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3 RadReview Thorax

front 1

Which of the following positions is required to demonstrate small amounts of air in the pleural cavity?
A.
AP supine
B.
AP Trendelenburg
C.
Lateral decubitus, affected side down
D.
Lateral decubitus, affected side up

back 1

D.
Lateral decubitus, affected side up

front 2

Which of the following will be demonstrated best in the 45-degree right anterior oblique (RAO) position?
A.
Right axillary ribs
B.
Left axillary ribs
C.
Sternum in the heart shadow
D.
Left scapular Y

back 2

B.
Left axillary ribs

front 3

Place the following anatomic structures in order from anterior to posterior:
1. Trachea
2. Apex of heart
3. Esophagus

back 3

C.
Apex of heart, trachea, esophagus

front 4

An increase in exposure factors usually is required in which of the following circumstances?

Edema

Ascites

Acromegaly

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

back 4

D.
1, 2, and 3

front 5

All the following statements regarding the position shown in Figure 2–17 are true except

Figure 2–17.
A.
a left pleural effusion could be demonstrated.
B.
a right pneumothorax could be demonstrated.
C.
a left lateral decubitus position is illustrated.
D.
the CR is directed vertically to the level of T7.

back 5

D.
the CR is directed vertically to the level of T7.

front 6

The patient's chin should be elevated during chest radiography to
A.
permit the diaphragm to move to its lowest position
B.
avoid superimposition on the apices
C.
assist in maintaining an upright position
D.
keep the MSP parallel

back 6

B.
avoid superimposition on the apices

front 7

The condition in which pulmonary alveoli lose their elasticity and become permanently inflated, causing the patient to consciously exhale, is
A.
bronchial asthma
B.
bronchitis
C.
emphysema
D.
tuberculosis

back 7

C.
emphysema

front 8

The lesser tubercle of the humerus will be visualized in profile in the
A.
AP shoulder external rotation radiograph.
B.
AP shoulder internal rotation radiograph.
C.
AP elbow radiograph.
D.
Lateral elbow radiograph.

back 8

B.
AP shoulder internal rotation radiograph.

front 9

What is the name of the plane indicated by the number 1 in Figure 6–17?

Figure 6–17.A.

Midcoronal plane
B.
Midsagittal plane
C.
Transverse plane
D.
Horizontal plane

back 9

A.
Midcoronal plane

front 10

The sternoclavicular joints will be best demonstrated in which of the following positions?
A.
Apical lordotic
B.
Anterior oblique
C.
Lateral
D.
Weight-bearing

back 10

B.
Anterior oblique

front 11

Figure 2–5 demonstrates which of the following conditions?

Figure 2–5.
A.
right upper lobe atelectasis
B.
left upper lobe atelectasis
C.
pneumothorax
D.
dextrocardia

back 11

D.
dextrocardia

front 12

Which of the following are characteristics of the hypersthenic body type?

Short, wide, transverse heart

High and peripheral large bowel

Diaphragm positioned low

A.
1 and 2 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

back 12

A.
1 and 2 only

front 13

Which of the following statements is (are) true regarding the radiograph shown in Figure 6–16?

Figure 6–16.

Courtesy of Stamford Hospital, Department of Radiology.

The part is rotated.

The patient is not shielded correctly.

There is excessive density.

A.
1 only
B.
2 only
C.
1 and 2 only
D.
1, 2, and 3

back 13

B.
2 only

front 14

A lateral projection of the larynx is occasionally required to rule out foreign body, polyps, or tumor. The CR should be directed
A.
just below the EAM
B.
to the level of the mandibular angles
C.
to the level of the laryngeal prominence
D.
to the level of C7

back 14

C.
to the level of the laryngeal prominence

front 15

During chest radiography, the act of inspiration

elevates the diaphragm

raises the ribs

depresses the abdominal viscera

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 15

C.
2 and 3 only

front 16

The PA chest radiograph shown in Figure 2–13 demonstrates

Figure 2–13.
Courtesy of Stamford Hospital, Department of Radiology.

rotation

scapulae superimposed on lung fields

adequate inspiration

A.
1 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

back 16

B.
1 and 3 only

front 17

The term used to describe expectoration of blood from the bronchi is
A.
hemoptysis
B.
hematemesis
C.
chronic obstructive pulmonary disease (COPD)
D.
bronchitis

back 17

A.
hemoptysis

front 18

The position illustrated in Figure 6–4 can be used successfully to demonstrate the

Figure 6–4.
PA oblique sternum

barium-filled pylorus and duodenum

left anterior ribs

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 18

D.
1, 2, and 3

front 19

Which of the following statements is (are) correct, with respect to a left lateral projection of the chest?

