MRO SECTIONAL ANATOMY 1 MRO SECTIONAL ANATOMY Module 1 by MikeJenny

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                        MRO: SECTIONAL ANATOMY
                    Module 1: Introduction to Sectional Anatomy

Table of Contents

Section 1: Introduction
1.1    Module Overview
1.2    Key Terms

Section 2: Terminology
2.1    Overview
2.2    Objectives
2.3    Anatomic Position
2.4    Directional Terms
2.5    Regional Terms
2.6    Landmarks
2.7    Review: Terminology
2.8    Section 2 Quiz
Section 3: Body Planes
3.1    Overview
3.2    Objectives
3.3    Body Planes (animation)
3.4    Sagittal Sectional Image
3.5    Coronal Sectional Image
3.6    Axial Sectional Image
3.7    Oblique Sectional Image
3.8    Review: Body Planes
3.9    Section 3 Quiz
Section 4: Body Cavities
4.1    Overview
4.2    Objectives
4.3    Main Cavities
4.4    Abdominopelvic Divisions
4.5    Review: Body Cavities
4.6    Section 4 Quiz
Section 5: Sectional Image Display
5.1    Overview
5.2    Objectives
5.3    Image Display
5.4    Gray Scale
5.5    3-D Imaging
5.6    Review: Sectional Image Display
5.7    Section 5 Quiz

Conclusion
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Section 1: Introduction [place in banner]

1.1    Module Overview

Figure 1-1

This module serves as an introduction to the study of sectional anatomy by reviewing basic
terminology related to human anatomy. In this module, the body planes are defined and
reviewed, the body cavities are identified, as well as the organs contained within each, and
terminology used to locate structures is presented. Finally, the module concludes with an
explanation of the display of sectional images. Hopefully, by the end of this module, you
will have a thorough understanding of these basics so that you may use this foundational
knowledge to study sectional anatomy of the various body parts in the subsequent modules.

Many images in this module include a special feature. Look for the      beside some images
in the module. This icon represents the “Learn More” feature, which provides a detailed
image description of an image relevant to your study. Click to open the image and
description in a new window. From the new window, the image can be enlarged by clicking
on it and using the menu options in the new window.

Click Next to review the Key Terms for this module.
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[Key Terms icon] 1.2        Key Terms

The following terms are essential to your understanding of sectional anatomy. Upon the
first occurrence of a key term in this module, the term will be hot linked to the glossary
definition, which will display in a separate pop-up window. Keep in mind that the key
terms can also be accessed at any time by clicking on the glossary button on the top menu
bar. You should make yourself familiar with all of the key terms defined in this module t o
begin developing your professional vocabulary. Practice using proper medical terminology
in laboratory and clinical settings with the appropriate persons. You will need to use
appropriate lay terms with your patients in order to communicate effectively.


   Window level
   Window width

Click Next to continue.
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Section 2: Terminology [place in banner]

2.1    Overview

Figure 1-2




Terminology for each profession is unique. The study of a new subject, such as sectional
anatomy, requires that one begin by mastering the language of the profession or subject
matter. This section introduces some new and (hopefully) reviews some familiar
terminology that is foundational to your study of sectional anatomy.

Click Next to continue.

[Image: photos.com.   Item: #5325304   ]
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(Screen 2 of 8)

[Objectives icon] 2.2        Objectives

The objectives for this section of the module will measure your learning outcomes of the
material covered in this section. A quiz is included at the end of the section with questions
that map to these objectives. The quiz is graded and scored. When you pass the quiz, you
will have successfully fulfilled the learning objectives of this section.

Upon completion of this section of the module, you should be able to:

1.   Define and describe the significance of anatomic position.
2.   Apply the terms used to denote various regions of the body.
3.   Define the terms used to localize anatomical structures.
4.   Locate the external landmarks used for imaging procedures.

Click Next to continue.
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2.3    Anatomic Position

Figure 1-3 [Please crop off diagrams to right of photo, as shown.]




Anatomic position is the reference position for all location terminology. Study the screen
illustration and note that the person is standing upright with the palms facing forward. This
reference position enables us to determine which structures are more anterior, medial,
proximal, or superficial to others.

Click Next to continue.

[Image edited from: Fig. 1-7 Patient in the anatomic position. (Frank, Eugene D..
Merrill's Atlas of Radiographic Positioning and Procedures: 3-Volume Set, 11th Edition.
Mosby, 022007.). <vbk:978-0-323-03317-6#B9780323033176500074_f7> ]
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2.4    Directional Terms

Figure 1-4 [Developer: Wrap text as shown.]

                           Terms used to denote directions in the study of anatomy are
                           presented in pairs of opposite terms. All terms are referenced to
                           anatomic position, which is illustrated and defined on the
                           previous screen.

                           Anterior/Posterior – anterior is synonymous with ventral and
                           refers the front of the body. Posterior is synonymous with dorsal
                           and denotes the back of the body.

                           Cephalic/Caudal – cephalic and cephalad are synonymous and
                           indicate toward or closer to the head. Its opposite term is caudal,
                           or caudad, meaning toward or closer to the feet.

                           Medial/Lateral – medial refers to being closer to midline while
                           lateral is further from the midline.

                           Proximal/Distal – proximal refers to a location closer to the
                           origin, or point of attachment, of the part and distal describes
                           being farther from the origin.

Superficial/Deep – superficial indicates closer to the surface and deep means that a
structure is farther away from the surface.

Superior/Inferior – superior indicates being above or on top of another structure while
inferior is below another structure.

Click Next to continue.

[Image edited from: Fig. 1-7 Patient in the anatomic position. (Frank, Eugene D.. Merrill's
Atlas of Radiographic Positioning and Procedures: 3-Volume Set, 11th Edition. Mosby,
022007.). <vbk:978-0-323-03317-6#B9780323033176500074_f7>
                                                                                          8


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2.5    Regional Terms

Regional terms relate to specific parts of the body and are often root words of medical
terms. The table below summarizes and defines the most common regional terms.

