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X-RAY
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1. The size of the penumbra is indirectly related to
*image sharpness
-penumbra  fuzziness
2. MA setting regulates the
*temperature of the filament
-MA  miliampers  millions of electrons  heat
-Kvp  penetrating power and contrast
3. Greatest increase in the number of electrons emitted results from an increase in
current to
*filament  thermionic emisssion  gives off electrons
-rectifier  changes AC to DC
-transformer  increases the voltage
4. Radiographic contrast is --- affected by kilovoltage
*inversely  increase in Kvp is decrease in contrast
5. In order to double the exposure of a film, the Kvp should be increased by
*15%
-increase Kvp by 15% and decrease mAs by 50%
6. Determines the penetrating power of an x-ray
*kilovoltage
7. Can be affected by film processing in the dark room
*film contrast
-penumbra is occurs in the x-ray room
-umbra  darkest part of a shadow  distractor
8. Exposed silver halides are removed from the film during which stage of film
processing
*fixation
-rinse  removes unused particles
9. A green or blue tint is added to the base of an x-ray film in order to
*reduce glare
10. The activator, restrainer preservative and hardener are all part of the
*developer
-restrainer is in developer ONLY
1
11. The most likely cause of artifacts which are smudging and branching linear black
marks along the edge of the x-ray
*exposure to static electricity
12. Greatest amount of ionizing radiation which is not expected to produce significant
radiation effects is known as
*MPD  maximum permissible dose (everybody)
-REM  radiation equivalent in men (worker)
-RAD  radiation absorbed dose (patient)
13. Has no effect on reducing the radiation dosage to the patient
*high grid ratio
-high speed screen  intensifying screen  in front of the bucky  allows you
to reduce the Kvp  protects the patient
-filtration and collimation  protects the patient
14. The radiographic density --- as the developer temperature --*decreases; decreases  less particles reacting  darker film (decreased density)
15. Lateral lumbosacral spot view is needed as an additional film due to --- noted on a
routine lateral lumbar view
*underexposure  less penetration
16. An x-ray film which is developed without being exposed appears
*transparent
-exposed  light
-exposed to light  black
17. Radiation of which of the following tissues is most likely to induce leukemia
*hemopoietic  cell that produce all blood cells
18. In the AP lower cervical spine x-ray, the central ray is angled --- degrees --- through
C4
*15 degree, cephalad
19. The maximum normal measurement of the atlantodental interspace in an adult is
*3mm
-5 mm in children  kids more flexible
20. Cervical x-rays are used to evaluate cervical spine stability
*flexion and extension
21. Views is taken while the patient breathes normally
*lateral chest  one exception to inspiration of thoracic and chest area views
2
22. X-rays requires a focal film distance of 40”
*lateral thoracic
-72 PA and lateral chest lateral, oblique, flex and extension cervical
23. Is the best view to see the lung apices without overlying clavicle
*apical lordotic
24. At which area of the spine are the facet joints usually coronal
*L5, S1
-if one coronal and other sagittal  facet tropism
25. On a lumbar oblique x-ray, the scotty dog neck represents
*pars interarticularis
26. View best to visualize the sacroiliac joints
*angulated lumbosacral
27. X-rays best assess instability or separation of the AC joint
*weight bearing AP
28. During a routine AP x-ray of the pelvis the lower extremities are in which position
*internally rotated 15 degrees  to visualize the femur heads better
29. Normal findings on a plain film of the abdomen include
*air densities within the large bowel
-NO air densities within the small bowel
30. During a radiographic exposure the intensifying screen can emit what color of light
*green or blue  also can be the color of the film to reduce glare
31. Can correct the lack of image sharpness caused by magnification
*decreased object film distance
-FFD (film focal distance, aka SFD – source film distance)  distance from x-ray
to film (40 or 72)
close focal distance  blurry and magnified (palm against face)
increase focal distance  increase sharpness and decrease magnification
(palm pulled away from face)
-OFD (object film distance)  distance from patient to film
close OFD  increase sharpness and decrease magnification (same as
increase in FFD)
32. Least likely to cause spinal stenosis in the lumbar spine
*rheumatoid arthritis  only affects the upper cervical spine (increased ADI) 
according to Boards
3
33. The characteristic x-ray finding in calcium pyrophosphate deposition disease
*chondrocalcinosis  calcification of the cartilage  CPPD
-lipping and spurring  DJD (osteoarthritis)
34. An AP lumbar film reveals increased density and coarse trabecular patterns of the
right femur.