The MSP must be perfectly vertical and parallel to the IR.

The right posterior ribs will be projected slightly posterior to the left posterior ribs.

Arms must be raised high to prevent upper-arm soft-tissue superimposition on lung field.

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

back 19

D.
1, 2, and 3

front 20

The thoracic cavity is lined by
A.
parietal pleura.
B.
visceral pleura.
C.
parietal peritoneum.
D.
visceral peritoneum.

back 20

A.
parietal pleura.

front 21

Graves disease is associated with
A.
thyroid underactivity
B.
thyroid overactivity
C.
adrenal underactivity
D.
adrenal overactivity

back 21

B.
thyroid overactivity

front 22

All the following statements regarding respiratory structures are true except
A.
the right lung has three lobes.
B.
the inferior portion of the lung is the apex.
C.
each lung is enclosed in serous membrane.
D.
the main stem bronchi enter the lung hilum.

back 22

B.
the inferior portion of the lung is the apex.

front 23

Each of the following statements regarding respiratory structures is true except
A.
the left lung has two lobes
B.
the lower portion of the lung is the base
C.
each lung is enclosed in peritoneum
D.
the main stem bronchus enters the lung hilum

back 23

C.
each lung is enclosed in peritoneum

front 24

The letter B in Figure 2–13 indicates

Figure 2–13.
Courtesy of Stamford Hospital, Department of Radiology.

A.
a left anterior rib
B.
a right posterior rib
C.
a left posterior rib
D.
a right anterior rib

back 24

A.
a left anterior rib

front 25

Which of the following is (are) evaluation criteria for a PA chest radiograph of the heart and lungs?

Ten posterior ribs should be seen above the diaphragm.

The medial ends of the clavicles should be equidistant from the vertebral column.

The scapulae should be seen through the upper lung fields.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 25

B.
1 and 2 only

front 26

Which of the following is a vessel that does not carry oxygenated blood?
A.
Pulmonary vein
B.
Pulmonary artery
C.
Coronary artery
D.
Chordae tendineae

back 26

B.
Pulmonary artery

front 27

During studies of the soft tissue of the neck, the exposure can be made
1. during phonation before/after opacification.
2. during Valsalva maneuver.
3. at the height of swallowing motion with opacification.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 27

D.
1, 2, and 3

front 28

The sternal angle is at approximately the same level as the
A.
T2–3 interspace
B.
T9–10 interspace
C.
T5
D.
costal margin

back 28

C.
T5

front 29

Which of the following is (are) part of the bony thorax?

Manubrium

Clavicles

24 ribs

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

back 29

C.
1 and 3 only

front 30

Characteristics of a patient with pulmonary emphysema include

shoulder girdle elevation

increased AP diameter of the chest

hyperventilation

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 30

B.
1 and 2 only

front 31

Widening of the intercostal spaces is characteristic of which of the following conditions?
A.
Pneumothorax
B.
Emphysema
C.
Pleural effusion
D.
Pneumonia

back 31

B.
Emphysema

front 32

To best visualize the lower ribs, the exposure should be made
A.
on normal inspiration
B.
on inspiration, second breath
C.
on expiration
D.
during shallow breathing

back 32

C.
on expiration

front 33

All of the following statements regarding the RAO position of the sternum are true, except
A.
the sternum is generally projected to the left of the vertebral column.
B.
shallow breathing during the exposure can obliterate prominent pulmonary markings.
C.
it is helpful to project the sternum over the heart.
D.
a thin thorax requires a lesser degree of obliquity than a thicker thorax.

back 33

D.
a thin thorax requires a lesser degree of obliquity than a thicker thorax.

front 34

To better demonstrate the interphalangeal joints of the toes, which of the following procedures may be employed?

Angle the CR 15 degrees caudad.

Angle the CR 15 degrees cephalad.

Place a sponge wedge under the foot with the toes elevated 15 degrees.