Term                  Region
Antebrachial          Forearm
Antecubital           Anterior elbow
Axillary              Armpit (inferior aspect of shoulder)
Brachial              Upper arm
Buccal                Cheek
Cervical              Neck
Costal                Ribs
Cubital               Posterior elbow
Dorsum                Top of foot or posterior surface of hand
Gluteal               Buttocks
Inguinal              Groin (where upper leg joins trunk)
Lumbar                Lower back
Opthalmic             Eye
Palmar /Volar         Anterior surface of hand
Pectoral              Anterior chest
Perineal/Perineum     Region between pubis and anus
Plantar               Sole of foot
Popliteal             Area behind the knee
Thenar                Thumb
Thoracic              Chest region; middle of back
Umbilical             Area around the navel

Click Next to continue.
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2.6    Landmarks

Figure 1-5 [Developer: Apply “Click to enlarge” feature.




Landmarks are palpable areas of the body that help imaging professionals localize internal
structures. An example is when we palpate the iliac crest to localize the centering level for
an AP projection of the abdomen. The iliac crest is approximately at the same level as L4,
the designated center of the AP projection of the abdomen. Click on the screen illustration
to study the common surface landmarks used in imaging.

Click Next to continue.


[Image: Fig. 3-8 (Frank, Eugene D.. Merrill's Atlas of Radiographic Positioning and
Procedures: 3-Volume Set, 11th Edition. Mosby, 022007.). <vbk:978-0-323-03317-
6#B9780323033176500098_f8>]
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[Activity icon] 2.7   Review: Terminology

It is time to take a break from learning and assess what you have learned so far. Click on
the numbered tabs to access the review exercises provided for your self-assessment.

[Tab 1]
Engine Type           Matching v3
Screen                Drag the number of the term to its definition.
Appearance




                                                                                (mockup)

Engine                Matching Flash Engine – version 3
Specifications           Use engine master: matching3.swf
                         Engine Size: 580 x 300 pixels
                         Maximum # question sets: 10
                               o Max # characters/question = 650
                               o Optional randomizing
                               o Optional height adjustment
                         Clues (targets) per question set
                               o Optional randomizing
                               o Maximum # = 8
                               o Optional height adjustment
                               o Maximum # characters/clue = 205 (More if there are less clues)
                               o Will accommodate media links
                         Answers
                               o Learner drags number of answer choice to field
                               o Optional randomizing
                               o Maximum # characters = unlimited (scrollbar)
                               o Maximum # distracters = 6
                               o Will accommodate media links
                         Number of attempts:
                                                                                                          11


                                  o 2 to unlimited
                              Scoring optional
                              Feedback
                                  o None
                              Displays inline, framed
Questions
                               Answers                          Clues                             Media Link
                                                                                          (specify if link is for clue or
                                                                                                     answer)
                     Thenar                  Thumb region
                     Gluteal                 Region of the buttocks
                     Perineum                Area between the anus and the pubis
                     Popliteal               Posterior aspect of the knee
                     Plantar                 Dorsal aspect of the foot
                     Volar                   Palm of the hand
                     Inguinal                Region where upper limb attaches to trunk;
                                             groin
                     Dorsum                  Top of the foot; back of the hand
                     Pectoral                Anterior chest region
                     Costal                  Ribs

Distracters


[Tab 2]

Engine Type      Crossword
Screen           Type the words into the puzzle using the clues provided.
Appearance




Engine           Crossword Flash Engine – version 1
Specifications       Use engine master: xword.swf
                                                                                                             12


                           Engine Size: 620 x 450 pixels
                           Clues and Terms
                               o The 20x20 squares must fit all of your words
                               o Learner types answer in blocks
                               o Optional randomizing
                               o Maximum # = 25 (depends on how long the words are)
                               o Maximum # characters per clue = unlimited (scrollbar)
                           Feedback
                               o None
                           Max attempts
                               o 3 per word, then it fills in automatically
                           Displays inline, framed
Questions
                            Terms                                            Clues
                 Proximal                 Describes a body part that is closer to the origin or point of attachment
                 Distal                   Describes a body part that is farther from the origin or point of attachment
                 Iliac crest              Palpated to find level of L4
                 Mastoid tip              Palpable point used to locate C1
                 Medial                   Term used to describe something closer to midline
                 Lateral                  Term used to describe something that is farther from midline
                 Xiphoid process          Palpable landmark for T10
                 Deep                     Description of a cut that goes through several tissue layers
                 Thyroid cartilage        External landmark at the level of C5
                 Cephalic                 Term meaning toward the head
                 Caudal                   Term meaning toward the feet
                 Inferior                 Below another structure
                 Superior                 Above another structure
                 Anatomic                 Reference position for all location terms
                 Axillary                 Armpit regional term
                 Antebrachial             Forearm region of the body
                 Jugular notch            External landmark at level of T2-T3




Click Next to continue.
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[Test icon] 2.8      Section 2 Quiz

You have completed Section 2: Terminology. If you feel comfortable with the
information, go to the Introduction to Sectional Anatomy folder in your navigation and
click on the Section 2: Terminology Quiz link.

On submission of the quiz, you will receive your grade. If you pass this quiz, you will have
fulfilled the objectives in this section.

Click Next to begin Section 3: Body Planes.
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Section 2 Quiz

There are a total of 10 questions. Each question is weighted equally, so answer each
question. Choose the best answer for each question.

    1. To localize T7 for imaging procedures, the external landmark used is the:
           a. Sternal angle
           b. Inferior angle of the scapula
           c. Iliac crest
           d. Xiphoid process
Answer:       B
Feedback:     The inferior angle of the scapula is a palpable, external landmark that is used
to locate T7.
Objective:    Locate the external landmarks used for imaging procedures.
Reference: Module 1, Section 2, Screen 6

   2. One might describe the relationship of the adrenal glands relative to the kidneys as
       being:
           a. Superior
           b. Inferior
           c. Superficial
           d. Deep
Answer:       A
Feedback:     The adrenal glands are situated on the upper poles of the kidneys and can be
described as being superior to the kidneys.
Objective:    Define the terms used to localize anatomical structures.
Reference: Module 1, Section 2, Screen 4

