Thorax and Abdomen

Question 1

What is the central ray for the AP upper ribs?

Answer 1

T7 (inferior angle of the scapula)

Question 2

What is the central ray for the AP lower ribs?

Answer 2

T10 (xiphoid process)

Question 3

How should the patient be positioned for the AP oblique projection of the ribs?

Answer 3

Oblique 45 degrees with affected side against IR (LPO or RPO)

Question 4

What anatomy should be included on an AP of the upper ribs?

Answer 4

Posterior ribs 1-9 + vertebral column within exposure field

Question 5

What anatomy should be included on an AP of the lower ribs?

Answer 5

Posterior ribs 8-12 + vertebral column within exposure field

Question 6

What positioning error occurred on an AP projection of the upper ribs if the ribs are elongated, and the clavicle is moving away/laterally from the vertebral column?

Answer 6

Rotation - towards affected side

Question 7

What positioning error occurred on an AP oblique projection of the lower ribs if the sternum is located closer to the lateral aspect of the ribs?

Answer 7

Excessive obliquity

Question 8

What positioning error occurred on an AP upper ribs if the diaphragm was located at the level of the 6th posterior rib?

Answer 8

Insufficient inspiration

Question 9

What pathologies may require us to image a chest on inspiration AND expiration?

Answer 9

Pneumothorax,
Foreign body,
Atelectasis,
Diaphragm movement

Question 10

What body habitus might require you to place the IR crosswise for a PA projection of the chest?

Answer 10

Hypersthenic

Question 11

What SID should be used for the PA and lateral chest?

Answer 11

180cm SID to reduce heart magnification and increase detail

Question 12

How should the patient be positioned for a lateral projection of the chest?

Answer 12

Left lateral, arms extended above the head

Question 13

What is the CR for the PA projection of the chest?

Answer 13

T7 (inferior scapular angle)

Question 14

What is the CR for the AP axial projection of the clavicle?

Answer 14

15-30 degrees cephalad to enter midshaft of clavicle

Question 15

What breathing instructions should be given for the a) AP and b) AP axial projections of the clavicle?

Answer 15

a) AP - expiration
b) AP axial - inspiration

Question 16

What image analysis criteria of the PA chest indicates there was no anterior or posterior tilt (midcoronal plane vertical and parallel with IR)?

Answer 16

1 inch of apices above clavicles; manubrium superimposed by T4

Question 17

How many ribs should be seen on a PA chest if the patient took the proper inspiration (2nd full inspiraton)?

Answer 17

9 posterior ribs + a portion of the 10th posterior rib above diaphragm

Question 18

What positioning error occurred on a PA chest if the left clavicle is superimposing the spine, and the right clavicle is moving laterally away from the spine?

Answer 18

Rotation - LAO

Question 19

What positioning error occurred on a PA chest if there is more than 1 inch of apices demonstrated above the clavicles?

Answer 19

Anterior tilt

Question 20

What positioning error occurred on a lateral projection of the chest if the posterior ribs are not superimposed, and the gastric bubble is seen more posterior than normal?

Answer 20

Rotation - left lung posterior, right lung anterior

Question 21

What positioning error occurred on an lateral chest if the hemidiaphragms are not superimposed at all?

Answer 21

Tilt - toward or away from the IR

Question 22

What positioning error occurred on an AP clavicle if the clavicle is demonstrated superior to the superior scapular angle?

Answer 22

Posterior tilt

Question 23

Where should the medial end of the clavicle be demonstrated on an accurately positioned AP axial clavicle?

Answer 23

Superimposed over the 1-3rd rib

Question 24

What anatomy must be included on the first image of the AP supine abdomen?

Answer 24

Pubic symphysis

Question 25

What anatomy must be included on the first image of an AP upright abdomen?

Answer 25

Diaphragms

Question 26

What anatomy must be included on the first image of an AP supine KUB?

Answer 26

Kidneys

Question 27

What projection of the abdomen would decrease patients' gonadal dose?

Answer 27

PA

Question 28

What is the CR for the AP supine KUB and AP supine abdomen?

Answer 28

Perpendicular to the iliac crests

Question 29

What is the CR for the AP upright abdomen?

Answer 29

Horizontal, 2 inches (5cm) above iliac crests

Question 30

What is the CR for the AP axial bladder?

Answer 30

10-15 degrees caudad, 2 inches (5 cm) above pubic symphysis

Question 31

What breathing instructions should be given for all projections of the abdomen?

Answer 31

Breathe in, breathe out, hold (expose on expiration)

Question 32

Where should the diaphragms be demonstrated on an AP supine and AP upright abdomen?

Answer 32

Superior to the 9th posterior ribs

Question 33

What analysis guidelines for the abdomen tells you that the patient is not rotated (midcoronal plane parallel with IR)?

Answer 33

Spinous processes in middle of vertebrae Pedicles equidistant to spinous processes Iliac wings symmetrical Sacrum in line with pubic symphysis

Question 34

What positioning error occurred on an AP abdomen if the spinous processes are not centered to vertebral bodies, and the left iliac wing is wider than the right?

Answer 34

Rotation - LPO

Question 35

What positioning error occurred on an AP axial bladder if the pubic symphysis is superimposing the bladder?

Answer 35

Insufficient caudal CR angulation

Question 36

Theory only: How should the patient be positioned for a PA oblique of the sternum?

Answer 36

PA, in the RAO position (to use heart for contrast) Obliqued 15-20 degrees

Question 37

Theory only: What ribs would be best demonstrated on a PA oblique projection of the ribs if the patient was LAO?

Answer 37

Right anterior ribs (ribs furthest from IR best demonstrated)

Question 38

Theory only: What is the CR for the PA projection of the SC joints?

Answer 38

T3

Question 39

Theory only: What structures are best demonstrated on an AP axial/Lordotic chest?

Answer 39

Apices and interlobar effusions

Question 40

Theory only: What is pathologies are demonstrated well on images of the soft tissue neck?

Answer 40

Foreign bodies Swelling/epiglottitis Masses Fractures of the larynx or hyoid bone

Question 41

Theory only: What is the CR for the AP and lateral projections of the soft tissue neck?

Answer 41

AP - through midsagittal plane at level of laryngeal prominence (upper airway); or manubrium (larynx and superior mediastinum) Lateral - through midcoronal plane at the level of the laryngeal prominence (upper airway); or jugular notch (trachea and superior mediastinum)