3 RadReview Thorax

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1

Which of the following positions is required to demonstrate small amounts of air in the pleural cavity?
A.
AP supine
B.
AP Trendelenburg
C.
Lateral decubitus, affected side down
D.
Lateral decubitus, affected side up

D.
Lateral decubitus, affected side up

2

Which of the following will be demonstrated best in the 45-degree right anterior oblique (RAO) position?
A.
Right axillary ribs
B.
Left axillary ribs
C.
Sternum in the heart shadow
D.
Left scapular Y

B.
Left axillary ribs

3

Place the following anatomic structures in order from anterior to posterior:
1. Trachea
2. Apex of heart
3. Esophagus

C.
Apex of heart, trachea, esophagus

4

An increase in exposure factors usually is required in which of the following circumstances?

Edema

Ascites

Acromegaly

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

5
card image

All the following statements regarding the position shown in Figure 2–17 are true except

Figure 2–17.
A.
a left pleural effusion could be demonstrated.
B.
a right pneumothorax could be demonstrated.
C.
a left lateral decubitus position is illustrated.
D.
the CR is directed vertically to the level of T7.

D.
the CR is directed vertically to the level of T7.

6

The patient's chin should be elevated during chest radiography to
A.
permit the diaphragm to move to its lowest position
B.
avoid superimposition on the apices
C.
assist in maintaining an upright position
D.
keep the MSP parallel

B.
avoid superimposition on the apices

7

The condition in which pulmonary alveoli lose their elasticity and become permanently inflated, causing the patient to consciously exhale, is
A.
bronchial asthma
B.
bronchitis
C.
emphysema
D.
tuberculosis

C.
emphysema

8

The lesser tubercle of the humerus will be visualized in profile in the
A.
AP shoulder external rotation radiograph.
B.
AP shoulder internal rotation radiograph.
C.
AP elbow radiograph.
D.
Lateral elbow radiograph.

B.
AP shoulder internal rotation radiograph.

9
card image

What is the name of the plane indicated by the number 1 in Figure 6–17?

Figure 6–17.A.

Midcoronal plane
B.
Midsagittal plane
C.
Transverse plane
D.
Horizontal plane

A.
Midcoronal plane

10

The sternoclavicular joints will be best demonstrated in which of the following positions?
A.
Apical lordotic
B.
Anterior oblique
C.
Lateral
D.
Weight-bearing

B.
Anterior oblique

11
card image

Figure 2–5 demonstrates which of the following conditions?

Figure 2–5.
A.
right upper lobe atelectasis
B.
left upper lobe atelectasis
C.
pneumothorax
D.
dextrocardia

D.
dextrocardia

12

Which of the following are characteristics of the hypersthenic body type?

Short, wide, transverse heart

High and peripheral large bowel

Diaphragm positioned low

A.
1 and 2 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

A.
1 and 2 only

13
card image

Which of the following statements is (are) true regarding the radiograph shown in Figure 6–16?

Figure 6–16.

Courtesy of Stamford Hospital, Department of Radiology.

The part is rotated.

The patient is not shielded correctly.

There is excessive density.

A.
1 only
B.
2 only
C.
1 and 2 only
D.
1, 2, and 3

B.
2 only

14

A lateral projection of the larynx is occasionally required to rule out foreign body, polyps, or tumor. The CR should be directed
A.
just below the EAM
B.
to the level of the mandibular angles
C.
to the level of the laryngeal prominence
D.
to the level of C7

C.
to the level of the laryngeal prominence

15

During chest radiography, the act of inspiration

elevates the diaphragm

raises the ribs

depresses the abdominal viscera

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

16
card image

The PA chest radiograph shown in Figure 2–13 demonstrates

Figure 2–13.
Courtesy of Stamford Hospital, Department of Radiology.

rotation

scapulae superimposed on lung fields

adequate inspiration

A.
1 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

B.
1 and 3 only

17

The term used to describe expectoration of blood from the bronchi is
A.
hemoptysis
B.
hematemesis
C.
chronic obstructive pulmonary disease (COPD)
D.
bronchitis

A.
hemoptysis

18
card image

The position illustrated in Figure 6–4 can be used successfully to demonstrate the

Figure 6–4.
PA oblique sternum

barium-filled pylorus and duodenum

left anterior ribs

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

19

Which of the following statements is (are) correct, with respect to a left lateral projection of the chest?

