Skull

1. Where should you center for the AP axial Townes view for the skull?
a. 1” superior to glabella
b. 2” superior to glabella
c. 1” superior to nasion
d. 2” superior to nasion
2. What’s the CR angle for the AP axial Townes view for the skull?
a. 15 degree caudad
b. 15 degree cephalad
c. 30 degree caudad
d. 30 degree cephalad
3. How should you position for the AP axial Townes view?
a. OML perpendicular to IR with chin down
b. IOML perpendicular to IR with chin down
c. OML 15 degrees caudal to IR
d. IOML 15 degrees cephalad to IR
4. Which cranial bone is best shown in the AP axial Townes view?
a. Parietal bones
b. Ethmoid bones
c. Sphenoid bones
d. Occipital bones
5. The radiograph of the AP Townes view was taken showing the dorsum
sellae superior to the foramen magnum. What should the technologist
do on the repeat?
a. Bring chin up
b. Bring chin down
c. Rotate head to the left
d. Rotate head to the right
6. The radiograph of the AP Townes view was taken with the dorsum
sellae superimposing over the posterior arch of C1. What should the
technologist do on the repeat?
a. Bring chin up
b. Bring chin down
c. Rotate head to the left
d. Rotate head to the right
7. A radiograph of an AP axial Townes method projection for cranium
reveals that the anterior arch of C1 is projection within the foramen
magnum. What modification is needed to correct this error present on
the initial radiograph?
a. Decrease caudal CR angle
b. Increase caudal CR angle
c. Flex the patient’s head more
d. None of the above
8. How should the technologist improve this AP axial Townes view for the
repeat?

a. Increase cephalic angle

b. Increase caudad angle
c. Rotate head to the left
d. Rotate head to the right
9. How should the technologist improve this AP axial Townes view for the
repeat?
 a. Increase cephalic angle & center higher
b. Increase caudad angle & center higher
c. Flex head more & center lower
d. Extend head more & center lower
10. A 70yr old women comes in a stretcher bed who is bedridden with a
skull x-ray. The technologist tells the patient to flex her head, but she
can only do so much. Her OML ended up being 25 degrees extended
with using sponges beneath her head. What should the CR angle be?
a. 5 degrees caudad
b. 5 degrees cephalad
c. 55 degrees caudad
d. 55 degrees cephalad
11. A 75yr old women comes in a stretcher bed who is bedridden with a
skull x-ray. The technologist tells the patient to flex her head, but she
can only do so much. Her OML ended up being 5 degrees extended
with using sponges beneath her head. What should the CR angle be?
a. 35 caudad
b. 35 cephalad
c. 25 caudad
d. 25 cephalad
12. A 90yr old man comes in a stretcher bed who is bedridden and
kyphotic. A skull x-ray was ordered. The technologist tells the patient to
extend his head as much as possible, but can only obtain an OML of
45 degrees caudad. What should the CR angle be?
a. 15 degrees cephalad
b. 15 degrees caudad
c. 45 degrees cephalad
d. 45 degrees caudad
13. A 85yr old man comes in a stretcher bed who is bedridden and
kyphotic. A skull x-ray was ordered. The technologist tells the patient to
extend his head as much as possible, but can only obtain an OML of
10 degrees caudad. What should the CR angle be?
a. 20 degrees cephalad
b. 20 degrees caudad
c. 40 degrees cephalad
d. 40 degrees caudad
14. On an AP Townes Axial skull view, the left petrous ridges appeared to
be longer than the right petrous ridges. What is the specific positioning
error present on this radiograph?
a. Tilting towards the left
b. Tilting towards the right
c. Rotation towards the left
d. Rotation towards the right
15. A radiograph of the AP Townes Axial view of the skull shows the
dorsum sellae closer to the right side of the foramen magnum, and lots
of space between the left posterior clinoid and left lateral portion of the
foramen magnum. Also, the right parietal and right occipital bones
appears to be elongated. How is the patient positioned?
a. Head is rotated to the left side
b. Head is rotated to the right side
c. Head is tilted up
d. Head is tilted down
16. How should the technologist fix the AP Townes Axial view of the skull
for the repeat?

a. Rotate head to the left

b. Rotate head to the right
c. Increase flexion of the neck
d. Increase extension of the neck
17. Where should you center for the PA caldwell view for the skull?
a. CR exit nasion
b. CR exit 1” superior to nasion
c. CR exit glabella
d. CR exit 1” superior to glabella
18. What’s the angle for the PA caldwell for the skull?
a. 15 degree caudad
b. 15 degree cephalad
c. 30 degree caudad
d. 30 degree cephalad
19. How should you position for the PA caldwell with 15 degree angle
caudad?
a. OML perpendicular to IR with chin down
b. IOML perpendicular to IR with chin down
c. OML 15 degrees caudal to IR
 d. IOML 15 degrees cephalad to IR
20. On a PA caldwell axial view, the distance from the lateral cranial
cortices to the lateral orbital margins are greater on the right side than
on the left side. What should the technologist do on the repeat?
a. Increase caudad angle
b. Increase cephalad angle
c. Rotate the patient’s face toward the left side
d. Rotate the patient’s face toward the right side
21. How should the technologist improve this PA axial caldwell radiograph
on the repeat?

a. Increase caudad angle

b. Increase cephalad angle
c. Rotate the patient’s face toward the left side
d. Rotate the patient’s face toward the right side
22. On the PA Caldwell axial view, the petrous ridges appears to be in the
lower ⅓ of the orbital margins. What should the technologist do to
improve this radiograph on the repeat?
a. Tuck the chin in more
b. Bring chin up
c. Rotate head towards the left
d. No repeat is necessary
23. On the PA Caldwell axial view, the petrous ridges are in the upper ⅓ of
the orbital margins. What should the technologist do to improve this
radiograph on the repeat?
a. Tuck the chin in more
b. Bring chin up until OML is perpendicular with the IR
c. Rotate head towards the left
d. No repeat is necessary
24. How should the technologist improve this PA axial caldwell radiograph
on the repeat?