*Paget’s disease (aka osteitis deformans)  increase in bone density
35. Emulsion layer of an x-ray film is composed of which active ingredient
*silver halide  silver bromide + silver iodide
-gelatin  holds silver crystals to film (NOT active)
-Tungstate  anode
36. Views of the knee best visualizes the proximal tibiofibular joint
*medial oblique
37. Maximum intercostal joint space in a normal adult rib should be --- mm or less
*5
38. Patient breathing patterns is appropriate for a PA chest film
*inspiration and hold  to push diaphragm down
39. Chest films of a retired 60 yoa male construction worker display thickened pleura
along the lateral chest wall. There is a curve linear calcification along both halves of
the diaphragm mild bilateral pleural effusion and a bilateral reticular nodular pattern
at the lower pulmonary lobes
*asbestosis  get mesotheleoma
-TB  miliary TB (little tiny dots)
-sarcoidosis  female, 30 to 40 yoa, usually African-American, potato nodes
(enlargement of the hilar lymph nodes)
40. For a female of childbearing age the 10 day rule applies to the safety of exposure to
x-ray during the 10 days
*following the onset of menses
41. Acromegaly is a hormonal problem which results from tumoral growth of the
pituitary gland during which stage
*skeletal maturity
-acromegaly  too much growth hormone  secreted by pituitary  big and
thick skull and feet  occurs after sealing of growth plate
-giantism  really tall and proportionate  occurs before sealing of growth
plate
-difference between the acromegaly and giantism is age  before or after closing
of growth plate
4
42. X-ray finding does not occur with rheumatoid arthritis
*non-uniform loss of joint space
-OA  unilateral and asymmetrical
-RA  bilateral and symmetrical
43. Location syringomyelia is most apt to produce neurogenic arthropathy
*shoulders  occurs in central spinal cord lesion  shawl like distribution
44. For an AP spot film of L5, S1 the tube should be
*angled cephalad
-coccyx view  angled caudad
45. Congenital blocked vertebrae are characterized by diminished AP diameter of the
vertebral body, possible fusion of the apophyseal joints rudimentary disc space
*wasp waist deformity
-surgical fusion  square
46. Bow line of Brailsford or inverted Napoleon hat sign is seen in
*spondylolisthesis
47. Sesamoid bone is located just proximal to the fifth metatarsal
*os peroneum
48. Has the greatest effect of decreasing patient radiation dose
*high Kvp
-film badge monitoring is too late to protect radiation dose
49. Prolonged chronic pain which is worse at night and relieved by aspirin is
characteristic of osteoid osteoma and
*Brodie’s abscess
50. Described as a triangular radial epiphysis with radial shortening of bone and bowing
accompanied by a lucent defect along the medial metaphysis
*Madelung’s deformity  ulna breaks
-syndachtly  fingers grow together
-radioulnar synostosis  fusion of radius and ulnar
51. skipped
52. Manifests as calcification of the tibial collateral ligament on the medial condyle of the
femur
*Pelligrini Stieda’s disease  appear on x-ray as wisp of smoke
-Blount’s disease  avascular necrosis of the proximal tibia  pathology NOT
an x-ray sign
-fabella  sesmoid bone of the patella
5
53. Foreleg of the scotty dog seen on an oblique view in the lumbar spine
*inferior articular process
54. Arthritides is most common in a multiparous female
*osteitis condensans ilii  star sign on x-ray, SI joint sclerosis
55. Resorption of the SI joint and widened pubic joint are x-ray findings in
*hyperparathyroidism  calcium out of bone and into blood
