Answers to Exercises

CHAPTER 1: PRELIMINARY STEPS IN RADIOGRAPHY

REVIEW 21. Smooth, involuntary (peristalsis); cardiac, involun-

tary (systole); and striated, voluntary
1. A radiographer is a radiologic technologist who ad-
ministers ionizing radiation to perform radiographic 22. Peristalsis
procedures. 23. Exposure time
2. ALARA stands for “as low as reasonably achiev- 24. Central nervous system
able” and is the fundamental radiation protection 25. c, d, e, g
protocol for radiographers. 26. True
3. a. American Registry of Radiologic Technologists 27. A device that receives the energy of the x-ray beam
b. American Society of Radiologic Technologists and forms the image of the body part
4. The ASRT wrote and maintains the Radiography 28. Solid-state digital detector, photostimulable storage
Practice Standards. They define the practice of radi- phosphor image plate (IP), fluoroscopic image re-
ography, describe necessary education and certifica- ceptor (IR), and cassette with film.
tion, and include the Radiographer Scope of Practice.
In addition, the practice standards include Clinical 29. Evaluate the radiograph
Performance Standards, Quality Performance 30. a. Without compensating filter
Standards, and Professional Performance Standards. b. With Ferlic wedge filter
The American Registry of Radiologic Technologists 31. milliamperage (mA), kilovolt peak (kVp), and expo-
(ARRT) created and maintains the Standards of sure time (seconds)
Ethics that apply to all radiologic technologists who
32. b
are certified by the organization.
33. b
5. The radiographic table should be cleaned after each
patient. 34. a
6. By following Standard Precautions and 35. a
Transmission-based precautions 36. a
7. Washing the hands 37. b
8. Under 38. a
9. Disposable gloves 39. b
10. Place them in a puncture-proof container 40. a
11. Cystography, intravenous urography, spinal punc- 41. b
ture, arthrography, angiography 42. b
12. False, to the side opposite of surgeon 43. a
13. Give an explanation of the procedure to be performed. 44. attempt to explain the latest AAPM research
14. Four 45. lengthwise, crosswise, and diagonal; lengthwise
15. The radiographer 46. collimate the exposure field
16. Interpretation of images is outside of the scope of prac- 47. Increase the SID
tice for radiographers. Requests for interpretations must
be referred to a qualified physician, such as a radiologist. 48. To avoid the superimposition of overlying or under-
lying structures, to avoid superimposing a curved
17. Limited diet, laxatives, and enemas structure on itself, to project through angled joints,
18. False, starch is radiopaque. and to project through angled structures without
19. To prevent confusing shadows (artifacts) foreshortening or elongation
20. Dentures, removable bridgework, earrings, neck- 49. SID (source-to-image receptor distance)
laces, hairpins, and eyeglasses 50. magnification, spatial resolution, and patient dose

e.1
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
51. 40 inches (102 cm); 44-48 inches (112-122 cm) 71. Image A
52. 72 inches (183 cm) 72. With the digits pointing upward and as viewed from
53. First, it minimizes the amount of radiation to the the perspective of the x-ray tube
patient by restricting exposure to essential anatomy 73. Image A
only. Second, it reduces the amount of scatter radia- 74. Image A
tion that can reach the IR, which reduces the poten-
75. a, c, d, f
tial for a reduction in contrast resolution.
76. Cumulative time
54. True
77. Anteroposterior
55. False. Shuttering gives only the displayed image the
appearance of proper collimation and does not pro- 78. Automatic exposure control
tect the patient from unnecessary radiation exposure. 79. American Society of Radiologic Technologists
The use of shuttering in place of proper collimation 80. Image receptor
is a violation of the ARRT Code of Ethics and a po-
tential legal liability. 81. Computed radiography
56. a, b, d 82. Central ray
57. c 83. Milliampere-second
58. a 84. Digital radiography
59. c 85. Anatomically programmed radiography
60. d 86. American Registry of Radiologic Technologists
61. a 87. Anterior superior iliac spine
62. a 88. Body mass index
63. d 89. Radiographic and fluoroscopic table weight lim-
its have doubled to 700 pounds. CT and MRI table
64. f weights and aperture openings have also increased.
65. d 90. Risk of injury to radiographers, other health care
66. g workers, and the patient
67. Refers to a position in which the patient is standing 91. The thorax, stomach, and colon
erect with the face and eyes directed forward, arms 92. a
extended by the sides with the palms of the hands
facing forward, heels together, and toes pointing 93. 22-inches
anteriorly
68. Radiographs are usually oriented on the display CHAPTER 1: SELF-TEST:
monitor so that the person looking at the image PRELIMINARY STEPS IN RADIOGRAPHY
sees the body part as though viewed facing the
patient. 1. b 8. d 15. d 22. d 29. d
2. a 9. b 16. c 23. d 30. d
69. Image A
3. a 10. d 17. c 24. c 31. a
70. As though the viewer sees the patient from the per-
4. b, c, d 11. c 18. c 25. c 32. b
spective of the x-ray tube (display the image so that
the side of the patient closer to the IR during the 5. b 12. c 19. c 26. a 33. b
procedure is also the side of the image closer to the 6. a 13. b 20. b 27. a 34. a
viewbox) 7. a 14. c 21. a 28. b 35. c

e.2
Chapter  Answers to Exercises Copyright © 2023 by Elsevier, Inc. All rights reserved.
CHAPTER 2: GENERAL ANATOMY AND RADIOGRAPHIC POSITIONING TERMINOLOGY