a. Tuck the chin in more, rotate head to the left

b. Bring chin up until OML is perpendicular with the IR, rotate head
to the left
c. Rotate head towards the left
d. No repeat is necessary
25. How should the technologist improve this PA axial caldwell radiograph
on the repeat?

a. Increase caudad angle

b. Increase cephalad angle
c. Bring chin up
d. No repeat is necessary
26. Which specific positioning error is present of the petrous ridges are
projected higher in the orbits than expected for a 15 degree PA axial
projection?
a. Patient’s head was tucked in sufficiently or CR was angled
cephalad more than needed
b. Patient’s head wasn’t tucked in enough or CR was angled
caudad more than needed
c. Patient’s head was extended
d. None of the above
27. What’s the correct positioning for the lateral skull?
a. CR 2” above EAM, IPL perpendicular to IR
b. CR 1” above EAM, IPL perpendicular to IR
c. CR 2” above EAM, IPL parallel to IR
d. CR 1” above EAM, IPL parallel to IR
28. What’s the correct technical factor the skull?
a. 70-75kV
b. 75-80kV
c. 80-85kV
d. 85-90kV
29. What anatomies would indicate signs of rotation on a lateral skull?
a. Orbital roofs, greater wings, atlas foramen
b. Atlas foramen, zygomatic bones
c. EAM, orbital roofs, atlas foramen
d. Zygomatic bones, EAM, mandibular rami, greater wings of
sphenoid
30. What anatomies would indicate signs of tilting on a lateral skull?
a. Orbital roofs, greater wings of sphenoid, EAM, zygomatic bones
b. EAM
c. Mandibular rami
d. Mandibular rami, greater wings of sphenoid
31. Which way is the head positioned if the vertebral foramen of C1 is
visualized on a lateral skull?
a. Head is tilted towards the IR
b. Head is tilted away from the IR
c. Head is rotated towards the IR
d. Head is rotated away from the IR
32. How should the technologist improve this lateral skull radiograph for
the repeat?
 a. Head rotation - ensure the MSP is perpendicular to the IR
b. Head rotation - ensure the MSP is parallel to the IR
c. Head tilt - ensure the IPL is perpendicular to the IR
d. Head tilt - ensure the IPL is parallel to the IR
33. How should the technologist improve this lateral skull radiograph for
the repeat?

a. Head rotation - ensure the IPL is perpendicular to the IR, center

higher and more posterior, increase collimation
b. Head rotation - ensure the IPL is perpendicular to the IR
c. Head tilt - ensure the MSP is parallel to the IR, center higher
and more posterior, increase collimation
d. Head tilt - ensure the MSP is parallel to the IR

Sinuses
1. What’s the kV for sinuses?
a. 50-60kV
b. 60-70kV
c. 70-75kV
 d. 75-85kV
2. Which one of the following is true about the paranasal sinuses?
a. Ethmoid sinus is anterior to the sphenoid sinus
b. Sphenoid sinus is anterior to the ethmoid sinus
c. Maxillary sinus is superior to the frontal sinus
d. The ethmoid sinus is not seen on the PA caldwell projection
3. Match the letters to the correct term

a. F= ethmoid sinus, G= sphenoid sinus

b. F= sphenoid sinus, G= ethmoid sinus
c. H= zygomatic bones
d. E= frontal bones
4. In order to demonstrate any possible air or fluid levels within the sinuses, it’s
important:
a. Position patient erect
b. Use horizontal CR
c. Both a) and b)
d. None of the above
5. Which modality is preferred in studying soft tissue changes and masses within
the sinuses?
a. MRI
b. CT
c. X-ray
d. U/S
6. Which projection provides an image of all 4 sinus groups?
a. Lateral
b. Water’s
c. PA Caldwell
d. SMV
7. Which groups of paranasal sinuses is best demonstrated with a PA caldwell
projection?
a. Frontal sinuses
b. Maxillary sinuses
 c. Frontal and ethmoid sinuses
d. Frontal and maxillary sinuses
8. To avoid angling the CR for the erect PA Caldwell sinus projection, the head
should be adjusted so that the OML is ___ degrees from horizontal
a. 15
b. 30
c. 37
d. 45
9. What view requires the OML to be 15 degrees elevated from the horizontal
line?
a. AP Townes
b. PA Caldwell
c. Waters
d. Lateral
10. Where is the CR for the PA Caldwell projection?
a. 1” superior to nasion
b. Exit at nasion
c. 1” superior to glabella
d. Exit at glabella
11. Where should the petrous ridges be located on a PA caldwell view for
sinuses?
a. Upper ⅓ of orbits
b. Upper ½ of orbits
c. Lower ⅓ of orbits
d. Lower ⅓ of maxillary sinuses
12. Where are the ethmoid sinuses positioned for the PA Caldwell projection?
a. Between orbits
b. Below orbits
c. Below maxillary sinuses
d. Superior to frontal sinuses
13. A radiograph of PA Caldwell projection for sinuses reveals that the petrous
ridges are projected into the lower half of the orbits and obscuring the ethmoid
sinuses. The technologist used a horizontal x-ray beam for the projection. The
skull was positioned to place the OML at a 15 degree angle from the
horizontal plane. What positioning modification is needed to correct this
problem during the repeat exposure?
a. Increase CR angle
b. Decrease CR angle
c. Increase OML
d. Decrease OML
14. What angle is used for the water’s view on a sinus projection?
a. OML is 30 degrees cephalad
b. OML is 37 degrees cephalad
c. IOML is 30 degrees cephalad
 d. IOML is 37 degrees cephalad
15. What angle is the MML to the IR?
a. 45 degrees
b. 50 degrees
c. 70 degrees
d. 90 degrees
16. Where is the CR for the water’s for the sinuses?
a. Exits glabella
b. Exits acantion
c. Exits nasion
d. Exits 1” superior to nasion
17. Which groups of paranasal sinuses is best demonstrated with a
parietoacanthial projection?
a. Frontal
b. Ethmoid
c. Maxillary
d. Sphenoid
18. The OML forms a ___ degree angle with the image receptor with
parietoacanthial projection
a. 15
b. 30
c. 37
d. 45
19. Where should the petrous ridges be positioned on the sinus water’s
projection?
a. ⅓ lower orbits
b. ⅓ lower maxillary sinuses
c. Below maxillary sinuses
d. Below mandible
20. On a Water’s sinus view, the maxillary sinuses and orbits are foreshortened.
How should this be fixed?
a. Reposition the head with less extension of the neck
b. Reposition the head with more extension of the neck
c. Increase CR angulation
d. Decrease CR angulation
21. How should the technologist position this patient for the repeat on a PA
Caldwell projection?
 a. Rotate head towards the right, increase neck flexion
b. Rotate head towards the right, decrease neck flexion
c. Rotate head towards the left, increase neck flexion
d. Rotate head towards the left, decrease neck flexion
22. How should the technologist position the patient on the repeat?

