Question 1

A less than optimal lateral sternum projection that does not demonstrate the sternum in profile and visualizes the superior heart shadow extending anterior to the sternum
A) resulted because the central ray was centered too posteriorly.
B) resulted because of poor costal breathing technique.
C) could be improved by rotating the right thorax anteriorly.
D) also would demonstrate the left thorax rotated posteriorly.

Accepted Answer

C

Question 2

An above-diaphragm AP or PA rib projection with accurate positioning demonstrates the
1)scapulae outside the lung field.
2)seventh posterior rib at the center of the exposure field.
3)eight posterior ribs above the diaphragm.
4)thoracic vertebrae-rib head articulations.
A) 1 and 2 only
B) 3 and 4 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

C

Question 3

For a PA oblique sternal projection (RAO position),
1)a 30-inch (76-cm) or 40-inch (100-cm) SID is used.
2)the patient's midcoronal plane is angled 15 to 20 degrees with the IR.
3)a long exposure time is used.
4)costal breathing is used.
A) 1 and 2 only
B) 3 and 4 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

D

Question 4

A left lateral sternal projection with poor positioning demonstrates the superior heart shadow extending beyond the sternum, into the anteriorly located lung. How should the patient be repositioned for an optimal projection to be obtained?
1)Rotate the left thorax posteriorly.
2)Position the arms behind the patient's back.
3)Take the exposure on deep inspiration.
4)Rotate the right thorax anteriorly.
A) 1 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only
E) 4 only

Accepted Answer

Option 1 (rotate the left thorax posteriorly) and option 4 (rotate the right thorax anteriorly) both involve adjusting the positioning of the patient to improve the visualization of the heart shadow. By rotating the thorax in either direction, the heart can be brought into a more anterior position, which will prevent it from extending into the lung field. Option 2 (position the arms behind the patient's back) is not likely to have an impact on the visualization of the heart shadow. Option 3 (take the exposure on deep inspiration) may be helpful in some cases, but it is not directly related to the problem of the heart shadow extending too far laterally.

Question 5

The right SC joint and right side of the manubrium are superimposed by the thoracic vertebrae on a PA oblique sternum projection (RAO position). Such a projection is produced when the
A) patient rotation is less than the required amount.
B) patient rotation is more than the required amount.
C) patient is rotated into an LAO position.
D) central ray is centered too close to the vertebral column.

Accepted Answer

The patient rotation being less than the required amount results in the right SC joint and right side of the manubrium being superimposed by the thoracic vertebrae in a PA oblique sternum projection (RAO position), as insufficient rotation prevents adequate separation of these structures from the spine.

Question 6

A below-diaphragm AP oblique rib projection (RPO position) with accurate positioning demonstrates the
1)ninth through twelfth ribs below the diaphragm.
2)axillary ribs without foreshortening.
3)seventh axillary rib at the center of the collimated field.
4)inferior sternal body just to the right of the vertebral column.
A) 1 and 2 only
B) 2 and 4 only
C) 1 and 3 only
D) 1, 2, and 4 only

Accepted Answer

The RPO position for a below-diaphragm AP oblique rib projection is designed to demonstrate the ninth through twelfth ribs below the diaphragm and the axillary ribs without foreshortening.

Question 7

An AP oblique rib projection obtained with the patient rotated less than 45 degrees demonstrates the
1)posterior ribs with decreased foreshortening.
2)axillary ribs, which are foreshortened.
3)anterior ribs adjacent to the lateral edge of the IR.
4)sternal body next to the vertebral column.
A) 1 and 2 only
B) 2 and 4 only
C) 3 and 4 only
D) 1, 2, and 4 only

Accepted Answer

In an AP oblique rib projection with the patient rotated less than 45 degrees, the posterior ribs will have decreased foreshortening because they are more parallel to the X-ray beam. The axillary ribs, being further from the beam's central path, will appear foreshortened. Additionally, the sternal body will appear closer to the vertebral column due to the oblique angle of the projection.

Question 8

On a PA oblique sternal projection (RAO position) with accurate positioning, the
1)manubrium is demonstrated to the left of the heart shadow.
2)posterior ribs are magnified.
3)sternum is demonstrated within the heart shadow.
4)lung markings are blurred.
A) 1 and 3 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 2, 3, and 4 only

Accepted Answer

The answer of On a PA oblique sternal projection (RAO...

Question 9

A lateral sternal projection
1) uses a grid and tight collimation to reduce scatter radiation.
2) demonstrates the sternum without humeral soft tissue superimposition.
3) is obtained after a deep inspiration.
4) requires placement of the top edge of the IR 1.5 inches (4 cm) above the jugular notch.
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 lateral sternal projection
1) uses a grid...