REVIEW Exercise 2: Osteology

Exercise 1: General Anatomy 1. b

1. a. The science of the structure of the body 2. c
b. The study of the function of the body organs 3. d
c. The detailed study of the body of knowledge re- 4. e
lating to the bones of the body 5. h
2. The body standing erect, face and eyes directed for- 6. g
ward, arms extended by the sides with the palms of
the hands facing forward, heels together, and the toes 7. j
pointing anteriorly with the great toes touching 8. i
3. Sagittal, coronal, horizontal, and oblique 9. f
4. Sagittal 10. l
5. Coronal 11. k
6. Midcoronal (also referred to as the midaxillary plane) 12. m
13. A. Gonion
7. Midsagittal
B. Mastoid tip
8. Horizontal (also referred to as a transverse or axial plane) C. Vertebra prominens
9. A. Sagittal plane 14. A. C5 and thyroid cartilage
B. Coronal plane B. T1
C. Horizontal plane C. T2, T3, and jugular notch
D. Oblique plane D. T4, T5, and sternal angle
10. Thoracic and abdominal E. T7 and inferior angle of scapula
11. b F. T9, T10, and xiphoid process
G. L2, L3, and inferior costal margin
12. a
H. L4, L5, and iliac crest
13. a I. S1 and anterior superior iliac spine
14. c J. Coccyx, pubic symphysis, and greater trochanters
15. b 15. 206
16. c 16. Appendicular and axial
17. b 17. b, c, e, f
18. a 18. a, b, c, d
19. c 19. c
20. a 20. b
21. A. Thoracic 21. d
B. Abdominal 22. a
C. Pleural 23. a, b, c, f, h
D. Pericardial 24. b
E. Pelvic 25. c
22. A. Right upper quadrant
B. Left upper quadrant 26. b
C. Right lower quadrant 27. e
D. Left lower quadrant 28. a
23. A. Right hypochondrium 29. d
B. Epigastrium 30. d
C. Left hypochondrium
D. Right lateral 31. a. Long bones consist of a body and two articular ends.
E. Umbilical b. Short bones consist mainly of spongy tissue and
F. Left lateral have only a thin outer layer of compact bone.
G. Right inguinal c. Flat bones consist mainly of compact bone in the form
H. Hypogastrium of two plates that enclose a layer of spongy tissue.
I. Left inguinal d. Irregular bones, because of their peculiar shape,
24. a. Hypersthenic cannot be classified as long, short, or flat bones.
b. Sthenic e. Sesamoid bones are small oval bones that develop
c. Hyposthenic in and near tendons and function to protect ten-
d. Asthenic dons from excessive wear.
e.3
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
Exercise 3: Arthrology 16. b
1. Functional and structural 17. d
2. Fibrous, cartilaginous, and synovial 18. e
3. b 19. c
4. a 20. a
5. c 21. f
6. a. Diarthrodial; synovial 22.
b. Synarthrodial; fibrous
c. Amphiarthrodial; cartilaginous
F M H A M U L U S
7. f P P
O A
8. e S U L C U S F R S T Y L O I D
9. d S L A O N
A E C T R O C H A N T E R
10. c
C O N D Y L E U O
11. a L T B E R O S I T Y
U B
12. b T U C E C
13. a, b U S O R L M H E A D
B R A I E
14. c, d
E F O R A M E N N A S
15. e R I
C C R E S TT
16. c, d, f, g, h C G R O O V E U N
17. c, d, f, g, h L I F I S S U
U R E
E P I C O N D Y L E S
18. c, d, e, f, g, h
19. f
20. d Exercise 5: Body Relationship Terms
21. d 1. d 6. l 11. f 16. o 21. i
22. e 2. t 7. q 12. m 17. g 22. p
23. f 3. v 8. k 13. u 18. s 23. e
24. c 4. j 9. b 14. c 19. h 24. n
25. b 5. r 10. a 15. q 20. j
26. d
25.
27. e
28. a
C A U D A D M
O D E
Exercise 4: Bony Markings and Features
S U P E R F I C I A L E D
1. j U S E I D
2. i P P L A N T A R C E P H A L I C
3. d E E L N O L S
R R I N T E R N A L T
4. n A
I I P E T
5. a O P S R P R O X I M A L
6. g R H I I A
7. k E L O L P
R A R A O C
8. m
A T T S E
9. f L A T E R A L E X T E R N A L
10. c R R E T
11. e A A R R
C A U D A L L I A
12. o
O L
13. l I N F E R I O R
14. h
15. b
e.4
Chapter  Answers to Exercises Copyright © 2023 by Elsevier, Inc. All rights reserved.
Exercise 6: Radiographic Positioning Terminology Exercise 7: Body Movement Terminology and
1. a. Refers to the path of the central ray Chapter 2 Abbreviations
b. As a noun: a specific patient body position (e.g., 1. o
body position or radiographic position); as a verb: 2. a
the act of placing a patient in the appropriate
3. n
position
c. The body part as it is seen from the perspective of 4. i
an x-ray film or other recording media (restricted 5. l
to the discussion of the image) 6. h
d. Denotes the originator of a particular radiographic 7. g
procedure, or additionally specifies placement of
the IR and central ray 8. b
2. a. P f. B k. P 9. k
b. B g. P l. B 10. m
c. B h. P m. P 11. j
d. P i. P n. R 12. e
e. R j. R o. R
13. c
3. c
14. d
4. a
15. f
5. b 16. A. Abduction; B. Adduction
6. d 17. A. Flexion; B. Extension
7. e 18. A. Eversion; B. Inversion
8. f 19. Pronation
9. Anteroposterior (AP) projection 20. Supination
10. Posteroanterior (PA) projection 21. Tilt
11. Axial projection 22. A. Dorsiflexion; B. Plantar flexion
12. Tangential projection 23. a. Alae
13. Lateral projection b. Alveoli
14. PA oblique projection c. Appendices
d. Calculi
15. e e. Diagnoses
16. f f. Diverticula
17. c g. Ganglia
h. Ilia
18. a
i. Laminae
19. d j. Metastases
20. b 24. a. American Registry of Radiologic Technologists
21. Supine (dorsal recumbent) b. Anterior superior iliac spine
c. Right anterior oblique
22. Prone (ventral recumbent) d. Left posterior oblique
23. Right lateral recumbent e. Ultrasound
24. Left lateral f. Left upper quadrant
25. Right lateral g. Computed tomography
26. Right anterior oblique (RAO) CHAPTER 2: SELF-TEST:
27. Left anterior oblique (LAO) GENERAL ANATOMY AND RADIOGRAPHIC
POSITIONING TERMINOLOGY
28. Left posterior oblique (LPO)
29. Right posterior oblique (RPO) 1. c 8. c 15. c 22. d 29. c 36. b
30. Left lateral decubitus 2. a 9. d 16. a 23. b 30. b 37. c
31. Right dorsal decubitus 3. c 10. b 17. c 24. d 31. c 38. c
32. Ventral decubitus 4. d 11. a 18. c 25. a 32. b 39. a
5. b 12. a 19. a 26. d 33. b 40. d
6. b 13. b 20. a 27. d 34. c
7. b 14. d 21. c 28. b 35. c

