RADIOGRAPHIC POSITIONING AND
RELATED ANATOMY
11TH EDITION
• Author(S)John P. Lampignano
TEST BANK
1)
Reference
Ch. 1 — PART ONE Terminology and Positioning — Positioning
Terminology
Question Stem
A 62-year-old patient requires a chest radiograph and you must
minimize cardiac magnification while evaluating for
pneumothorax. Which projection and patient orientation best
accomplish this goal?
Options
A. AP supine with horizontal beam
B. AP upright with IR anterior to chest
C. PA upright with IR against the chest and the patient facing
,the image receptor
D. Lateral decubitus with affected side up
Correct Answer
C
Rationales
• Correct (C): A PA upright projection with the patient’s
anterior chest against the image receptor reduces OID,
minimizing cardiac magnification and improving
visualization of pleural spaces—consistent with positioning
terminology and projection rationale.
• A (incorrect): AP supine increases OID and cardiac
magnification and is poor for evaluating pneumothorax
compared with upright PA.
• B (incorrect): AP upright still places the heart farther from
the IR than a PA and increases magnification.
• D (incorrect): Lateral decubitus is useful for small pleural
effusions but not optimal for reducing cardiac
magnification during routine chest evaluation.
Teaching Point
PA upright reduces OID and cardiac magnification for optimal
chest imaging.
Citation
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
,2)
Reference
Ch. 1 — PART ONE Terminology and Positioning — Positioning
Principles
Question Stem
You obtain a lateral elbow projection and notice the trochlea
and capitulum are not superimposed, producing an oblique
appearance. What positioning error most likely produced this
image?
Options
A. Excessive flexion of the elbow
B. Rotation of the humerus around its long axis
C. Incomplete true lateral — humeral epicondyles not
perpendicular to IR
D. Use of incorrect SID
Correct Answer
C
Rationales
• Correct (C): A true lateral requires the medial and lateral
epicondyles to be superimposed; if they aren’t, the elbow
is rotated relative to the IR producing an oblique
appearance.
, • A (incorrect): Excessive flexion changes joint space
appearance but does not specifically prevent epicondylar
superimposition if long-axis alignment is correct.
• B (incorrect): Rotation about the humeral long axis would
alter epicondylar orientation but the typical measurable
error for non-superimposed trochlea/capitulum is
improper lateral alignment.
• D (incorrect): SID affects magnification, not
superimposition of elbow condyles.
Teaching Point
For a true lateral elbow, align epicondyles perpendicular to the
IR to achieve superimposition.
Citation
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
3)
Reference
Ch. 1 — PART ONE Terminology and Positioning — Positioning
Principles
Question Stem
A trauma patient with suspected cervical spine injury must be
imaged using the lateral cervical projection. Which positioning
principle best reduces motion and preserves a diagnostic study?
RELATED ANATOMY
11TH EDITION
• Author(S)John P. Lampignano
TEST BANK
1)
Reference
Ch. 1 — PART ONE Terminology and Positioning — Positioning
Terminology
Question Stem
A 62-year-old patient requires a chest radiograph and you must
minimize cardiac magnification while evaluating for
pneumothorax. Which projection and patient orientation best
accomplish this goal?
Options
A. AP supine with horizontal beam
B. AP upright with IR anterior to chest
C. PA upright with IR against the chest and the patient facing
,the image receptor
D. Lateral decubitus with affected side up
Correct Answer
C
Rationales
• Correct (C): A PA upright projection with the patient’s
anterior chest against the image receptor reduces OID,
minimizing cardiac magnification and improving
visualization of pleural spaces—consistent with positioning
terminology and projection rationale.
• A (incorrect): AP supine increases OID and cardiac
magnification and is poor for evaluating pneumothorax
compared with upright PA.
• B (incorrect): AP upright still places the heart farther from
the IR than a PA and increases magnification.
• D (incorrect): Lateral decubitus is useful for small pleural
effusions but not optimal for reducing cardiac
magnification during routine chest evaluation.
Teaching Point
PA upright reduces OID and cardiac magnification for optimal
chest imaging.
Citation
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
,2)
Reference
Ch. 1 — PART ONE Terminology and Positioning — Positioning
Principles
Question Stem
You obtain a lateral elbow projection and notice the trochlea
and capitulum are not superimposed, producing an oblique
appearance. What positioning error most likely produced this
image?
Options
A. Excessive flexion of the elbow
B. Rotation of the humerus around its long axis
C. Incomplete true lateral — humeral epicondyles not
perpendicular to IR
D. Use of incorrect SID
Correct Answer
C
Rationales
• Correct (C): A true lateral requires the medial and lateral
epicondyles to be superimposed; if they aren’t, the elbow
is rotated relative to the IR producing an oblique
appearance.
, • A (incorrect): Excessive flexion changes joint space
appearance but does not specifically prevent epicondylar
superimposition if long-axis alignment is correct.
• B (incorrect): Rotation about the humeral long axis would
alter epicondylar orientation but the typical measurable
error for non-superimposed trochlea/capitulum is
improper lateral alignment.
• D (incorrect): SID affects magnification, not
superimposition of elbow condyles.
Teaching Point
For a true lateral elbow, align epicondyles perpendicular to the
IR to achieve superimposition.
Citation
Lampignano, J. P. (2024). Textbook of Radiographic Positioning
and Related Anatomy (11th Ed.). Ch. 1.
3)
Reference
Ch. 1 — PART ONE Terminology and Positioning — Positioning
Principles
Question Stem
A trauma patient with suspected cervical spine injury must be
imaged using the lateral cervical projection. Which positioning
principle best reduces motion and preserves a diagnostic study?
