1.

The lumbar transverse process is represented by what part of the “scotty dog” seen in a correctly
positioned oblique lumbar spine?

a.) ear b.) nose

c.) eye d.) body

-a correctly positioned oblique lumbar spine scotty dog images of the superior articular process, the
patient’s shows nose to the transverse process, his eye to the pedicle, his neck to the pars articularis and
his body to the lamina.

2.) When a patient is received for a cervical spine to rule out sublaxation or fracture, which of the
following projections should be done?

a.) routine cervical spine, seated b.) routine cervical spine, recumbent

c.) horizontal beam lateral d.) flexion and extension lateral

-any movement of the head and neck could cause serious damage to the spinal cord. A horizontal beam
lateral is performed and evaluated. The physicians will then decide what further films are required.

3.) Which of the following positions will demonstrate the lumbar apophyseal articulations?

a.) AP projection b.) lateral projection

c.) 30 degrees RPO d.) 45 degrees LPO

-the articular facets (apophyseal joints) of the L5-S1 articulation form a 30 degrees angle with the MSP.
The 45 degrees oblique position will demonstrate the apophyseal joints of L1-L4.

4.) Which of the following is/are appropriate technique/s for imaging a patient with possible traumatic
spine injury?

1.) Instruct the patient to turn slowly and stop if anything hurts

2.) Maneuver the x-ray tube instead of moving the patient.

3.) Call for help and use the log rolling method to turn the px.

a.) 1 and 2 only b.) 1 and 3 only

c.) 2 and 3 only d.) 1,2 and 3

-when imaging a patient with possible traumatic spine injury, it is appropriate to either maneuver the x-
ray tube instead of the patient or, if the patient must be moved, to use the log rolling method. This
cannot be done by one person, so the radiographer must summon in assistance.
5.) Which of the following projections can be used to supplement the traditional “open mouth method”
when the upper portion of the odontoid process cannot be well demonstrated?

a.) AP or PA though the foramen magnum b.) AP oblique with R and L head rotation

c.) Horizontal beam lateral d.) AP axial

-accurate adjustment of these structures usually will allow good visualization of the odontoid process
and the atlanto-axial projection. The patient anatomy occasionally prevent the usual visualization of the
odontoid process can be visualized through the foramen magnum.

6.) Place the patient in a lateral recumbent position with the head elevated on the patient’s arm. Centre
the midcoronal of the body to the midline of the grid. Extend the arm closest to the IR above the head
and the CR is angulated 3-5 degrees caudally. What is the best described by this position?

a.) pillars method b.) swimmers method

c.) lateral projection d.) otonello method

-the swimmers technique is performed when shoulder superimposition obscures C7 on a lateral cervical
spine projection or when a lateral projection of the upper thoracic vertebra is needed.

7.) In Grandy method for the visualization of the lateral view of the cervical vertebrae, the patient is on
erect position in front of the VCH, The part understudy is in perfect lateral position, the C4 is at the
centre part of the cassette, the central ray is directed _________.

a.) angulated cephalad b.) angulated caudad

c.) vertical d.) horizontal

-the Grandy method demonstrates the lateral view of the cervical bodies and their interspaces, the
articular pillars, the lower five zygopophyseal joint and the CR is directed horizontally.

8.) What serves as a fulcrum in the left and the right bending for scoliosis series?

a.) C1 b.) T4

c.) L5 d.) sacrum

-L5 serves as the fulcrum in the R and L bending for scoliosis series
9.) With the CR directed along a straight line extending from the superior edge of the crest of the
uppermost ilium through L5 to the inguinal region of the dependent side. Depending on the alignment
of the spine, the central ray angulation may vary from 15 to 30 degrees caudad. What
projection/method is described for visualization of intervertebral foramen?

a.) Chamberlaine method b.) AP axial projection

c.) Nolke method d.) Kovacs method

Kovacs method was described. nolke method is used for sacral vertebral canal and SI joint visualization.
Chamberlaine is for abnormal SI motion.

