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© = 2007 A. Ruprecht
Selected
Oral and Maxillof= acial Radiology
Interactive =
Review Questions<= /span>
A. Ruprecht D= .D.S., M.Sc.D., F.R.C.D.(C)
 Prof= essor and Director of Oral and Maxillofacial Radiology
 Prof= essor of Radiology
 Prof= essor of Anatomy and Cell Biology
The University of Iowa
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© 2007 A. Ruprecht
For each question select the answer that you think is correct.
When you click on that answer, it will take you to another slide that will tell= = you whether that answer is correct or incorrect.
When you click anywhere on this slide (except over the arrows in the l= ower left hand corner) you will be returned to the original answer.  You can now select another answ= er if your first choice was incorrect. You can keep doing this until you decide to go to the next question.
If you click on any place on the question slide  (except over the arrows in = the lower left hand corner) you will be taken to the next question slide.
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© 2007 A. Ruprecht
Example question.
Which of the following answers is correct? (Click = on whichever you choose)
A. Correct&nb= sp;
B. Incorrect&= nbsp;
(Click anywhere on the slide that has no text to go to the next question. whichev= er you choose)
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© 2007 A. Ruprecht
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;           
        = ;            &n= bsp;            = ;     Correct
        = ;            &n= bsp;            = ;       Click anywhere within the text of this slide.
        = ;            &n= bsp;            = ;     
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© 2007 A. Ruprecht
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;           
        = ;            &n= bsp;            = ;     Incorrect
        = ;            &n= bsp;            = ;       Click anywhere within the text of this slide.
        = ;            &n= bsp;            = ;     
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© 2007 A. Ruprecht
Contrast of the image is affected by which of the following?
=
a. mA
=
b. kVp
=
c. exposure time
=
d. focal film distance
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© 2007 A. Ruprecht
= Incorrect.  
mA deals with the amount of current flowing across the x-ray tu= be, and as such the quantity of x radiation produced. This resu= lts in variations in the exposure of the film. This translat= es into changes in density (“darkness”) of the = r= adiograph.
Changes in mA only effect contrast if the film is grossly under- or ove= rexposed, so that the exposure in within the toe and heel or the s= houlder of the H and D curve. In the first instance the image would be= so light as to be non-diagnostic. In the latter it would be so dense (dark) that it would be non-diagnostic.
3D"Text
Density
Log10 Relative Exp= osure
0       1         2        3       4        5
5.0
4.0
3.0
2.0
1.0
0
Toe
Heel
Slope
Shoulder
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© 2007 A. Ruprecht
= Correct.
kVp effects contrast. A lower kVp setting produces short scale co= ntrast. This translates into what we would call increased contrast (o= r I refer to as increased functional contrast). A higher kVp setting pr= oduces long scale contrast. This translates into what we would ca= ll decreased contrast (or I refer to as decreased functional co= ntrast).
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        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;             .     
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charset="us-ascii" Slide 1
© 2007 A. Ruprecht
3D"Text
Density
Log10 Relative Exp= osure
0       1         2        3       4        5
5.0
4.0
3.0
2.0
1.0
0
Toe
Heel
Slope
Shoulder
= Incorrect.  
Exposure time deals with the length of time current flows a= cross the x-ray tube, and as such the quantity of x radiation p= roduced. This results in variations in the exposure of the f= ilm. This translates into changes in density (“darknessR= 21;) of the radiograph.
Changes in exposure time only effect contrast if the film is <= span style=3D'position:absolute;top:61.14%;left:0%;width:97.36%;height:4.34%'>g= rossly under- or overexposed, so that the exposure in within <= span style=3D'position:absolute;top:69.83%;left:0%;width:99.56%;height:4.34%'>t= he toe and heel or the shoulder of the H and D curve. In the first i= nstance the image would be so light as to be non-diagnostic. In t= he latter it would be so dense (dark) that it would be non-d= iagnostic.
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
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© 2007 A. Ruprecht
= Incorrect.  
Focal-film distance affects the exposure of the film in that as focal-fi= lm distance increases the beam spreads out more and a= s a result each part of the film receives less of the radiation. Conversely, as the focal-film decreases, the beam spreads = out l= ess by the time it reaches the film, and as a result each part of the film receives more of the radiation These changes translate into ch= anges in density (“darkness”) of the radiograph.