a. Rotate head towards the right, increase neck flexion

b. Decrease neck flexion
c. Increase neck flexion
d. Rotate head towards the left, decrease neck flexion
23. Where is the sphenoid sinus located on a correctly positioned parietoacanthial
projection?
a. Between orbits
b. Superior to maxillary sinuses
c. Inferior to maxillary sinuses
d. Inferior to ethmoid sinuses
24. Which one of the following is true about PA axial Caldwell projection?
 a. Face is rotated towards the side with least distance between lateral
orbital margins to lateral cranial cortices and form crista galli to lateral
cranial cortex
b. Face is rotated towards the side with the greatest distance between
lateral orbital margins to lateral cranial cortices and form crista galli to
lateral cranial cortex
c. Petrous ridges are inferior to infraorbital margins meaning the chin was
not brought down enough for correct OML position. To fix, bring chin
down
d. Petrous ridges are superior to infraorbital margins meaning the chin
was not brought down enough for correct OML position. To fix, bring
chin down
25. Where is the CR for the lateral sinus projection?
a. ½ between outer canthus and EAM
b. ½ between occipital bone and EAM
c. 1” above EAM
d. 2” above EAM
26. Which of the following is true about the sinus lateral projection?
a. Rotation is indicated by anterior to posterior separation of the
mandibular rami
b. Rotation is indicated by superior to inferior separation of the
mandibular rami
c. Tilting is indicated by anterior to posterior separation of mandibular
rami
d. Tilting in indicated by anterior to posterior separation of petrous ridges
27. Match the following terms with the correct projection
1. Lateral A. Best view of frontal and
2. Parietoacanthial ethmoid sinuses
3. PA Caldwell B. Best view of maxillary
sinuses
C. All 4 paranasal sinuses
demonstrated