10.) For AP axial projection of the LS junction and SI joints, an angle of 30-35 degrees cephalad will be
the average. However, there is a difference in angling depending on the patients gender. What is the
satisfactory angle applied for male patients?

a.) 30 degrees b.) 32 degrees

c.) 33 degrees d.) 35 degees

- An angulation of 30 degrees in male patients and 35 degrees in female patient is usually satisfactory.

11.) The lumbar pedicle is represented by what part of the “scotty dog” seen in a correctly positioned
oblique lumbar spine?

a.) ear b.) nose

c.) eye d.) body

-a correctly positioned oblique lumbar spine scotty dog images of the superior articular process, the
patient’s shows nose to the transverse process, his eye to the pedicle, his neck to the pars articularis and
his body to the lamina.

12.) What is/are the advantage/s of performing PA projection of the lumbar spine?

1.) intervertebral disk spaces are being placed parallel to the divergence of the beam

2.) intervertebral disk spaces are being placed perpendicular to the divergence of the beam

3.) This projection also reduces the dose to the patient.

a.) 1 only b.) 1 and 3 only

c.) 2 only d.) 2 and 3 only

- The PA projection places the intervertebral disk pace at an angle closely paralleling the divergence of
the beam of radiation. This projection also reduces the do e to the patient. For this reason the PA
projection is sometime used for upright studies of the lumbar and lumbosacral spine.
13.) What are the evaluation criteria of obtaining a properly positioned and lateral projection of the
thoracic spine?

1.) Twelve thoracic vertebrae centered on the image receptor.

2.) Superimposition of the shoulders on the upper vertebrae may cause underexposure in this
area.

3.) Open intervertebral disk spaces.

4.) Blurred mandible with resultant visualization of the underlying atlas and axis

a.) 1, 2 and 3 only b.) 2, 3 and 4 only

c.) 1 and 2 only c) 1 and 4 only

-blurred mandible will be seen in otonello method

14.) The vertebral arch or pillars are visualized by performing a PA axial oblique projection of the cervical
spine. What technique could be used to demonstrate C2-C5?

a.) flex the patient’s neck b.) extend the patient’s neck

c.) no neck flexion and extension d.) parallel CR

- To demonstrate the C2-C5, flex the patient's neck somewhat to reduce the cervical curve

15.) The vertebral arch or pillars are visualized by performing a PA axial oblique projection of the cervical
spine. What technique could be used to demonstrate C5-C7 and T1-T4?

a.) flex the patient’s neck b.) extend the patient’s neck

c.) no neck flexion and extension d.) parallel CR

- To demonstrate C5-C7 and T1-T4, adjust the patient's head in moderate extension.

16.) What is the ideal AP oblique body rotation to well visualize the zygapophyseal joints?

a.) 30 degrees b.) 45 degrees

c.) 20 degrees d.) 60 degrees

- Rotating the body 20 degrees anterior (PA oblique) or posterior (AP oblique) will form the coronal
plane form an angle of 70 degrees from the plane of the IR.
17.) For AP axial projection of the LS junction and SI joints, an angle of 30-35 degrees cephalad will be
the average. However, there is a difference in angling depending on the patients gender. What is the
satisfactory angle applied for female patients?

a.) 30 degrees b.) 32 degrees

c.) 33 degrees d.) 35 degees

- An angulation of 30 degrees in male patients and 35 degrees in female patient is usually satisfactory.

18.) What is the CR in obtaining AP axial projection of the sacrum?

a.) 15 degree cephalad and center it to a point 2 inches (5 cm) superior to the pubic symphysis

b.) 10 degrees caudad and center it to a point about 2 inches (5 cm) superior to the pubic symphysis

c.) 15 degrees caudad and center it to the clearly visible sacral curve

d.) 10 degrees cephalic and center it to a point about 2 inches (5 cm) superior to the easy palpable
coccyx

-With the patient supine, direct the central ray 15 degree cephalad and center it to a point 2 inches (5
cm) superior to the pubic symphysis.

