X-Ray Certification Anatomy and Image Analysis 3 — Questions and Answers
Question 1: On an oblique projection of the lumbar spine, the 'Scottie dog' image is formed by several structures; which structure represents the dog's eye?
- Transverse process
- Pedicle (Correct answer)
- Superior articular process
- Lamina
Correct answer: Pedicle
The pedicle forms the 'eye' of the Scottie dog on the oblique lumbar spine projection and is evaluated for pars interarticularis defects.
Question 2: On a PA chest radiograph, which hilar structure is normally located more superiorly — the right or the left?
- Right hilum
- Left hilum (Correct answer)
- They are at the same level
- It varies by patient position
Correct answer: Left hilum
The left hilum is normally positioned 0.5–1.5 cm higher than the right due to the aortic arch and left pulmonary artery anatomy.
Question 3: A radiograph demonstrating the calcaneus in profile with the subtalar joint open is which projection?
- Plantodorsal (axial) calcaneus
- Lateral calcaneus (Correct answer)
- AP foot
- Oblique foot
Correct answer: Lateral calcaneus
The lateral calcaneus projection places the calcaneus in true profile and opens the subtalar (talocalcaneal) joint for evaluation.
Question 4: The carina, which marks the bifurcation of the trachea, is located at approximately which vertebral level?
- T2–T3
- T4–T5 (Correct answer)
- T8–T9
- L1
Correct answer: T4–T5
The carina lies at approximately the T4–T5 level (sternal angle) and is used as a landmark for endotracheal tube placement verification.
Question 5: Which carpal bone is the most commonly fractured carpal bone, frequently missed on initial radiographs?
- Lunate
- Triquetrum
- Scaphoid (Correct answer)
- Capitate
Correct answer: Scaphoid
The scaphoid is the most commonly fractured carpal bone, and fractures may be radiographically occult initially due to its position and blood supply.
Question 6: On an AP projection of the abdomen, which psoas muscle shadow is normally visible and what does its obliteration suggest?
- Left psoas only; suggests splenic pathology
- Both psoas margins; obliteration suggests retroperitoneal pathology (Correct answer)
- Right psoas only; suggests hepatic pathology
- Neither; psoas is never visible on plain film
Correct answer: Both psoas margins; obliteration suggests retroperitoneal pathology
Both psoas muscle margins are normally visible as soft tissue stripes; obliteration of one or both suggests retroperitoneal fluid, hemorrhage, or mass.
Question 7: The 'gull-wing' deformity of the distal interphalangeal joints on a hand radiograph is characteristic of which condition?
- Rheumatoid arthritis
- Gout
- Erosive osteoarthritis (Correct answer)
- Psoriatic arthritis
Correct answer: Erosive osteoarthritis
Erosive osteoarthritis produces central erosions of the DIP joints that create a 'gull-wing' or 'seagull' pattern on hand radiographs.
X-Ray Certification Anatomy and Image Analysis 3
On an oblique projection of the lumbar spine, the 'Scottie dog' image is formed by several structures; which structure represents the dog's eye?