   3. Which body position is used for localization terms in anatomy and imaging
       procedures?
           a. Trendelenberg
           b. Fowler’s
           c. Sim’s
           d. Anatomic position
Answer:       D
Feedback:     Anatomic position is used as the reference to localize anatomical structures.
Objective:    Define and describe the significance of anatomic position.
Reference: Module 1, Section 2, Screen 3

   4. A patient has a cut on the sole of his foot. Which term is used to denote the sole of
      the foot?
          a. Volar
          b. Thenar
          c. Plantar
          d. Dorsum
Answer:      C
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Feedback:     The plantar surface of the foot refers to the sole of the foot.
Objective:    Apply the terms used to denote various regions of the body.
Reference:    Module 1, Section 2, Screen 5

   5. Which of the following can be palpated to find L4?
           a. Inferior angle of the scapula
           b. Pubic symphysis
           c. Inferior costal margin
           d. Iliac crest
Answer:       D
Feedback:     The iliac crest is the external landmark used to locate L4.
Objective:    Locate the external landmarks used for imaging procedures.
Reference: Module 1, Section 2, Screen 6

   6. The posterior aspect of the knee joint is referred to as the ____ region.
           a. Buccal
           b. Brachial
           c. Popliteal
           d. Cubital
Answer:       C
Feedback:     The popliteal region is the area on the posterior aspect of the knee joint.
Objective:    Apply the terms used to denote various regions of the body.
Reference: Module 1, Section 2, Screen 5

    7. All of the following are proximal to the tarsals except for:
           a. Metatarsals
           b. Tibia
           c. Femur
           d. Innominate bone
Answer:        A
Feedback:      The metatarsals are distal to the tarsals, rather than proximal, since they are
farther from the point of attachment for the lower limb.
Objective:     Define the terms used to localize anatomical structures.
Reference: Module 1, Section 2, Screen 4

   8. Muscles that are located more interior in the body are described as being:
           a. Deep
           b. Superficial
           c. Distal
           d. Proximal
Answer:       A
Feedback:     Deep structures are located more interior than superficial structures.
Objective:    Define the terms used to localize anatomical structures.
Reference: Module 1, Section 2, Screen 4

   9. The regional term for the forearm is:
                                                                                          16


          a.   Brachial
          b.   Antebrachial
          c.   Axillary
          d.   Cubital
Answer:        B
Feedback:      The antebrachial region refers to the forearm.
Objective:     Apply the terms used to denote various regions of the body.
Reference:     Module 1, Section 2, Screen 5

   10. In anatomic position, the hands are positioned:
           a. Supinated
           b. Pronated
           c. In a 45 degree oblique
           d. Lateral
Answer:       A
Feedback:     As a part of the definition of anatomic position, the hands must be positioned
with the palms turned outward or facing forward, which is supinated.
Objective:    Define and describe the significance of anatomic position.
Reference: Module 1, Section 2, Screen 3

       ##End Section 2 Quiz
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Section 3: Body Planes [place in banner]

3.1    Overview

Figure 1-6




This section provides a review of the planes of the body. In order to study sectional
anatomy, you must thoroughly comprehend the planes of the body and the orientation of
anatomical structures within each plane. Sectional images may be obtained in numerous
body planes, including axial, or transverse, sagittal, oblique, and coronal. Once the plane of
the image has been identified, you will need to use that information to ascertain anterior
from posterior, medial from lateral, etc., in order to recognize anatomy included in the
sectional image.

Click Next to continue.

http://coursewareobjects.elsevier.com/objects/elr/Bontrager7e/IC/images/001036.jp
g
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[Objectives icon] 3.2        Objectives

The objectives for this section of the module will measure your learning outcomes of the
material covered in this section. A quiz is included at the end of the section with questions
that map to these objectives. The quiz is graded and scored. When you pass the quiz, you
will have successfully fulfilled the learning objectives of this section.

Upon completion of this section of the module, you should be able to:

   1. Define the body planes.
   2. Recognize the plane presented when given a sectional image.

Click Next to continue.
                                                                                              19


(Screen 3 of 9)

3.3    Body Planes (animation)

Click on the link to view an animation that defines and illustrates the planes of the body.

[Animation icon] Body Planes


Click Next to continue.
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(Screen 4 of 9)

3.4    Sagittal Sectional Image

Figure 1-7




As you learned in the previous animation, sagittal planes pass vertically through the body
or a part from anterior to posterior. Study the screen image, which is a sagittal image of the
head and thorax obtained at the median sagittal plane. Notice how sagittal images allow for
identification of structures from the anterior to the posterior as well as what is proximal or
distal and superior or inferior. Since sagittal images section the part or body from lateral to
medial, it is difficult to localize anatomy in those terms without an entire series of sagittal
images.

Click Next to continue.

http://coursewareobjects.elsevier.com/objects/elr/Bontrager7e/IC/images/001038.jpg
                                                                                           21



(Screen 5 of 9)

3.5    Coronal Sectional Image

Figure 1-8




Again, coronal planes were defined in the previous animation as vertical planes that pass
through the body from top to bottom. Coronal images are obtained by imaging a part from
anterior to posterior. Anatomy is easily seen as being closer to midline, or deep, or closer
to the surface, or lateral aspect, which may also be described as superficial. Also, proximal
and distal structures are well demonstrated on coronal images. The screen illustration is a
coronal MR image of the head and thorax. In coronal images, it is difficult to discern
anterior from posterior structures without the entire series of coronal images of the part.

Click Next to continue.

http://coursewareobjects.elsevier.com/objects/elr/Bontrager7e/IC/images/001039.jp
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3.6    Axial Sectional Image

Figure 1-9




As mentioned in the previous animation, an axial plane passes horizontally though the body
or transversely from front to back. Axial and transverse are used synonymously when
referring to plane or images obtained in this plane. Axial images demonstrate anterior from
posterior as well as medial to lateral anatomical structures. Structures that are closer to the
surface, or superficial, as compared to those located deeper in the body can also be
distinguished on axial images. The screen illustration is an axial MR image of the mid-
thorax region, including the upper limbs. Since the part or body is imaged in transverse
sections from top to bottom, it is difficult to distinguish which structures are more proximal
or distal without an entire series of axial images.