e.5
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
CHAPTER 5: UPPER EXTREMITY

CHAPTER 5: SECTION 1: OSTEOLOGY AND E. Scaphoid

ARTHROLOGY OF THE UPPER EXTREMITY F. Lunate
G. Pisiform
Section 1: Exercise 1 H. Triquetrum
1.
D Section 1: Exercise 3
A. Triquetrum
D
D
B. Pisiform
M C. Hamate
M D. Capitate
M E. Trapezoid
D
F. Trapezium
P P Section 1: Exercise 4
M
P
A. Olecranon process
B. Trochlear notch
P
C. Radial head
D. Radial neck
D
E. Radial tuberosity
F. Body of radius
3 2 G. Radial styloid process
4 P
H. Coronoid process of ulna
5 I. Body of ulna
J. Ulnar head
1 K. Ulnar styloid process

Section 1: Exercise 5
A. Humeroradial
B. Radiocarpal
C. Humeroulnar
D. Proximal radioulnar
E. Distal radioulnar

Section 1: Exercise 6

2. A. Proximal interphalangeal (PIP) joint of the fifth A. Coronoid fossa

digit, right hand B. Medial epicondyle
B. Fifth metacarpophalangeal (MCP) joint, right hand C. Trochlea
C. Carpals, right wrist D. Radial fossa
D. Distal interphalangeal (DIP) joint of the third E. Capitulum
digit, right hand F. Lateral epicondyle
E. Interphalangeal (IP) joint of the first digit, right G. Olecranon fossa
hand Section 1: Exercise 7
F. Metacarpophalangeal (MCP) joint of the first
digit, right hand A. Humerus
G. First metacarpal, right hand B. Radius
H. Carpometacarpal (CMC) joint of the first digit, C. Ulna
right hand D. Olecranon process
I. Radius (right) E. Medial epicondyle
J. Ulna (right) F. Trochlea
G. Lateral epicondyle
Section 1: Exercise 2 H. Capitulum
A. Hamate
B. Capitate
C. Trapezoid
D. Trapezium

