Diagnostic Imaging Exam Materials
Course Introduction
Diagnostic Imaging introduces students to the fundamental principles and techniques involved in visualizing the internal structures of the human body for clinical evaluation and diagnosis. The course covers the physics and applications of major imaging modalities, including X-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine. Emphasis is placed on the interpretation of diagnostic images, the selection of appropriate imaging methods for various clinical scenarios, patient safety, and the role of imaging in disease detection, monitoring, and management. Students will develop critical skills in analyzing images, understanding the indications and limitations of each modality, and appreciating advances in imaging technology and their impact on patient care.
Recommended Textbook
merrills atlas of radiographic positioning and procedures 13th edition 3 volume set by bruce long
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Page 2
Chapter 1: Preliminary Steps in Radiography
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Sample Questions
Q1) The controlling factors for magnification are:
A) density and contrast.
B) object-to-image receptor distance (OID) and source-to-image receptor distance (SID).
C) central ray angle and central ray alignment.
D) part/image receptor alignment and SID.
Answer: B
Q2) The ability to visualize very small structures on a medical image is termed: A) contrast.
B) density.
C) distortion.
D) spatial resolution.
Answer: D
Q3) The primary controlling factor of radiographic contrast in screen-film radiography is: A) mA.
B) time.
C) kVp.
D) SID.
Answer: C
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Page 3
Chapter 2: Compensating Filters
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Sample Questions
Q1) Which of the following would be considered advantages in using anatomic compensating filters?
1)Reduces radiation exposure to the patient
2)Provides an even image density
3)Increases image contrast and detail
A) 1 and 2
B) 2 and 3
C) 1 and 3
D) 1, 2, and 3
Answer: A
Q2) A wedge filter would be ideal for which of the following projections?
A) AP chest
B) AP thoracic spine
C) Lateral C7-T1
D) Lateral hip
Answer: B
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4
Chapter 3: General Anatomy and Radiographic Positioning
Terminology
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Sample Questions
Q1) Which of the following terms refers to the back part of a body or organ?
A) Ventral
B) Dorsal
C) Distal
D) Proximal
Answer: B
Q2) When there is longitudinal angulation of the central ray with the long axis of the body, the projection will always use the term:
A) oblique.
B) axial.
C) lateral.
D) decubitus.
Answer: B
Q3) Which of the following is an x-ray "projection"?
A) RPO
B) LAO
C) Dorsoplantar
D) Recumbent
Answer: C
Page 5
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Chapter 4: Upper Limb
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Sample Questions
Q1) Which of the following projections clearly demonstrates the scaphoid?
1)PA in ulnar flexion
2)PA oblique in lateral rotation
3)PA axial (Stecher method)
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q2) Flexing the fingers for a PA projection of the wrist causes which of the following?
A) Placement of the carpal bones farther from the IR
B) Placement of the carpal bones closer to the IR
C) Less pain for the patient when the wrist is broken
D) Greater resolution of the carpal interspaces
Q3) For a PA projection of the second digit, the central ray is directed to the _____ joint.
A) distal interphalangeal
B) proximal interphalangeal
C) metacarpophalangeal
D) carpometacarpal
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Chapter 5: Shoulder Girdle
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Sample Questions
Q1) How far should the arm be abducted for an inferosuperior projection of the shoulder joint?
A) 15 degrees
B) 30 degrees
C) 45 degrees
D) 90 degrees
Q2) How many pounds of weight should be affixed to each wrist for the AP projection of the AC joint?
A) 2 lb
B) 5 lb
C) 2 to 4 lb
D) 5 to 8 lb
Q3) Which of the following projections can be used to demonstrate the clavicle?
1)AP or PA
2)AP axial
3)PA axial
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
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Chapter 6: Lower Limb
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Sample Questions
Q1) Which of the following are the essential oblique projections of the ankle?
1)AP oblique, 45-degree medial rotation
2)AP oblique, 45-degree lateral rotation
3)AP oblique, 15- to 20-degree medial rotation for the ankle mortise
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q2) The two flat, superior surfaces of the tibia are called the:
A) tubercles.
B) malleoli.
C) condyles.
D) tibial plateaus.
Q3) All of the joints of the foot are synovial (freely movable) except the: A) femorotibial.
B) patellofemoral.
C) distal tibiofibular.