Click Next to continue.


http://coursewareobjects.elsevier.com/objects/elr/Bontrager7e/IC/images/001040.jpg
                                                                                              23



(Screen 7 of 9)

3.7    Oblique Sectional Image

Figure 1-10




Oblique planes are probably the most difficult for most imaging professionals since it is
difficult to use a reference point or plane to localize structures. Recognition of structures in
oblique images requires one to possess a global knowledge of gross anatomy. Oblique
planes are used in imaging to demonstrate relationships of complex articulations, as shown
in the screen illustration. The screen illustration features a localizer diagram on the left side
of the corresponding MR image. This image was obtained in an oblique axial plane through
the ankle joint as indicated on the localizer diagram.

Click Next to continue.

[Image: El-Khoury online. url:
http://coursewareobjects.elsevier.com/objects/elr/ElKhoury/IC/jpg/014002005.jpg ]
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(Screen 8 of 9)

[Activity icon] 3.8   Review: Body Planes

It is time to take a break from learning and assess what you have learned so far. Click on
the numbered tabs to access the review exercises provided for your self-assessment.

[Tab 1]

Engine Type       Image Association
Screen            Click on the labels and drag to label the plane of each sectional image.
Appearance




Engine            Image Association Flash Engine – version 1
Specifications    Use engine master: imageassoc.swf
                      Engine Size: 580 x 350 pixels
                      Questions
                            o Image required for each question
                            o Optional randomizing
                            o Maximum # = 6
                      Answers
                            o Learner drags label to the image
                            o Automatic randomizing
                            o Same choices displayed for all images
                            o May use each answer more than once and for multiple images
                            o Maximum # distracters = 6
                            o Maximum # of characters = 17
                      Feedback
                            o None at the present time
                      Displays inline, framed
                                  Label                                   Image file
Image 1           Oblique                                  El-Khoury online. url:
                                                           http://coursewareobjects.elsevier.com/o
                                                                                      25


                                                          bjects/elr/ElKhoury/IC/jpg/014002005.j
                                                          pg
Image 2        Axial                                      http://coursewareobjects.elsevier.co
                                                          m/objects/elr/Bontrager7e/IC/images
                                                          /001040.jpg

Image 3        Coronal                                    http://coursewareobjects.elsevier.co
                                                          m/objects/elr/Bontrager7e/IC/images
                                                          /001039.jpg

Image 4        Sagittal                                   http://coursewareobjects.elsevier.co
                                                          m/objects/elr/Bontrager7e/IC/images
                                                          /001038.jpg

Distracters



[Tab 2]
Engine Type    Labeling (Identification )
Screen         Click and drag the labels to the correct body plane.
Appearance




Engine         Identification Flash Engine – version 1
Specifications     Use engine master: pictureit.swf
                   Engine Size: 580 x 350 pixels
                   Image required
                   Labels
                         o Learner drags number of answer choice to field
                         o Automatic randomizing
                         o Maximum # = 14
                                                                                   26


                          o Maximum # of characters = 17
                          o No distracters
                     Feedback
                          o None at the present time
                     Displays inline, framed
Image file      http://coursewareobjects.elsevier.com/objects/elr/Bontrager7e/IC/images/001036.j
location
Questions
                   Label Choices                     Correct Positions
                                                   (Paste or reference an image)
                 Midsagittal plane
                 Midcoronal plane
                 Oblique plane
                 Axial plane




Click Next to continue.
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(Screen 9 of 9)

[Test icon] 3.9      Section 3 Quiz

You have completed Section 3: Body Planes. If you feel comfortable with the
information, go to the Introduction to Sectional Anatomy folder in your navigation and
click on the Section 3: Body Planes Quiz link.

On submission of the quiz, you will receive your grade. If you pass this quiz, you will have
fulfilled the objectives in this section.

Click Next to begin Section 4: Body Cavities.
                                                                                           28


Section 3 Quiz

There are a total of five questions. Each question is weighted equally, so answer each
question. Choose the best answer for each question.

    1. Which body plane passes vertically through the body from head to toe and divides it
       into equal anterior and posterior halves?
           a. Median sagittal plan
           b. Median axial plane
           c. Median coronal plane
           d. Median oblique plane
Answer:       C
Feedback:      The median coronal plane passes vertically through the body from head to
toe and divides it into equal anterior and posterior sections.
Objective:    Define the body planes.
Reference: Module 1, Section 3, Screen 3

   2. Refer to the image below. In what plane was this sectional image obtained?




[Fig. 2.6 in Ryan, Stephanie. Anatomy for Diagnostic Imaging, 2nd Edition. Saunders Book
Company, 012004. <vbk:0-7020-2620-4#B0702026204500049_f6>]
            a. Sagittal
            b. Axial
            c. Oblique
            d. Coronal
Answer:        B
Feedback:      This is an axial MR image of the brain and may also be referred to as a
transverse image.
Objective:     Recognize the plane presented when given a sectional image.
Reference: Module 1, Section 3, Screen 6

   3. A plane that passes through the body at any angle to the other body planes is the:
         a. Oblique plane
         b. Sagittal plane
         c. Coronal plane
                                                                                            29


           d. Transverse plane
Answer:       A
Feedback:     Oblique planes pass through the body at an angle to the other body planes.
Objective:    Define the body planes.
Reference: Module 1, Section 3, Screen 3

   4. The body plane that passes vertically through the body from front to back is the:
           a. Coronal
           b. Axial
           c. Transverse
           d. Sagittal
Answer:       D
Feedback:     Sagittal planes pass through the body vertically from front to back.
Objective:    Define the body planes.
Reference: Module 1, Section 3, Screen 3

   5. Review the MR image of the knee. What plane is demonstrated?




[Fig. 8.13D from Ryan, Stephanie. Anatomy for Diagnostic Imaging, 2nd Edition. Saunders
Book Company, 012004. <vbk:0-7020-2620-4#B0702026204500104_f13>]
            a. Sagittal
            b. Coronal
            c. Axial
            d. Oblique
Answer:        A
Feedback:      This is a sagittal MR image of the knee. Notice how the anterior and
posterior aspects of the knee are well visualized in this plane as well as proximal and distal
structures.
Objective:     Recognize the plane presented when given a sectional image.
Reference: Module 1, Section 3, Screen 4

       ##End Section 3 Quiz
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(Screen 1 of 6)

Section 4: Body Cavities [place in banner]

4.1    Overview

Figure 1-11




This section of the module defines the body cavities and details which organs are located
within each body cavity. The size and shape of body cavities varies from one body habitus
to another. For example, asthenic body types are long but narrow, so organs within the
cavities are generally located lower than in other body types.