Facial bones
1. For PA Axial Caldwell, where is the CR?
a. Exits nasion
b. 1” superior to glabella
c. 1” superior to nasion
d. Exits glabella
2. Where are the petrous ridges on the Caldwell?
a. ⅓ lower of orbits
b. ½ lower of orbits
 c. ½ lower maxillary sinuses
d. ⅓ lower maxillary sinuses
3. What is the angle on the Parietoacanthial waters for facial bones?
a. OML is 30 degrees
b. OML is 37 degrees
c. IOML is 30 degrees
d. IOML is 37 degrees
4. Where are the petrous ridges on the Waters?
a. ⅓ lower maxillary sinuses
b. Lower than maxillary sinuses
c. ½ lower orbits
d. ⅓ lower orbits
5. Which line is perpendicular to the IR for a water’s view?
a. OML
b. IOML
c. IPL
d. MML
6. For the modified water’s view, what angle is used?
a. 30 OML
b. 55 OML
c. 30 IOML
d. 55 IOML
7. Where are the petrous ridges on a modified water’s view?
a. Lower maxillary sinuses
b. Inferior to maxillary sinuses
c. Inferior to orbital rims
d. Upper maxillary sinuses
8. Where is the CR for the lateral view of the facial bones?
a. Zygoma (Midway b/n out canthus and EAM)
b. 2” superior to EAM
c. 1” superior to EAM
d. Zygoma (1” superior to EAM)
9. In what 2 anatomies would a deviated nasal septum most likely to occur?
a. Septal cartilage, vomer
b. Ethmoid bone, vomer
c. Septal cartilage, ethmoid bone
d. Parietal bone, septal cartilage
10. Match the following with its correct terms.
A. Gonion 1. Vertical portion of
B. Mandibular notch mandible
C. Body 2. The chin
D. Condyloid process 3. Mandibular angle
E. Coronoid process 4. Point of union between
F. Ramus both halves of the
 G. Mentum mandible
H. Symphysis menti 5. Bony process located
anterior to the mandibular
notch
6. Horizontal portion of
mandible
7. Posterior process of upper
ramus
8. U-shaped notch
11. This bone is one single unpaired facial bone that separates the nasal bones.
a. Septal cartilage
b. Ethmoid bone
c. Petrous bone
d. Vomer
12. 3 structures make up the nasal septum. Which one of the following is correct
in regards to their placement?
a. Septal cartilage is the most anterior, and vomer is superior to the
ethmoid
b. Ethmoid is superior to the septal cartilage, with the vomer bone anterior
to the septal cartilage
c. Septal cartilage is the most anterior, ethmoid bone is inferior to the
vomer bone, vomer bone sits superior to the septal cartilage and
ethmoid bone
d. Septal cartilage is the most anterior, ethmoid bone is superior to the
vomer bone, vomer bone sits inferior to the septal cartilage and
ethmoid bone
13. From anterior to posterior, the cone shaped orbits project upward at an angle
of ___ and toward the midsagittal plane at an angle of ___
a. 37, 37
b. 30, 30
c. 30, 37
d. 45, 37
14. What is another term for the 2nd cranial nerve?
a. Olfactory nerve
b. Optic nerve
c. Maxillary nerve
d. Trigeminal nerve
15. True or false: the common basic PA axial projection for facial bones requires
a 15 degree caudal angle or CR, projecting the dense petrous ridges into the
lower ⅓ of the orbits
a. True
b. False
16. True or false: an increase in mAs of 25% to 30% is often required for the
geriatric patient with advanced osteoporosis.
 a. True
b. false
17. T/F: Nucmed is not helpful in diagnosing occult facial occult bone fractures
a. True
b. False
18. T/F: MRI is an excellent imaging modality for the detection of small metal
foreign bodies in the eye
a. True
b. False
19. What’s the name of the fracture that results from a direct blow to the orbit
leading to a description of the inferior orbital margin?
a. Blowout
b. Tripod
c. Contrecoup
d. Compression
20. What’s the major disadvantage of performing a straight PA projection for facial
bones, with no Cr angulation or neck extension, as compared with other PA
facial bone projection?
a. Orbits are obscured by petrous ridges
b. Petrous ridges obscure the maxillary sinuses
c. Orbits are too large
d. Petrous ridges are too large
21. What facial bones structures are best seen on the waters?
a. Frontal bones
b. Maxillary, orbits, frontal bones
c. Maxillary, orbits, nasal septum, zygomatic bones
d. Orbits
22. What Cr angle is used to project the petrous ridges just below the orbital floor
with the PA axial projection?
a. None
b. 30
c. 20
d. 45
23. Comparing the water’s to the modified water’s, which structures are
specifically shown better?
a. Orbital floor is better demonstrated on the water’s
b. Orbital floor is better demonstrated on the modified water’s
c. Zygomatic bone is better demonstrated on the water’s
d. Zygomatic bone is better demonstrated on the modified water’s
24. Give 2 positioning differences between the lateral projection of the cranium
and the lateral projection for the facial bones?
a. CR is different, IR lengthwise/crosswise are different on both
projections
b. CR is different, different SID
 c. Different OID and SID
d. Collimating, SID
25. Give 2 reasons why projections of the facial bones are performed PA rather
than AP when possible?
a. Less SID, less dose to the thyroid gland
b. Less OID, less dose the thyroid gland
c. Less SID, less OID
d. Less dose, less dose to the frontal bones
26. For the modified water’s, what angle is used?
a. OML 37 degrees
b. OML 30 degrees
c. OML 55 degrees
d. LML 55 degrees
27. A radiograph of a waters projection reveals the petrous ridges projected within
the maxillary sinuses. Is this an acceptable image? If not, what must be done
to improve the image during the repeat exposure?
a. Extend neck more
b. Flex neck more
c. Increase CR angle caudal
d. Increase CR angle cephalad
28. A radiograph of a waters projection reveals that the distance between the
lateral margins of the orbits and the lateral aspect of the skull is not equal.
What type of positioning error led to this radiographic outcome?
a. Tilting towards the side with the greatest distance between the orbits
and lateral margins of the skull
b. Rotation towards the side with the greatest distance between the orbits
and lateral margins of the skull
c. Tilting towards the side with the least distance between the orbits and
lateral margins of the skull
d. Rotation towards the side with the least distance between the orbits
and lateral margins of the skull
29. A radiograph of a 30 degree PA axial projection of the facial bones reveals
that the petrous ridges are projected at the level of the inferior orbital margins.
Is this an acceptable image? If not, what must be done to improve the quality
of the image during the repeat exposure?
a. No, increase neck flexion
b. No, increase neck extension
c. Yes, it’s acceptable
d. Yes, but it would’ve been better if the petrous ridges were in the ⅓
orbital regions even though 30 degrees was used
30. A lateral radiograph of the facial bones demonstrates that the bodies of the
mandible are not superimposed; one is about 1cm superior to the other. How
would this be corrected on a repeat exposure?
a. Tilting was involved, so bring MSP parallel to the IR
 b. Tilting was involved, so bring MSP perpendicular to the IR
c. Rotation was involved, so bring MCP parallel to the IR
d. Rotation was involved, so bring MSP perpendicular to the IR
31. A patient with a possible blowout fracture of the right orbit enters the
emergency room. In addition to the basic facial bone routine, what single
projection would best demonstrate this type of injury?
a. Modified water’s
b. Water’s
c. PA axial no angle
d. PA axial 15 degrees
32. A patient comes to the radiology department with a clinical history of a
deviated bony nasal septum. Which facial bone projection will best
demonstrate the degree of deviation
a. Lateral
b. Lateral, Pa axial
c. Water’s, PA axial, PA
d. Water’s
33. Which part of the ethmoid bone contains the ethmoid air cells?
a. Medial masses (labrinth)
b. Lateral masses (labrinth)
c. Medial masses (sphenoid side)
d. Lateral masses (sphenoid side)
34. The sphenoid sinus lies directly inferior to the ___?
a. Vomer
b. Septal cartilage
c. Sella turcica
d. Ethmoid bone
35. T/F: U/S of the sphenoid sinus can be performed to rule out sinusitis
a. True
b. False
36. Which one of the following imaging modalities would best demonstrate bony
erosion of the maxillary sinus due to acute sinusitis?
a. CT
b. MRI
c. U/S
d. Radiography
37. T/F: Facial bone studies should be performed erect when possible
a. True
b. False
38. T/F: A Le Fort fracture produces a “free-floating” zygomatic bone
a. True
b. False
39. Which frontal projection of the facial bones best visualizes the region of the
maxilla and orbits?
 a. Water’s
b. PA caldwell 15 degrees
c. Lateral
d. PA Caldwell 30 degrees (modified)
40. For possible cranial trauma, which single projection of the facial bones best
demonstrates any possible air-fluid levels in the sinuses if the patient can’t
stand or sit erect?
a. Lateral shoot-thru
b. Reverse water’s
c. Reverse Caldwell
d. Reverse Caldwell 30 degrees (modified)
41. Which plane is placed parallel to the IR with a true lateral projection of the
facial bones?
a. IPL
b. MSP
c. MCP
d. MAP
42. What is the angle between OML and IR with a Waters projection?
a. 20
b. 30
c. 37
d. 40
43. The CR is centered to exit at the level of the ___ for a well-positioned 15 PA
axial projection of the facial bones.
a. Nasion
b. Glabella
c. Midorbits
d. Acanthion
44. Where are the petrous ridges projected for a properly positioned modified
parietoacanthial projection?
a. ⅓ lower orbits
b. Directly inferior to orbits
c. ⅓ lower maxillary sinuses
d. Directly inferior to maxillary sinuses
45. Why should a horizontal CR be used for the erect PA Caldwell projection for
sinuses rather than the usual caudad angle?
a. There will be more OID using no CR angle, therefore it’s more likely for
distortion to happen
b. Using PA Caldwell without CR angle will reduce the OID, therefore air
fluids will be shown without distortion
c. Less OID
d. Less SID
46. A radiograph of a 15 PA projection of the facial bones reveals that the petrous
ridges are projected at the level of the mid orbital rims. What specific
positioning or CR angling error led to this radiographic outcome?
a. There was insufficient caudal angle
b. There was insufficient cephalad angle
c. The patient moved
d. There was insufficient technique used
47. A patient with severe facial bone injuries comes into the emergency room.
The patient is wearing a cervical collar and cannot be moved. What type of
positioning routine should be performed for this situation?
a. Reverse waters with CR parallel to MML (cephalic angle used) + shoot
through lateral projection
b. Reverse waters with CR parallel to OML (cephalic angle used) + shoot
through lateral projection
c. Reverse waters with CR perpendicular to MML (cephalic angle used) +
shoot through lateral projection
d. Reverse waters with CR perpendicular to OML (cephalic angled used)
+ shoot through lateral projection
48. A patient with possible facial fractures, including a possible “blow-out” fracture
to the right orbit, was brought through from the emergency room to the
radiology department. What special facial bone projection would be included
with the basic facial bone routine with parietoacanthial (waters), and PA axial
(caldwell)?
a. Modified waters (55 degrees) to show the orbital rims/floors
b. Modified caldwell (30 degrees) to show the orbital rims/floors
c. Reverse waters (37 degrees) since patient could be fractured
d. Either A) or B)
49. A patient with a clinical history of secondary osteomyelitis comes to the
radiology department. Which imaging modalities or procedures can be
performed to demonstrate the extent of damage to the sinuses?
a. MRI can best demonstrate osteomyelitis
b. CT can best demonstrate the possible bony erosion the pathology
could’ve caused
c. U/S could demonstrate the pain the patient is having
d. The sinus routine would best demonstrate the pathology, but CT could
best demonstrate the bony erosion osteomyelitis could’ve produced
50. What should the technologist do in the repeat for lateral facial projection?
 a. Rotate head so IPL is perpendicular to the IR
b. Rotate head so IPL is parallel to the IR
c. Tilt head so IPL is perpendicular to the IR
d. Tilt head so IPL is parallel to the IR
51. What should the technologist do on the repeat for the water’s facial projection
for the best diagnostic view?