19.) What is the CR in obtaining PA axial projection of the sacrum?

a.) 15 degree cephalad and center it to a point 2 inches (5 cm) superior to the pubic symphysis

b.) 10 degrees caudad and center it to a point about 2 inches (5 cm) superior to the pubic symphysis

c.) 15 degrees caudad and center it to the clearly visible sacral curve

d.) 10 degrees cephalic and center it to a point about 2 inches (5 cm) superior to the easy palpable
coccyx

- With the patient prone, angle the central ray 15 degrees caudad and center it to the clearly visible
sacral curve
20.) What is the CR in obtaining AP axial projection of the coccyx?

a.) 15 degree cephalad and center it to a point 2 inches (5 cm) superior to the pubic symphysis

b.) 10 degrees caudad and center it to a point about 2 inches (5 cm) superior to the pubic symphysis

c.) 15 degrees caudad and center it to the clearly visible sacral curve

d.) 10 degrees cephalic and center it to a point about 2 inches (5 cm) superior to the easy palpable
coccyx

- With the patient supine, direct the central ray 10 degrees caudad and center it to a point about 2
inches (5 cm) superior to the pubic symphysis

21.) What is the CR in obtaining PA axial projection of the coccyx?

a.) 15 degree cephalad and center it to a point 2 inches (5 cm) superior to the pubic symphysis

b.) 10 degrees caudad and center it to a point about 2 inches (5 cm) superior to the pubic symphysis

c.) 15 degrees caudad and center it to the clearly visible sacral curve

d.) 10 degrees cephalic and center it to a point about 2 inches (5 cm) superior to the easy palpable
coccyx

- With the patient prone, angle the central ray 10 degree cephalad and center it to the easily palpable
coccyx

22.) This method requires the patient seated at the end of the radiographic table and has a
perpendicular central ray along the axis of the sacrum.

a.) Chamberlaine method b.) AP axial projection

c.) Nolke method d.) Kovacs method

-Nolke method is described. Chamberlaine is for abnormal SI motion, kovacs method is for intervertebral
foramina visualization.
23.) What is/are widely used as routine for scoliosis series for thoracic and lumbar spine?

1.) PA projection erect

2.) PA projection recumbent

3.) PA right flexion recumbent

4.) PA left flexion recumbent

a.) 1, 3 and 4 only b.) 2,3 and 4 only

c.) 3 and 4 only d.) all of mentioned

- Another widely used scoliosis series consists of four images of the thoracic and lumbar spine: a direct
PA projection with the patient standing, a direct PA projection with the patient prone. And PA
projections with alternate right and left lateral flexion in the prone position.

24.) What are the evaluation criteria in evaluating lateral projection of the cervico-thoracic spine?

1.) lateral vertebrae not rotated

2.) shoulders separated from each other

3.) radiographed area approximately C5-T4

4.) x-ray penetration of the shoulder region

a.) 1,2 and 3 only b.) 1,2 and 4 only

c.) 2,3 and 4 only d.) all mentioned

- The following should be clearly demonstrated in lateral projection of the cervicothoracic region: •
Lateral vertebrae not appreciably rotated • Shoulders separated from each other • Area from
approximately C5 to T4 • X-ray penetration of the shoulder region

25.) A patient entered the x-ray room having the request of Lumbar spine radiograph. Upon interview,
the patient told the radiographer that he is complaining about his arthritis. What position and projection
shoud be used?

a.) AP and Lateral recumbent b.) AP and lateral erect

c.) AP and obliques recumbent d.) AP and obliques erect

- for arthritic patient, it is best to do the weigh bearing position.

26.) The lumbar lamina is represented by what part of the “scotty dog” seen in a correctly positioned
oblique lumbar spine?

a.) ear b.) nose

c.) eye d.) body

-a correctly positioned oblique lumbar spine scotty dog images of the superior articular process, the
patient’s shows nose to the transverse process, his eye to the pedicle, his neck to the pars articularis and
his body to the lamina.

