Deck 21: Introduction to Chest Radiography

Question 1

A radiolucent tubular ("track-like") shadow running through the lung field, suggesting the presence of air-space disease, is known as __________.

A) air-bronchogram
B) air-alveologram
C) butterfly hilum
D) fourth mogul

Answer 1

air-bronchogram

Question 2

Which of the following is the most common accessory lung fissure?

A) Right minor
B) Inferior
C) Azygous
D) Apical parietal

Answer 2

Inferior

Question 3

Accessory pathways of communication between adjacent alveoli are known as __________.

A) Pores of Kohn
B) Canals of Lambert
C) interlobular septa
D) acini

Answer 3

Pores of Kohn

Question 4

Which of the following is not a common indication for ordering chest radiographs?

A) Chronic cough
B) Hemoptysis
C) Shortness of breath
D) Asymptomatic screening

Question 5

Which of the following chest diseases would be best assessed with magnetic resonance imaging, as opposed to computed tomography?

A) Mediastinal lymphadenopathy
B) Solitary pulmonary nodule
C) Interstitial fibrosis
D) Centrilobular emphysema

Question 6

Kartagener syndrome describes the clinical triad of chronic sinusitis, bronchiectasis, and __________.

A) interstitial pneumonia
B) situs inversus
C) levocardia
D) chronic obstructive pulmonary disease

Question 7

Where is the azygous fissure usually found?

A) Right upper lobe
B) Right middle lobe
C) Left upper lobe
D) Left lower lobe

Question 8

Which of the following is the most likely explanation for a linear density paralleling the superior margin of the clavicle on PA chest radiographic examination?

A) Periosteal reaction
B) Duplication of the clavicle
C) Chronic osteomyelitis
D) Companion shadow

Question 9

Using the roentgenometric, not anatomic, divisions, the ________ region of the mediastinum contains the heart.

A) middle
B) anterior
C) posterior
D) superior

Question 10

Which of the following patterns of lung disease most closely correlates to the appearance of fine radiodense linear shadows scattered throughout regions of the lung fields?

A) Air-space
B) Interstitial
C) Cavity
D) Mass

Question 11

An expiratory chest radiograph may be beneficial in further assessment of a patient with suspected __________.

A) hilar lymphadenopathy
B) "check-valve" bronchial obstruction
C) pleural effusion
D) air-space consolidation

Question 12

Advancing age, support tissue laxity, and increased thoracic kyphosis contribute to unwinding of the arch of the aorta, also known as aortic __________.

A) aneurysm
B) straightening
C) uncoiling
D) displacement

Question 13

Above what age should posteroanterior and lateral radiographic projections become standard, versus only a PA chest radiograph?

A) 30
B) 40
C) 50
D) 60

Question 14

Arrange the airways from biggest to smallest diameter.

A) Trachea, respiratory bronchiole, alveolar duct, primary bronchus
B) Primary bronchus, terminal bronchus, alveolar duct, respiratory bronchiole
C) Terminal bronchus, respiratory bronchiole, tertiary bronchus, alveolar duct
D) Trachea, primary bronchi, respiratory bronchiole, alveolar duct

Question 15

Which term does not describe the presence of water-based pathology (i.e., blood, edema, cells, protein, pus) with the alveolar sacs of the lung parenchyma?

A) Reticular
B) Consolidation
C) Air-space disease
D) Alveolar disease

Question 16

When a chest film is properly exposed, how many posterior rib elements should be seen above the right hemidiaphragm?

A) 6
B) 8
C) 10
D) 12

Question 17

The most terminal division of the airways within the lungs are the __________.

A) lobar bronchi
B) segmental bronchi
C) bronchopulmonary segments
D) lobular bronchioles

Question 18

Which in the following most accurately describes respiration instructions for PA chest radiographic examination?

A) Full inspiration
B) Full expiration
C) Continuous inspiration through exposure
D) Continuous expiration through exposure

Question 19

Which of the following is not a typical part of the technical protocol of chest radiography?

