Test Bank for Radiographic Image Analysis 4th Edition by Martensen

Test Bank for Radiographic Image Analysis 4th

Edition by Martensen

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Chapter 06: Image Analysis of the Lower Extremity

MULTIPLE CHOICE

1. The IP and MTP joint spaces on toe projections are open and demonstrated without
distortion when the
1. central ray is aligned parallel with them.
2. central ray is aligned perpendicular to them.
3. joints are aligned parallel with the IR.
4. joints are aligned perpendicular to the IR.
a. 1 and 3 only
b. 1 and 4 only
c. 2 and 3 only
d. 2 and 4 only
ANS: B REF: PP. 280-283

2. For an AP oblique second toe projection, the toe is rotated _____ degrees _____.
a. 30; laterally
b. 45; laterally
c. 30; medially
d. 45; medially
ANS: D REF: P. 284

3. An AP first toe projection that was obtained with the foot and toe rotated 45 degrees
medially demonstrates
1. equal soft tissue width on both sides of each of the phalanges.
2. more midshaft concavity on one side of the phalanges than on the opposite side.
3. twice as much soft tissue on one side of the phalanges as on the opposite side.
4. convexity on one side of the phalanges and concavity on the opposite side.
a. 1 and 2 only
b. 1 and 4 only
c. 2 and 3 only.
d. 3 and 4 only
ANS: C REF: PP. 284-285

4. For a lateral fourth toe projection, the

1. foot is rotated laterally until the toe is in a lateral projection.
2. adjacent toes are drawn away from the affected toe.
3. long axis of the digit is aligned with the transverse axis of the collimated field.
4. central ray is centered to the PIP joint.
a. 1 and 2 only
b. 2 and 3 only
c. 1, 2, and 4 only
d. 1, 3, and 4 only
ANS: C REF: PP. 286-287
5. Which of the following positioning setup procedures must be completed to obtain open
tarsometatarsal and navicular-cuneiform joint spaces on an AP axial foot projection?
1. The patient’s foot is positioned flat against the IR.
2. The foot, ankle, and lower leg are aligned.
3. The central ray is angled 10 to 15 degrees proximally.
4. A compensating filter is placed over the toes.
a. 1 and 3 only
b. 3 only
c. 1, 2, and 3 only
d. 1 and 4 only
ANS: A REF: PP. 288-290

6. Where should the central ray be centered for an AP axial projection of the foot?
a. Third metatarsophalangeal joint
b. Base of the third metatarsal
c. Anterior talus
d. Intermediate cuneiform
ANS: B REF: PP. 288-290

7. An AP axial foot projection obtained with the foot laterally rotated demonstrates
1. a closed medial–intermediate cuneiform joint space.
2. closed tarsometatarsal joint spaces.
3. the calcaneus with increased talar superimposition.
4. a decrease in metatarsal base superimposition.
a. 1 and 3 only
b. 1 and 4 only
c. 2 and 3 only
d. 1, 2, and 4 only
ANS: A REF: P. 290

8. How can the positioning setup procedure be adjusted for an AP axial foot projection to
demonstrate uniform image density throughout the toes and foot areas?
1. Position the toes at the anode end of the x-ray tube.
2. Use a kVp above 75.
3. Use a grid.
4. Place a contact shield over the toes.
a. 1 only
b. 2 and 3 only
c. 1 and 4 only
d. 4 only
ANS: A REF: P. 291

9. An AP oblique foot projection with accurate positioning demonstrates

1. open first and second intermetatarsal joint spaces.
2. open joint spaces around the cuboid.
3. slight superimposition of the fourth and fifth metatarsal bases.
4. the long axis of the foot aligned with the long axis of the collimated field.
 a. 1 and 2 only
b. 1 and 3 only
c. 1, 3, and 4 only
d. 2 and 4 only
ANS: D REF: P. 294

10. What joint spaces are open on an AP oblique foot projection with accurate positioning?
1. Second through fifth intermetatarsal joints
2. Navicular-cuneiform
3. Joint spaces surrounding the cuboid
4. Tarsometatarsal
a. 1 and 3 only
b. 3 only
c. 1, 3, and 4 only
d. 1, 2, 3, and 4
ANS: A REF: P. 294