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
2 and 3 only

back 34

D.
2 and 3 only

front 35

The act of expiration will cause the

diaphragm to move inferiorly

sternum and ribs to move inferiorly

diaphragm to move superiorly

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 35

C.
2 and 3 only

front 36

In which of the following procedures is quiet, shallow breathing recommended during the exposure to obliterate prominent pulmonary vascular markings?

RAO sternum

Lateral thoracic spine

AP scapula

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 36

D.
1, 2, and 3

front 37

Deoxygenated blood from the head and thorax is returned to the heart by the
A.
pulmonary artery
B.
pulmonary veins
C.
superior vena cava
D.
thoracic aorta

back 37

C.
superior vena cava

front 38

Which of the following statements with respect to the PA chest seen in Figure 2–11 is (are) correct?

Figure 2–11.
Courtesy of Stamford Hospital, Department of Radiology.

Adequate inspiration is demonstrated.

The shoulders are rolled forward adequately.

Rotation is demonstrated.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 38

D.
1, 2, and 3

front 39

An aspirated foreign body is more likely to enter the lower respiratory tract via the
A.
left main stem bronchus.
B.
right main stem bronchus.
C.
bronchioles.
D.
alveoli.

back 39

B.
right main stem bronchus.

front 40

Which of the following are mediastinal structures?

Heart

Trachea

Esophagus

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 40

D.
1, 2, and 3

front 41

The inhalation of liquid or solid particles into the nose, throat, or lungs is referred to as
A.
asphyxia
B.
aspiration
C.
atelectasis
D.
asystole

back 41

B.
aspiration

front 42

Dorsal decubitus projections of the chest are used to evaluate small amounts of

fluid in the posterior chest

air in the posterior chest

fluid in the anterior chest

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 42

A.
1 only

front 43

Below-diaphragm ribs are better demonstrated when
A.
respiration is suspended at the end of full inhalation.
B.
exposed using shallow breathing technique.
C.
the patient is in the recumbent position.
D.
the patient is in the AP erect position.

back 43

C.
the patient is in the recumbent position.

front 44

Which of the following positions may be used to effectively demonstrate the right posterior axillary ribs?
A.
LAO
B.
RAO
C.
RPO
D.
LPO

back 44

C.
RPO

front 45

A dorsal decubitus position of the chest may be used to evaluate small amounts of
1. fluid in the posterior chest.
2. air in the posterior chest.
3. fluid in the anterior chest.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 45

A.
1 only

front 46

All the following positions are used frequently to demonstrate the sternoclavicular articulations except
A.
weight-bearing
B.
RAO
C.
LAO
D.
PA

back 46

A.
weight-bearing

front 47

The condition that results from a persistent fetal foramen ovale is
A.
an atrial septal defect
B.
a ventricular septal defect
C.
a patent ductus arteriosus
D.
coarctation of the aorta

back 47

A.
an atrial septal defect

front 48

All of the following statements regarding respiratory structures are true except
A.
the right lung has two lobes.
B.
the uppermost portion of the lung is the apex.
C.
each lung is enclosed in pleura.
D.
the trachea bifurcates into mainstem bronchi.

back 48

A.
the right lung has two lobes.

front 49

To demonstrate the pulmonary apices with the patient in the AP position, the
A.
central ray is directed 15° to 20° cephalad.
B.
central ray is directed 15° to 20° caudad.
C.
exposure is made on full exhalation.
D.
patient's shoulders are rolled forward.

back 49

A.
central ray is directed 15° to 20° cephalad.

front 50

Which of the following statements is (are) true regarding Figure 2–30?

Figure 2–30.
Courtesy of Stamford Hospital, Department of Radiology.

The image was made in the LAO position.

The CR should enter more inferiorly.

The sternum is projected onto the left side of the thorax.

A.
1 only
B.
2 only
C.
2 and 3 only
D.
1, 2, and 3

back 50

C.
2 and 3 only

front 51

Inspiration and expiration projections of the chest are performed to demonstrate

partial or complete collapse of pulmonary lobe(s)

air in the pleural cavity

foreign body

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

back 51

D.
1, 2, and 3

front 52

The laryngeal prominence is formed by the
A.
thyroid gland
B.
thyroid cartilage
C.
vocal cords
D.
pharynx

back 52

B.
thyroid cartilage

front 53

The AP axial projection of the chest for pulmonary apices

requires 15 to 20 degrees of cephalad angulation

projects the apices above the clavicles

should demonstrate the medial ends of the clavicles equidistant from the vertebral column

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

back 53

C.
1 and 3 only

front 54

Which of the following statements is (are) correct regarding the chest radiograph in Figure 6–19?