e.13
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
Section 1: Exercise 8 Section 1: Exercise 14: Common Abbreviations of
A. Head the Upper Extremity
B. Greater tubercle 1. Proximal interphalangeal joint
C. Lesser tubercle 2. Metacarpophalangeal joint
D. Body 3. Distal interphalangeal joint
E. Medial epicondyle 4. Interphalangeal
F. Trochlea 5. Image plate
G. Coronoid fossa
H. Lateral epicondyle Section 1: Exercise 15
I. Capitulum 1. Phalanges, 14; metacarpals, 5; and carpals, 8
Section 1: Exercise 9 2. b
3. c
1. c
2. a 4. c
3. d 5. Carpals
4. e 6. Head
5. b
7. b
Section 1: Exercise 10 8. c
1. D 6. P 11. P 9. a
2. D 7. D 12. P 10. a. 5
3. D 8. P 13. D b. 4
4. P 9. P 14. D c. 5
5. P 10. D 15. D 11. b
Section 1: Exercise 11 12. b
1. R, U, H 13. a. Scaphoid; navicular (P)
2. H b. Lunate; semilunar (P)
3. H c. Triquetrum; triquetral; cuneiform; triangular (P)
4. U d. Pisiform (P)
5. H e. Trapezium; greater multangular (D)
6. H f. Trapezoid; lesser multangular (D)
7. R, U g. Capitate; os magnum; capitatum (D)
8. H h. Hamate; unciform (D)
9. U 14. Wrist joint proper
10. H 15. Radius (lateral) and ulna (medial)
11. R 16. Distal
12. U
17. Proximal
13. U
14. H 18. Distal
15. H 19. Proximal
Section 1: Exercise 12
20. d
21. c
1. a
2. b, c, d, e, f 22. a
3. b, c 23. d
4. b, c, d, e, f 24. c
5. g
25. b
6. g
7. b, c 26. a
27. b, c, f
Section 1: Exercise 13
28. b
1. m 6. j 11. p 29. Humeroulnar, humeroradial, and scapulohumeral
2. b 7. r 12. o 30. Coronoid fossa (anterior surface); olecranon fossa
3. h 8. c 13. e (posterior surface)
4. f 9. n 14. d
5. q 10. l 15. i

e.14
Chapter  Answers to Exercises Copyright © 2023 by Elsevier, Inc. All rights reserved.
Section 1: Exercise 16: Upper Extremity Anatomy ■ Long axis of digit parallel to plane of IR
Crossword Puzzle ■ Perpendicular to PIP joint of digit of interest
2. A. Distal phalanx
T R O C H L E A S B. Distal interphalangeal joint
A T C. Middle phalanx
P Y D. Proximal interphalangeal joint
P R O X I M A L L E. Proximal phalanx
T F O S S A F. Metacarpophalangeal joint
A C I G. Head of metacarpal
H T R A P E Z O I D 3. PA
L U N A T E R N
4. Lateral
M P R T
A P H A L A N G E S 5. From the prone position, the second digit was in-
T L D R E ternally rotated 90 degrees to place it in a lateral
E S I P P position.
U H I 6. a
M S A C
E L O
7. To demonstrate the bones and joints accurately
C A P I T U L U M A N 8. 45 degrees
C A N D 9. To place the part closer to the IR and to improve its
O C H G Y recorded detail
R G R E A T E R T U B E R C L E
O R M A E
10. The wedge supports the digits in a position parallel
N P E L S with the plane of the IR so that the interphalangeal
O L E C R A N O N R joint spaces will be open.
I L U
D D I S T A L S Section 2: Exercise 2: Positioning for the First
Digit (Thumb)
(Your answers for “Key patient/part positioning points”
CHAPTER 5: SECTION 2: POSITIONING OF THE may be different than those provided. This area should re-
UPPER EXTREMITY flect positioning reminders to help your learning the most.)
1. AP
Section 2: Exercise 1: Positioning for the Fingers ■ 1 inch (2.5 cm) on all sides of the digit, including 1
(Your answers for “Key patient/part positioning points” inch (2.5 cm) proximal to CMC joint
may be different than those provided. This area should re- ■ Seated at end of table, affected upper extremity
flect positioning reminders to help your learning the most.) resting on table; hand in extreme internal rotation
1. PA to place posterior surface of thumb on IR
■ 1 inch (2.5 cm) on all sides of the digit, including 1 ■ Long axis of digit parallel to plane of IR
inch (2.5 cm) proximal to MCP joint ■ Perpendicular to MCP joint of first digit
■ Seated at end of table, affected upper extremity PA oblique
resting on table; hand pronated, fingers extended ■ 1 inch (2.5 cm) on all sides of the digit, including 1
and spread slightly inch (2.5 cm) proximal to CMC joint
■ Long axis of digit parallel to plane of IR ■ Seated at end of table, affected upper extremity
■ Perpendicular to PIP joint of digit of interest resting on table; hand pronated and thumb ab-
PA oblique ducted; should be in 45-degree oblique with IR
■ 1 inch (2.5 cm) on all sides of the digit, including 1 ■ Long axis of digit parallel to plane of IR
inch (2.5 cm) proximal to MCP joint ■ Perpendicular to MCP joint of first digit
■ Seated at end of table, affected upper extremity Lateral
resting on table; pronated digit rotated laterally 45 ■ 1 inch (2.5 cm) on all sides of the digit, including 1
degrees from IR plane inch (2.5 cm) proximal to CMC joint
■ Long axis of digit parallel to plane of IR ■ Seated at end of table, affected upper extremity
■ Perpendicular to PIP joint of digit of interest resting on table; hand pronated, fingers flexed to
Lateral roll thumb laterally into true lateral
■ 1 inch (2.5 cm) on all sides of the digit, including 1 ■ Long axis of digit parallel to plane of IR
inch (2.5 cm) proximal to MCP joint ■ Perpendicular to MCP joint of first digit
■ Seated at end of table, affected upper extremity 2. PA
resting on table; digit extended and rotated to place 3. Increased OID and magnification, resulting in a loss
as close to IR as possible in lateral position of recorded detail

