Deck 11: Image Analysis of the Cranium

Question 1

An AP axial (Towne method) cranial projection with poor positioning demonstrates a foreshortened dorsum sellae and the atlas's posterior arch within the foramen magnum. How was the positioning setup mispositioned for such a projection to be obtained?
1)The patient's face was rotated toward the right side.
2)The chin was not adequately tucked.
3)The OML was not aligned perpendicular to the IR.
4)The central ray was angled too caudally.

A) 1 and 3 only
B) 2 and 4 only
C) 2 and 3 only
D) 3 and 4 only

Answer 1

3 and 4 only

Question 2

For an AP axial cranial projection (Towne method), the
1)midsagittal plane is aligned with the long axis of the image receptor's longitudinal axis.
2)midsagittal plane is positioned parallel with the IR.
3)midcoronal plane is positioned parallel with the IR.
4)OML is aligned perpendicular to the IR.

A) 1 and 2 only
B) 3 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

Answer 2

1, 3, and 4 only

Question 3

For a PA axial cranial projection (Caldwell method), the
1)midsagittal plane is aligned perpendicular to the IR.
2)central ray is angled 15 degrees caudally.
3)OML is aligned perpendicular to the IR.
4)central ray is centered to the nasion.

A) 1 and 3 only
B) 2 and 4 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

Answer 3

1, 2, 3, and 4

Question 4

A PA axial cranial projection (Caldwell method) with accurate positioning demonstrates
1)equal distance from the crista galli to the lateral cranial cortices on each side.
2)the petrous ridges aligned with the supraorbital margins.
3)the petrous pyramids superimposed over the infraorbital margins.
4)the superior orbital fissures demonstrated within the orbits.

A) 1 and 4 only
B) 2 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

Question 5

A PA axial cranial projection (Caldwell method) with poor positioning demonstrates the petrous ridges inferior to the infraorbital margins. How was the patient positioned for such a projection to be obtained?
1)The patient's chin was not tucked enough.
2)The OML was not positioned perpendicular to the IR.
3)The patient's face was rotated toward the right side.
4)The patient's head was tilted.

A) 1 and 2 only
B) 2 only
C) 2 and 3 only
D) 4 only

Question 6

A lateral cranial projection with accurate positioning demonstrates the
1)sella turcica in profile.
2)right orbital roof slightly superior to the left orbital roof.
3)dorsum sellae within the foramen magnum.
4)mandibular rami superimposed.

A) 1 and 4 only
B) 3 only
C) 1, 2, and 4 only
D) 4 only

Question 7

A patient requires a trauma AP axial cranial projection (Caldwell method). When the central ray is aligned with the OML, the tube angle reads 13 degrees caudad. What central ray angle should be used?

A) 15 degrees caudad
B) 2 degrees caudad
C) 2 degrees cephalad
D) 28 degrees caudad

Question 8

An AP cranial projection with poor positioning demonstrates the petrous ridges inferior to the supraorbital margins. How could the positioning setup be adjusted for an optimal projection to be obtained?
1)Rotate the patient's face toward the left side.
2)Angle the central ray caudally.
3)Position the OML perpendicular to the IR.
4)Tuck the patient's chin more.

A) 1 only
B) 2 and 3 only
C) 3 and 4 only
D) 2, 3, and 4 only

Question 9

A PA cranial projection with poor positioning demonstrates the petrous ridges too superior to the supraorbital margins. How was the patient positioned for such a projection to be obtained?
1)The patient's chin was inadequately tucked.
2)The OML was not positioned perpendicular to the IR.
3)The patient's face was rotated toward the right side.
4)The patient's head was tilted.

A) 1 and 2 only
B) 2 only
C) 3 only
D) 2 and 4 only

Question 10

For a lateral cranial projection, the
1)midsagittal plane is positioned parallel with the IR.
2)IPL is positioned parallel with the IR.
3)IOML is perpendicular to the front edge of the IR.
4)central ray is centered 2 inches (5 cm) anterior to the EAM.

A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 1, 3, and 4 only

Question 11

A poorly positioned AP axial cranial projection (Caldwell method) demonstrates the petrous ridges inferior to the infraorbital margins. How could the positioning setup be adjusted to obtain an optimal projection?
1)Rotate the patient's face toward the left side.
2)Adjust the central ray angulation caudally.
3)Tuck the patient's chin until the OML is perpendicular to the IR.
4)Elevate the patient's chin until the OML is perpendicular to the IR.