Click Next to continue.

http://coursewareobjects.elsevier.com/objects/elr/Frank/MerrillsAtlas11e/IC/images/00301
0.jpg
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(Screen 2 of 6)

[Objectives icon] 4.2        Objectives

The objectives for this section of the module will measure your learning outcomes of the
material covered in this section. A quiz is included at the end of the section with questions
that map to these objectives. The quiz is graded and scored. When you pass the quiz, you
will have successfully fulfilled the learning objectives of this section.

Upon completion of this section of the module, you should be able to:

1.   Identify the body cavities.
2.   Name the organs located in each of the body cavities.
3.   Explain the regions and quadrants of the abdomen.
4.   Identify the organs in each quadrant of the abdomen.


Click Next to continue.
                                                                                            32



(Screen 4 of 6)

4.3    Main Cavities

Figure 1-12




The body is divided into two main cavities: the ventral and dorsal cavities. The dorsal
cavity contains the brain, spinal cord, and the vertebral column. The ventral cavity ha s
three subdivisions: (1) thoracic cavity, (2) abdominal cavity, and (3) pelvic cavity. Often,
the abdomen and pelvis are referred to collectively as the abdominopelvic cavity. The
thoracic cavity begins at the neck and is separated from the larger abdom inal cavity by the
diaphragm. The inferior border of the abdominal cavity and the superior border of the
pelvic cavity is the pelvic inlet. The organs contained within each cavity are outlined in the
table below.

Organs in Each Body Cavity [Developer: Link text to pop-up separate window
containing table below.]
Cavity               Organs
Thoracic             Lungs
                     Heart
                     Great vessels
                     Thymus
                     Esophagus
Abdominal            Stomach
                     Liver
                     Gallbladder
                     Pancreas
                     Spleen
                     Intestines
                     Kidneys
                     Ureters
                                                                                      33


Pelvic              Urinary bladder
                    Rectum
                    Reproductive organs

Click Next to continue.

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1/001005.jpg
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(Screen 4 of 6)

4.4    Abdominopelvic Divisions

Figure 1-13




The large abdominopelvic cavity is divided in two different ways: either four quadrants
(left screen image) or nine regions (right screen image) in order to localize structures more
readily. The four quadrants are formed by the median sagittal plane and an intersecting
axial plane at the level of the umbilicus. Each quadrant is named descriptively by location
as the right upper, right lower, left upper, and left lower quadrants. Each also has a
corresponding abbreviation, i.e., RUQ, RLQ, LUQ, and LLQ. The nine regions are formed
by two transverse planes intersecting two sagittal planes. The transverse planes are at the
level of the inferior border of L1 and the middle of L5, while the sagittal planes bisect the
clavicles and pass to the mid-inguinal area on each side. The nine regions form three rows.
The regions in the superior row are named as the right hypochondriac, epigastrium, and left
hypochondriac. The middle row regions are the right lumbar, umbilical, and left lumbar.
The inferior row is the right iliac, hypogastrium, and left iliac regions. The organs in each
abdominal quadrant are outlined in the tables linked below. Click each link to study the
tables in detail.

Abdominal Quadrants [link text to pop-up table below in separate window]
Quadrant        Organs
RUQ             Right lobe of liver
                Gallbladder
                Right kidney
                Medial portion of stomach
                Portions of small and large intestines
LUQ             Left lobe of liver
                Stomach
                                                                                      35


                    Tail of pancreas
                    Spleen
                    Left kidney
                    Portions of large intestine
RLQ                 Cecum
                    Appendix
                    Portions of small intestine
                    Right ureter
                    Right ovary
                    Right spermatic cord
LLQ                 Most of small intestine
                    Portions of large intestine
                    Left ureter
                    Left ovary
                    Left spermatic cord

Click Next to continue.

http://coursewareobjects.elsevier.com/objects/elr/Frank/MerrillsAtlas11e/IC/images/00300
6.jpg
http://coursewareobjects.elsevier.com/objects/elr/Frank/MerrillsAtlas11e/IC/images/00300
7.jpg
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(Screen 5 of 6)

[Activity icon] 4.5    Review: Body Cavities

It is time to take a break from learning and assess what you have learned so far. Click on
the numbered tabs to access the review exercises provided for your self-assessment.

[Tab 1]
Engine Type       Labeling (Identification )
Screen            Click and drag the labels to the correct body cavities.
Appearance




Engine            Identification Flash Engine – version 1
Specifications        Use engine master: pictureit.swf
                      Engine Size: 580 x 350 pixels
                      Image required
                      Labels
                            o Learner drags number of answer choice to field
                            o Automatic randomizing
                            o Maximum # = 14
                            o Maximum # of characters = 17
                            o No distracters
                      Feedback
                            o None at the present time
                      Displays inline, framed
Image file        FIG. 1-3 The two major cavities in the body. (Applegate, Edith J.. The Sectional
location          Anatomy Learning System: 2-Volume Set, 2nd Edition. Saunders Book Company,
                  082001.). <vbk:0-7216-8443-2#B0721684432500052_f3>
                  http://coursewareobjects.elsevier.com/objects/elr/Applegate/SAle arning3e/IC/jpg/Chapter01/001005.jpg
Questions
                      Label Choices                                   Correct Positions
                                                                                        37

                                                        (Paste or reference an image)
                Dorsal cavity
                Ventral cavity
                Thoracic cavity
                Abdominal cavity
                Pelvic cavity




[Tab 2]

Engine Type    Labeling (Identification )
Screen         Click and drag the labels to the correct body cavities.
Appearance