11. Which of the following pertains to the positioning setup for an AP oblique foot projection
on a patient with a high longitudinal arch?
1. Rotate the patient’s foot 60 degrees.
2. Angle the central ray 15 degrees proximally.
3. Align the long axis of the foot with the long axis of the collimated field.
4. Center the central ray to the third metatarsal base.
a. 1 and 3 only
b. 3 and 4 only
c. 1, 2, and 4 only
d. 1, 3, and 4 only
ANS: D REF: P. 295

12. On a lateral foot projection with accurate positioning, the

1. medial talar dome is demonstrated slightly superior to the lateral dome.
2. tibiotalar joint space is open.
3. talar domes are superimposed.
4. distal fibula is superimposed by the posterior half of the distal tibia.
a. 1 and 3 only
b. 2 and 4 only
c. 2, 3, and 4 only
d. 3 and 4 only
ANS: C REF: P. 298

13. Which aspect of the foot is placed parallel with the IR for a routine lateral foot projection?
a. Plantar
b. Dorsal
c. Lateral
d. Medial
ANS: C REF: P. 298
14. If the medial talar dome were positioned distal to the lateral talar dome on a lateral foot
projection, which of the following is true?
a. The patient’s heel was elevated off the IR.
b. The patient’s proximal tibia was elevated.
c. The patient’s forefoot and toes were elevated off the IR.
d. The patient’s distal lower leg was elevated.
ANS: B REF: P. 300

15. A lateral foot projection obtained in a patient whose leg was externally rotated (heel off IR)
demonstrates
1. more than 0.5 inch (1 cm) of the cuboid posterior to the navicular.
2. the fibula situated too posterior to the tibia.
3. the lateral talar dome anterior to the medial talar dome.
4. an obscured tibiotalar joint space.
a. 1 and 2 only
b. 2 only
c. 3 only
d. 2 and 4 only
ANS: D REF: P. 300

16. Which of the following pertains to a lateral foot projection that demonstrates the lateral talar
dome distal to the medial talar dome?
1. The patient was imaged with the distal tibia elevated.
2. More than 0.5 inch (1 cm) of the cuboid is demonstrated posterior to the navicular.
3. The lateral talar dome is also anterior to the medial talar dome.
4. The fibula would be situated too far posterior to the tibia.
a. 1 only
b. 1 and 2 only
c. 3 and 4 only
d. 1, 2, 3, and 4
ANS: B REF: PP. 300-301

17. Which of the following is true with respect to axial calcaneal projections?
1. The image demonstrates an open talocalcaneal joint space.
2. The foot is flexed 90 degrees to the lower leg and rotated slightly laterally.
3. A 40-degree central ray is directed proximally.
4. The central ray is centered to the distal fifth metatarsal.
a. 1 and 3 only
b. 1 and 2 only
c. 3 and 4 only
d. 1, 3, and 4 only
ANS: A REF: P. 305

18. An axial calcaneus projection with the patient’s foot in plantar flexion and the central ray
angled 40 degrees proximally demonstrates a(n)
1. elongated calcaneal tuberosity.
 2. foreshortened calcaneal tuberosity.
3. open talocalcaneal joint space.
4. closed talocalcaneal joint space.
a. 1 and 3 only
b. 1 and 4 only
c. 2 and 3 only
d. 2 and 4 only
ANS: D REF: P. 305

19. For an AP ankle projection, the

1. intermalleolar line is aligned at a 15- to 20-degree angle with the IR.
2. lateral malleolus is positioned more posterior than the medial malleolus.
3. long axis of the foot is positioned perpendicular to the IR.
4. central ray is centered at the level of the medial malleolus.
a. 2 and 4 only
b. 2, 3, and 4 only
c. 1, 3, and 4 only
d. 1, 2, 3, and 4
ANS: D REF: P. 308

20. An AP ankle projection obtained with the patient’s leg in lateral rotation will demonstrate
which of the following?
1. A closed medial mortise
2. Decreased talar and fibular superimposition
3. An open lateral mortise
4. The sinus tarsi
a. 1 only
b. 1 and 2 only
c. 2, 3, and 4 only
d. 4 only
ANS: A REF: P. 311

