ARRT Thorax and Abdomen Procedures 4 — Questions and Answers
Question 1: Which oblique position of the sternum projects it to the left of the spine and away from the vertebral column?
- LAO 15–20°
- RAO 15–20° (Correct answer)
- LPO 20–30°
- RPO 20–30°
Correct answer: RAO 15–20°
The RAO position of 15–20° rotates the sternum to the left, projecting it over the heart shadow and away from the vertebral column.
Question 2: During an esophagram using barium, which position best demonstrates a posterior esophageal impression caused by an aberrant right subclavian artery?
- AP erect
- RAO
- Lateral (Correct answer)
- PA prone
Correct answer: Lateral
An aberrant right subclavian artery (dysphagia lusoria) creates a diagonal posterior impression on the esophagus best seen in the lateral projection.
Question 3: For a lateral chest projection, how much rotation of the patient is considered acceptable on the final image?
- Posterior ribs must be superimposed within 0.5 cm (Correct answer)
- Posterior ribs must be superimposed within 1.5 cm
- Rib separation of up to 2.5 cm is acceptable
- Any rotation is acceptable if the heart is visible
Correct answer: Posterior ribs must be superimposed within 0.5 cm
On a true lateral chest, the posterior ribs should be superimposed within 0.5 cm; greater separation indicates rotation and oblique positioning.
Question 4: A kidney-ureter-bladder (KUB) radiograph should include which anatomical landmarks from top to bottom?
- T10 to the pubic symphysis
- T12 to the ischial tuberosities
- Upper pole of kidneys to the pubic symphysis (Correct answer)
- Diaphragm to the lesser trochanters
Correct answer: Upper pole of kidneys to the pubic symphysis
A KUB must include the upper poles of the kidneys superiorly and the pubic symphysis inferiorly to ensure the entire urinary tract is visualized.
Question 5: Which projection of the ribs above the diaphragm requires the patient to suspend respiration on full expiration?
- AP ribs above diaphragm — inspiration
- AP ribs below diaphragm — expiration
- AP ribs above diaphragm — expiration (Correct answer)
- Oblique ribs above diaphragm — inspiration
Correct answer: AP ribs above diaphragm — expiration
Ribs above the diaphragm are imaged on full expiration when evaluating for rib fractures, because expiration elevates the diaphragm and uncovers more of the lower ribs.
Question 6: On a PA chest, silhouette sign obliteration of the right heart border most likely indicates pathology in which lung segment?
- Right lower lobe
- Right upper lobe
- Right middle lobe (Correct answer)
- Left lower lobe
Correct answer: Right middle lobe
The right heart border is formed by the right middle lobe; silhouette sign obliteration of this border indicates consolidation or atelectasis of the right middle lobe.
Question 7: When imaging the ribs in the RPO position, which ribs are best demonstrated?
- Left posterior ribs
- Right posterior ribs
- Left axillary ribs
- Right axillary ribs (Correct answer)
Correct answer: Right axillary ribs
In the RPO position, the right side is elevated, projecting the right axillary ribs away from the spine and sternum for clear visualization.
ARRT Thorax and Abdomen Procedures 4
Which oblique position of the sternum projects it to the left of the spine and away from the vertebral column?