Engine         Identification Flash Engine – version 1
Specifications     Use engine master: pictureit.swf
                   Engine Size: 580 x 350 pixels
                   Image required
                   Labels
                         o Learner drags number of answer choice to field
                         o Automatic randomizing
                         o Maximum # = 14
                         o Maximum # of characters = 17
                         o No distracters
                                                                                    38


                     Feedback
                         o None at the present time
                   Displays inline, framed
Image file    Fig. 3-7, (Frank, Eugene D.. Merrill's Atlas of Radiographic Positioning and Procedures:
location      Volume Set, 11th Edition. Mosby, 022007.). <vbk:978-0-323-03317-
              6#B9780323033176500098_f7>
              http://coursewareobjects.elsevier.com/objects/elr/Frank/MerrillsAtlas11e/IC/images/00300

Questions
                 Label Choices                        Correct Positions
                                                    (Paste or reference an image)
               R. hypochondrium
               L. hypochondrium
               Umbilical
               Epigastrium
               R. lumbar
               L. lumbar
               L. inguinal
               R. inguinal
               Hypogastrium




[Tab 3]

Engine Type   Bin Drop
                                                                                   39


Screen
Appearance




             Bin Drop Flash Engine - version 1
                 Use engine master: bindrop.swf
                 Engine Size: 580 x 350 pixels
                 Columns:
                       o Maximum number = 4
                       o Column headings max # characters = 12 characters/ 2 lines
                       o May include pre-filled answers
                 Answer choices
                       o Learner drags answer choice to field
                       o Maximum number per column = 4
                       o Max number of characters/answer = 175
                       o Automatically randomized
                       o Must be entered multiple times if they are used multiple times
                       o Will accommodate images
                       o No distracters
                 Feedback
                       o None at the present time
             Displays inline, framed
                                                                                    40


Engine               Label column headings
Specifications       Bold any answers that should be prefilled
                     Indicate whether field is text or image
                     Supply file name for images
                   RUQ                 LUQ                RLQ        LLQ
                   R lobe of liver     Stomach            Appendix   Most of small
                                                                     intestine
                   Gallbladder         Spleen             Cecum      L ureter
                   Medial stomach      Tail of pancreas   R ovary    L ovary
                   R kidney            L kidney           R ureter   L spermatic cord


Correct
Answers




Click Next to continue.
                                                                                          41



(Screen 6 of 6)

[Test icon] 4.6      Section 4 Quiz

You have completed Section 4: Body Cavities. If you feel comfortable with the
information, go to the Introduction to Sectional Anatomy folder in your navigation and
click on the Section 4: Body Cavities Quiz link.

On submission of the quiz, you will receive your grade. If you pass this quiz, you will have
fulfilled the objectives in this section.

Click Next to begin Section 5: Sectional Image Display.
                                                                                           42


Section 4 Quiz

There are a total of seven questions. Each question is weighted equally, so answer each
question. Choose the best answer for each question.

   1. The gallbladder is located in the _________ of the abdomen.
           a. right upper quadrant
           b. left upper quadrant
           c. right lower quadrant
           d. left lower quadrant
Answer:       A
Feedback:     The gallbladder is located in the right upper quadrant of the abdomen.
Objective:    Identify the organs in each quadrant of the abdomen.
Reference: Module 1, Section 4, Screen 4

   2. In which cavity of the body is the central nervous system located?
           a. Cranial
           b. Ventral
           c. Dorsal
           d. Coronal
Answer:       C
Feedback:     The central nervous system is located in the dorsal body cavity.
Objective:    Name the organs located in each of the body cavities.
Reference: Module 1, Section 4, Screen 3

   3. The region of the abdomen located in the center of the middle row is called the:
           a. Epigastrium
           b. Chondrium
           c. Gastrium
           d. Umbilical
Answer:       D
Feedback:     The umbilical region is the name of the region in the center of the middle
row.
Objective:    Explain the regions and quadrants of the abdomen.
Reference: Module 1, Section 4, Screen 4

   4. The ventral cavity of the body is subdivided into the:
           a. Thoracic, abdominal, and inguinal cavities
           b. Thoracic, abdominal, and pelvic cavities
           c. Cranial, cardiac, and abdominopelvic
           d. Cardiac, subphrenic, and suprapubic
Answer:        B
Feedback:      The ventral body cavity is subdivided into the thoracic, abdominal , and
pelvic cavities.
Objective:     Identify the body cavities.
Reference: Module 1, Section 4, Screen 3
                                                                                    43


   5. The spleen is located in the:
           a. Abdominal cavity
           b. Pelvic cavity
           c. Left lower quadrant
           d. Left inguinal region
Answer:       A
Feedback:     The spleen is located in the abdominal cavity.
Objective:    Name the organs located in each of the body cavities.
Reference: Module 1, Section 4, Screen 3

   6. Which of the following organs is located in the right lower quadrant of the
       abdomen?
           a. Right lobe of the liver
           b. Stomach
           c. Appendix
           d. Medial portion of the stomach
Answer:       C
Feedback:     The appendix is located in the right lower quadrant of the abdomen.
Objective:    Identify the organs in each quadrant of the abdomen.
Reference: Module 1, Section 4, Screen 4

   7. All of the following are located in the pelvic cavity except for:
           a. Urinary bladder
           b. Uterus
           c. Rectum
           d. Cecum
Answer:       D
Feedback:     The cecum is located in the abdominal cavity.
Objective:    Name the organs located in each of the body cavities.
Reference: Module 1, Section 4, Screen 3

       ##End Section 4 Quiz
                                                                                          44


(Screen 1 of 7)

Section 5: Sectional Image Display [place in banner]

5.1    Overview

Figure 1-14




Display of sectional images must be standardized just as it is in radiography. Recall that
radiographic images are most commonly displayed in anatomic position except for the
hands and feet, which are traditionally displayed as if you are looking at your own hand or
foot held up. In sectional image display, there are discrepancies based on individual
preferences; however, there are some specifics that are presented in this section. The scout
image with the sections numbered is an essential tool when viewing sectional images. In
this course, most images are presented with a localizer diagram that displays the level and
plane of the displayed image, as demonstrated in the screen illustration.

Click Next to continue.