A) 1 only
B) 2 and 3 only
C) 3 and 4 only
D) 2, 3, and 4 only

Question 12

When the central ray is aligned with a patient's OML, the tube angle reads 25 degrees caudad. What angulation would you use for this patient for a trauma AP axial (Towne method) cranial projection?

A) Perpendicular
B) 55 degrees caudad
C) 45 degrees caudad
D) 10 degrees cephalad

Question 13

For an AP axial (Towne method) mandible projection,
1)the central ray is centered to the midsagittal plane at the level of the glabella.
2)the central ray is angled 35 to 40 degrees caudally.
3)the IOML is positioned perpendicular to the IR.
4)a lengthwise 8- × 10-inch IR is used.

A) 3 and 4 only
B) 1 and 2 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 14

Which of the following pertains to an AP axial (Towne method) cranial projection obtained with the patient's face rotated toward the left side?

A) The dorsum sellae is demonstrated superior to the foramen magnum.
B) The atlas's posterior arch is demonstrated within the foramen magnum.
C) The distance from the dorsum sellae to the lateral foramen magnum on the patient's left side is narrower than on the right side.
D) The distance from the dorsum sellae to the lateral foramen magnum on the patient's right side is narrower than on the left side.

Question 15

A PA cranial projection obtained with the patient's face rotated toward the right side demonstrates a greater distanced from the

A) lateral orbital margin to the lateral cranial cortex on the left side than on the right side.
B) crista galli to the lateral cranial cortex on the right side than on the left side.
C) right mandibular ramus to the cervical vertebrae than from the left mandibular ramus to the cervical vertebrae.
D) lateral orbital margin to the lateral cranial cortex on the right side than on the left side.

Question 16

A PA cranial projection with accurate positioning demonstrates
1)equal distances from the lateral orbital margin to the lateral cranial cortices on each side.
2)the anterior clinoids and dorsum sellae superior to the ethmoid sinuses.
3)the petrous ridges horizontally through the lowest third of the orbits.
4)the internal acoustic meatus horizontally through the orbital center.

A) 1 and 2 only
B) 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

Question 17

An AP cranial projection can be distinguished from a PA cranial projection because it demonstrates
1)less orbital magnification.
2)the internal auditory canals horizontally through the orbits.
3)less distance from the lateral orbital margins to the lateral cranial cortices.
4)the anterior clinoids and dorsum sellae superior to the ethmoid sinuses.

A) 1 only
B) 1 and 3 only
C) 3 only
D) 2, 3, and 4 only

Question 18

An AP axial cranial projection (Towne method) with accurate positioning demonstrates
1)equal distances from the posterior clinoid processes to the lateral borders of the foramen magnum on each side.
2)the midsagittal plane perpendicular to the IR.
3)the dorsum sellae within the foramen magnum.
4)the posterior clinoids inferior to the foramen magnum.

A) 1, 2, and 3 only
B) 1 and 3 only
C) 2 and 4 only
D) 1, 2, 3, and 4

Question 19

For a PA cranial projection, the
1)midsagittal plane is positioned parallel with the IR.
2)OML is aligned perpendicular to the IR.
3)central ray is aligned perpendicular to the IR.
4)central ray is centered to the nasion.

A) 1 and 3 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 1 and 4 only

Question 20

An AP axial (Towne method) cranial projection with poor positioning demonstrates the dorsum sellae superior to the foramen magnum. How was the positioning setup mispositioned for such a projection to be obtained?
1)The patient's face was rotated toward the left side.
2)The chin was not adequately tucked.
3)The OML was not aligned perpendicular to the IR.
4)The central ray was angled too caudally.

A) 1 only
B) 4 only
C) 2 and 3 only
D) 2, 3, and 4 only

Question 21

An acanthioparietal sinus projection (Waters method) can be distinguished from a parietoacanthial sinus projection because
1)it demonstrates the bony nasal septum in alignment with the collimated field's longitudinal axis.
2)it demonstrates greater orbital magnification.
3)it demonstrates less distance from the lateral orbital rims to the lateral cranial cortices.
4)the petrous ridges are demonstrated superior to the maxillary sinuses.

A) 1, 2, and 3 only
B) 2 and 3 only
C) 1 and 4 only
D) 3 and 4 only

Question 22

A patient is unable to elevate the chin enough for a parietoacanthial facial bone projection (Waters method). How could the positioning setup be adjusted for an optimal projection to be obtained?

A) Angle the central ray cephalically.
B) The projection cannot be obtained.
C) Align the central ray parallel with the MML.
D) Elevate the patient's chin as far as possible and use a perpendicular central ray.