Figure 6–19.
Courtesy of Stamford Hospital, Department of Radiology.

Rotation of the chest is demonstrated.

The pulmonary apices are not visualized.

The costophrenic angles are demonstrated.

A.
1 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

back 54

B.
1 and 3 only

front 55

Differences between body habitus types are likely to affect all the following except
A.
the size and shape of an organ.
B.
the position of an organ.
C.
the position of the diaphragm.
D.
the degree of bone porosity.

back 55

D.
the degree of bone porosity.

front 56

Which of the anatomic structures listed below is seen most anteriorly in a lateral projection of the chest?
A.
Esophagus
B.
Trachea
C.
Cardiac apex
D.
Superimposed scapular borders

back 56

C.
Cardiac apex

front 57

Which of the following statements is (are) correct with respect to evaluation criteria for a PA projection of the chest for lungs?

Sternal extremities of clavicles are equidistant from vertebral borders.

Ten posterior ribs are demonstrated above the diaphragm.

The esophagus is visible in the midline.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 57

B.
1 and 2 only

front 58

Aspirated foreign bodies in older children and adults are most likely to lodge in the
A.
right main stem bronchus
B.
left main stem bronchus
C.
esophagus
D.
proximal stomach

back 58

A.
right main stem bronchus

front 59

Imperfect expansion of the lungs, often accompanied by dyspnea, is called
A.
atelectasis.
B.
pneumothorax.
C.
pneumonia.
D.
COPD.

back 59

A.
atelectasis.

front 60

Which of the following statements regarding Figure 2–10 is (are) true?

Figure 2–10.
Courtesy of Stamford Hospital, Department of Radiology.

Correct degree of rotation is present.

Midphalanges are foreshortened.

Fingers are parallel to the IR.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 60

B.
1 and 2 only

front 61

The ridge that marks the bifurcation of the trachea into the right and left primary bronchi is the
A.
root.
B.
hilus.
C.
carina.
D.
epiglottis.

back 61

C.
carina.

front 62

The RAO position is used to project the sternum to the left of the thoracic vertebrae in order to take advantage of
A.
pulmonary markings
B.
heart shadow
C.
posterior ribs
D.
costal cartilages

back 62

B.
heart shadow

front 63

Which of the following pathologic conditions require(s) a decrease in exposure factors?

Pneumothorax

Emphysema

Multiple myeloma

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 63

D.
1, 2, and 3

front 64

Using the PA projection, which of the following tube angle and direction combinations is correct for an axial projection of the clavicle?
A.
5 to 15 degrees caudad
B.
5 to 15 degrees cephalad
C.
15 to 30 degrees cephalad
D.
15 to 30 degrees caudad

back 64

D.
15 to 30 degrees caudad

front 65

Which of the following positions is required to demonstrate small amounts of fluid in the pleural cavity?
A.
Lateral decubitus, affected side up
B.
Lateral decubitus, affected side down
C.
AP Trendelenburg
D.
AP supine

back 65

B.
Lateral decubitus, affected side down

front 66

During atrial systole, blood flows into the

right ventricle via the mitral valve

left ventricle via the bicuspid valve

right ventricle via the tricuspid valve

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 66

C.
2 and 3 only

front 67

Tracheotomy is an effective technique most commonly used to restore breathing when there is
A.
respiratory pathway obstruction above the larynx
B.
crushed tracheal rings owing to trauma.
C.
respiratory pathway closure owing to inflammation and swelling
D.
all the above

back 67

A.
respiratory pathway obstruction above the larynx

front 68

Which of the following positions will demonstrate the right axillary ribs?
1. RAO
2. LAO
3. RPO

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 68

C.
2 and 3 only

front 69

Which of the following statements is/are true regarding Figure A?
1. The radiograph was made in the LAO position.
2. The central ray should enter more inferiorly.
3. The sternum is projected onto the left side of the thorax.