-Rickets  cause bowlegged due to osteomalacia
56. Procedures most indicated to rule out Arnold Chiari malformation in a 15 yoa male
with basilar invagination demonstrated by plain film radiography
*magnetic resonance
-myelography  spinal tap  injection of dye
57. An object is moved from 10 feet to 5 feet from a source of radiation receives --radiation
*four times as much  inverse square law  ½ distance = 4 x x-ray (double
distance = ¼ the x-ray)
58. Characterized by a broadening of the femoral metaphysis, enlargment of the greater
trochanter and femoral angle less than 120
*coxa vara
-normal femoral angle = 120 to 130
-Down’s syndrome  laxed transverse ligament  increased ADI interspace
59. Structures is least frequently involved in Reiter’s syndrome
*hand  affects hands like OA but not as frequently
-Reiter’s syndrome  same as OA with emphysis of shoulder and knee  can’t
see, can’t pee, can’t dance with me
60. Avascular necrosis subsequent to fracture or trauma most commonly occurs in the
*scaphoid  Preisser’s
-Keinbock’s  AV of the lunate
-Sever’s  avulsion of the head of the calcaneous  very young (avulsions occur
with open growth plates)
61. Periarticular osteopenia is most notable in which condition
*RA  always described this way
62. Imaging modalities frequently utilizes surface coils
*magnetic resonance
-metal coils  magnet
-hydrogen ions are in the body
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63. Multiple round opacities with sclerotic margins and lucent center noted in the
buttocks are most likely caused by
*calcification at previous injection sites
-phleboliths  inside vein  in pelvic basin and linear
64. Imaging modalities is most helpful to determine early erosion of cortical bone around
joints
*magnetic resonance
-bone scan  picks up growth  increase in osteoblastic activity
65. Occurs most commonly in the subarticular portion of a long bone
*Giant cell tumor  occurs in the epiphysis
-Ewing’s sarcoma  diaphysis
-multiple myeloma  everywhere  cold spots
-reticulum cell sarcoma  reticulocyte in bone marrow  diaphysis
66. Views should be taken to outline a pneumothorax if the PA view is negative
*PA during expiration
-most common cause of pneumothorax  surgery
-lateral  looking for fluid level  costophrenic angle
67. A fracture of the distal ulna with radial head dislocation is a --- fracture
*Monteggia
-Colles and Galeazzi  radial fracture
-Salter  occur in kids  comparison of growth plates
68. Mediastinal widening which demonstrates an enlarged nodular shadow bilaterally
may indicate
*lymphoma  in the hilar region  Hodgkins’s disease
-pleural effusion  water filled
-pneumonia  NOT bilateral
69. Imaging modalities has the advantage of representing a structure in numerous
different planes with potentially equal clarity
*CT
-MRI  slices  transverse in one plane
70. A known complication of a fracture of long bone
*fat embolism
71. Causes a mediastinal shift to the side of the diseased lung
*atelectasis  pulls everything towards it  “atelectasis sucks”
7
72. Lateral and PA chest x-rays of the patient with advanced emphysema are not likely to
display
*lobar consolidation  pneumonia  looks white (solid)
-emphysema  NOT pneumonia
-emphysema  too much air (looks dark on film)  present is low, flat
hemidiaphragm, narrow vertical heart shadow, decreased retrosternal
space
73. Not usually included in the differential diagnosis of a mass in the anterior
mediastinum
*hiatal hernia
-anterior mediastinum  three T’s
thymus
thyroid
teratoma  tooth, hair, etc.