a. Increase CR cephalad
b. Increase CR caudal
c. Increase neck extension
d. No repeat is necessary
52. Modified water’s projection was taken, what should be done on the repeat?
 a. Increase CR cephalad
b. Increase CR caudal
c. Increase neck extension
d. No repeat is necessary
53. For a water’s (37) projection in the image below, what should be done on the
repeat for an elderly patient who cannot move her neck?

a. Increase neck flexion because the patient should be able to move the
neck
b. Increase neck extension because the patient should be able to move
the neck
c. Increase CR angulation caudally until it’s aligned with the MML
d. Increase CR angulation cephalad until it’s aligned with the MML

Orbits
1. What is the routine for orbits?
a. PA caldwell, lateral, water’s
b. PA caldwell, Lateral, Modified Water’s
c. Modified Water’s, lateral
 d. PA caldwell, lateral, AP Townes
2. What is the routine for orbits trauma?
a. PA caldwell, lateral, water’s
b. PA caldwell, Lateral, modified Water’s
c. Modified Water’s, lateral
d. PA caldwell, lateral, AP Townes
3. Where’s the CR angle for the orbit’s caldwell?
a. Glabella
b. 1” superior to glabella
c. Nasion
d. Mid orbits
4. For the orbit’s parietoacanthial water’s, where does the CR exit?
a. Glabella
b. Acanthion
c. Nasion
d. Mid orbits
5. Which one of the following is perpendicular to the IR for an orbit’s Modified
parietoacanthial Waters Projection?
a. OML
b. LML
c. MML
d. IOML
6. Where does the CR exit on an orbit’s lateral projection?
a. Midway between EAM and orbits
b. Nasion
c. Glabella
d. Mid way between EAM and zygoma
7. Which one of the following is correct about the orbit’s lateral projection?
a. OML is perpendicular to IR
b. IOML is perpendicular to IR
c. CR is on anterior to the zygoma
d. CR is midway between zygoma and EAM

Nasal bones
1. What’s the routine for nasal bones?
a. PA caldwell, lateral
b. Water’s, lateral, PA caldwell
c. Water’s, lateral
d. AP Townes, lateral, PA caldwell
2. Where’s the CR for the lateral nasal bones?
a. Nasion
b. ½” inferior to nasion
 c. ½” superior to nasion
d. Zygoma
3. Is a grid used for nasion projections?
a. Yes because it’s larger than 10cm
b. No because it’s smaller than 10cm
c. Yes because it’s smaller than 10cm
d. No because it’s larger than 10cm

