ARRT Thorax and Abdomen Procedures 2 — Questions and Answers
Question 1: Which projection best demonstrates the right lung in a patient who cannot stand, when evaluating for pleural effusion?
- AP supine
- Right lateral decubitus (Correct answer)
- Left lateral decubitus
- AP semi-erect
Correct answer: Right lateral decubitus
The right lateral decubitus position (right side down) causes free pleural fluid to layer along the dependent right thoracic wall, making it visible on the AP projection.
Question 2: On a PA chest radiograph, the right hemidiaphragm is normally located at which vertebral level on full inspiration?
- T8–T9
- T10–T11 (Correct answer)
- T12–L1
- L2–L3
Correct answer: T10–T11
On a properly inspired PA chest, the right hemidiaphragm is normally seen at the level of the 10th–11th thoracic vertebra posteriorly.
Question 3: A technologist is performing an AP axial projection (Lindblom) of the ribs below the diaphragm. What kVp range is most appropriate?
- 60–70 kVp
- 70–80 kVp
- 80–85 kVp (Correct answer)
- 90–100 kVp
Correct answer: 80–85 kVp
Ribs below the diaphragm overlie abdominal structures, requiring approximately 80–85 kVp to adequately penetrate the additional tissue.
Question 4: When performing a sternum lateral projection, which breathing technique is recommended to blur out overlying ribs and lung markings?
- Full inspiration suspended
- Full expiration suspended
- Shallow breathing during exposure (Correct answer)
- Valsalva maneuver
Correct answer: Shallow breathing during exposure
Shallow breathing (also called breathing technique) during the exposure blurs the ribs and pulmonary vasculature, improving visualization of the sternum.
Question 5: For a PA chest projection, the central ray is directed to which landmark?
- Xiphoid process
- T7 (level of inferior angle of scapula) (Correct answer)
- Jugular notch (T2)
- Midsternum at T4
Correct answer: T7 (level of inferior angle of scapula)
The central ray is directed perpendicular to the IR at the level of T7, which corresponds to the inferior angle of the scapula on the posterior surface.
Question 6: An AP abdomen radiograph taken in the left lateral decubitus position is primarily used to demonstrate which finding?
- Retroperitoneal masses
- Free intraperitoneal air (Correct answer)
- Renal calculi
- Psoas muscle outline
Correct answer: Free intraperitoneal air
The left lateral decubitus allows free air to rise to the right side adjacent to the liver, where it is easily detected against the dense hepatic shadow.
Question 7: Which of the following is a sign of an inadequate inspiration on a PA chest radiograph?
- Clavicles projected above the apices
- Fewer than 10 posterior ribs visible above the diaphragm (Correct answer)
- Scapulae projected outside the lung fields
- Heart shadow measuring less than half the thoracic width
Correct answer: Fewer than 10 posterior ribs visible above the diaphragm
A diagnostic PA chest requires at least 10 posterior ribs visible above the diaphragm; fewer indicates inadequate inspiration and a suboptimal study.
ARRT Thorax and Abdomen Procedures 2
Which projection best demonstrates the right lung in a patient who cannot stand, when evaluating for pleural effusion?