-goiter  thymus
74. Megenblase refers to
*stomach gas
75. Cholelithiasis can be confirmed by plain film x-ray in ---% of cases
*15-20
76. Prevertebral measurements are not useful in diagnosing
*spinal stenosis  Eisenstein’s line  15 mm (15 letter in the two word)
The rules of 7
-up to 7  retropharyngeal space
-up to 14  retrolaryngeal space
-up to 21  retrotracheal space
77. skipped
78. circumscribed  geographic
permeative = motheaten
79. Boehler’s angle  normal 28  40 yoa
80. flocculent opacities  cartilage
81. iliac crest apophysis  Reisser’s sign  lateral to medial
82. Calcification of which of the following is often misdiagnosed as atherosclerostic
plaque in the vertebral artery
*thyroid cartilage
83. Not an x-ray finding of emphysema
*widening of the upper mediastinum
8
84. Can cause enlargement of the hilar lymph nodes
*sarcoidosis  potatoe nodes
85. Small rounded and laminar opacities at the periphery of the pelvic basin suggests
which
*phleboliths  medial and inside the vein
-laminar  inside a vessel
-previous injection sites  lateral and clustered
86. A patient who presents with Crohn’s disease, spinal pain with restricted range of
motion and inflammatory sacroileitis most likely has
*enteropathic arthritis  AS + diarrhea
-Crohn’s disease  diarrhea
87. Causes radiographically demonstrable calcific deposits in the paraspinal region of the
psoas muscle
*cold abscess  infection in the psoas muscle
-Brodie’s abscess  osteomyelitis (infection) in a child  pain at night and
relieved by aspirin
-osteoid osteoma  tumor relieved by aspirin
88. The most likely source of metastasis in a patient between 15 and 30
*lymphoma
89. Structures which have a high --- content produce the highest signal intensity on a T2
weighted Magnetic Resonance Imaging
*water
90. Likely to appear as calcifications across the abdominal midline of a plain film x-ray
*pancreatic calculi
-ureteral calculi  straight up and down
91. The least likely cause of an increased acromioclavicular measuremnet
*DJD  spares the AC joint
92. The presence of fibular deviation of he digits and dorsal subluxation at the metatarsal
phalangeal joint characteristic of rheumatoid and psoriatic arthritis is
*Lenois deformity  laterally
-Madlung’s deformity  radial deviation of the hand  medially
93. Lines used to indicated a fracture of the femoral neck
*Shenton’s
-Skinner’s  fracture + displacement
-Kohler’s  protrusio acetabuli
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94. The lower limit for a normal Boehler’s angle is --- degrees
*28
-upper limit is 48
95. X-ray signs refers to end plate invagination or a remnant of the notochord commonly
visible in a lumbar inferior end plate
*cubpid’s bow  aka nodochordal impression  centrally located  only one 
PA film
-Schmoryl’s node  anterior portion of the inferior end plate  can have more
than one  lateral film
96. A Chance fracture is also known as a --- fracture
*fulcrum  aka Seatbelt fracture (lap belt only)
97. Fractures characterized by multiple small fragments of bone
*comminuted
-compound  through the skin
-complex  NOT a type of fracture
98. The x-ray findings of widening of the symphysis pubis, multiple wormian bones and
agenesis of the clavicles
*cleidocranial dysplasia
cleido = clavicle
99. A vertebra which is positioned so that one pedicle is barely visible on an AP lumbar
and the other is 2/3 toward the midline is listed as
*1+
-normal  2 pedicles
-1+  one barely visible
-2+  only see one
100. Intersegmental conditions at L5 is unstable
*7mm anterior slippage during flexion
-spondylolisthesis  greater than grade 2 is unstable
101. Imaging procedures is most appropriate to provided initial diagnostic information to
rule out an abdominal aortic aneurysm
*plain film radiography of the abdomen  need to be done first
102. A 5 mm retropharyngeal interspace at the level of C2, C3 on a neutrolateral view of
an adult indicate
*normal finding  up to 7
-retrolaryngeal  up to 14