Zygomatic bones
1. Where is the centering point for the AP Axial Townes view for the zygoma?
a. 1” superior to the glabella
b. 2” superior to the glabella
c. 1” inferior to the glabella
d. 2” inferior to the glabella
2. How should the patient be positioned for an AP Axial Townes view?
a. OML is parallel to the IR, 30 CR caudal angle
b. OML is perpendicular to the IR, 30 CR caudal angle
c. IOML is parallel to the IR, 30 CR caudal angle
d. IOML is perpendicular to the IR, 30 CR caudal angle
3. What view is this called?

a. Zygoma: SMV view

b. Zygoma: AP Townes view
c. Zygoma: Waters view
d. Zygoma: Inferosuperior Tangential projection
4. What is this called?
 a. Zygoma: SMV view
b. Zygoma: AP Townes view
c. Zygoma: Waters view
d. Zygoma: Inferosuperior Tangential projection
5. How should the patient be positioned for an SMV view?
a. OML is parallel to the IR, CR and MSP perpendicular to IR
b. OML is perpendicular to the IR, CR and MSP perpendicular to IR
c. IOML is parallel to the IR, CR and MSP perpendicular to IR
d. IOML is perpendicular to the IR, CR and MSP perpendicular to IR
6. Where should the CR be positioned for an SMV view?
a. 1 ½” superior to mandibular symphysis
b. 1 ½” inferior to mandibular symphysis
c. ½” superior to mandibular symphysis
d. ½” inferior to mandibular symphysis
7. What view is this called for the zygomatic bones?

a. Zygoma: SMV view

b. Zygoma: AP Townes view
c. Zygoma: Waters view
d. Zygoma: Inferosuperior Tangential projection
8. How should you position for the Zygomatic Tangential projection?
a. OML is parallel, and CR and MSP are perpendicular to the IR
b. OML is parallel at first to IR, and CR is perpendicular to the IR, then
head is tilted 15 towards the side of interest
 c. IOML is parallel, and CR and MSP are perpendicular to the IR
d. IOML is parallel at first to IR, CR is perpendicular to the IR, then head
is tilted 15 towards the side of interest
9. A “free-floating” zygomatic bone is the frequent result of a ___ fracture
a. Compression
b. Contrecoup
c. Tripod
d. Blow-out
10. True or false: The tangential projection for a unilateral zygomatic arch
requires that the skull be rotated and tilted 15 degrees away from the affected
a. True, skull must be rotated away from affected side
b. True, skull must be rotated 15 degrees
c. False, it’s 15 degrees toward the affected side
d. False, it’s 10 degrees toward the affected side
11. Which specific facial bone structures, other than the mandible, are best
demonstrated with the SMV projection if the correct exposure factors are
used?
a. Sinuses
b. Orbits
c. Skull
d. Zygomatic bones
12. A patient with a possible fracture of the left zygomatic arch enters the
emergency room. Neither the AP axial nor the SMV projection demonstrates
the left side well. The radiologist is indecisive as to whether this zygomatic
arch is fractured. What other projections can the technologist provide to better
define this area?
a. Left lateral side
b. Right lateral side
c. Tangential inferosuperior projection, 15 degrees rotations towards left
side
d. Tangential inferosuperior projection, 15 degrees rotations towards right
side
13. As part of a study of the zygomatic arch, the technologist attempts to perform
the SMV position. Because of the size of the patient’s shoulders, he is unable
to flex the neck adequately to place the IOML parallel to the IR. What other
options does the technologist have to produce an acceptable SMV projection?
a. OML parallel to IR
b. CR is perpendicular to IOML
c. CR is adjusted so its perpendicular to IOML, and IR perpendicular to
IOML
d. CR is adjusted so its perpendicular to IOML, and IR parallel to IOML
 Mandible
1. What is the routine for the mandible?
a. Modified towne, PA axial, AP, PA, Axiolateral, axiolateral oblique
b. Modified towne, PA axial, AP, PA, Axiolateral
c. Modified towne, PA axial, AP, PA
d. Modified towne, PA axial, AP
2. Which line is perpendicular for the Modified townes view?
a. IOML
b. OML
c. LML
d. MML
3. What CR caudal angle is used for the modified townes mandible view?
a. 30
b. 35
c. 37
d. 39
4. Where’s the CR on the modified townes view for the mandible?
a. Between gonion and EAM
b. Between EAM and menti symphysis
c. glabella
d. 1” superior to glabella
5. Where are the dorsum sellae and posterior clinoids located for the modified
townes mandible?
a. In the Superior foramen magnum level
b. Inferior to the foramen magnum
c. Superior to foramen magnum
d. Anterior to the foramen magnum
6. What should the technologist do on the repeat for this AP townes mandible on
a young patient?
 a. Tuck the chin in more
b. Extend chin more
c. Increase CR angle cephalically
d. Increase CR angle caudally
7. What should the technologist do on the repeat for this AP townes mandible on
an elderly patient with rheumatoid arthritis?

