium is superimposed over the fourth thoracic vertebra.
4)10 or 11 posterior ribs are demonstrated above the diaphragm.
A) 1 and 2 only
B) 1, 2, and 3 only
C) 3 and 4 only
D) 1, 2, 3, and 4

Accepted Answer

B

Question 2

Which of the following pertains to a lateral chest projection with accurate positioning that was obtained with the right side positioned adjacent to the IR?
1)The heart shadow demonstrates increased magnification over a left lateral projection.
2)The left lung demonstrates the sharpest recorded details.
3)The left hemidiaphragm is demonstrated inferior to the right hemidiaphragm.
4)One and one-half inches (4 cm) of space separates the posterior and anterior ribs.
A) 1 only
B) 1 and 3 only
C) 1, 2, and 3 only
D) 2 and 4 only

Accepted Answer

1) The heart shadow is not increased in magnification on a lateral projection with right side adjacent to the IR. This statement is incorrect.
2) The left lung is closest to the IR and therefore demonstrates the sharpest recorded details.
3) The left hemidiaphragm is inferior to the right on a left lateral projection with right side adjacent to the IR.
4) On a lateral projection, the posterior and anterior ribs should be superimposed, so there shouldn't be any space between them. Therefore, statement 4 is incorrect. 
Therefore, only statements 1 and 3 are incorrect, making B the correct answer.

Question 3

A left lateral chest projection demonstrates the gastric air bubble directly beneath the superior hemidiaphragm. Which is the superior lung?
A) Left
B) Right

Accepted Answer

The gastric air bubble is typically located on the left side of the body, which means that the superior lung is on the right side. Thus, the correct choice is B.

Question 4

On inhalation, the lungs expand
1)vertically.
2)transversely.
3)anteroposteriorly.
A) 1 only
B) 2 and 3 only
C) 1 and 2 only
D) 1, 2, and 3

Accepted Answer

During inhalation, the lungs expand in all three dimensions: vertically (due to the diaphragm moving downward), transversely (as the rib cage expands outward), and anteroposteriorly (with the sternum moving outward), allowing for increased lung volume and air intake.

Question 5

Heart penetration on an AP chest projection
1)is obtained by increasing the kVp.
2)results in a lower contrast image.
3)is required when apparatuses located at the mediastinal region are of interest.
4)results in a decrease in scatter radiation reaching the IR.
A) 1 and 3 only
B) 1, 2, and 3 only
C) 3 only
D) 1, 2, 3, and 4

Accepted Answer

Heart penetration on an AP chest projection is achieved by adjusting the kVp settings, which allows for better visualization of structures within the chest, including those in the mediastinal region. Increasing the kVp results in a lower contrast image due to the higher energy photons being able to penetrate more dense tissues, such as the heart, but it does not decrease the amount of scatter radiation reaching the image receptor (IR).

Question 6

The last rib is attached to the ____ vertebra.
A) eleventh
B) tenth
C) twelfth
D) ninth

Accepted Answer

The last rib is known as the floating rib because it is not connected to the sternum like the other ribs, but it is attached to the twelfth thoracic vertebra. Therefore, the correct choice is C - twelfth.

Question 7

For a PA chest projection with accurate positioning, the
1)SID is set at 72 inches (183 cm).
2)shoulders are positioned at equal distances from the IR.
3)upper midcoronal plane is tilted slightly toward the IR.
4)elbows and shoulders are rotated posteriorly.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

The SID is set at 72 inches to reduce magnification and improve image quality, and the shoulders should be equidistant from the IR to ensure no rotation.

Question 8

A PA chest projection with poor positioning demonstrates the scapulae in the lung field and elevated lateral clavicular ends. How should the patient be repositioned for an optimal projection to be obtained?
1)Tilt the upper midcoronal plane away from the IR.
2)Depress the shoulders.
3)Coax the patient into a deeper inspiration.
4)Anteriorly rotate the shoulders and elbows.
A) 1 and 4 only
B) 2 only
C) 2, 3, and 4 only
D) 2 and 4 only

Accepted Answer

Option 2 is correct as the scapulae in the lung field can be caused by elevated shoulders. Depress the shoulders to prevent the overlapping of the lung field by the scapulae.
Option 4 is correct as it helps to prevent the rotation of the clavicles upward, which can impede the visualization of the apices. Anteriorly rotate the shoulders and elbows to avoid the clavicles to overlap the lung field.
Options 1 and 3 are incorrect as tilting the upper midcoronal plane away from the IR may lead to elongation of the heart, and asking the patient to take a deeper inspiration may also not address the issue of the scapulae and the clavicles in the lung field.

