RADIOGRAPHIC POSITIONING AND
RELATED ANATOMY
11TH EDITION
• Author(S)John P. Lampignano
TEST BANK
1
Reference
Ch. 1 — Terminology, Positioning, and Imaging Principles —
Positioning Terminology
Question Stem
A patient arrives for a chest radiograph and the order specifies
a PA rather than an AP projection. Which reason most directly
explains choosing a PA projection for an upright chest
radiograph?
Options
A. PA projection shortens SID and increases recorded detail.
B. PA projection places the heart closer to the IR, reducing
magnification.
C. PA projection places the heart farther from the IR, reducing
,magnification.
D. PA projection is required because the CR must be angled
caudad.
Correct Answer
C
Rationales
• Correct (C): In a PA projection the anterior structures
(including the heart) are farther from the x-ray tube and
closer to the image receptor, reducing OID and therefore
reducing magnification—this principle is emphasized in
Lampignano’s positioning terminology.
• Incorrect (A): SID is not shortened by choosing PA; SID is
an independent factor and shortening it would reduce
recorded detail, so this option is incorrect.
• Incorrect (B): This reverses the relationship—placing the
heart closer to the IR reduces magnification; in an AP
projection the heart is farther from the IR.
• Incorrect (D): A PA projection does not require a caudad
CR angle as a rule; angulation depends on the exam and
anatomy, not on PA vs AP alone.
Teaching Point
PA projection reduces heart magnification by minimizing object-
to-IR distance.
,Citation (APA)
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
2
Reference
Ch. 1 — Terminology, Positioning, and Imaging Principles —
Positioning Terminology
Question Stem
A request appears for a lateral decubitus abdomen to
demonstrate air-fluid levels. Which positioning element is
essential to demonstrate the air-fluid interface?
Options
A. Place patient supine and elevate the affected side 15°.
B. Position the patient lateral with the x-ray beam vertical
(horizontal CR).
C. Use a steep caudad tube angle to project air superiorly.
D. Perform AP projection with the patient upright only.
Correct Answer
B
Rationales
• Correct (B): A decubitus requires the patient to be
recumbent on a side with the CR horizontal so free
intraperitoneal air will rise and be visualized as an air-fluid
, interface, as described in Lampignano’s decubitus
terminology.
• Incorrect (A): Elevating while supine does not produce the
necessary horizontal beam orientation for an air-fluid
interface; decubitus position and horizontal CR are
required.
• Incorrect (C): Angling the tube changes projection
geometry but will not substitute for a horizontal CR
required to demonstrate true air-fluid levels.
• Incorrect (D): Upright AP can show air-fluid levels when
feasible, but the decubitus specifically requires horizontal
CR and lateral recumbency to demonstrate subtle
collections when upright cannot be obtained.
Teaching Point
Decubitus views require a horizontal CR to visualize air-fluid
interfaces.
Citation (APA)
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
3
Reference
Ch. 1 — Terminology, Positioning, and Imaging Principles —
Positioning Terminology
RELATED ANATOMY
11TH EDITION
• Author(S)John P. Lampignano
TEST BANK
1
Reference
Ch. 1 — Terminology, Positioning, and Imaging Principles —
Positioning Terminology
Question Stem
A patient arrives for a chest radiograph and the order specifies
a PA rather than an AP projection. Which reason most directly
explains choosing a PA projection for an upright chest
radiograph?
Options
A. PA projection shortens SID and increases recorded detail.
B. PA projection places the heart closer to the IR, reducing
magnification.
C. PA projection places the heart farther from the IR, reducing
,magnification.
D. PA projection is required because the CR must be angled
caudad.
Correct Answer
C
Rationales
• Correct (C): In a PA projection the anterior structures
(including the heart) are farther from the x-ray tube and
closer to the image receptor, reducing OID and therefore
reducing magnification—this principle is emphasized in
Lampignano’s positioning terminology.
• Incorrect (A): SID is not shortened by choosing PA; SID is
an independent factor and shortening it would reduce
recorded detail, so this option is incorrect.
• Incorrect (B): This reverses the relationship—placing the
heart closer to the IR reduces magnification; in an AP
projection the heart is farther from the IR.
• Incorrect (D): A PA projection does not require a caudad
CR angle as a rule; angulation depends on the exam and
anatomy, not on PA vs AP alone.
Teaching Point
PA projection reduces heart magnification by minimizing object-
to-IR distance.
,Citation (APA)
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
2
Reference
Ch. 1 — Terminology, Positioning, and Imaging Principles —
Positioning Terminology
Question Stem
A request appears for a lateral decubitus abdomen to
demonstrate air-fluid levels. Which positioning element is
essential to demonstrate the air-fluid interface?
Options
A. Place patient supine and elevate the affected side 15°.
B. Position the patient lateral with the x-ray beam vertical
(horizontal CR).
C. Use a steep caudad tube angle to project air superiorly.
D. Perform AP projection with the patient upright only.
Correct Answer
B
Rationales
• Correct (B): A decubitus requires the patient to be
recumbent on a side with the CR horizontal so free
intraperitoneal air will rise and be visualized as an air-fluid
, interface, as described in Lampignano’s decubitus
terminology.
• Incorrect (A): Elevating while supine does not produce the
necessary horizontal beam orientation for an air-fluid
interface; decubitus position and horizontal CR are
required.
• Incorrect (C): Angling the tube changes projection
geometry but will not substitute for a horizontal CR
required to demonstrate true air-fluid levels.
• Incorrect (D): Upright AP can show air-fluid levels when
feasible, but the decubitus specifically requires horizontal
CR and lateral recumbency to demonstrate subtle
collections when upright cannot be obtained.
Teaching Point
Decubitus views require a horizontal CR to visualize air-fluid
interfaces.
Citation (APA)
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
3
Reference
Ch. 1 — Terminology, Positioning, and Imaging Principles —
Positioning Terminology