e.15
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
4. Trapezium
5. A. Distal phalanx
B. Interphalangeal joint
C. Proximal phalanx
D. Metacarpophalangeal joint
E. First metacarpal
F. Carpometacarpal joint
Section 2: Exercise 3: Positioning for the Hand
(Your answers for “Key patient/part positioning points”
may be different than those provided. This area should re-
flect positioning reminders to help your learning the most.)
1. PA
■ 1 inch (2.5 cm) on all sides of the hand including
1 inch (2.5 cm) proximal to ulnar styloid
■ Seated at end of table, affected upper extremity
resting on table; hand pronated, fingers extended
and spread slightly apart
■ Long axis of hand aligned with long axis of IR
■ Perpendicular to third MCP joint
PA oblique
■ 1 inch (2.5 cm) on all sides of the hand, including
1 inch (2.5 cm) proximal to ulnar styloid
■ Seated at end of table, affected upper extremity
resting on table; from PA, rotate hand laterally to
a 45-degree angle with IR; fingers extended and
spread slightly apart—radiolucent sponge pro-
vides support
■ Long axis of hand aligned with long axis of IR
■ Perpendicular to third MCP joint
Lateral—in extension
■ 1 inch (2.5 cm) on all sides of the hand and thumb,
including 1 inch (2.5 cm) proximal to ulnar styloid
■ Seated at end of table, affected upper extremity rest-
ing on table; from PA oblique, rolled laterally until
in a lateral position resting on ulnar surface; fingers
extended and superimposed; thumb abducted
■ Styloid processes of radius and ulna superim-
posed and perpendicular to IR; long axis of hand
aligned with long axis of IR
■ Perpendicular to second MCP joint
Lateral—fan lateral position
■ 1 inch (2.5 cm) on all sides of the hand and thumb,
including 1 inch (2.5 cm) proximal to ulnar styloid
■ Seated at end of table, affected upper extremity
resting on table; from PA oblique, rolled laterally
until in a lateral position resting on ulnar surface;
fingers extended and positioned spread apart (“fan
shape”); thumb abducted
■ Styloid processes of radius and ulna superim-
posed and perpendicular to IR; long axis of hand
aligned with long axis of IR
■ Perpendicular to second MCP joint
2. c
3. A. Distal phalanx of the second digit
B. Middle phalanx of the second digit
C. Proximal phalanx of the second digit
D. Second metacarpophalangeal joint
e.16
Chapter  Answers to Exercises
E. Radius
F. Ulna
G. Distal interphalangeal joint of the third digit
H. Proximal interphalangeal joint of the third digit
I. Phalanges
J. Metacarpals
K. Carpals
4. Fig. 5.13: The digits are parallel with the plane of the
image receptor.
5. Fig. 5.15: Demonstrates open interphalangeal joints
because the digits are parallel with the plane of the
IR. In Fig. 5.16, the digits are not parallel with the
IR; they appear foreshortened, and their interphalan-
geal joints are closed on most digits.
6. Fig 5.17: Fan lateral position
Fig 5.18: Lateral in extension
7. d
8. b
9. a
10. A. Phalanges
B. Metacarpals
C. Carpals
D. Distal phalanx of the thumb
E. Proximal phalanx of the thumb
F. First metacarpal
G. Radius
H. Ulna
Section 2: Exercise 4: Positioning for the Wrist
and Scaphoid
(Your answers for “Key patient/part positioning points”
may be different than those provided. This area should re-
flect positioning reminders to help your learning the most.)
1. PA
■ 2.5 inches (6 cm) proximal and distal to the wrist
joint and 1 inch (2.5 cm) on the sides
■ Seated at end of table, affected upper extremity in
same plane and resting on table; anterior surface
of wrist resting on IR; fingers loosely flexed
■ Styloid processes of radius and ulna parallel with IR
plane; long axis of wrist aligned with long axis of IR
■ Perpendicular to midcarpals
PA oblique
■ 2.5 inches (6 cm) proximal and distal to the wrist
joint and 1 inch (2.5 cm) on the sides
■ Seated at end of table, affected upper extremity in
same plane and resting on table; from PA, rolled
laterally 45 degrees
■ Styloid processes of radius and ulna at 45-degree
angle to IR; long axis of wrist aligned with long
axis of IR
■ Perpendicular to midcarpals; enters just distal to
radius
Lateral
■ 2.5 inches (6 cm) proximal and distal to the wrist joint
and 1 inch (2.5 cm) on palmar and dorsal surfaces
Copyright © 2023 by Elsevier, Inc. All rights reserved.
 ■Seated at end of table, affected upper extremity in 11. PA; ulnar deviation
same plane and resting on table; from PA oblique, 12. d
rolled laterally until in a lateral position resting on
ulnar surface 13. c
■ Styloid processes of radius and ulna superim- 14. PA axial; Stecher
posed and perpendicular to IR; long axis of wrist 15. c
aligned with long axis of IR
■ Perpendicular to wrist joint
16. b
PA—ulnar deviation position 17. a
■ 2.5 inches (6 cm) proximal and distal to the wrist 18. c
joint and 1 inch (2.5 cm) on the sides
■ Seated at end of table, affected upper extremity in Section 2: Exercise 5: Positioning for the Carpal
same plane and resting on table; anterior surface Canal
of wrist on IR; fingers flexed loosely; hand turned
(Your answers for “Key patient/part positioning points”
toward ulna as much as possible
■ Styloid processes of radius and ulna parallel with
may be different than those provided. This area should
reflect positioning reminders to help your learning the
IR; long axis of hand turned toward ulna
■ Perpendicular to scaphoid
most.)
1. Tangential (Gaynor-Hart)
PA axial—scaphoid (Stecher) ■ 1 inch (2.5 cm) on the three sides of the shadow of
■ 2.5 inches (6 cm) proximal and distal to the wrist
the wrist
joint and 1 inch (2.5 cm) on the sides ■ Seated at end of table, affected upper extremity in
■ Seated at end of table, affected upper extremity in
same plane and resting on table; anterior surface
same plane and resting on table; anterior surface
of wrist on IR; hand hyperextended to place palm
of wrist on IR; fingers flexed loosely; IR at distal
vertical
end of wrist elevated 20 degrees ■ Styloid processes of radius and ulna parallel with IR
■ Styloid processes of radius and ulna parallel with
■ Angled 25 to 30 degrees to long axis of hand; enters
IR; long axis of wrist aligned with IR long axis
■ Perpendicular; enters scaphoid (or 20 degrees to-
1 inch (2.5 cm) distal to third metacarpal base
2. b
wards elbow if IR is flat)
3. c
2. OID; spatial resolution
4. A. Lunate
3. A. Pisiform B. Trapezoid
B. Triquetrum C. Trapezium
C. Hamate D. Scaphoid
D. Lunate E. Triquetrum
E. Capitate F. Capitate
F. Scaphoid G. Hamulus of hamate
G. Trapezoid H. Pisiform
H. Trapezium
4. c Section 2: Exercise 6: Positioning for the Forearm
5. a (Your answers for “Key patient/part positioning points”
6. A. First metacarpal may be different than those provided. This area should re-
B. Trapezium flect positioning reminders to help your learning the most.)
C. Scaphoid 1. AP
D. Capitate ■ 2 inches (5 cm) distal to the wrist and proximal to
E. Lunate the elbow and 1 inch (2.5 cm) on the sides
F. Radius ■ Seated at end of table, affected upper extremity in
G. Ulna same plane and resting on table; posterior surface
7. Radius and ulna of forearm on IR
■ Styloid processes of radius and ulna and humeral
8. c
epicondyles parallel with IR; long axis of forearm
9. Ulna aligned with IR long axis
10. A. First metacarpal ■ Perpendicular; enters midforearm
B. Trapezium Lateral (lateromedial)
C. Trapezoid ■ 2 inches (5 cm) distal to the wrist and proximal to
D. Scaphoid the elbow and 1 inch (2.5 cm) on the sides
E. Lunate ■ Seated at end of table, affected upper extremity in
F. Radius same plane and resting on table; medial surface of
G. Ulna forearm on IR; elbow flexed 90 degrees