Question 9

A left lateral chest projection with poor positioning demonstrates the humeri soft tissue superimposed over the anterior lung apices. How was the patient positioned for such an image to be obtained?
A) The chest was rotated.
B) The inferior midsagittal plane was tilted toward the IR.
C) The humeri were positioned at a 90-degree angle with the body.
D) The central ray was angled caudally.

Accepted Answer

The humeri being positioned at a 90-degree angle with the body would cause their soft tissue to be superimposed over the anterior lung apices in a lateral chest projection.

Question 10

A mobile AP chest projection obtained with the central ray angled caudally demonstrates
1)vertically contoured ribs.
2)the manubrium projected superior to the fourth thoracic vertebra.
3)less than 1 inch (2.5 cm) of the apices above the clavicles.
4)vertical clavicles.
A) 1 and 3 only
B) 2 and 3 only
C) 2 and 4 only
D) 1 and 4 only

Accepted Answer

Angling the central ray caudally for a mobile AP chest projection results in vertically contoured ribs and vertical clavicles. This is because the angle of the X-ray beam aligns more closely with the natural orientation of these structures when the patient is in a supine position.

Question 11

The IR is positioned ____ for a PA chest projection of a hypersthenic patient.
A) crosswise
B) lengthwise

Accepted Answer

A hypersthenic patient has a greater depth from front-to-back than from side-to-side. Therefore, the IR should be positioned crosswise to capture the entire chest area.

Question 12

A PA chest projection obtained with the patient rotated into an RAO position demonstrates
1)1 inch (2.5 cm) of the apical lung field above the clavicles.
2)the vertebral column superimposed over the left sternoclavicular (SC) joint.
3)elevated lateral clavicular ends.
4)the left posterior ribs with greater length than the right posterior ribs.
A) 2 only
B) 1, 2, and 4 only
C) 3 only
D) 1 and 4 only

Accepted Answer

The answer of A PA chest projection obtained with the...

Question 13

A PA chest projection obtained on expiration demonstrates
1)a narrower and longer heart shadow.
2)an underexposed image if exposure is not increased when a manual technique is used.
3)a broader and shorter heart shadow.
4)fewer than 10 posterior ribs above the diaphragm.
A) 1 and 2 only
B) 1, 2, and 4 only
C) 3 and 4 only
D) 2, 3, and 4 only

Accepted Answer

The answer of A PA chest projection obtained on expiration...

Question 14

A PA chest projection with accurate positioning demonstrates
1)10 or 11 posterior ribs above the diaphragm.
2)equal posterior rib length on both sides of the chest.
3)the manubrium superimposed by the fourth thoracic vertebra.
4)the scapulae outside the lung field.
A) 1, 2, and 4 only
B) 2 and 4 only
C) 1 and 3 only
D) 1, 2, 3, and 4

Accepted Answer

The answer of A PA chest projection with accurate positioning...

Question 15

A PA chest projection with poor positioning demonstrates vertical clavicles and the manubrium at the same level as the fifth thoracic vertebra. How was the patient positioned for such an image to be obtained?
A) The shoulders and elbows were not internally rotated.
B) The shoulders were elevated.
C) The patient's upper midcoronal plane was tilted toward the IR.
D) The central ray was angled caudally.

Accepted Answer

In a PA chest projection, the patient's upper midcoronal plane should be perpendicular to the image receptor, and the shoulders and elbows should be rotated internally to move the scapulae laterally. If the upper midcoronal plane is tilted toward the IR, it can cause the clavicles to appear more vertical and the manubrium to be at the same level as the fifth thoracic vertebra. The other choices (A, B, and D) do not directly affect the positioning seen in the image.

Question 16

A left lateral chest projection obtained with the patient's left side rotated anteriorly demonstrates the
1)anterior and posterior ribs with more than 0.5 inch (1 cm) of superimposition.
2)heart shadow entirely posterior to the sternum.
3)right hemidiaphragm inferior to the left hemidiaphragm.
4)humeral soft tissue superimposed over the anterior lung apices.
A) 1 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 2, and 4 only

Accepted Answer

A left lateral chest projection obtained with the patient's left side rotated anteriorly will demonstrate the anterior and posterior ribs with more than 0.5 inches (1 cm) of superimposition. The heart shadow will not be entirely posterior to the sternum and the right hemidiaphragm will not be inferior to the left hemidiaphragm, as these would be seen on a PA or AP chest projection. Also, humeral soft tissue will not be superimposed over the anterior lung apices, as this would be seen on an AP chest projection. Therefore, the correct choice is 1 only.