A) 40-inch focal film distance
B) 110 to 150 kVp
C) Posterior to anterior patient position with respect to the x-ray beam
D) Full patient inspiration

Question 20

Higher partial pressures of oxygen in the upper lung segments are suspected to contribute to predilection of infection in these regions by __________.

A) Staphylococcus pneumoniae
B) Streptococcus pneumoniae
C) Pseudomonas aeruginosa
D) Mycobacteria tuberculosis

Question 21

Accumulation of air in the potential space between the parietal and visceral pleurae is known as ____________.

A) pneumothorax
B) hemothorax
C) pleurisy
D) hydrops

Question 22

The appearance of a curvilinear radiolucent defect at the periphery of a lung mass is indicative of __________.

A) community-acquired pneumonia
B) chronic interstitial disease
C) connective-tissue disease
D) necrotizing cavitation

Question 23

Radiographic shadows within the upper mediastinum with borders that become lost above the level of the clavicles indicate a lesion located within the __________.

A) spinal canal
B) lung apices
C) anterior neck
D) aortopulmonary window

Question 24

Which of the following is the basic functional unit of respiration within the lung?

A) Primary lobule
B) Secondary lobule
C) Alveolar duct
D) Terminal bronchiole

Question 25

Which of the following is most likely represented by a right-sided mediastinal mass in an infant?

A) Teratoma
B) Enlarged thymus
C) Lymphoma
D) Dextrocardia

Question 26

A flattened appearance of the aortic knob and pulmonary trunk occurs as a result of __________ collapse.

A) left upper lobe
B) left lower lobe
C) right middle lobe
D) right lower lobe

Question 27

Atelectasis of which lobe is associated with the "S" sign of Golden?

A) Right upper
B) Right middle
C) Left upper
D) Left lower

Question 28

Hilum overlay sign is present when an apparent hilar mass continues to reveal a well-defined superimposed __________.

A) pulmonary artery
B) pulmonary vein
C) mainstem bronchus
D) azygos vein

Question 29

Which of the following radiographic projections may be beneficial in further characterizing a suspected apical lung lesion identified on a standard exam?

A) Inspiration
B) Expiration
C) Lateral decubitus
D) Apical lordotic

Question 30

The lingular segment of the lung is located within the __________.

A) left upper lobe
B) left lower lobe
C) right upper lobe
D) right lower lobe

Question 31

Which in the following cell types is responsible for production of the surfactant that reduces alveolar surface tension, helping to maintain an open alveolar sac?

A) Type I pneumonocyte
B) Type II pneumonocyte
C) Chondrocyte
D) Squamous

Question 32

Nonvisualization of which structure(s) necessitates repeating a PA chest radiograph?

A) Scapulae
B) Distal clavicles
C) Costophrenic angles
D) Sternum

Question 33

The left lung hilum is typically located __________ than the right hilum.

A) 1-3 cm higher
B) 4-5 cm higher
C) 1-3 cm lower
D) 4-5 cm lower

Question 34

Which of the following is associated with a superiorly displaced gastric air bubble?

A) Hiatal hernia
B) Splenomegaly
C) Hepatomegaly
D) Ascites

Question 35

Which of the following kVp ranges is most appropriate for chest radiography?

A) 50-60
B) 61-90
C) 91-100
D) 110-150

Question 36

In radiographs, obliteration of anatomic borders between tissues of similar density in contact with one another defines the __________ sign.

A) gloved finger
B) sail
C) hilum overlay
D) silhouette

Question 37

Which of the following diagnostic imaging modalities has largely replaced conventional tomograms in evaluating chest disease?

A) MRI
B) CT
C) Ventilation/perfusion
D) Diagnostic ultrasound

Question 38

Which of the following pathologies would most likely be associated with an extrapleural sign?

A) Pulmonary edema
B) Atelectasis
C) Rib fracture
D) Pneumothorax

Question 39

The two major general categories of parenchymal disease of the lung are air-space and __________ patterns.

A) alveolar
B) interstitial
C) consolidation
D) granulomatous

Question 40

The appearance of lucent tubes traversing a region of lung consolidation is known as a(n) __________ sign.

A) air bronchogram
B) air crescent
C) extrapleural
D) figure 3