27.) In the lateral projection of the L5-S1 junction, what is the CR angulation for male patients if the
spine is not in true horizontal position?

a.) 8 degrees caudally b.) 8 degrees cephalic

c.) 5 degrees caudally d.) 5 degrees cephalic

-When the spine is not in the true horizontal position, the central ray is angled 5 degrees caudally for
male patients and 8 degrees caudally for female patients.

28.) In the lateral projection of the L5-S1 junction, what is the CR angulation for male patients if the
spine is not in true horizontal position?

a.) 8 degrees caudally b.) 8 degrees cephalic

c.) 5 degrees caudally d.) 5 degrees cephalic

-When the spine is not in the true horizontal position, the central ray is angled 5 degrees caudally for
male patients and 8 degrees caudally for female patients.

29.) What is the reference point for AP oblique projection of SI joints?

a.) 1.5 inch medial to the elevated ASIS b.) 1.5 inch lateral to the elevated ASIS

c.) 1 inch medial to the elevated ASIS d.) 1 inch lateral to the elevated ASIS

-the CR for AP oblique SI joint is Perpendicular to the center of the IR, entering 1 inch (2.5 cm) medial to
the elevated ASIS
30.) What is the reference point in obtaining a lateral projection of the coccyx?

a.) 9cm posterior to the ASIS b.) 9cm posterior to the ASIS and 5cm inferior

c.) perpecdicular to the ASIS d.) perpendicular to the ASIS and 5cm superior

- Perpendicular and directed toward a point 3 ½ inches (9 cm) posterior to the ASIS and 2 inches (5 cm)
inferior. Tills centering should work for most patients.

31.) What is the CR lateral projection “Pawlow” method suggest?

a.) Directed to the inter-disk of C7 and T1 at an angle of 6 to 8 degree caudad.

b.) Directed to the inter-disk of C7 and T1 at an angle of 3 to 5 degree caudad.

c.) Directed to the inter-disk of C7 and T1 at an angle of 6 to 8 degree cephalic.

d) Directed to the inter-disk of C7 and T1 at an angle of 3 to 5 degree cephalic.

-the CR in lateral projection “Pawlow” method is directed to the inter-disk of C7 and T1 at an angle of 3
to 5 degree caudad.

32.) What is the CR angulation needed to visualize PA axial oblique of the vertebral arch?

a.) Directed to C7 at an average angle of 45 degrees cephalad

b.) Directed to C7 at an average angle of 45 degrees caudad

c.) Directed to C7 at an average angle of 35 degrees caudad

d.) Directed to C7 at an average angle of 35 degrees cephalad

- Directed to C7 at an average angle of 35 degrees cephalad (range: 30 to 40 degrees) and exiting at the
level of the mandibular symphysis

33.) This AP projection is also known as the “wagging” technique.

a.) grandy method b.) ottonello method

c.) fisherman method d.) pillars

- grandy method is for lateral c-spine method. otonello is also known as the wagging technique
34.) What is the recommended SID in performing PA axial oblique projection of the cervical
intervertebral foramina?

a.) 40-42 inches b.) 40-60 inches

c.) 72-100 inches d.) 60-72 inches

- A 60-72-inch ( 1 52- to 1 83- cm) SID is recommended because of the increased OlD.

35.) What is the recommended SID in performing lateral projection of the cervical spine?

a.) 40-42 inches b.) 40-60 inches

c.) 72-100 inches d.) 60-72 inches

- A 60-72-inch ( 1 52- to 1 83- cm) SID is recommended because of the increased OlD.

36.) What is the CR of a lateral projection of cervical spine?

a.) C2 b.) C3 c.) C4 d.) C5

-Horizontal and perpendicular to C4. With such centering, the magnified outline of the shoulder farthest
from the IR i be projected below the lower cervical vertebrae.

37.) What is the CR of an AP axial projection of cervical spine?

a.) 5-10 degrees cephalic b.) 10-15 degrees cephalic

c.) 15-20 degrees cephalic d.) 20-25 degrees cephalic

- Directed through C4 at an angle of 15 to 20 degrees cephalad. The central ray enters at or slightly
inferior to the most prominent point of the thyroid cartilage.