21. A 15- to 20-degree internally rotated AP oblique ankle projection with accurate positioning
demonstrates which of the following joints as open spaces?
1. Tibiotalar
2. Talofibular
3. Lateral mortise
4. Medial mortise
a. 1 and 4 only
b. 2 and 3 only
c. 1, 2, and 4 only
d. 1, 2, and 3 only
ANS: C REF: PP. 315-316

22. For a 15- to 20-degree internally rotated AP oblique ankle projection, the
1. central ray is centered at the level of the medial malleolus.
2. foot is dorsiflexed to a 90-degree angle with the lower leg.
 3. long axis of the lower leg is aligned with the long axis of the collimated field.
4. leg is internally rotated until the intermalleolar line is parallel with the IR.
a. 1 and 2 only
b. 2 and 4 only
c. 1 and 3 only
d. 1, 2, 3, and 4
ANS: D REF: P. 314

23. A 15- to 20-degree internally rotated AP oblique ankle projection with poor positioning
demonstrates an open distal lateral mortise superimposing the calcaneus. How was the
patient mispositioned for such an image to be obtained?
a. The foot was plantarflexed.
b. The leg was not adequately internally rotated.
c. The central ray was centered too caudally.
d. The proximal lower leg was elevated.
ANS: A REF: PP. 315-316

24. Why should the foot be dorsiflexed to a 90-degree angle with the lower leg for a lateral
ankle projection?
1. It places the tibiotalar joint in a neutral position.
2. It prevents the patient from rotating posteriorly.
3. It allows the anterior pretalar fat pad to be used to detect joint effusion.
4. It positions the talar domes on top of each other.
a. 1 and 3 only
b. 1, 2, and 3 only
c. 3 only
d. 1 and 4 only
ANS: A REF: P. 320

25. For a lateral ankle projection, the

1. medial and lateral malleoli are positioned directly on top of each other.
2. lateral foot surface is aligned parallel with the IR.
3. lower leg is parallel with the imaging table.
4. central ray is centered to the medial malleolus.
a. 2 and 4 only
b. 1 and 3 only
c. 2, 3, and 4 only
d. 1, 2, 3, and 4
ANS: C REF: P. 318

26. A lateral ankle projection with accurate positioning demonstrates

1. an open tibiotalar joint.
2. a narrowed talocalcaneal joint.
3. 1 inch (2.5 cm) of the fifth metatarsal base.
4. the fibula in the posterior half of the tibia.
a. 1, 2, and 3 only.
b. 2 and 4 only.
 c. 1, 3, and 4 only.
d. 1, 2, 3, and 4
ANS: C REF: P. 318

27. A lateral ankle projection demonstrates the fibula too anterior to the tibia, and a narrowed
talocalcaneal joint. How are the talar domes positioned on this projection?
1. Medial dome anterior
2. Medial dome proximal
3. Lateral dome anterior
4. Lateral dome proximal
a. 1 and 2 only
b. 2 and 3 only
c. 3 and 4 only
d. 1 and 4 only
ANS: C REF: P. 320

28. For an AP projection of the knee with accurate positioning,

1. an imaginary line connecting the femoral epicondyles is aligned parallel with the IR.
2. the intercondylar eminence is centered within the intercondylar fossa.
3. the fibular head is demonstrated about 0.5 inch (1.25 cm) distal to the tibial plateau.
4. the femoral condyles are symmetrical.
a. 1 and 2 only
b. 2 and 3 only
c. 1, 2, and 4 only
d. 1, 2, 3, and 4
ANS: D REF: P. 328

29. A cephalic central ray angulation is required on an AP knee projection when the
1. examination is performed with the patient in an upright position.
2. patient’s anterior tibial margin is demonstrated distal to the posterior tibial margin on
the resulting image.
3. the patient’s ASIS to imaging table measurement is 22 cm.
4. the knee is flexed and a curved IR is used.
a. 2 and 3 only
b. 4 only
c. 2 and 4 only
d. 1, 2, and 4 only
ANS: C REF: PP. 328-329