-retrotracheal  up to 21
10
103. The most useful mensuration procedure to evaluate a slipped capital femoral
epiphysis
*Kline’s line
104. Risser’s sign refers to the epiphyseal closure of the
*iliac crest
105. Approximately which percentage of bone destruction must be present in order to
see it on a bone scan
*3-5
106. Procedures employs echogenic techniques
*diagnostic ultrasound
107. Meniscal damage and cruciate ligament tears are best evaluated with
*magnetic resonance imaging  soft tissue structures
108. Techniques has the greatest efficacy for determining presence of occult breast
cancer
*mammography
109. The study of choice to evaluate spinal canal stenosis
*magnetic resonance
110. The concentration of hydrogen photons forms the basis of an image in
*magnetic resonance
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1. Grid ratio may be defined as the --- to the --*height of the lead strips; distance between the strips
2. Branching tree-like black streaks on a processed film are likely due to
*static electricity
3. The correct patient position procedure for a flexion lateral cervical film
*tuck chin then flex the head forward as far as possible
4. What is the location of the Y epiphysis
*acetabulum
5. Anterior wedging of T5 through T7, sclerosis and irregularity of the end plates of T4
through T9, Schmoryl’s nodes at T6 and T7 and mildly to moderately decreased disc
height at T5 to T9 represent
*Scheuermann’s disease
6. A sclerotic enlarged pedicle and pars region due to unequal stress on a vertebra from
a unilateral spondylolysis may radiographically simulate
*osteoid osteoma  blastic tumors of the spine  “Ivory pedicle”
7. Calcification of the --- is often misdiagnosed as atherosclerotic plaquing in the
vertebral artery
*thyroid cartilage
8. Bone windows and soft tissue windows are terms frequently used in
*computed tomography
9. The best x-ray view to evaluate the right IVF in the cervical spine
*right anterior oblique
ANT
POST
C
same
o
L
opposite
s
SI
same
o
“cheek to cheek”
cervical  if cheek is against the bucky  same side
lumbar  if left butt cheek is against the bucky  same side
10. The neck of the scotty dog as seen on the left posterior oblique view of the lumbar
spine represents
*left pars
11. Phleboliths that are seen in the pelvic bowl of a 34 yoa female probably indicates
*no clinical significance
12
12. Characteristic of a unicameral bone cyst
*spontaneous pathologic fracture
-unicameral bone cyst  eccentrically located
13. A solitary discrete area of boney sclerosis usually referred to as a bone island is also
known as
*enostoma
-osteoma  found in the frontal sinsus
14. A solitary calcified pulmonary nodule is most likely to be
*healed granuloma
-looking at PA chest
-pathology of lung usually show multiple nodules
15. Rectification allows --- to occur
*unidirectional tube current
16. --- removes the heat from the target of a stationary anode x-ray tube
*copper
17. Shoulder x-rays of a 65 yoa patient reveals an uneven pattern of bone density in the
humeral head with some accentuated trabeculae, thick cortex and enlargement of the
humeral head. There is no flattening of the articular surface, the joint space is well
maintained and the soft tissue is not involved
*Paget’s
18. The purpose of using aluminum filtration in an x-ray beam is to
*absorb the less penetrating x-rays  filter out long x-rays  weak
19. An atlantodental interval of 4 mm measurement on a neutrolateral x-ray of a 7 yoa
indicates
*normal finding
20. The function of intensifying screens is to
*increase the penetration of the x-rays
21. To take a left anterior cervical oblique x-ray view the tube should be directed --degrees --*15, caudad
-for cervical obliques ONLY
cephalad  P (posterior)
caudad  A (anterior)
22. An anterior oblique lumbar film is best to see the
*contralateral articular process  pars
13
23. A tumor matrix which demonstrates flexed rings or flocculent opacities is probably of