Question 10

A PA oblique sternal projection (RAO position) with poor positioning demonstrates the right SC joint and manubrium superimposed by the thoracic vertebrae. How should the patient be repositioned for an optimal projection to be obtained?
A) Have the patient take a deep inspiration before the image is obtained.
B) Center the central ray and IR closer to the vertebral column.
C) Increase the degree of patient obliquity.
D) Decrease the degree of patient obliquity.

Accepted Answer

Increasing the degree of patient obliquity on an RAO sternal projection will move the SC joint and manubrium further away from the thoracic vertebrae, resulting in a clearer image of these structures.

Question 11

How is an AP or PA rib projection of a patient with lower anterior rib pain obtained?
1)With the patient in an AP projection
2)On expiration
3)Using 65 to 70 kVp
4)With the shoulders at equal distances to the imaging table
A) 1 and 3 only
B) 2 and 4 only
C) 1 and 4 only
D) 1, 2, 3, and 4

Accepted Answer

An AP or PA rib projection for lower anterior rib pain is typically obtained on expiration to elevate the diaphragm and with the shoulders at equal distances to the imaging table to ensure no rotation.

Question 12

On a PA oblique sternal projection (RAO position), the posterior ribs are blurred and magnified because
1)a short SID is used.
2)a long exposure time is used.
3)the image is obtained on expiration.
4)a detail screen is used.
A) 1 and 2 only
B) 1, 2, and 3 only
C) 1 only
D) 2 and 4 only

Accepted Answer

The answer of On a PA oblique sternal projection (RAO...

Question 13

For an AP oblique rib projection (RPO or LPO position) obtained to evaluate upper posterior rib pain,
1)a 70- to 80-kVp technique is used.
2)the tenth axillary rib is centered to the collimated field.
3)the patient is rotated 45 degrees away from the affected side.
4)the image is obtained after deep expiration.
A) 1 and 2 only
B) 1 and 4 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Accepted Answer

A 70- to 80-kVp technique is used for rib imaging, and the tenth axillary rib is centered to the collimated field.

Quiz 10: Image Analysis of the Sternum and Ribs

A less than optimal lateral sternum projection that does not demonstrate the sternum in profile and visualizes the superior heart shadow extending anterior to the sternum

An above-diaphragm AP or PA rib projection with accurate positioning demonstrates the 1) scapulae outside the lung field. 2) seventh posterior rib at the center of the exposure field. 3) eight posterior ribs above the diaphragm. 4) thoracic vertebrae-rib head articulations.

For a PA oblique sternal projection (RAO position) , 1) a 30-inch (76-cm) or 40-inch (100-cm) SID is used. 2) the patient's midcoronal plane is angled 15 to 20 degrees with the IR. 3) a long exposure time is used. 4) costal breathing is used.

The right SC joint and right side of the manubrium are superimposed by the thoracic vertebrae on a PA oblique sternum projection (RAO position) . Such a projection is produced when the

An AP oblique rib projection obtained with the patient rotated less than 45 degrees demonstrates the 1) posterior ribs with decreased foreshortening. 2) axillary ribs, which are foreshortened. 3) anterior ribs adjacent to the lateral edge of the IR. 4) sternal body next to the vertebral column.

On a PA oblique sternal projection (RAO position) with accurate positioning, the 1) manubrium is demonstrated to the left of the heart shadow. 2) posterior ribs are magnified. 3) sternum is demonstrated within the heart shadow. 4) lung markings are blurred.

A lateral sternal projection 1) uses a grid and tight collimation to reduce scatter radiation. 2) demonstrates the sternum without humeral soft tissue superimposition. 3) is obtained after a deep inspiration. 4) requires placement of the top edge of the IR 1.5 inches (4 cm) above the jugular notch.

A PA oblique sternal projection (RAO position) with poor positioning demonstrates the right SC joint and manubrium superimposed by the thoracic vertebrae. How should the patient be repositioned for an optimal projection to be obtained?

How is an AP or PA rib projection of a patient with lower anterior rib pain obtained? 1) With the patient in an AP projection 2) On expiration 3) Using 65 to 70 kVp 4) With the shoulders at equal distances to the imaging table

On a PA oblique sternal projection (RAO position) , the posterior ribs are blurred and magnified because 1) a short SID is used. 2) a long exposure time is used. 3) the image is obtained on expiration. 4) a detail screen is used.