Changes in focal-film distance only effect contrast if the film is gross= ly under- or overexposed, so that the exposure in within t= he toe and heel or the shoulder of the H and D curve. In the first instance the image would be so light as to be non-diagnost= ic. In the latter it would be so dense (dark) that it w= ould be nondiagnostic.
x        = ;        x1
y        = ;            &n= bsp;          y1
4x2
x2
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0003_image022.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhEgFnAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0003_image023.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALGABaACu ANkAgQAAAAAAANkxkvwBKAL/hI+py+0PYQix2ouz3jxP2oXiSJbhB5rqyrYYmrryTJsoENf6zjvU ZMj1hsQZ8IcrKpesY/LJjEo9ICR0is0ygMmUUAuecq3XsJnJfXrP7GW6ivi25y4y/CCn622xO34P uEKmlpAXePhy5feH2LiRFsQo6UgZMQglZFi52VU4GckZ6pn5CSoqeom5dYpaprigyaqX+gorW0nb t3rbuDiZF8sb5mvqWircRlxsGIwsVhzn2dDsjAb9yVydfI39QK09pAyt+Q2+s7Z7LG2OJX5Nzp7l 7hpbHt+Cnq4efW9tzA/QRz8l+fRxszUw3L53FewlPLGQWzOHDx9FNDaxoo6C/wYPItRY5yJGCxRB NhT55VtJkwJRdmzJsgTHaS9pxpQp8l+5lTd/nfz4s2eHmTYV2ON5U1fQdSSFclBqqWhTp4lyejxK tapHoEynZo1q9Z9Yb18lBATL1WtZfTthal3bta3UC0gTQlVr9CncvGG3lqx7LwfWuW/hCvbgVgNg cIcRJy78tTHkro7LkqpcEy9VyZPPKl7LmS5ZiJH5Ys6sOSnl1Ks7m7z8eTRpobBPp7VIu/VS1KJ7 1rZtWsTiVrrRPsbN8jfw4LNBChkAPbr06dSjB6hO/Tr27djHxvvCPbx18QO0kw+/ld3z89zNt2fP 3XO/HPDfk3dfP7r87wryY//Hvx2A9TEXWAL+/XeegOzdZs56B06nYHYPDsAbMvRNCGGCDxLWIAIY SnjfhhxWc+GH42mYn2zqeWiidBGCCJ9x2sTQYoYoxiijMzTWeGKIOOYozI48Qveijee5xoqQQxZp pHhInpLCkC7CxyR0sVl4gJRTslclhctBmaWW/lWpV5Bhipkfk80leSaaVDo5lJkAuHngiyMM144B dNYZn3C3gLDnmNvhBOacgabZHaHEHYpodSrg6YaejDYqnSCtTCrodE2EQgGmlFqJzyadelqfezJA Gg6pnxpByaiqcqkfq450+eqUG81aa6le0oBqDbTmSiQPvc4AbKk9DBvqiCT/OIQsg2cAI+uXydKR zanI3TrLcTZci+0c0Eb75KbearvtlcKOq6yi4Yr7LLnlmnsOG9WCuy67YMxrLbfxDuPuu9LS+0y6 /tZrb8ACq/tvvnkejDDBli7M8LJxEgRxhQ33RrEU+PI6ccb+RCxxmZF+bPHFGBfRrFn9Piyyx0TA c27HLiu08qNrooyzir7e/HLOIJt88sw76zy0zCPvW7PNPPeM9M9As8Z00U6HbPTRHBMttb5Wh4R1 1lr7rPDUVFe9NctJm92yxmGXXPDXQg/s7NVLlz222HWnHUWv9dANr9pKd93t3G8LfoAAhh+OeOKK L85444YH4HjkiUMueeWW/18+XDCXb8455Zwv7vnnol/+dwOjn8546KirjnrriKO9gOuys3467bKP DrsCt7tuu+i977557gkAv/ruvxMvufAIIF+78czjXnrsz/vu/PTBK2+A9Z8f37n2lbc9vPebcz++ +JGDv7z5lpOPufqMo1+4+5Wzv778iU8rvf2R0z+//ofDnz3/OY5//dMf/nQnwAESj4C7O2D4Epi6 BRoQgBBUIPAY6Dqu5a+CoJOg/ByYPg528IIfBGEARThCEqpPgw9EoeIwuL8VmhAALoygB723tvjV 8IXIg+HnWNjCHR7Oh40jIumAqEMhIs6INpxeDk+oxCUyj4nnQyIUowiDG/8yD2A0jOISUaBF5D2x i14c4gR66MQnlnFyZwxjA9W4xsk9j4qK42Ic5ThFMQLsjuaj4+tyyMc+Ek9uSQzk9PwoAEJe0ZCH fCMgGek9OiqSjJC0niTpVUnxUTFrmYxkBhXZSU+2jpOh1B4RSVlKS54ucKkUpehY2UpVvlJqsTQl 9AhZS1tyDpa5bOT1itZLXR4Rl8H0peWQVkxZHhNbyVRm8rrVTGc2LmbRlOb7oFnNOT6TmdnUZhVv 1U1jXpOb4czjOMFZTm8ujprpNGcdz9VOdf4xXvGU5//gWU803u9Y+bTnsSjZz+oZLhwBdSdBC6rP RPIToR58GUPReNCHXtAHoRKd6BAKAAA7 ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0004.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
A change from 75 kVp to 90 kVp, while maintaining all other factors the same will result in what change in exposure?