--- origin
*cartilaginous
24. A 10 yoa female presents with wrist pain. X-ray findings indicate marked soft tissue
calcification, osteopenia and bone resorption
*hyperparathyroidism
-osteopoikilosis  look like blastic mets  freckles everywhere in the bone
-osteomalacia  bone softening  do NOT lose bone mass
25. A circumscribed and uniformly lytic lesion is best described as
*geographic
-motheaten and permeative  same
26. Process does not represent an interaction between x-ray and matter
*thermionic emission
27. What is the order of radiographic densities from the most radiolucent to the most
radiopaque
*air, fat, water, bone, metal  “All Fat Women Buy Marshmallow”
-radiolucent  black
-radiopaque  white
28. What does it indicate if the ADI space in an adult female is 2 mm on a neutrolateral
x-ray, 1 mm in extension and 5 mm in flexion
*atlantoaxial instability
29. Imaging procedure requires the patient to be injected with a radioactive substance
*bone scan  Technichium 99
30. The best definition of a wormian bone
*irregular bones along various suture lines and fontanelles
31. The lumbar IVF is best seen on which x-ray view
*lateral
32. Kohler’s teardrop is located on
*acetabulum
33. Calcification of which structure is clinically significant
*basal ganglia
34. Which disorder generally has an accompanying periarticular erosion
*RA  aka Rat bite erosion
-gout  overhanging edge sign
14
35. --- is also know as a staghorn calculus
*urinary tract stone in the calyces
36. What is the primary purpose of an intensifying screen
*reduce patient dose  reduce Kvp
37. What determines the penetrating power of he x-ray
*kilovoltage  effects contrast
38. In order to obtain 60 MAS when the MA is set at 300, exposure time should be --seconds
*0.20
39. Syndesmophytes are characteristic of
*AS  also found in psoriatic arthritis
-syndesmophytes  marginal or nonmarginal and along the vertebral body
40. The separation of a partially movable joint is known as a --- fracture
*diastatic  separation into two pieces
41. Does not determine the amount of scatter radiation produced during an x-ray
exposure
*object film distance
42. The most common location for a tuberculous infection of bone is
*vertebra  Gibbous deformity or Pott’s
15
EXTRA NOTES
pneumoperitoneum  air trapped between diaphragm and liver
hyperlucency  see BLACK  air (emphysema)
best view to see lingula  lateral chest
unilateral high hemidiaphragm  lobar collapse
phrenic nerve irritation  lowers hemidiaphragm
best to view pisiform  ulnar deviation
AP lumbopelvic  15 degree internal rotation
increase x-rays  increase photoelectric effect  increase characteristic effect
increase heat produced by filament  more electrons emitted
quick removal of film from carton  produce static electricity
patient exposure  GRID does NOT affect patient dose
Malgaigne fracture  contralateral SI fracture
bucket handle fracture  ipsilatera SI and ischial tube fracture
early metastasis  use BONE SCAN  blastic areas show up as hot areas
mulitple myeloma  cold spots
Pelligrini Steida  Ca of medial collateral ligament  medial aspect of medial femoral
condyle (wisp of smoke on x-ray)
osteochondritis dessicans  lateral aspect of medial condyle
myelogram  dye in subarachnoid space
compression fracture  lateral view
pathological  both anterior and posterior affected  systemic axial  anterior
affected, posterior is normal
ulnar deviation without ulnar styloid erosion  systemic lupus  is reversible
ulnar deviation with ulnar styloid erosin  RA
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retropharyngeal = 7
retrolaryngeal = 14
retrotracheal = 21
ADI
child = 5mm
adult = 3mm
x-rays have greater velocity than visible light
cause degenerative sponylolithesis  osteoarthritis  DJD
pars defect  spondylolysis  due to trauma
Ca seen laterla to C3  carotid atherosclerosis
total filtration in chiropractic x-ray  2.5mm
thyroid atheroscloerosis  C4 to C5
17