D) proximal tibiofibular.
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8
Chapter 7: Pelvis and Upper Femora
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Sample Questions
Q1) The strongest bone in the body is the:
A) femur.
B) pelvis.
C) skull.
D) humerus.
Q2) The central ray for an AP pelvis is directed perpendicular to the center of the IR. The central-ray entrance point will be about _____ inches _____ to the pubic symphysis.
A) 2; superior
B) 3; superior
C) 2; inferior
D) 3; inferior
Q3) Unless contraindicated, the lower limb and leg should be internally rotated for an axiolateral projection of the hip (Danelius-Miller). How many degrees of rotation are required?
A) 10
B) 15
C) 20
D) 15 to 20
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9
Chapter 8: Vertebral Column
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Sample Questions
Q1) Which of the following lines must be perpendicular to the IR for the AP "open mouth" atlas and axis?
A) Glabellomeatal line
B) Orbitomeatal line
C) Acanthiomeatal line
D) A line drawn from the lower edge of the upper incisors to the tip of the mastoid process
Q2) How many degrees is the body rotated for the AP oblique projection of the sacroiliac joint?
A) 20
B) 40
C) 30
D) 25 to 30
Q3) Where should the superior edge of the IR/collimated field be placed for an AP projection of the thoracic vertebrae?
A) 1 inch above the shoulders
B) 1 \(1 / 2\) to 2 inches above the shoulders
C) 1 \(1 / 2\) to 2 inches below the shoulders
D) At the level of the shoulders
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Page 10
Chapter 9: Bony Thorax
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Sample Questions
Q1) Which of the following is the recommended breathing technique that should be used when examining the ribs that lie at the level of the diaphragm?
A) One deep inspiration (or expiration) and hold
B) Two deep expirations (or inspirations) and hold
C) Suspended respiration
D) Slow, shallow breathing
Q2) Which SID is recommended for the lateral projection of the sternum for management of magnification?
A) 48 inches
B) 60 inches
C) 72 inches
D) 120 inches
Q3) The central ray for a PA projection of the upper ribs is:
A) 0 degrees.
B) 5 degrees caudad.
C) 10 degrees cephalad.
D) 12 degrees cephalad.
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11
Chapter 10: Thoracic Viscera
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Sample Questions
Q1) The right lung is about how much shorter than the left?
A) \(1 / 2\) inch
B) 1 inch
C) 1 \(1 / 2\) inches
D) 2 inches
Q2) How many ribs should be visible above the diaphragm on a PA chest radiograph?
A) 9
B) 10
C) 11
D) 12
Q3) The area between the two lungs is termed the:
A) carina.
B) thorax.
C) mediastinum.
D) pleural space.
Q4) For AP oblique projections of the chest, the side of interest is generally the side _____ the IR.
A) closer to B) farther from
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Chapter 11: Long Bone Measurement
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Sample Questions
Q1) Which of the following is currently the examination method of choice for long bone measurements because of its accuracy and reduced dose?
A) Conventional radiography
B) Magnetic resonance imaging
C) Computed tomography
D) Direct digital radiography
Q2) What patient positions may be used for a long bone measurement?
1)Standing
2)Prone
3)Supine
A) 1 only
B) 2 only
C) 3 only
D) 1, 2, and 3
Q3) Which landmark is used to localize the shoulder joint for upper limb long bone measurement?
A) Superior margin of the humeral head
B) Medial margin of the glenoid fossa
C) 1 inch inferior to the coracoid process
D) 2 inches inferior and medial to the superolateral border of the shoulder
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Chapter 12: Contrast Arthrography
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Sample Questions
Q1) Which of the following contrast media may be injected into a joint space for radiography of the menisci, cartilage, bursae, etc.?
1)Air
2)Barium
3)Iodine contrast medium
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q2) Which of the following is administered during arthrography before the injection of contrast?
A) Conscious sedation
B) Sterile saline
C) Local anesthetic
D) General anesthetic
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14
Chapter 13: Trauma Radiography
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Sample Questions
Q1) Which projection is necessary if the top of T1 and the C7-T1 interspace is not clearly demonstrated on the lateral projection, dorsal decubitus position of the cervical spine?
A) AP projection, open-mouth position
B) Lateral projection, swimmer's technique
C) Lateral projection of the thoracic spine
D) AP axial C-spine
Q2) Which imaging modality has replaced conventional trauma skull radiography in most Level I trauma centers?