e.17
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
 ■ Styloid processes of radius and ulna and humeral ■ Humeral epicondyles medially rotated to
epicondyles superimposed and perpendicular to IR; 45-­degree angle with IR; long axis of extremity
long axis of forearm aligned with IR long axis aligned with IR long axis
■ Perpendicular; enters midforearm ■ Perpendicular; enters elbow joint
2. a AP oblique—lateral rotation position
3. Radius and ulna crossed over each other ■ 3 inches (7.6 cm) proximal and distal to the elbow
4. A. Medial epicondyle joint and 1 inch (2.5 cm) on the sides
B. Lateral epicondyle ■ Seated at end of table, affected upper extremity in
C. Radial head same plane and resting on table; elbow extended,
D. Radial neck resting on posterior surface on IR; hand laterally
E. Radial tuberosity rotated to place first and second digits on table
F. Ulnar body ■ Humeral epicondyles laterally rotated to
G. Radial body 45-­degree angle with IR
H. Epiphysis ■ Perpendicular; enters elbow joint
I. Radial styloid process AP—distal humerus—partial flexion position
5. c ■ 3 inches (7.6 cm) proximal and distal to the elbow
6. False (The hand should be in the lateral position with joint and 1 inch (2.5 cm) on the sides
the thumb side up.) ■ Seated at end of table, affected humerus resting
7. A. Olecranon process on table and in same plane; elbow flexed; poste-
B. Humeral epicondyle rior surface of humerus on IR with elevated fore-
C. Coronoid process arm supported; hand supinated (if possible)
D. Radial head ■ Humeral epicondyles parallel with IR
E. Ulnar body ■ Perpendicular to distal humerus; enters elbow joint
F. Radial body (increased flexion may require distal angle on CR)
G. Ulnar styloid process AP—proximal forearm—partial flexion position
■ 3 inches (7.6 cm) proximal and distal to the elbow
Section 2: Exercise 7: Positioning for the Elbow joint and 1 inch (2.5 cm) on the sides
(Your answers for “Key patient/part positioning points” ■ Seated at end of table, affected forearm in same plane