Figure A. Courtesy of Stamford Hospital, Department of Radiology.
A.
1 only
B.
2 only
C.
2 and 3 only
D.
1, 2, and 3

back 69

C.
2 and 3 only

front 70

How should a chest examination to rule out air–fluid levels be obtained on a patient having traumatic injuries?
A.
Perform the examination in the Trendelenburg position.
B.
Erect inspiration and expiration images should be obtained.
C.
Include a lateral chest examination performed in dorsal decubitus position.
D.
Perform the examination AP supine at 44 inches SID.

back 70

C.
Include a lateral chest examination performed in dorsal decubitus position.

front 71

Which of the following criteria are used to evaluate a PA projection of the chest?
1. Ten posterior ribs should be visualized.
2. Sternoclavicular joints should be symmetrical.
3. The scapulae should be lateral to the lung fields.

A.
1 and 2 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

back 71

D.
1, 2, and 3

front 72

The sternoclavicular joints are best demonstrated with the patient PA and
A.
in a slight oblique position, affected side adjacent to the IR
B.
in a slight oblique position, affected side away from the IR
C.
erect and weight-bearing
D.
erect with and without weights

back 72

A.
in a slight oblique position, affected side adjacent to the IR

front 73

In which of the following examinations is exposure on full expiration required?
A.
PA chest
B.
Below diaphragm ribs
C.
AP lordotic chest
D.
Lateral thoracic spine

back 73

B.
Below diaphragm ribs

front 74

The plane that passes vertically through the body, dividing it into anterior and posterior halves, is termed the
A.
median sagittal plane (MSP)
B.
midcoronal plane
C.
sagittal plane
D.
transverse plane

back 74

B.
midcoronal plane

front 75

Which of the following positions can be used to demonstrate the axillary ribs of the right thorax?

RAO

LAO

RPO

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

back 75

C.
2 and 3 only

front 76

The esophagus commences at about the level of
A.
C3.
B.
C6.
C.
T1.
D.
T11.

back 76

B.
C6.

front 77

The body habitus characterized by a long and narrow thoracic cavity and low midline stomach and gallbladder is the
A.
asthenic
B.
hyposthenic
C.
sthenic
D.
hypersthenic

back 77

A.
asthenic

front 78

All the following statements regarding the bony thorax are true except
A.
the first seven pairs of ribs are referred to as vertebrosternal, or true, ribs.
B.
the only articulation between the thorax and the upper extremity is the sternoclavicular joint.
C.
the gladiolus is the upper part of the sternum and is quadrilateral in shape.
D.
the anterior ends of the ribs are about 4 in. below the level of the vertebral ends.

back 78

C.
the gladiolus is the upper part of the sternum and is quadrilateral in shape.

front 79

Blood is returned to the left atrium, from the lungs, via the
A.
aorta.
B.
superior vena cava.
C.
pulmonary veins.
D.
pulmonary artery.

back 79

C.
pulmonary veins.

front 80

Which of the following positions is most likely to offer the best visualization of the pulmonary apices?
A.
Lateral decubitus
B.
Dorsal decubitus
C.
Erect lateral
D.
AP axial lordotic

back 80

D.
AP axial lordotic

front 81

Acceptable method(s) of minimizing motion unsharpness is (are)

suspended respiration.

short exposure time.

patient instruction.

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

back 81

D.
1, 2, and 3

front 82

What are the positions most commonly employed for a radiographic examination of the sternum?
1. Lateral
2. RAO
3. LAO

A.
1 and 2 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

back 82

A.
1 and 2 only

front 83

The AP axial projection of the pulmonary apices requires the CR to be directed
A.
15 degrees cephalad
B.
15 degrees caudad
C.
30 degrees cephalad
D.
30 degrees caudad

back 83

A.
15 degrees cephalad

front 84

The manubrial notch is at approximately the same level as the
A.
fifth thoracic vertebra.
B.
T2–3 interspace.
C.
T4–5 interspace.
D.
costal margin.

back 84

B.
T2–3 interspace.

front 85

Pacemaker electrodes can be introduced through a vein in the chest or upper extremity, from where they are advanced to the
A.
left atrium
B.
right atrium
C.
left ventricle
D.
right ventricle

back 85

D.
right ventricle

front 86

A frontal view of the sternum is best accomplished in which of the following positions?
A.
AP
B.
PA
C.
RAO
D.
LAO

back 86

C.
RAO

front 87

An acute infection of the lungs is called
A.
atelectasis.
B.
pneumothorax.
C.
pneumonia.
D.
COPD.

back 87

C.
pneumonia.