Question 23

An optimal PA cranium projection demonstrates all of the following except

A) equal distance from the lateral orbital margins to the lateral cranial cortices on both sides.
B) anterior clinoids and dorsum sellae seen inferior to the ethmoid sinuses.
C) petrous ridges superimposing the supraorbital margins.
D) internal acoustic meatus visualized through the center of the orbits.

Question 24

A patient is unable to hyperextend the neck enough for an SMV cranial projection (Schueller method). How should the positioning setup be adjusted for an optimal projection to be obtained?

A) Align the central ray perpendicular to the IOML.
B) Extend the patient's neck as far as possible and use a perpendicular central ray.
C) Align the central ray perpendicular to the OML.
D) The projection cannot be obtained.

Question 25

An SMV cranial projection (Schueller method) with accurate positioning demonstrates
1)the nasal fossae just anterior to the ethmoid sinuses.
2)the mandibular mentum slightly posterior to the ethmoid sinuses.
3)an equal distance from the mandibular ramus to the lateral cranial cortex on both sides.
4)the bony nasal septum aligned with the long axis of the exposure field.

A) 2 and 3 only
B) 1 and 3 only
C) 1, 3 and 4 only
D) 1, 2, 3, and 4

Question 26

Which of the following is true of an SMV cranial projection (Schueller method) obtained with the vertex of the patient's head tilted toward the right side?

A) The mandibular mentum will be turned toward the right side.
B) The distance from the left mandibular ramus to the lateral cranial cortex is greater than the distance from the right ramus to the lateral cranial cortex.
C) The mandibular mentum is demonstrated anterior to the ethmoid sinuses.
D) The distance from the right mandibular ramus to the lateral cranial cortex is greater than the distance from the left ramus to the lateral cranial cortex.

Question 27

A parietoacanthial sinus projection (Waters method) with accurate positioning demonstrates
1)an equal distance from the lateral orbital margin to the lateral cranial cortex on both sides.
2)the bony nasal septum in alignment with the long axis of the exposure field.
3)the petrous ridges demonstrated inferior to the maxillary sinuses.
4)the ethmoid sinus through the mouth cavity in an open-mouth position.

A) 1 and 2 only
B) 3 and 4 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 28

A lateral cranial projection demonstrates the EAM and inferior cranial cortices without superimposition. One of each corresponding structure is demonstrated inferior to the other. How was the patient mispositioned for such a projection to be obtained?

A) The patient's head was tilted.
B) The patient's head was rotated.
C) The patient's chin was elevated.
D) The central ray was centered too superiorly.

Question 29

An AP axial cranium projection (Towne method) demonstrating the dorsum sellae superimposing the atlas's posterior arch

A) was obtained with the patient's face rotated toward the right side.
B) will require the central ray angle to be adjusted caudally until it forms a 30-degree angle with the OML.
C) will require the patient's chin to be elevated to obtain an optimal projection.
D) will also demonstrate elongation of the dorsum sellae.

Question 30

A optimally positioned AP axial cranium projection (Towne method) demonstrates all of the following except

A) the inferior occipital bone at the center of the exposure field.
B) symmetrical petrous ridges.
C) the dorsum sellae within the foramen magnum.
D) the posterior clinoids superior to the foramen magnum.

Question 31

For a submentovertex (SMV) cranial projection (Schueller method), the
1)central ray is aligned perpendicular to the IR.
2)central ray is centered to the midsagittal plane at a level 0.75 inch (2 cm) anterior to the level of the EAM.
3)IOML is parallel with the IR.
4)midsagittal plane is perpendicular to the IR.

A) 1 and 2 only
B) 3 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

Question 32

The distance from the posterior clinoid process to the lateral foramen magnum is less on the patient's left side than on the right side on an AP axial cranium projection (Towne method). To obtain an optimal projection,

A) elevate the patient's chin until the OML is perpendicular to the IR.
B) tuck the patient's chin until the OML is perpendicular to the IR.
C) rotate the patient's face toward the left side until the midsagittal plane is perpendicular to the IR.
D) rotate the patient's face toward the right side until the midsagittal plane is perpendicular to the IR.

Question 33

A poorly positioned parietoacanthial facial bone projection (Waters method) demonstrates the petrous ridges within the maxillary sinuses. How was the positioning setup mispositioned for such a projection to be obtained?
1)The MML was not aligned perpendicular to the IR.
2)The patient's head was rotated toward the left side.
3)The patient's chin was tucked more than needed.
4)The central ray was angled too cephalically.