30. If the patient is unable to extend the knee fully, an open femorotibial joint is accomplished
by aligning the central ray perpendicular to the anterior surface of the lower leg and then
a. decreasing the angle 3 to 5 degrees and centering to the femorotibial joint.
b. increasing the angle 3 to 5 degrees and centering to the femorotibial joint.
c. centering to the femorotibial joint.
ANS: A REF: P. 330
31. The placement of the patella in relationship to the femorotibial joint space on an AP knee
projection is affected by
1. patellar subluxation.
2. knee rotation.
3. knee flexion.
4. foot inversion.
a. 2 only
b. 1 and 3 only
c. 1, 2, and 3 only
d. 1, 2, 3, and 4
ANS: B REF: P. 330

32. An AP knee projection obtained with the central ray angled too cephalically demonstrates
1. symmetrical femoral condyles.
2. a foreshortened fibular head.
3. the fibular head at a position less than 0.5 inch (1 cm) distal to the tibial plateau.
4. a narrowed or closed femorotibial joint space.
a. 1, 3, and 4 only
b. 1, 2, and 4 only
c. 2 and 3 only
d. 1, 2, 3, and 4
ANS: B REF: PP. 331-332

33. An AP knee projection obtained with the knee internally rotated demonstrates
1. a larger appearing medial femoral condyle than lateral condyle.
2. a larger appearing lateral femoral condyle than medial condyle.
3. the fibular head with increased tibial superimposition.
4. the fibular head with decreased tibial superimposition.
a. 1 and 3 only
b. 1 and 4 only
c. 2 and 3 only
d. 2 and 4 only
ANS: D REF: P. 329

34. For an externally rotated AP oblique knee projection with accurate positioning, the
1. fibular head is demonstrated free of tibial superimposition.
2. lateral femoral condyle is demonstrated in profile.
3. fibular head, neck, and shaft are superimposed by the tibia.
4. medial condyle is shown in profile.
a. 1 and 2 only
b. 1 and 4 only
c. 2 and 3 only
d. 3 and 4 only
ANS: D REF: P. 332

35. For an externally rotated AP oblique knee projection, the

 1. leg is externally rotated until an imaginary line connecting the femoral epicondyles is at
a 45-degree angle with the IR.
2. leg is internally rotated until an imaginary line connecting the femoral epicondyles is at
a 45-degree angle with the IR.
3. central ray is aligned parallel with the tibia plateau.
4. central ray is centered at a level 0.75 inch (2 cm) distal to the medial femoral
epicondyles.
a. 1 and 4 only
b. 1 and 3 only
c. 2 and 4 only
d. 1, 3, and 4 only
ANS: B REF: PP. 332-333

36. For a lateral knee projection,

1. an imaginary line connecting the femoral epicondyles is aligned parallel with the IR.
2. a patient with long femora and a narrow pelvis does not require an angled central ray.
3. a grid is used if the knee measures over 10 cm.
4. the central ray is centered 1 inch (2.5 cm) distal to the medial femoral epicondyles.
a. 1 and 2 only
b. 2 and 4 only
c. 2, 3, and 4 only
d. 1, 2, 3, and 4
ANS: C REF: P. 337 | PP. 341-342

37. A lateral knee projection with accurate positioning demonstrates

1. superimposed femoral condyles.
2. the fibular head without tibial superimposition.
3. an open femorotibial joint space.
4. one-fourth of the distal femur and proximal lower leg.
a. 1 and 3 only
b. 2 and 4 only
c. 1, 3, and 4 only
d. 1, 2, 3, and 4
ANS: C REF: P. 337

38. If the medial femoral condyle is situated anterior to the lateral femoral condyle on a lateral
knee projection with poor positioning, which of the following is true?
1. The fibular head demonstrates increased tibia superimposition.
2. The adductor tubercle will be located on the anterior condyle.
3. The distal surface of the anterior condyle will appear flatter.
4. The fibular head will demonstrate a decrease in tibial superimposition.
a. 1 and 2 only
b. 2 and 3 only
c. 2 and 4 only
d. 2, 3, and 4 only
ANS: C REF: P. 344
39. A lateral knee projection demonstrates the medial femoral condyle anterior and proximal to
the lateral femoral condyle. How was the positioning setup mispositioned for such an image
to be obtained?
1. The central ray was angled too caudally.
2. The central ray was angled too cephalically.
3. The patient’s patella was positioned too close to the IR.
4. The patient’s patella was positioned too far away from the IR.
a. 1 and 3 only
b. 1 and 4 only
c. 2 and 3 only
d. 2 and 4 only
ANS: C REF: PP. 340-342