The MSP must be perfectly vertical and parallel to the IR.

The right posterior ribs will be projected slightly posterior to the left posterior ribs.

Arms must be raised high to prevent upper-arm soft-tissue superimposition on lung field.

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

20

The thoracic cavity is lined by
A.
parietal pleura.
B.
visceral pleura.
C.
parietal peritoneum.
D.
visceral peritoneum.

A.
parietal pleura.

21

Graves disease is associated with
A.
thyroid underactivity
B.
thyroid overactivity
C.
adrenal underactivity
D.
adrenal overactivity

B.
thyroid overactivity

22

All the following statements regarding respiratory structures are true except
A.
the right lung has three lobes.
B.
the inferior portion of the lung is the apex.
C.
each lung is enclosed in serous membrane.
D.
the main stem bronchi enter the lung hilum.

B.
the inferior portion of the lung is the apex.

23

Each of the following statements regarding respiratory structures is true except
A.
the left lung has two lobes
B.
the lower portion of the lung is the base
C.
each lung is enclosed in peritoneum
D.
the main stem bronchus enters the lung hilum

C.
each lung is enclosed in peritoneum

24
card image

The letter B in Figure 2–13 indicates

Figure 2–13.
Courtesy of Stamford Hospital, Department of Radiology.

A.
a left anterior rib
B.
a right posterior rib
C.
a left posterior rib
D.
a right anterior rib

A.
a left anterior rib

25

Which of the following is (are) evaluation criteria for a PA chest radiograph of the heart and lungs?

Ten posterior ribs should be seen above the diaphragm.

The medial ends of the clavicles should be equidistant from the vertebral column.

The scapulae should be seen through the upper lung fields.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

B.
1 and 2 only

26

Which of the following is a vessel that does not carry oxygenated blood?
A.
Pulmonary vein
B.
Pulmonary artery
C.
Coronary artery
D.
Chordae tendineae

B.
Pulmonary artery

27

During studies of the soft tissue of the neck, the exposure can be made
1. during phonation before/after opacification.
2. during Valsalva maneuver.
3. at the height of swallowing motion with opacification.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

28

The sternal angle is at approximately the same level as the
A.
T2–3 interspace
B.
T9–10 interspace
C.
T5
D.
costal margin

C.
T5

29

Which of the following is (are) part of the bony thorax?

Manubrium

Clavicles

24 ribs

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

C.
1 and 3 only

30

Characteristics of a patient with pulmonary emphysema include

shoulder girdle elevation

increased AP diameter of the chest

hyperventilation

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

B.
1 and 2 only

31

Widening of the intercostal spaces is characteristic of which of the following conditions?
A.
Pneumothorax
B.
Emphysema
C.
Pleural effusion
D.
Pneumonia

B.
Emphysema

32

To best visualize the lower ribs, the exposure should be made
A.
on normal inspiration
B.
on inspiration, second breath
C.
on expiration
D.
during shallow breathing

C.
on expiration

33

All of the following statements regarding the RAO position of the sternum are true, except
A.
the sternum is generally projected to the left of the vertebral column.
B.
shallow breathing during the exposure can obliterate prominent pulmonary markings.
C.
it is helpful to project the sternum over the heart.
D.
a thin thorax requires a lesser degree of obliquity than a thicker thorax.

D.
a thin thorax requires a lesser degree of obliquity than a thicker thorax.

34

To better demonstrate the interphalangeal joints of the toes, which of the following procedures may be employed?