may be different than those provided. This area should and resting on table; elbow flexed, posterior surface
reflect positioning reminders to help your learning the of forearm on IR; hand supinated (if possible)
most.) ■ Humeral epicondyles and styloid processes of

1. AP radius and ulna parallel with IR; long axis of ex-

■ 3 inches (7.6 cm) proximal and distal to the elbow tremity aligned with IR long axis
joint and 1 inch (2.5 cm) on the sides ■ Perpendicular; enters elbow joint
■ Seated at end of table, affected upper extremity in Axiolateral (Coyle)
same plane and resting on table; elbow extended, ■ 3 inches (7.6 cm) proximal and distal to the elbow

posterior surface on IR; hand supinated joint

■ Humeral epicondyles and styloid processes of ra- ■ Seated at end of table, affected upper extremity

dius and ulna parallel with IR; long axis of extrem- in same plane and resting on table or supine for
ity aligned with IR long axis trauma; elbow flexed 90 degrees for radial head;
■ Perpendicular; enters elbow joint 80 degrees for coronoid process, hand pronated
Lateral ■ Humeral epicondyles perpendicular to IR; long
■ 3 inches (7.6 cm) proximal and distal to the elbow axis of extremity aligned with IR long axis
joint ■ Angled 45 degrees toward shoulder for radial
■ Seated at end of table, affected upper extremity in head; 45 degrees away from the shoulder for cor-
same plane and resting on table; elbow flexed 90 onoid process; enters elbow joint
degrees, medial surface on IR; hand and wrist in 2. To prevent rotation of the bones of the forearm
lateral position 3. A. Medial epicondyle
■ Humeral epicondyles and styloid processes of B. Lateral epicondyle
radius and ulna superimposed and perpendicular C. Capitulum
to IR D. Trochlea
■ Perpendicular; enters elbow joint E. Proximal ulna
AP oblique—medial rotation position F. Radial head
■ 3 inches (7.6 cm) proximal and distal to the elbow G. Radial neck
joint and 1 inch (2.5 cm) on the sides H. Radial tuberosity
■ Seated at end of table, affected upper extremity 4. c
in same plane and resting on table; elbow ex- 5. 90 degrees
tended, resting on posterior surface on IR; hand
pronated 6. Superimposed

e.18
Chapter  Answers to Exercises Copyright © 2023 by Elsevier, Inc. All rights reserved.
 7. A. Radial head Lateral
B. Radial tuberosity ■ 2 inches (5 cm) distal to the elbow joint and superior
C. Radial neck to the shoulder and 1 inch (2.5 cm) on the sides
D. Ulna ■ Upright or supine; affected upper extremity in
E. Anterior fat pad same plane; medial surface on IR; elbow flexed
F. Humeral epicondyles 90 degrees for upright position; pronated hand be-
G. Coronoid process hind hip
H. Olecranon process ■ Humeral epicondyles and styloid processes per-
8. c pendicular to IR
■ Perpendicular; enters midhumerus
9. Medial rotation
2. Supine or upright
10. A. Olecranon process
B. Medial epicondyle 3. Supinated
C. Trochlea 4. To place the affected arm in contact with the IR or
D. Coronoid process table
11. A. Capitulum 5. b, d, f
B. Radial head
6. A. Acromion
C. Radial neck
B. Greater tubercle
D. Radial tuberosity
C. Glenoid cavity
12. a. Fig. 5.30
D. Lesser tubercle
b. Fig. 5.29
E. Body
c. Fig. 5.30
F. Medial epicondyle
d. Fig. 5.29
G. Capitulum
e. Fig. 5.29
H. Trochlea
13. Fig. 5.31
I. Ulna
14. Fig. 5.32 J. Radius
15. Fig. 5.32 7. The elbow joint may appear partially closed.
16. Distal humerus 8. Humeral epicondyles
17. Proximal radius and ulna 9. The proximal portion (including the humeral head),
18. Radius and ulna the lesser tubercle, and the greater tubercle
19. Distal humerus 10. A. Acromion process
B. Lesser tubercle
20. Hand should be pronated for the axiolateral projec- C. Body
tion (Coyle method) of the elbow D. Capitulum
21. An open elbow joint between the radial head and capitulum E. Olecranon process
22. The radial head
Section 2: Exercise 9: Positioning of the Upper
23. The coronoid process of the ulna Extremity
24. f
1. First metacarpophalangeal joint
25. c
2. AP projection
26. e
3. Proximal interphalangeal joint of the third digit
27. b
4. To minimize OID
28. a
5. Distal and proximal phalanges of the thumb, the first
metacarpal, and the trapezium carpal
Section 2: Exercise 8: Positioning for the Humerus
6. Second (index finger) and fifth (little finger)
(Your answers for “Key patient/part positioning points”
may be different than those provided. This area should re- 7. Perpendicular to the third metacarpophalangeal joint
flect positioning reminders to help your learning the most.) 8. Anterior (palmar or ventral)
1. AP 9. 45 degrees; 90 degrees
■ 2 inches (5 cm) distal to the elbow joint and superior 10. Elevated from the IR and parallel with the plane of
to the shoulder and 1 inch (2.5 cm) on the sides the IR
■ Upright or supine; affected upper extremity in same
11. Metacarpals
plane; posterior surface on IR; hand supinated
■ Humeral epicondyles and styloid processes paral- 12. Phalanges
lel with IR 13. To place the anterior surface of the wrist in contact
■ Perpendicular; enters midhumerus with the IR