40. A lateral knee projection obtained with the patella positioned too close to the IR (leg
externally rotated) will demonstrate the
1. fibula with increased tibial superimposition.
2. fibula with decreased tibial superimposition.
3. medial femoral condyle anterior to the lateral femoral condyle.
4. medial condyle distal to the lateral femoral condyle.
a. 1 and 3 only
b. 1 and 4 only
c. 2 and 3 only
d. 2 and 4 only
ANS: C REF: PP. 341-342

41. A 5- to 7-degree central ray angulation is used for a lateral knee projection
1. to project the medial condyle anterosuperiorly.
2. on a patient with a narrow pelvis and long femora.
3. to offset the reduction in medial inclination that occurs when the patient is in a lateral
recumbent position.
4. to achieve an open femorotibial joint space.
a. 1 and 2 only
b. 2 and 3 only
c. 1, 3, and 4 only
d. 2, 3, and 4 only
ANS: C REF: PP. 338-340

42. Positioning the femur at a 60- to 70-degree angle with the imaging table for the PA axial
knee projection (Holmblad method)
1. superimposes the proximal surfaces of the intercondylar fossa.
2. places the patellar apex superior to the intercondylar fossa.
3. superimposes the lateral and the medial surfaces of the intercondylar fossa.
4. superimposes the anterior and posterior margins of the tibia plateau.
a. 1 only
b. 1 and 2 only
c. 3 and 4 only
d. 1, 2, and 3 only
 ANS: B REF: P. 345

43. Proper elevation of the distal lower leg and vertical placement of the foot’s long axis (heel is
not rotated side to side) for the PA axial knee projection (Holmblad method)
1. superimposes the proximal surfaces of the intercondylar fossa.
2. places the patellar apex superior to the intercondylar fossa.
3. superimposes the lateral and the medial surfaces of the intercondylar fossa.
4. superimposes the anterior and the posterior margins of the tibial plateau.
a. 1 and 2 only
b. 4 only
c. 3 and 4 only
d. 2, 3, and 4 only.
ANS: C REF: PP. 345-346

44. If a PA axial knee projection (Holmblad method) is obtained with the patient’s heel rotated
internally, which of the following are true?
1. The proximal surfaces of the intercondylar fossa are not superimposed.
2. The lateral and the medial surfaces of the intercondylar fossa are not superimposed.
3. The patella is rotated laterally.
4. The tibia is demonstrated without fibular head superimposition.
a. 1 and 3 only
b. 2 and 3 only
c. 2, 3, and 4 only
d. 1 and 4 only
ANS: B REF: PP. 346-347

45. For a tangential knee projection (Merchant method),

1. an imaginary line connecting the femoral epicondyles is aligned parallel with the
imaging table.
2. the medial condyles demonstrate more height than the lateral condyles.
3. the femorotibial joints are open.
4. the patient is instructed to relax the leg muscles.
a. 1 and 4 only
b. 1 and 2 only
c. 2 and 3 only
d. 1, 2, 3, and 4
ANS: A REF: PP. 351-352

46. If the curves of the posterior knees are not accurately positioned just above the bend of the
“axial viewer” for a tangential knee projection (Merchant method), the
1. patellae may be projected into the patellofemoral joint spaces.
2. tibial tuberosities may be demonstrated within the joint spaces.
3. soft tissue from the anterior thighs is projected into the joint spaces.
4. knees are flexed more or less than 45 degrees.
a. 1 and 4 only
b. 1 and 2 only
c. 2 and 3 only
 d. 1, 2, and 4 only
ANS: D REF: PP. 352-353

47. The tangential knee projection (Merchant method) can also be described as a(n) _____
projection.
a. inferosuperior
b. mediolateral
c. superoinferior
d. AP
ANS: C REF: P. 351

48. When the legs are flexed 30 degrees for the tangential knee projection (Merchant method),
the central ray should be angled
a. 75 degrees.
b. 45 degrees.
c. 60 degrees.
d. perpendicular to the lower leg.
ANS: A REF: PP. 352-353