A) CT
B) MRI
C) Nuclear medicine
D) Angiography
Q3) Which projection must be evaluated before taking any other images on a trauma patient?
A) AP projection of the atlas and axis, open-mouth position
B) Lateral projection, swimmer's technique
C) Lateral projection of the C-spine, dorsal decubitus position
D) AP axial C-spine
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Chapter 14: Mouth and Salivary Glands
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Sample Questions
Q1) Which of the following is not one of the salivary glands?
A) Tonsil
B) Parotid
C) Sublingual
D) Submandibular
Q2) Which salivary glands are the largest?
A) Parotid
B) Submandibular
C) Sublingual
D) Submandibular and sublingual are equal in size.
Q3) The salivary glands produce how much saliva each day?
A) 0.25 L
B) 0.50 L
C) 1 L
D) 1.5 L
Q4) Radiographic examination of the salivary glands using contrast medium is called: A) parotitis.
B) angiography.
C) sialography.
D) sialostenosis.
Page 16
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Chapter 15: Anterior Part of Neck
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Sample Questions
Q1) All of the following are techniques used during radiographic examination of the pharyngolaryngeal structures except:
A) swallowing.
B) phonation.
C) sneezing.
D) breathing.
Q2) For the AP projection of the pharynx and larynx, the central ray should be directed perpendicular to the:
A) thyroid cartilage.
B) laryngeal prominence.
C) cricoid cartilage.
D) jugular notch.
Q3) Which of the following lies in the anterior neck?
1)Thyroid gland
2)Parathyroid glands
3)Thymus gland
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
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Chapter 16: Abdomen
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Sample Questions
Q1) The pathologic accumulation of fluid in the peritoneal cavity is termed:
A) obstruction.
B) ascites.
C) aortic aneurysm.
D) ileus.
Q2) Demonstrating small amounts of intraperitoneal gas in patients with an acute abdomen is often necessary. How long should the patient lie in the left lateral position before the exposure is made?
A) 10 to 20 minutes
B) 30 to 45 minutes
C) Variable, depending on the body habitus
D) Variable, depending on the patient's condition
Q3) One of the primary reasons a left lateral decubitus abdominal image is performed is to demonstrate:
A) foreign bodies.
B) the location of tumor masses.
C) intestinal gas.
D) air-fluid levels.
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18
Chapter 17: Digestive System: Alimentary Canal
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Sample Questions
Q1) What is the respiration phase for all radiographic exposures of the stomach and intestines?
A) Inspiration
B) Expiration
C) Suspended respiration
D) Slow, shallow breathing
Q2) The wall of the esophagus is composed of how many layers of tissue?
A) One
B) Two
C) Three
D) Four
Q3) The largest gland in the body is the:
A) liver.
B) spleen.
C) pancreas.
D) duodenum.
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Page 19
Chapter 18: Urinary System and Venipuncture
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Sample Questions
Q1) A radiographic examination of the urinary bladder is termed:
A) cystography.
B) cystourethrography.
C) cystoureterography.
D) retrograde urography.
Q2) How much will the kidneys drop in the change from the supine to the upright position?
A) 1 inch
B) 2 inches
C) 3 inches
D) 3 \(1 / 2\) inches
Q3) How much is the body rotated for the AP oblique projection of the urinary bladder during a cystogram?
A) 25 degrees
B) 45 degrees
C) 40 to 60 degrees
D) 60 to 80 degrees
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20
Chapter 19: Reproductive System
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Sample Questions
Q1) What is the most common type of testicular tumor?
A) Cryptorchidism
B) Prostate cancer
C) Seminoma
D) Dermoid
Q2) Measurement of the fetal head and pelvic outlet can be performed using which of the following?
1)Sonography
2)Hysterosalpingography
3)Pelvimetry (Colcher-Sussman method)
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q3) Radiographic examination of the uterus and uterine tubes is termed:
A) vaginography.
B) hysterosalpingography.
C) pelvic pneumography.
D) pelvimetry.
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Page 21
Chapter 20: Skull, Facial Bones, and Paranasal Sinuses
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Sample Questions
Q1) Which plane of the head is placed parallel to the plane of the image receptor for a lateral projection of the skull?