e.19
Copyright © 2023 by Elsevier, Inc. All rights reserved. Chapter  Answers to Exercises
14. Perpendicular to the midcarpal area Section 2: Exercise 11: Upper Extremity Image
15. Distal radius, distal ulna, and proximal metacarpals Evaluation
16. 45 degrees 1. The proximal and distal interphalangeal joints are
not well demonstrated because of overlapping ends
17. Lateral
of the phalanges. Apparently this finger was slightly
18. Ulnar (medial) flexed and not entirely in contact with the IR.
19. Lateral 2. The first metacarpal and the trapezium are not seen.
20. Lateral (radial) 3. Radial crossover is demonstrated because the hand
21. Scaphoid and trapezium was pronated.
22. Scaphoid 4. a
23. The IR is inclined toward the elbow at an angle of 20 5. c
degrees. 6. b
24. The radius crosses over the ulna, which results in an 7. b
oblique image of the forearm.
8. b
25. Supinated
9. d
26. Styloid process
10. Abduct the thumb enough to avoid soft tissue overlap
27. Superimposed over each other with palm. Rotate the hand and wrist more laterally
28. True lateral, thumb side up so that styloid processes are superimposed. Move
29. The hand was not supinated. CR center point higher to enter at second MCP joint
so that all of the distal phalanges will be included.
30. To help adjust the humeral epicondyles and the ante-
rior surface of the forearm parallel with the plane of 11. True
the IR 12. False
31. Head, neck, and tuberosity 13. The coronoid process of the ulna is not in profile, and
32. True lateral with the thumb side up (to keep the ra- the medial epicondyle of the humerus is not elon-
dial head from rotating from its lateral position) gated enough.
33. AP oblique projection in medial rotation position 14. Rotate the elbow more medially, until the humeral
epicondyles are 45 degrees from the plane of the IR.
34. Laterally (externally)
15. The radial head, neck, and tuberosity are not pro-
35. Two jected free of superimposition.
36. For one exposure, the humerus is parallel and in con-
tact with the IR; for the other exposure, the forearm
is parallel and in contact with the IR. CHAPTER 5: SELF-TEST:
OSTEOLOGY, ARTHROLOGY, AND POSITIONING OF
37. Angled 45 degrees away from the shoulder
THE UPPER EXTREMITY
38. Epicondyles
39. AP 1. b 18. a 35. d 52. b 69. d 85. d
40. Place the IR between the humerus and the thorax. 2. b 19. d 36. d 53. b 70. a 86. c
3. d 20. d 37. c 54. b 71. c 87. b
Section 2: Exercise 10: Identifying Projections of 4. d 21. c 38. c 55. c 72. d 88. d
the Upper Extremity 5. b 22. c 39. c 56. c 73. c 89. d
1. PA oblique fifth digit 6. a 23. a 40. b 57. a 74. b 90. d
2. Lateral first digit (thumb) 7. b 24. c 41. a 58. a 75. b 91. a
3. PA third digit 8. a 25. b 42. b 59. d 76. c 92. b
9. b 26. d 43. c 60. c 77. b 93. a
4. PA oblique hand
10. c 27. c 44. c 61. a 78. c 94. b
5. Lateral hand—in extension
11. d 28. b 45. c 62. b 79. a 95. c
6. PA wrist in ulnar deviation 12. d 29. b 46. a 63. d 80. b 96. d
7. AP forearm 13. b 30. d 47. c 64. b 81. a 97. b
8. AP oblique elbow in medial rotation 14. b 31. a 48. b 65. d 82. b 98. d
9. PA axial wrist (Stecher method) 15. d 32. d 49. b 66. d 83. b 99. a
10. AP humerus 16. c 33. a 50. a 67. c 84. a 100. a
17. a 34. a 51. a 68. c

e.20
Chapter  Answers to Exercises Copyright © 2023 by Elsevier, Inc. All rights reserved.