49. A less than optimal AP axial toe projection demonstrates more soft tissue width on the
lateral side than on the medial side of the phalanges. Which of the following is true about
this projection?
a. The toe needs to be rotated laterally to obtain an optimal projection.
b. If the patient is unable to move, the central ray angle needs to be adjusted medially
to obtain an optimal projection.
c. The projection will also demonstrate closed IP and MTP joint spaces.
d. The projection will also demonstrate less midshaft concavity on the lateral side of
the phalanges compared with the medial side.
ANS: A REF: PP. 279-280

50. An optimal AP axial foot projection demonstrates all of the following except
a. an open medial-intermediate cuneiform joint space.
b. uniform density across the phalanges, metatarsals, and tarsals.
c. the calcaneus without talar superimposition.
d. open TMT joint spaces.
ANS: C REF: PP. 288-290

51. A less than optimal AP oblique foot projection demonstrates closed lateral
cuneiform–cuboid, navicular–cuboid, and third through fifth intermetatarsal joint spaces.
The fourth metatarsal tubercle is demonstrated without fifth metatarsal superimposition.
Which of the following is true?
a. The patient’s foot was overrotated.
b. The patient had a high longitudinal arch and a 45-degree oblique was obtained.
c. A 10- to 15-degree proximal central ray angle was used for the projection.
d. The patient had a low longitudinal arch and a 30-degree oblique was obtained.
ANS: B REF: P. 295
52. An accurately positioned lateral foot projection demonstrates all of the following except
a. superimposed talar domes.
b. the distal metatarsals at the center of the exposure field.
c. contrast and density adequate to demonstrate the anterior pretalar and posterior
pericapsular fat pads.
d. open tibiotalar joint space.
ANS: A REF: PP. 298-299

53. A less than optimal lateral foot projection demonstrating the lateral talar dome proximal to
the medial talar dome
a. will also demonstrate more than 0.5 inch (1.25 cm) of the cuboid posterior to the
navicular bone if the patient has a high longitudinal arch.
b. was obtained with the proximal lower leg elevated.
c. was obtained with the leg externally rotated.
d. will also demonstrate the fibula too posterior on the tibia.
ANS: B REF: PP. 301-302

54. If the patient is unable to dorsiflex the foot to a vertical position for an axial calcaneus
projection, the
a. central ray should be angled less than the routinely required amount.
b. central ray should be angled until it is aligned with the third metatarsal base and
the distal fibula.
c. image will demonstrate an open talocalcaneal joint as long as a 40-degree angle is
used.
d. image will demonstrate a foreshortened calcaneal tuberosity unless the central ray
angle is increased over the routinely required angulation.
ANS: D REF: PP. 304-305

55. A less than optimal axial calcaneus projection demonstrates an obscured talocalcaneal joint
space and an elongated calcaneus tuberosity. The projection was obtained with the
a. patient’s foot dorsiflexed beyond the required vertical position.
b. central ray angled less than the routinely required amount.
c. patient’s foot in plantar flexion.
d. leg and ankle medially rotated.
ANS: A REF: P. 304

56. An optimal mortise (15- to 20-degree) AP oblique ankle projection demonstrates the
a. distal fibula without talar superimposition.
b. medial mortise as an open space.
c. fibula without tibial superimposition.
d. sinus tarsus.
ANS: B REF: P. 314
57. A poorly positioned 45-degree AP oblique ankle projection demonstrates the calcaneus
obscuring the distal aspect of the lateral mortise and the distal fibula. How should the
positioning setup be adjusted to obtain an optimal projection?
a. Increase the degree of internal leg rotation.
b. Decrease the degree of internal leg rotation.
c. Dorsiflex the foot to a 90-degree angle with the lower leg.
d. Center the central ray more distally on the ankle.
ANS: C REF: PP. 315-316

58. An accurately positioned AP knee projection demonstrates all of the following except the
a. medial and lateral femoral epicondyles in profile.
b. fibular head 1 inch (2.5 cm) distal to the tibial plateau.
c. superimposed tibial condylar margins.
d. intercondylar eminence in the center of the intercondylar fossa.
ANS: B REF: P. 328