a. Tuck the chin in more

b. Extend chin more
 c. Increase CR angle cephalically
d. Increase CR angle caudally
8. For a regular PA mandible projection, what is the CR angle?
a. 0 degree
b. 15 degree caudad
c. 20 degree cephalad
d. 25 degree cephalad
9. Where does the CR exit on the PA mandible projection?
a. Nasion
b. Lips
c. 1” superior to nasion
d. 1” inferior to lips
10. Which one of the following is perpendicular to the IR for the PA mandible
projection?
a. IOML
b. OML
c. MML
d. LML
11. Where are the petrous ridges located on the PA mandible projection?
a. Supraorbital margins
b. Lower ⅓ orbits
c. Lower ⅓ maxillary sinuses
d. Infraorbital margins
12. Where are the anterior clinoids and dorsum sellae on the PA mandible
projection?
a. Inferior to ethmoid sinuses
b. Lateral to ethmoid sinuses
c. Superior to ethmoid sinuses
d. Superior to sphenoid sinuses
13. What should the technologist do on the repeat for the PA mandible
projection?
 a. Increase CR angulation caudad
b. Increase CR angulation cephalad
c. Increase neck flexion
d. Increase neck extension
14. What should the technologist do on the repeat for the PA mandible
projection?

a. Increase CR angulation caudad, centre lips

b. Increase CR angulation cephalad, centre at the lips
c. Increase neck flexion, centre at the lips
d. Increase neck extension, centre at the lips
15. Which one of the following projections were most likely taken? There was no
angle required for this projection.
 a. PA mandible projection with CR angle too caudal
b. PA mandible projection with insufficient neck flexion
c. AP mandible projection with insufficient neck flexion
d. AP mandible projection with CR angle too caudal
16. Patient comes in with a mandibular fracture, what projection will effectively
take a diagnostic image of the fracture?
a. AP projection
b. PA projection
c. AP projection with CR perpendicular to OML
d. PA projection with CR perpendicular to OML
17. What’s the difference between AP and PA projections of the facial bones or
skull?
a. Orbits are larger on the AP
b. Orbits are larger on the PA
c. Mandible is larger on the AP
d. Mandible is larger on the PA
18. How do you position for PA mandible projection?
a. OML is perpendicular to IR, CR exits lips
b. IOML is perpendicular to IR, CR exits, lips
c. MML is perpendicular to IR, CR exits acanthion
d. LML is perpendicular to IR, CR exits acanthion
19. How do you position for the PA axial mandible projection?
a. OML is perpendicular, CR is 20-25 cephalad, CR exits acanthion
b. OML is perpendicular, CR is 20-25 caudad, CR exits acanthion
c. IOML is perpendicular, CR is 20-25 caudad, CR exits lips
d. IOML is perpendicular, CR is 20-25 cephalad, CR exits lips
20. What does the PA axial view elongate and view what anatomies best?
a. Proximal rami
b. Distal rami
c. Distall rami, coronoid processes
 d. Proximal rami, condyloid processes
21. How do you position for an axiolateral mandible position for a general survey?
a. IPL is parallel to IR, CR is 25 degree cephalad, 30 degree rotation of
head toward the IR
b. MSP is perpendicular to IR, CR is 25 degree caudal, 10-15 degree
rotation of head toward the IR
c. MCP is perpendicular to IR, CR is 25 degree caudal, 30 degree
rotation of head toward the IR
d. IPL is perpendicular to IR at first, CR is 25 degree cephalad, 10-15
degree tilting of head toward the IR
22. Where is the CR for the axiolateral view?
a. CR to exit mandibular region of interest
b. CR to enter mandibular region of interest
c. CR to enter mandibular region of interest (exits zygoma)
d. CR to exit mandibular region of interest (enter zygoma)
23. Which projection of the mandible will project the opposite half of the mandible
away from the side of interest?
a. PA/PA axial
b. AP
c. AP axial
d. Axiolateral oblique
24. What must be done to prevent the ramus of the mandible from being superior
imposed over the c-spine with an axiolateral oblique projection of the
mandible?
a. Flex the chin
b. Extend the chin
c. Use more cephalic angle
d. Use more caudal angle
25. How much skull rotation is used toward the image receptor for each different
axiolateral oblique projection for demonstrating each of the following?

1. Body of mandible a. 10-15 degrees

2. mentum b. 30 degrees
3. Ramus c. 45 degrees
4. General survey d. 0 degrees
5. Maximum CR angle for all e. 25 degrees
projection?

26. What specific positioning error has been committed if both sides of the
mandible are superimposed with an axiolateral oblique projection?
a. Too much tilting
b. Too much rotation
c. Insufficient cephalic angle
d. Insufficient caudal angle
27. Which positioning line is placed perpendicular to the IR for a PA or PA axial
projection of the mandible?
a. IOML
b. OML
c. MML
d. LML
28. T/F: For a true frontal view of the mandibular body, the AML should be
perpendicular to the image receptor
a. True, AP is the view
b. True, PA is the view
c. False, MML is perpendicular
d. False, LML is perpendicular
29. T/F: The CR should be angled 20-25 degrees caudad for the PA axial
projection of the mandible
a. True
b. False, it should be 20-25 degrees cephalad
c. False, it should be 15 degrees caudad
d. False, it should be 15 degrees cephalad
30. Which aspect of the mandible is best visualized with an AP axial projection?
a. Coronoid processes
b. Ramus
c. Gonion
d. Condyloid processes
31. What CR is required for the AP axial projection of the mandible if the OML is
placed perpendicular to the IR?
a. 30
b. 20
c. 42
d. 35
32. If the IOML is perpendicular, what CR is needed for the AP axial projection of
the mandible?
a. 30
b. 20
c. 42
d. 35
33. Where’s the CR for the AP axial projection of the mandible?
a. Glabella
b. Nasion
c. Acanthion
d. Lips
34. Which imaging system provides a single, frontal perspective of the entire
mandible?
a. AP
b. AP axial
 c. PA
d. Panorex
35. A radiograph of an axiolateral oblique projection of the mandible reveals that
the body of the mandible is severely foreshortened. The body of the mandible
is the area of interest. What positioning error led to this radiographic
outcome?
a. Insufficient angle was used, or not enough tilt was acquired
b. Excessive angle was used, or not enough tilt was acquired
c. Insufficient angle was used, or too much tilt was acquired
d. Excessive angle was used, or too much tilt was acquired
36. A patient comes in and shows injury near the mentum. How should you
position the patient to show the show region of interest?
a. Use 0 degree skull rotation w/ 15 degree head tilt & 10 cephalic CR
angle
b. Use 10-15 degree skull rotation w/ 15 degree head tilt & 10 cephalic
CR angle
c. Use 30 degree skull rotation w/ 25 degree head tilt
d. Use 45 degree skull rotation w/ 25 degree head tilt
37. A patient comes in and shows injury near the mandibular body. How should
you position the patient to show the show region of interest?
a. Use 0 degree skull rotation w/ 15 degree head tilt & 10 cephalic CR
angle
b. Use 10-15 degree skull rotation w/ 15 degree head tilt & 10 cephalic
CR angle
c. Use 30 degree skull rotation w/ 25 degree head tilt
d. Use 45 degree skull rotation w/ 25 degree head tilt
38. A patient comes in and shows injury near the ramus of the mandible. How
should you position the patient to show the show region of interest?
a. Use 0 degree skull rotation w/ 15 degree head tilt & 10 cephalic CR
angle
b. Use 10-15 degree skull rotation w/ 15 degree head tilt & 10 cephalic
CR angle
c. Use 30 degree skull rotation w/ 25 degree head tilt
d. Use 45 degree skull rotation w/ 25 degree head tilt
39. Which one of the following factors will prevent superimposition of the ramus
on the c-spine for the axiolateral oblique mandible projection?
a. Angle CR 10-15 cephalad
b. Have patient open mouth during exposure
c. Extend chin slightly
d. Rotate head toward IR
40. How much CR angulation should be used for a PA axial projection of the
mandible?
a. None
b. 10-15 cephalad
 c. 20-25 cephalad
d. 5 cephalad
41. What structures are better defined when the CR angulation is increased from
35-40 caudad for the AP axial projection of the mandible?
a. Coronoid processes
b. Ramus
c. Condyloid processes
d. TMJ
42. What view is this called?