A) Sagittal
B) Transverse
C) Midsagittal
D) Midcoronal
Q2) Which sinus is projected through the mouth on the open-mouth modification of the Waters method?
A) Frontal
B) Ethmoidal
C) Sphenoidal
D) Maxillary
Q3) All of the following are facial bones except the:
A) ethmoid.
B) maxillae.
C) mandible.
D) zygomatic bones.
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Chapter 21: Mammography
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Q1) What type of generators do mammography machines have?
A) Single-phase
B) Three-phase
C) Falling load
D) High frequency
Q2) For which projections of the breast would minimal compression be used?
A) All postsurgery projections
B) All magnification projections
C) CC and MLO with displaced implant
D) CC and MLO with full implant
Q3) The mean glandular dose for a typical two-projection mammogram done using a screen/IR is _____ mrad.
A) 100
B) 320
C) 400
D) 450
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Chapter 22: Central Nervous System
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Q1) All of the following imaging modalities may be used for image-guided interventional pain management except:
A) fluoroscopy.
B) CT.
C) ultrasound.
D) MRI.
Q2) Percutaneous vertebroplasty is done under fluoroscopy to:
A) stabilize fracture fragments.
B) restore the spine to a more normal curve.
C) reduce hunchback deformities.
D) locate vascular abnormalities.
Q3) Which imaging examination is usually performed immediately after a myelogram?
A) MRI
B) NM
C) US
D) CT
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Chapter 23: Vascular, Cardiac, and Interventional Radiography
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Q1) What is the most common arterial site of catheterization for selective angiography?
A) Brachial
B) Femoral
C) Axillary
D) Carotid
Q2) Guidewires come in a variety of shapes and sizes, and selection is based on:
1)injector pressure.
2)access needle size.
3)catheter.
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q3) The most widely used method of catheterization for selective angiography is known as the _____ method.
A) Amplatz
B) Stecher
C) modified Seldinger
D) Schüller
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Chapter 24: Pediatric Imaging
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Q1) Which of the following are common pediatric fractures?
1)Salter-Harris
2)Plastic
3)Supracondylar
A) 1 and 2 only
B) 1 and 3 only
C) 2 and 3 only
D) 1, 2, and 3
Q2) How is rotation evaluated on a pediatric chest image?
A) Superimposition of anterior and posterior midline structures
B) Visualization of eight to nine posterior ribs
C) Visualization of the intervertebral disk spaces through the heart
D) Anatomy from the trachea to the costophrenic angles is seen
Q3) When performing limb radiography on a pediatric patient, what may not be required to evaluate for fracture?
A) Images showing the relative position of the two ends of the bone
B) The contralateral side
C) Use of large focal spot
D) Soft tissue
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Chapter 25: Geriatric Radiography
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Q1) Traditional positioning for a chest radiograph may be difficult for the elderly patient. An alternative would be to:
A) position the patient for an AP.
B) have a CT scan for the chest.
C) wrap his or her arms around the chest stand.
D) leave arms down at the side of the body.
Q2) The aging experience is individual and is affected by: 1)attitude.
2)lifestyle choices.
3)heredity.
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q3) When imaging the upper or lower limbs on geriatric patients, keep in mind that:
A) many projections can be combined to decrease time and discomfort.
B) mobility and flexibility is often decreased.
C) long bones shrink as age increases.
D) scatter radiation is greater in those with osteoporosis.
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Chapter 26: Mobile Radiography
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Q1) The generators for mobile units have the same kilowatt rating as stationary x-ray equipment.
A)True
B)False
Q2) Which of the following attire is worn by the radiographer when entering a strict isolation room for a mobile radiography examination?
1)Mask
2)Gown
3)Gloves
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q3) According to federal regulations, the source-to-skin (SSD) distance during mobile radiography may not be less than _____ inches.
A) 10
B) 12
C) 15
D) 24
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Page 28
Chapter 27: Surgical Radiography
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Q1) Less frequently used x-ray equipment in the OR should be cleaned:
A) every 3 days.
B) at least once a week.
C) every 2 weeks.
D) once a month.
Q2) What should the radiographer do after removing the cover from the IR?
A) Quickly take it to be processed.
B) Give it to a nonsterile team member.
C) Put it on the floor.
D) Remove gloves before handling it.
Q3) Reaching over a sterile field is allowed by:
A) both sterile and nonsterile team members.