59. A poorly positioned AP knee projection demonstrating a larger lateral femoral condyle than
medial condyle
a. was obtained with the patient’s leg externally rotated.
b. may also demonstrate the fibular head without tibial superimposition.
c. will also demonstrate a closed knee joint.
d. will also demonstrate the fibular head 1 inch (2.5 cm) distal to the tibial plateau.
ANS: B REF: P. 334

60. An AP knee projection on a patient with an ASIS to tabletop measurement of 17 cm was

obtained using a perpendicular central ray. The resulting image will demonstrate
a. an open knee joint.
b. an elongated fibular head.
c. the fibular head more than 0.5 inch (1.25 cm) from the tibial plateau.
d. the anterior tibial margin distal to the posterior tibial margin.
ANS: C REF: PP. 331-332

61. An internally rotated AP oblique knee projection demonstrates the tibia partially
superimposed over the fibular head. How should the positioning setup be adjusted to obtain
an optimal projection?
a. Increase the degree of internal rotation.
b. Decrease the degree of internal rotation.
c. Adjust the central ray angulation 5 degrees caudally.
d. Fully extend the knee.
ANS: A REF: P. 334

62. An externally rotated AP oblique knee projection that was taken with the knee rotated more
than 45 degrees will demonstrate the
a. fibular head aligned with the anterior edge of the tibia.
b. fibula without tibial superimposition.
c. fibula located in the center of the tibia.
 d. lateral condyle in profile.
ANS: C REF: P. 334

63. An optimal lateral knee projection demonstrates

a. contrast and density to visualize the posterior pericapsular fat pads.
b. the tibia without fibular head superimposition.
c. 45 degrees of knee flexion.
d. superimposed femoral condyles.
ANS: D REF: P. 337

64. A less than optimal lateral knee projection that demonstrates the medial femoral condyle
anterior to the lateral femoral condyle will also demonstrate
a. the fibula superimposed by the tibia.
b. the abductor tubercle on the anterior femoral condyle.
c. an open patellofemoral joint.
d. an unobscured suprapatellar fat pad.
ANS: B REF: P. 340

65. A cross-table lateromedial knee projection demonstrates the medial femoral condyle distal
to the lateral femoral condyle. To obtain an optimal projection,
a. rotate the x-ray tube column to align the central ray more cephalically.
b. adjust the central ray angulation posteriorly.
c. adduct the patient’s leg.
d. internally rotate the patient’s leg.
ANS: C REF: PP. 343-344

66. An accurately positioned PA axial knee projection (Holmblad method) demonstrates all of
the following except
a. superimposition of the proximal intercondylar fossa surfaces.
b. the intercondylar eminence and tubercles in profile.
c. the patellar apex within the intercondylar fossa.
d. the fibular head 0.5 inch (1.25 cm) distal to the tibial plateau.
ANS: C REF: P. 345

67. A less than optimal PA axial knee projection (Holmblad method) demonstrating the medial
and lateral aspects of the intercondylar fossa without superimposition
a. will also demonstrate the tibia without fibular head superimposition if the heel was
rotated medially.
b. will also demonstrate a laterally situated patella if the heel was rotated laterally.
c. was obtained because the knee was underflexed.
d. was obtained because the femur was positioned vertically.
ANS: D REF: PP. 345-346

68. Which of the following statements is true about an optimal tangential knee projection
(Merchant method)?
a. A patellar subluxation is demonstrated as long as the patellae are positioned
Test Bank for Radiographic Image Analysis 4th Edition by Martensen

directly above the intercondylar sulcus.

b. The lateral femoral condyle demonstrates more height than the medial femoral
condyle.
c. To demonstrate a patellar subluxation, the quadriceps femoris must be tightly
contracted.
d. The central ray and axial view angulation, when added, should equal 100 degrees.
ANS: B REF: P. 351

69. A less than optimal tangential knee projection (Merchant method) demonstrating the tibial
tuberosities within the patellofemoral joint spaces
a. was obtained because the posterior knee curve was positioned too far below the
bend of the axial viewer.
b. was obtained because the knee was bent more than 45 degrees.
c. will result when the patient has large calves and the axial viewer’s angle is not
decreased.
d. will also demonstrate soft tissue from the patient’s anterior thighs projected onto
the patellae and patellofemoral joint spaces.
ANS: C REF: PP. 353-354

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