A) 1 and 3 only
B) 2 only
C) 3 and 4 only
D) 1, 3, and 4 only

Question 34

A lateral cranial projection with poor positioning demonstrates the greater wings of the sphenoid and anterior cranial cortices without superimposition. One of each of the corresponding structures is demonstrated posterior to the other. How was the patient mispositioned for such a projection to be obtained?

A) The patient's head was tilted.
B) The patient's head was rotated.
C) The patient's chin was elevated.
D) The central ray was centered too superiorly.

Question 35

A poorly positioned SMV cranial projection (Schueller method) demonstrates the mandibular mentum too far anterior to the ethmoid sinuses. How was the positioning setup mispositioned for such a projection to be obtained?
1)The patient's neck was overextended.
2)The IOML was not aligned parallel with the IR.
3)The central ray was angled too caudally.
4)The patient's head was tilted toward the right side.

A) 1 and 2 only
B) 2 and 4 only
C) 3 and 4 only
D) 1, 2, and 4 only

Question 36

For a parietoacanthial sinus projection (Waters method), the
1)patient is positioned upright to demonstrate air-fluid levels within the maxillary sinuses.
2)MML is aligned perpendicular to the IR.
3)central ray is centered to the acanthion.
4)OML is at a 37-degree angle with the central ray.

A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

Question 37

An SMV cranial projection (Schueller method) with poor positioning demonstrates the mandibular mentum posterior to the ethmoid sinuses. How could the positioning setup be adjusted for an optimal projection to be obtained?
1)Tilt the patient's head toward the left side.
2)Angle the central ray cephalically.
3)Increase neck extension.
4)Align the IOML parallel with the IR.

A) 1 only
B) 2 and 4 only
C) 3 and 4 only
D) 2, 3, and 4 only

Question 38

A PA cranium projection demonstrating the petrous ridges superior to the supraorbital margins

A) was obtained with the patient's chin tucked more than the required amount.
B) was obtained with the OML perpendicular to the IR.
C) will also demonstrate the internal acoustic meatus.
D) will require the patient to increase the amount the chin is tucked to obtain an optimal image.

Question 39

An acanthioparietal facial bone projection (Waters method) with poor positioning demonstrates the petrous ridges too far inferior to the maxillary sinuses. How could the positioning setup be adjusted for an optimal projection to be obtained?
1)Depress the patient's chin.
2)Align the central ray parallel with the MML.
3)Align the MML perpendicular to the IR.
4)Adjust the central ray angulation caudally.

A) 1 and 3 only
B) 2 and 3 only
C) 1 and 4 only
D) 1, 2, 3, and 4

Question 40

A less than optimal PA axial cranium projection (Caldwell method) that requires the chin to be elevated to obtain optimal positioning will

A) demonstrate unequal distance from the lateral orbital margins to the lateral cranial cortices on both sides.
B) demonstrate the superior orbital fissures within the orbits.
C) demonstrate the petrous ridges and pyramids in the superior half of the orbits.
D) need the IOML to be aligned perpendicular to the IR.

Question 41

A parietocanthial facial bone projection (Waters method) demonstrating the petrous ridges within the maxillary sinuses

A) would have been obtained with the patient's chin elevated more than needed to align the acanthioparietal line perpendicular to the IR.
B) would have been obtained with the patient's chin insufficiently elevated to align the MML perpendicular to the IR.
C) will require a cephalic central ray angulation if the patient is unable to adjust the chin.
D) would have resulted if the projection was obtained with the patient's mouth open.

Question 42

An optimally positioned lateral cranium projection demonstrates all of the following except

A) an area 2 inches (5 cm) superior to the EAM at the center of the exposure field.
B) superimposition of the greater wings of the sphenoid and orbital roofs.
C) the sella turcica on end.
D) posteroinferior occipital bones and posterior arch of the atlas free of superimposition.

Question 43

Which of the following statements is not true about an SMV cranium projection (Schueller method)?

A) The IOML should be placed parallel to the IR for the projection.
B) Positioning the midsagittal plane perpendicular to the IR prevents cranial tilting.
C) The dens is centered within the exposure field.
D) If the resulting image demonstrates the mandibular mentum posterior to the ethmoid sinuses, the central ray can be angled caudally to obtain an optimal projection.

Question 44

A lateral cranium projection obtained with the top of the patient's head tilted away from the IR will demonstrate all of the following except the

A) left side greater wing of the sphenoid inferior to the right side greater wing.
B) atlas's vertebral foramen.
C) inferior cranial cortices without superimposition.
D) right EAM inferior to the left EAM.