Another Nifty Quiz from Annie’s Archives: Positioning

1. What portion of the breast is best demonstrated by the CC projection?
   

   1. Axillary

   2. Inframammary crease

   3. Subareolar

   4. Tail of Spence

   5. Pectoralis minor

2. Which area of the breast is
   visualized better on the CC than the MLO?

   1. Axillary

   2. Subareolar

   3. Pectoralis major

   4. Lateral

   5. Medial

3. Where should the opposite arm be
   placed when positioning the CC View?

   1. Forward (holding the handle bar
      if available)

   2. Relaxed at the side

   3. Relaxed in external rotation

   4. Flexed with hand on hip

   5. Relaxed in internal rotation

      
      

4. What is the best view or technique used to demonstrate Ca recurrence on the affected side of a mastectomy patient?

   1. LM

   2. Tangential

   3. Lumpogram

   4. CC

   5. Axillary tail

      
      

5. Which of the following will tighten the pectoral muscle, making positioning and compression
   difficult?

   1. Poor posture

   2. Raising the shoulder

   3. Gripping the handrail

   4. External rotation of the hand

   5. Lowering the chin

      
      

6. In what direction should the prosthesis be displaced when performing
   the ID views?

   1. Anterior/inferior

   2. Posterior/inferior

   3. Lateral/superior

   4. Posterior/superior

   5. Lateral/medial

      
      

7. Where should the arm on the side of the body being imaged be placed when positioning the CC view?

   1. Forward (holding the handle bar if available)

   2. Relaxed at the side

   3. Relaxed in external rotation

   4. Flexed with hand on hip

   5. Relaxed in internal rotation

      
      

8. What plane is referred to when discussing ‘oblique’ for the MLO projection?

   1. Axis of the plane of compression

   2. Axis of the angle of the chest wall

   3. Degree of obliquity between the IMF and the chest wall

   4. Mid-sagittal plane

   5. The clavicular sternal plane

      
      

9. Of the following projections, which one demonstrates the most breast tissue?

   1. MLO

   2. CC

   3. LM

   4. ML

   5. XCCL

      
      

10. What is the proper position of the C-arm for the MLO projection?

    
    

    1. Perpendicular to the pectoralis

    2. Parallel to the IMF

    3. Perpendicular to the chest wall

    4. Parallel to the sternal-clavicular plane

    5. Parallel to the pectoral muscle

       
       

11. Which of the following projections would best demonstrate a lesion in the far medial
    portion of the breast?

    1. AT

    2. XCCL

    3. CV

    4. MLO

    5. SIO

       
       

12. Which of the following views is an exact substitute for the MLO projection?

    1. AT

    2. LMO

    3. 30 ˚ AX

    4. SIO

    5. ML

       
       

13. Before final compression of the MLO view what is the most advantageous direction for the patient to rotate her shoulder?

    
    

    1. Anterior

    2. Externally

    3. Posterior

    4. Inferior

    5. Superior

       
       

14. Which of the following is the proper action when the nipple is not in profile on an otherwise adequate CC view?

    1. Adjust the technique for a lower OD

    2. Reposition the breast until the nipple is in profile

    3. Perform an extra view of the anterior portion of the breast with the nipple in profile

    4. Perform a FB projection

    5. No action should be taken unless the patient is symptomatic

       
       

15. Which area of the breast is not well demonstrated by the CC view

    
    

    1. Inferior/anterior

    2. Superior/posterior

    3. Central/medial

    4. Superior/anterior

    5. Inferior/medial

       
       

16. What is the best technique to remove the fat fold from the axillary area on the CC projection?

    
    

    1. Internally rotate the shoulder

    2. Place the hand on the hip

    3. Move arm anteriorly

    4. Externally rotate the shoulder

    5. Pull up the breast tissue under the clavicle

       
       

17. Which is the preferred possible solution to performing a CC on a kyphotic patient?

    
    

    1. Raise both arms and place the hands behind the neck

    2. Rotate c-arm 15˚

    3. Oblique patient 30˚ to the affected side

    4. Perform a SIO projection

    5. Perform a FB projection

       
       

18. Which of the following actions will assist in the inclusion of the all the medial tissue on the CC image?

    
    

    1. Do a FB view

    2. Rotate C-arm 10˚

    3. Turn patient’s head toward the affected side

    4. Lift and place the opposite breast onto the bucky

    5. Have patient lift and hold opposite breast towards unaffected side

       
       

19. Which of the following describes pectoralis excavatum?

    1. Concave chest wall

    2. Depressed sternum

    3. Barrel chest

    4. Short torso

    5. Kyphotic spine

       
       

20. Which of the following positions are recommended for patients with post-op heart surgery, prominent pace-makers or main line pick catheters?

    1. LMO

    2. MLO

    3. ML

    4. XCCL

    5. RM

21. Which of the following positions would best demonstrate superimposed densities in the tissue?

    1. LM

    2. XCCL

    3. CV

    4. AT

    5. RL

22. Which of the following projections would best demonstrate skin calcifications?

    1. CC

    2. MLO

    3. TAN

    4. AT

    5. RM

       
       

23. The projection pictured below is a:

    1. ML view

    2. LMO view

    3. AT view

    4. LM view

    5. TAN view

24. Lesions at which location in the breast would be best demonstrated by a LM or ML projection?

    
    

    1. L 3:00

    2. R 12:00

    3. L 9:00

    4. R 8:00

    5. L 2:00

25. Which of the following is NOT a contraindication for performing ID views?

    1. Explanted

    2. Tissue firmly encapsulated

    3. Major rupture

    4. Post mastectomy implants surrounded by skin

    5. Very large implants within small breasts

26. Which of the following is a possible solution to very tiny breasts that keep slipping out of
    compression?

    1. Spot compression paddle

    2. XCCL view

    3. CV view

    4. Magnify tissue

    5. Do MLO views only

       
       

27. Which position will best demonstrate a TAN view of a lesion in the lateral region of the
    breast?

    1. CC

    2. MLO

    3. SIO

    4. LMO

    5. LM

CONCLUSION:

It is always a good idea to keep testing our knowledge and reminding ourselves of pertinent information about our specialty. Have fun with the quiz and pass it on.

SOLUTION KEY

1=3, 2=5, 3=1, 4=5, 5=2, 6=4, 7=3, 8=1, 9=1, 10=5, 11=3, 12=2, 13=1, 14=3, 15=2, 16=4, 17=5, 18=4, 19=2, 20=1, 21=5, 22=3, 23=4, 24=2, 25=5, 26=1, 27=1.