a. PA
b. PA axial
c. AP
d. Axiolateral oblique
43. What view is this called?

a. PA
b. PA axial
 c. AP
d. Axiolateral oblique

TMJs
1. What is the protocol for TMJs?
a. Lateral, AP axial, axiolateral (closed mouth)
b. Lateral, AP axial (modified townes), axiolateral (closed mouth)
c. AP axial, axiolateral (closed/open mouth)
d. AP axial (modified townes), axiolateral (closed/open mouth)
2. What angle is used for the modified townes view for the TMJs with the OML
perpendicular to the IR?
a. 30 caudal
b. 35 caudal
c. 40 caudal
d. 42 caudal
3. Where’s the CR for the townes view of the TMJs?
a. Glabella
b. 3” above glabella
c. 3” above nasion
d. Nasion
4. What CR angle is used for the AP townes TMJs with the IOML perpendicular
to the IR?
a. 30 caudal
b. 35 caudal
c. 40 caudal
d. 42 caudal
5. How do you position for the TMJs townes view (modified)?
a. Erect
b. Recumbent
c. Supine
d. Lateral
6. Which angle will demonstrate the condyloid processes of mandible and ™
fossa best if the OML was perpendicular to the IR?
a. 30 caudal
b. 35 caudal
c. 40 caudal
d. 42 caudal
7. Which angle will demonstrate the TMJs and ™ fossae best if the OML was
perpendicular to the IR?
a. 30 caudal
b. 35 caudal
c. 40 caudal
 d. 42 caudal
8. For the axiolateral oblique for TMJs, which line is perpendicular to the IR?
a. IOML
b. OML
c. LML
d. AML
9. How do you position for the axiolateral oblique?
a. Start with OML perpendicular to IR, rotated head toward IR 15 degrees
b. Start with AML perpendicular to IR, rotated head toward IR 15 degrees
c. Start with IOML perpendicular to IR, rotated head toward IR 15
degrees
d. Start with IOML perpendicular to IR, rotated head away from the IR 15
degrees
10. Where is the CR for the axiolateral oblique TMJs?
a. 1 ½” superior to EAM
b. 1” superior to EAM
c. ½” superior to EAM
d. EAM
11. What angle is used for the axiolateral oblique TMJs?
a. 15 cephalad
b. 15 caudal
c. 10 cephalad
d. 10 caudal
12. Which side is demonstrated for the axiolateral oblique TMJs?
a. Downside
b. Upside
13. How do you position for the axiolateral TMJs?
a. Recumbent, OML is perpendicular to IR, CR is 25-30 caudal, CR is ½ “
anterior and 2” superior to EAM
b. Recumbent, IOML is perpendicular to IR, CR is 25-30 caudal, CR is ½
“ anterior and 2” superior to EAM
c. Recumbent, OML is perpendicular to IR, CR is 25-30 caudal, CR is 2“
anterior and ½ ” superior to EAM
d. Recumbent, IOML is perpendicular to IR, CR is 20-25 caudal, CR is ½
“ anterior and 2” superior to EAM
14. On a closed mouth TMJ axiolateral projection, how are the region of interest
(anatomies) positioned?
a. Condyle is lodged in the temporomandibular fossa
b. Condyle is not lodged in the temporomandibular fossa
c. Coronoid process is lodged in the ™ fossa
d. Coronoid process is not lodged in the ™ fossa
15. Which anatomy moves when the mouth opens?
a. Condyle
b. ™ fossa
 c. Both
d. Neither
16. Describe the movement of the condyle when the mouth opens
a. Moves inferior
b. Moves superior
c. Moves posterior
d. Moves anterior
17. Is this projection with an open mouth or closed mouth?

a. Open, axiolateral
b. Open, lateral view
c. Closed, axiolateral
d. Closed, lateral view
18. Is this projection with an open mouth or closed mouth?

a. Open, axiolateral
b. Open, lateral view
c. Closed, axiolateral
d. Closed, lateral view