Question 17

For a left lateral chest projection with accurate positioning, the
1)SID is set at 40 inches (102 cm).
2)humeri are positioned vertically.
3)shoulders, posterior ribs, and posterior pelvic wings are aligned perpendicular to the image receptor (IR).
4)midsagittal plane is aligned perpendicular to the IR.
A) 1 and 3 only
B) 2 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Accepted Answer

For a left lateral chest projection, the humeri should be positioned vertically to prevent superimposition over the thorax, and the shoulders, posterior ribs, and posterior pelvic wings should be aligned perpendicular to the image receptor to ensure an accurate lateral view. The midsagittal plane alignment is not specific to lateral chest positioning, and the standard SID for chest radiography is typically 72 inches, not 40 inches, to reduce magnification and improve image quality.

Question 18

A left lateral chest projection with accurate positioning demonstrates
1)no humeral soft tissue in the lung field.
2)no more than a total of 0.5 inch (1 cm) of space between the posterior or anterior ribs.
3)the right hemidiaphragm inferior to the left hemidiaphragm.
4)the hemidiaphragms inferior to the eleventh thoracic vertebra.
A) 1, 2, and 4 only
B) 1 and 2 only
C) 3 and 4 only
D) 2 and 3 only

Accepted Answer

1) No humeral soft tissue in the lung field ensures that the patient is properly rotated.2) No more than 0.5 inch (1 cm) of space between the posterior or anterior ribs indicates that the patient is not over-rotated.4) The hemidiaphragms inferior to the eleventh thoracic vertebra ensures that the patient is not under-rotated.

Question 19

A rotated left lateral chest projection demonstrates the heart shadow posterior to the sternum. Which is the anteriorly positioned lung?
A) Left
B) Right

Accepted Answer

In a rotated left lateral chest projection, the right lung is anteriorly positioned, closer to the sternum, while the left lung and heart are more posterior.

Question 20

Air-fluid levels on an AP chest projection
1)demonstrate an increase in density where the fluid is present.
2)are formed when air and fluid separate.
3)are precisely demonstrated when the patient is in a partially upright position.
4)are precisely demonstrated when the central ray is horizontal.
A) 1 and 3 only
B) 1, 2, and 4 only
C) 2 and 4 only
D) 2, 3, and 4 only

Accepted Answer

Air-fluid levels are formed when air and fluid separate within a cavity, and they are best demonstrated when the central ray is horizontal, allowing the fluid to level out and the air to rise above it.

Quiz 3: Image Analysis of the Chest and Abdomen

A left lateral chest projection demonstrates the gastric air bubble directly beneath the superior hemidiaphragm. Which is the superior lung?

On inhalation, the lungs expand 1) vertically. 2) transversely. 3) anteroposteriorly.

Heart penetration on an AP chest projection 1) is obtained by increasing the kVp. 2) results in a lower contrast image. 3) is required when apparatuses located at the mediastinal region are of interest. 4) results in a decrease in scatter radiation reaching the IR.

The last rib is attached to the ____ vertebra.

For a PA chest projection with accurate positioning, the 1) SID is set at 72 inches (183 cm) . 2) shoulders are positioned at equal distances from the IR. 3) upper midcoronal plane is tilted slightly toward the IR. 4) elbows and shoulders are rotated posteriorly.

A left lateral chest projection with poor positioning demonstrates the humeri soft tissue superimposed over the anterior lung apices. How was the patient positioned for such an image to be obtained?

A mobile AP chest projection obtained with the central ray angled caudally demonstrates 1) vertically contoured ribs. 2) the manubrium projected superior to the fourth thoracic vertebra. 3) less than 1 inch (2.5 cm) of the apices above the clavicles. 4) vertical clavicles.

The IR is positioned ____ for a PA chest projection of a hypersthenic patient.

A PA chest projection obtained on expiration demonstrates 1) a narrower and longer heart shadow. 2) an underexposed image if exposure is not increased when a manual technique is used. 3) a broader and shorter heart shadow. 4) fewer than 10 posterior ribs above the diaphragm.

A PA chest projection with accurate positioning demonstrates 1) 10 or 11 posterior ribs above the diaphragm. 2) equal posterior rib length on both sides of the chest. 3) the manubrium superimposed by the fourth thoracic vertebra. 4) the scapulae outside the lung field.

A PA chest projection with poor positioning demonstrates vertical clavicles and the manubrium at the same level as the fifth thoracic vertebra. How was the patient positioned for such an image to be obtained?

A rotated left lateral chest projection demonstrates the heart shadow posterior to the sternum. Which is the anteriorly positioned lung?

Air-fluid levels on an AP chest projection 1) demonstrate an increase in density where the fluid is present. 2) are formed when air and fluid separate. 3) are precisely demonstrated when the patient is in a partially upright position. 4) are precisely demonstrated when the central ray is horizontal.