=
a. a twofold increase
=
b. a twofold decrease
=
c. a fourfold increase
=
d. a fourfold decrease
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© 2007 A. Ruprecht
Correct
A change from 75 kVp to 90 kVp is an increase of 15 kVp. Every 15 kV= p increase results in a doubling of the exposure rate (roughly).
Thus, going from 60 kVp to 90 kVp would result in a fourfold increas= e, that is a doubling from 60 kVp to 75 kVp, and then a further doubling from 75 kVp to 90kVp.
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0007_image025.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0008.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Incorrect
Increasing kVp without making any other changes would increase the <= /span>exposure rate.
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0008_image026.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0009.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Incorrect
A change from 75 kVp to 90 kVp is an increase of 15 kVp. Increasing <= span style=3D'position:absolute;top:54.5%;left:13.29%;width:94.56%;height:4.0%'= >the kVp by 15 does increase the exposure rate, but by a different factor
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0009_image027.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0010.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
A change from ANSI speed D film to ANSI speed F film requires what change in exposure?=
=
a. a reduction to 2/5 of the original exposure
=
b. a twofold increase to the original exposure
=
c. a reduction to 1/10 of the original exposure
=
d. a fourfold increase to  the original exposure
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0010_image028.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhIwFnAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0011.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Correct
D speed film requires a dose unit of 1/24 of the original dose unit required= for dental film used in 1919. F speed film requires a dose of 1/6= 0. Thus it requires an exposure approximately 2/5 of that of D speed film.
Date
1919
1925
1941
1955-74
1955-present
1981
2000
Kodak Film Used
Regular dental film (Single emulsion)
Radia-Tized dental x-ray film
Ultra-Speed dental x-ray film
Radia-Tized dental x-ray film
Ultra-Speed dental x-ray film
Ektaspeed dental x-ray film
F speed dental x-ray film
Dose
1 unit
1/2 unit
1/4 unit
1/4 unit
1/24 unit
1/48 unit
1/60 unit
<= /div>
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0011_image029.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0012.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Incorrect
As ANSI film speed designations ascend in the alphabet, i.e. from A = toward Z, the speed of the emulsion increases, meaning that less exposure is needed.
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0012_image030.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0013.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Incorrect
As ANSI film speed designations ascend in the alphabet, i.e. from A = toward Z, the speed of the emulsion does increase, meaning that less exposure is needed. However the factor change here is incorrect.
=         = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;       
        = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp; .    &n= bsp;
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0013_image031.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLwKoAXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0014.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Using a film-screen combination when making a radiograph results in which of the following?
=
a. a decrease in exposure, but increase in detail and definition
=
b. a decrease in exposure, detail and definition
=
c. an increase in exposure, detail and definition
=
d. an increase in exposure, but increase in detail and definition
------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0014_image032.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhhQFnAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAB AAEAgAAAAAECAwICRAEAOw== ------=_NextPart_01C78729.354A2910 Content-Location: file:///C:/2D764A33/Interactivequestions_files/slide0015.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1
© 2007 A. Ruprecht
Incorrect
A film-screen combination does decrease the patient exposure, but at the expense of detail and definition.