B) only nonsterile team members.
C) only sterile team members.
D) only the surgeon.
Q4) Institution-approved attire worn in the OR:
A) can be worn over 2 days.
B) should be fresh for each shift.
C) can be used regardless of condition.
D) is not necessary in the semirestricted areas.
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Chapter 29: Computed Tomography
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Q1) The most common reporting method of dose reporting on the present scanners is:
A) Multiple Scan Average Dose (MSAD).
B) Computed Tomography Dose Index (CTDI).
C) Dose-length product (DLP).
D) Computed Tomography Dose Index Volume (CTDIvol).
Q2) Fourth-generation CT scanners use the following configuration:
A) translate tube and rotating detectors.
B) rotating tube and detectors.
C) only rotating detectors.
D) only rotating tube.
Q3) The CT system's ability to freeze any motion of a scanned object is termed:
A) detector quantum efficiency.
B) temporal resolution.
C) reconstruction algorithm.
D) spatial resolution.
Q4) Dose in CT is considered to be:
A) independent of size.
B) size dependent.
C) related to the CT numbers.
D) similar to a chest examination.
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Chapter 30: Magnetic Resonance Imaging
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Q1) A spin echo pulse sequence can provide which of the following weighted images?
1)T1
2)T2
3)Proton density
A) 1 and 2 only
B) 1 and 3 only
C) 2 and 3 only
D) 1, 2, and 3
Q2) Compared with CT image acquisition, MRI can obtain images:
A) independently in any plane.
B) only in the sagittal plane.
C) only in the coronal plane.
D) in the sagittal and coronal planes.
Q3) Hydrogen is used for imaging in MRI because it:
A) has a large nucleus.
B) has a large precession.
C) is the most common element in the body.
D) is the only nucleus that can be imaged.
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Chapter 31: Diagnostic Ultrasound
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Q1) Routine obstetric screening exams are usually requested between _____ gestational weeks.
A) 8 and 12
B) 12 and 16
C) 16 and 24
D) 24 and 30
Q2) A full bladder is used for imaging the female pelvis as a sonic window and to also:
A) flatten the vagina.
B) reposition the intestines laterally.
C) distend the uterus.
D) flatten the ovaries.
Q3) Sometimes examinations in the abdominal cavity are difficult to perform because of:
A) air or gas in the gastrointestinal tract.
B) bony anatomy.
C) tissue differences.
D) too much fluid.
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Chapter 32: Nuclear Medicine
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Q1) The radiotracer for PET scanning is chosen for:
A) studies that will show only anatomy.
B) its long half-life compared with nuclear medicine.
C) its similarity to naturally occurring biochemicals.
D) faster examination times.
Q2) PET scanning is an examination that can visualize a patient's:
A) physiology.
B) anatomy.
C) soft tissue.
D) bone detail.
Q3) SPECT imaging produces images that:
A) are similar to those done in CT.
B) will show only large lesions.
C) require increased amounts of radionuclides.
D) show only motion.
Q4) The crystal used in gamma cameras is made of:
A) sodium iodide.
B) cesium-activated iodide.
C) thallium-activated sodium iodide.
D) lithium fluoride.
Page 33
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Chapter 33: Bone Densitometry
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) The Z-score is used to determine:
A) the reference population.
B) fracture risk for the patient.
C) if the measured BMD is reasonable.
D) patient age and bone loss.
Q2) Which of the following is not a risk factor for osteoporosis?
A) Daily physical activity
B) Alcohol consumption
C) Low body weight
D) Low calcium intake
Q3) A BMD measurement from a patient is most useful when it can be compared statistically to:
A) the same patient age population.
B) a population living in the same area.
C) multiple scans on the same patient.
D) an appropriate sex-matched reference population.
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Chapter 34: Radiation Oncology
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Sample Questions
Q1) Radiation oncology may be used in conjunction with: 1)surgery.
2)chemotherapy.
3)angiography.
A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 1, 2, and 3
Q2) _____ is done to relieve symptoms, not to cure.
A) Fractionation
B) Differentiation
C) Palliation
D) Conformal radiation
Q3) Intensity-modulated radiation therapy (IMRT) uses:
A) radioactive isotopes.
B) multileaf collimators.
C) cerrobend blocks.
D) permanent implants.
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