38.) The following are used to radiograph the Dens except:

a.) fuchs method b.) judd method

c.) grandy method d.) kasabach method

-the dens is not visualized in the grandy method

39.) What are the structures shown in obtaining fuchs method?

1.) mandible 2.) anterior arch of atlas 3.) dens

4.) foramen magnum 5.) body of axis 6.) posterior arch of C1

7.) occipital bone

a.) 1,2,4,and 7 only b.) 2, 4, 6 and 7 only

c.) 2,3,4,5, 6 and 7 only d.) all of the above

-mandible, anterior arch of atlas, dens, foramen magnum, body of axis, posterior arch of C1 and occipital
bone are all visualized in fuchs method.

40.) What are the preparations before performing a Lumbar radiograph?

a.) bowel preparation b.) emptying the urinary bladder

c.) non of the mentioned c.) all mentioned

-bowel preparation and bladder emptying are necessary for lumbar spine radiography unless evaluating
fracture.

41.) In this PA projection of the intervertebral disk, the patient is in standing position with the CR
directed perpendicular to L3 at an angle of 15-20 degrees caudad. What method is described?

a.) Chamberlaine method b.) weight bearing method

c.) Nolke method d.) Kovacs method

-the weight bearing method R an L bending has a CR of 15-20 degrees caudally directed to L4 and L5

42.) The evaluation criteria for PA projection of weight bearing intervertebral disk of lumbar spine are
the following except:

a.) Area from the lower thoracic interspaces to all of the sacrum

b.) No rotation of the patient in the bending position

c.) Bending direction correctly identified on the image with appropriate lead marker

d.) axial view of the lower lumbar interspaces

-there is no axial view because the projection is anteroposterior

43.) What is the degree of body obliquity required to demonstrate sacroiliac joint AP projection?

a.) 25-30 degrees b.) 35-40 degrees

c.) 15-20 degrees d.) 45 degrees

-for posterior oblique position of SI joint, 25-30 degrees is the recommended obliquity

44.) What is the degree of body obliquity required to demonstrate zygapophyseal joints?

a.) 25-30 degrees b.) 35-40 degrees

c.) 15-20 degrees d.) 45 degrees

- for the zygapophyseal joint adjust the degree of body rotation to an angle of 45 degrees for the lumbar
region and 30 degrees from the horizontal.

45.) What are the structures shown in imaging L5-S1 lumbosacral junction?

1.) Open lumbosacral joint

2.) Collimated x-ray beam that includes all of LS and the upper sacrum

3.) Lumbosacral joint in the center of the exposure area

4.) Crests of the ilia closely superimposing each other when the x-ray beam is not angled

a.) 1,2 and 3 only b.) 2,3 and 4 only

c.) 1, 3 and 4 only d.) all of the above

-all mentioned are part of the evaluation criteria

46.) What is the central ray of AP oblique projection of zygapophyseal joint?

a.) Perpendicular to the IR exiting or entering the level of T7

b.) Perpendicular to the IR exiting or entering the level of T6

c.) Perpendicular to the IR exiting or entering the level of T5

d.) Perpendicular to the IR exiting or entering the level of T9

-the CR for AP oblique projection of zygapophyseal joint is perpendicular to T7

47.) This projection is also called the "swimmer's lateral" projection It is most often performed with
either a lateral cervical or lateral thoracic projection when the shoulders superimpose the vertebrae in
the area of interest.

a.) fuchs method b.) judd method

c.) pawlow method d.) kasabach method

-pawlow method is also called the swimmers lateral because of their position.

48.) When taking an AP cervical open mouth x-ray image, what is the ideal position for the patient?

a.) patient should be sitting and facing straight ahead with her mouth slightly open

b.) patient should be sitting with her chin tucked and mouth open as wide as possible

c.) patient should be standing and facing straight ahead with her mouth slightly open

d.) patient should be sitting and facing straight ahead with her mouth slightly open

- When taking an AP cervical open mouth x-ray image, the patient should be sitting with her chin tucked
and mouth open as wide as possible

49.) When taking oblique cervical x-ray images, the body is at ___ degrees, the tube is at ____ degrees,
and the CR is through ____.

a.) 15, 45, C4 b.) 45, 90, C4

c.) 45, 15, C4 d.) 15, 45, thyroid process

- When taking oblique cervical x-ray images, the body is at 45 degrees, the tube is at 15 degrees, and the
CR is through C4.