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2012.jpg
                                                                                            45



(Screen 2 of 7)

[Objectives icon] 5.2        Objectives

The objectives for this section of the module will measure your learning outcomes of t he
material covered in this section. A quiz is included at the end of the section with questions
that map to these objectives. The quiz is graded and scored. When you pass the quiz, you
will have successfully fulfilled the learning objectives of this secti on.

Upon completion of this section of the module, you should be able to:

1.     Differentiate between window width and window level.
2.     Describe the proper display of sectional images.
3.     Define the types of image reconstructions used in sectional imaging.

Click Next to continue.
                                                                                                 46


(Screen 3 of 7)

5.3      Image Display

Figure 1-15




As mentioned previously, there are some display and viewing differences according to
individual preferences. The following image display guidelines are the generally accepted
display methods that you may use to help identify anatomical structures on the sectional
images in the subsequent modules.

     Axial images – displayed as if the viewer is standing at the patient’s feet and looking
      toward the patient’s head; the patient’s right is on the viewer’s left and vice versa,
      while the patient’s anterior surface is at the top and the posterior is at the bottom of the
      image.
     Sagittal images – displayed as if the patient is in a lateral position; viewer looks into
      either the patient’s right or left side; head, superior, or proximal aspect at the top of the
      image.
     Coronal images – displayed as if facing the patient; patient’s right is on viewer’s left
      and vice versa; head end at top of image and foot end at bottom of image.

Click Next to continue.

[Image: www.photos.com         Item: #3656545   ]
                                                                                             47



(Screen 4 of 7)

5.4     Gray Scale

      Figure 1-16 [Developer: Add “Learn More” feature to screen illustration]




Digital images are composed of elements termed pixels or voxels. Each is assigned a
specific value according to the density of the tissues imaged. Each value co rresponds to a
shade of gray in the displayed image. The gray scale is the range of gray tones displayed
and can be manipulated in digital images. Windowing is the term used to denote adjusting
the gray scale to optimize visualization of certain tissues in digital images. The number of
shades of gray displayed in the image is the window width. The window level sets the
brightness of the image display by setting the midpoint of the range of grays (densities) for
the image.

The screen illustration provides three examples of gray scale display on CT images. Click
to access the Learn More description for more information.

Click Next to continue.

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pg
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(Screen 5 of 7)

5.5    3-D Imaging

Three-dimensional images require a stack of axial images and their data, which can be re-
analyzed in several ways to reconstruct the scanned anatomy and display it in 3-D. The
methods of three-dimensional image reconstruction are listed below. Click on each to read
a definition and view a sample image.

   Multiplanar reformation [Developer: link text to open a Learn More window of
Figure 47.44 in Adam: Granger and Allison’s Diagnostic Radiology, 5 th edition.
Mdconsult url: http://www.mdconsult.com/das/book/body/115053025-
10/787166264/1611/f4-u1.0-B978-0-443-10163-2..50050-6..gr44.jpg ]

    Curved planar reformation [Developer: link text to open a Learn More window of
Figure 22.4D in Adam: Granger and Allison’s Diagnostic Radiology, 5 th edition.
Mdconsult.com url: http://www.mdconsult.com/das/book/body/115053025-12/0/1611/f4-
u1.0-B978-0-443-10163-2..50025-7..gr4.jpg ] Crop image to show only Image D of 22.4.]

     Shaded surface display [Developer: link text to open a Learn More window of Figure
1.18 in Kelley: Sectional Anatomy for Imaging Professionals, 2 nd edition
http://coursewareobjects.elsevier.com/objects/elr/Kelley/sectionalanatomy2e/IC/images/00
1018.jpg Crop image to show only CT image.

    Maximum intensity projection [Developer: link text to open a Learn More window
of Figure 11-1 in Adam: Granger and Allison’s Diagnostic Radiology, 5th edition.
mdconsult.com url: http://www.mdconsult.com/das/book/body/115053025-9/0/1611/f4-u1.0-
B978-0-443-10163-2..50014-2..gr1.jpg ]

     Volume rendering [Developer: link text to open a Learn More window of Figure 11-2
in Adam: Granger and Allison’s Diagnostic Radiology, 5th edition.. mdconsult.com url:
http://www.mdconsult.com/das/book/body/115053025-9/0/1611/f4-u1.0-B978-0-443-
10163-2..50014-2..gr2.jpg ]


Click Next to continue.
                                                                                             49



(Screen 6 of 7)

[Activity icon] 5.6   Review: Sectional Image Display

It is time to take a break from learning and assess what you have learned so far. Click on
the numbered tabs to access the review exercises provided for your self-assessment.

[Tab 1]
Engine Type       Bin Drop
Screen
Appearance




                  Bin Drop Flash Engine - version 1
                      Use engine master: bindrop.swf
                      Engine Size: 580 x 350 pixels
                      Columns:
                           o Maximum number = 4
                           o Column headings max # characters = 12 characters/ 2 lines
                           o May include pre-filled answers
                      Answer choices
                           o Learner drags answer choice to field
                           o Maximum number per column = 4
                           o Max number of characters/answer = 175
                           o Automatically randomized
                           o Must be entered multiple times if they are used multiple times
                           o Will accommodate images
                           o No distracters
                      Feedback
                                                                                                     50


                         o None at the present time
               Displays inline, framed




Engine              Label column headings
Specifications      Bold any answers that should be prefilled
                    Indicate whether field is text or image
                    Supply file name for images
                   MIP                  SSD                      Multiplanar           Volume Rendering
                   Image:  Figure 11-   Image: Figure 1.18       Image: Figure         Figure 11-2 in
                   1 in Adam:           in Kelley:               47.44 in Adam:        Adam: Granger
                   Granger and          Sectional                Granger and           and Allison’s
                   Allison’s            Anatomy for              Allison’s             Diagnostic
                   Diagnostic           Imaging                  Diagnostic            Radiology, 5th
                   Radiology, 5th       Professionals, 2nd       Radiology, 5th        edition.
                   edition.             editionhttp://coursew    edition.              mdconsult.com
                   mdconsult.com        areobjects.elsevier.co   Mdconsult.com         url:
                                        m/objects/elr/Kelley/s
                   url:                 ectionalanatomy2e/IC/    url:                  http://www.mdco
                   http://www.mdco      images/001018.jpg        http://www.mdco       nsult.com/das/boo
                   nsult.com/das/boo                             nsult.com/das/boo     k/body/11505302
                   k/body/11505302                               k/body/11505302       5-9/0/1611/f4-
                   5-9/0/1611/f4-                                5-                    u1.0-B978-0-443-
                   u1.0-B978-0-443-                              10/787166264/16       10163-2..50014-
                   10163-2..50014-                               11/f4-u1.0-B978-      2..gr2.jpg
                   2..gr1.jpg                                    0-443-10163-
                                                                 2..50050-
                                                                 6..gr44.jpg