50.) When taking a Lateral Cervical X-Ray Image, what is the Tube Tilt and Distance?

a.) no tube tilt at 40 degrees b.) 15 degree Tube Tilt towards the floor at 72 Inches

c.) No Tube Tilt at 72 Inches d.) 5 Degree Tube Tilt towards the floor at 40 inches

- When taking a Lateral Cervical X-Ray Image, no tilt of x-ray tube is done.

51.) When taking an AP Cervical Open Mouth X-Ray Image, where should the central ray be pointed?

a.) through the open mouth b.) Through the tip of the nose

c.) through the Thyroid Cartilage d.) Through C4

- When taking an AP Cervical Open Mouth X-Ray Image, the CR should be pointed through the open
mouth

52.) Besides the AP Cervical and the Lateral Cervical images, what are the other commonly taken images
of the cervical spine?

a.) Posterior Oblique b.) Anterior Oblique

c.) Flexion and Extension d.) All of the above

-all of the above can be done depending on patient’s situation

53.) When taking an AP Cervical Open Mouth X-Ray Image, what is the Tube Tilt and Distance?

a.) no Tube Tilt at a Distance of 40 Inches

b.) 15 degree Tube Tilt towards the floor at a Distance of 40 Inches

c.) 15 degree Tube Tilt towards the head at a Distance of 40 Inches

d.) 5 degree Tube Tilt towards the floor at a Distance of 72 Inches

- When taking an AP Cervical Open Mouth X-Ray Image, the x-ray tube must be tilted 15 degrees
cephalad.

54.) When taking an AP Lumbar spine, what is the Tube Tilt and Distance?

a.) no Tube Tilt at a Distance of 40 Inches

b.) 15 degree Tube Tilt towards the floor at a Distance of 40 Inches

c.) 15 degree Tube Tilt towards the head at a Distance of 40 Inches

d.) 5 degree Tube Tilt towards the floor at a Distance of 72 Inches

- When taking an AP Lumbar spine, the x-ray tube must be parallel 2’ above iliac crest
55.) At what level is the CR directed in obtaining a lateral view of the thoracic spine?

a.) at the level of T5 b.) at the level of T6

c.) at the level of T7 d.) at the level of T8

- the level of the 7th thoracic vertebra, which correlates to the inferior border of the scapula, centered directly
over the thoracic spine

56.) Besides the AP and Lateral thoracic spine images, what are the other commonly taken images of the
thoracic spine?

a.) Posterior Oblique b.) Anterior Oblique

c.) Flexion and Extension d.) All of the above

-all of the above can be done depending on patient’s situation

57.) Besides the AP and Lateral lumbar spine images, what are the other commonly taken images of the
lumbar spine?

a.) Posterior Oblique b.) Anterior Oblique

c.) Flexion and Extension d.) All of the above

-all of the above can be done depending on patient’s situation

58.) What is the common routine used in thoracic and lumbar spine radiography?

a.) AP and lateral b.) AP and obliques

c.) obliques and lateral d.) AP and PA

-the common routine used is AP and lateral. Obliques are supplementary

59.) The left anterior posterior oblique projection of the lumbar spine will best demonstrate the
zygapophyseal joint____to the film surface.

a.) closest b.) farthest

c.) neither d.) either

- The left anterior posterior oblique projection of the lumbar spine will best demonstrate the
zygapophyseal joint closes to the film surface.
60.) Which of the following angles is required for an AP projection of the sacrum

a.) 5 degrees caudal b.) 5 degrees cephalic

c.) 15 degrees caudal d.) 15 degrees cephalic

-15 degrees cephalic is required for an AP projection of the sacrum