                   Targets the          Sets a threshold         Uses a series of 2-   All CT numbers
                   highest voxel        number, and              D image data to       encountered by
                   numbers and          every volumetric         create volumetric     the ray projected
                   maps them into a     value greater than       images along any      through the data
                   2-D image            the defined              plane                 set are weighted
                                        number is shaded,                              and displayed
                                        creating a defined                             accordingly
                                                                                                  51


                                     surface
                 Primarily used in   Used to            Often used for skeletal   Better demonstrates
                                                        lesions and fractures     narrowed areas
                 angiographic        demonstrate
                 imaging             surface
                                     abnormalities




Correct
Answers




[Tab 2]

Engine Type      Fill-In (drag and drop)
Screen           Click and drag the correct term to complete each statement.
Appearance




Engine           Fill-In Flash Engine – version 1
Specifications        Use engine master: fillin.swf
                      Engine Size: 580 x 300 pixels
                      Will accommodate an image
                      Questions
                            o Optional randomizing
                            o Maximum # = 10
                                                                                   52


                            o Maximum # characters per question = 360
                            o Will accommodate media links
                     Answer Choices
                            o Learner drags answer choice to field
                            o Optional randomizing
                            o Maximum # correct = 12 (if answer choices span 1 column)
                            o Maximum # distracters = 6
                            o Maximum # characters = 17
                     Feedback
                            o None
                     Max attempts
                            o 2-endless
                     Scoring optional
                     Displays inline, framed
                Bold correct answer(s) in each question                         Media Link
Question 1      The number of shades of gray displayed in a digital image is
                the window width.
Question 2      The overall brightness of a digital image is termed the
                window level.
Question 3      The window level is adjusted by setting the midpoint of the
                gray scale.
Question 4      Axial sectional images are displayed as if the viewer is
                standing at the patient’s feet and looking toward the
                patient’s head.
Question 5      Coronal sectional images are displayed as if facing the
                patient.
Question 6      Sagittal sectional images are displayed as if the patient is in
                a lateral position.
Distracters


Click Next to continue.
                                                                                          53



(Screen 7 of 7)

[Test icon] 5.7      Section 5 Quiz

You have completed Section 5: Sectional Image Display. If you feel comfortable with the
information, go to the Introduction to Sectional Anatomy folder in your navigation and
click on the Section 5: Sectional Image Display Quiz link.

On submission of the quiz, you will receive your grade. If you pass this quiz, you will have
fulfilled the objectives in this section.

Click Next to conclude this module.
                                                                                            54


Section 5 Quiz

There are a total of six questions. Each question is weighted equally, so answer each
question. Choose the best answer for each question.

   1. Coronal images are displayed as if:
           a. The viewer and patient are facing the same direction
           b. The patient is facing right or left
           c. The viewer and patient are face to face
           d. The patient is behind the viewer
Answer:       C
Feedback:     Coronal images are generally displayed as if viewer and patient are face to
face.
Objective:    Describe the proper display of sectional images.
Reference: Module 1, Section 5, Screen 3


    2. Which type of 3-D image reconstruction will not show internal structures?
           a. Curved multiplanar
           b. Maximum intensity projection
           c. Volume rendering
           d. Shaded surface display
Answer:       D
Feedback:     Shaded surface display is used to demonstrate surface abnormalities, so it
will not demonstrate internal structures.
Objective:    Define the types of image reconstructions used in sectional imaging.
Reference: Module 1, Section 5, Screen 5

   3. The number of shades of gray displayed in a digital image is called the:
           a. Window width
           b. Window level
           c. Image matrix
           d. Pixeling
Answer:        A
Feedback:      Window width is defined as the number of shades of gray displayed in a
digital image.
Objective:     Differentiate between window width and window level.
Reference: Module 1, Section 5, Screen 4

   4. To adjust the brightness of a digital image, the _____ is adjusted.
           a. window width
           b. widow level
           c. image matrix
           d. maximum intensity voxel
Answer:       B
Feedback:     The window level controls the overall brightness of a digital image.
Objective:    Differentiate between window width and window level.
                                                                                           55


Reference:    Module 1, Section 5, Screen 4

   5. Which type of 3-D image reconstruction technique is most often used in
       angiographic procedures?
           a. Maximum intensity projection
           b. Volume rendering
           c. Shaded surface display
           d. Multiplanar reconstruction
Answer:       A
Feedback:     Maximum intensity projection is most often applied in angiographic imaging.
Objective:    Define the types of image reconstructions used in sectional imaging.
Reference: Module 1, Section 5, Screen 5

   6. Sectional images that are displayed as if the viewer is standing at the patient’s feet
       and looking up are obtained in the ________ plane.
           a. sagittal
           b. axial
           c. coronal
           d. oblique
Answer:       B
Feedback:     Axial images are displayed as if the viewer is standing at the patient’s feet
and looking up so that the patient’s right is on the viewer’s left and vice versa.
Objective:    Describe the proper display of sectional images.
Reference: Module 1, Section 5, Screen 3

       ##End Section 5 Quiz
                                                                                           56



Introduction to Sectional Anatomy [place in banner]

Conclusion

You have completed Module 1: Introduction to Sectional Anatomy in Mosby’s
Radiography Online: Sectional Anatomy.

You should now be prepared to take the Module Exam.You may wish to assess your
readiness for the exam by reviewing the content and/or reviewing your answers on the
section quizzes. If you missed questions on the section quizzes, be sure to review those
sections in the module before taking the Module Exam.


       ##END MODULE 1

								
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