Angle the CR 15 degrees caudad.

Angle the CR 15 degrees cephalad.

Place a sponge wedge under the foot with the toes elevated 15 degrees.

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
2 and 3 only

D.
2 and 3 only

35

The act of expiration will cause the

diaphragm to move inferiorly

sternum and ribs to move inferiorly

diaphragm to move superiorly

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

36

In which of the following procedures is quiet, shallow breathing recommended during the exposure to obliterate prominent pulmonary vascular markings?

RAO sternum

Lateral thoracic spine

AP scapula

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

37

Deoxygenated blood from the head and thorax is returned to the heart by the
A.
pulmonary artery
B.
pulmonary veins
C.
superior vena cava
D.
thoracic aorta

C.
superior vena cava

38
card image

Which of the following statements with respect to the PA chest seen in Figure 2–11 is (are) correct?

Figure 2–11.
Courtesy of Stamford Hospital, Department of Radiology.

Adequate inspiration is demonstrated.

The shoulders are rolled forward adequately.

Rotation is demonstrated.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

39

An aspirated foreign body is more likely to enter the lower respiratory tract via the
A.
left main stem bronchus.
B.
right main stem bronchus.
C.
bronchioles.
D.
alveoli.

B.
right main stem bronchus.

40

Which of the following are mediastinal structures?

Heart

Trachea

Esophagus

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

41

The inhalation of liquid or solid particles into the nose, throat, or lungs is referred to as
A.
asphyxia
B.
aspiration
C.
atelectasis
D.
asystole

B.
aspiration

42

Dorsal decubitus projections of the chest are used to evaluate small amounts of

fluid in the posterior chest

air in the posterior chest

fluid in the anterior chest

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

A.
1 only

43

Below-diaphragm ribs are better demonstrated when
A.
respiration is suspended at the end of full inhalation.
B.
exposed using shallow breathing technique.
C.
the patient is in the recumbent position.
D.
the patient is in the AP erect position.

C.
the patient is in the recumbent position.

44

Which of the following positions may be used to effectively demonstrate the right posterior axillary ribs?
A.
LAO
B.
RAO
C.
RPO
D.
LPO

C.
RPO

45

A dorsal decubitus position of the chest may be used to evaluate small amounts of
1. fluid in the posterior chest.
2. air in the posterior chest.
3. fluid in the anterior chest.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

A.
1 only

46

All the following positions are used frequently to demonstrate the sternoclavicular articulations except
A.
weight-bearing
B.
RAO
C.
LAO
D.
PA

A.
weight-bearing

47

The condition that results from a persistent fetal foramen ovale is
A.
an atrial septal defect
B.
a ventricular septal defect
C.
a patent ductus arteriosus
D.
coarctation of the aorta

A.
an atrial septal defect

48

All of the following statements regarding respiratory structures are true except
A.
the right lung has two lobes.
B.
the uppermost portion of the lung is the apex.
C.
each lung is enclosed in pleura.
D.
the trachea bifurcates into mainstem bronchi.

A.
the right lung has two lobes.

49

To demonstrate the pulmonary apices with the patient in the AP position, the
A.
central ray is directed 15° to 20° cephalad.
B.
central ray is directed 15° to 20° caudad.
C.
exposure is made on full exhalation.
D.
patient's shoulders are rolled forward.

A.
central ray is directed 15° to 20° cephalad.

50
card image

Which of the following statements is (are) true regarding Figure 2–30?

Figure 2–30.
Courtesy of Stamford Hospital, Department of Radiology.

The image was made in the LAO position.

The CR should enter more inferiorly.

The sternum is projected onto the left side of the thorax.

A.
1 only
B.
2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

51

Inspiration and expiration projections of the chest are performed to demonstrate

partial or complete collapse of pulmonary lobe(s)

air in the pleural cavity

foreign body

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

52

The laryngeal prominence is formed by the
A.
thyroid gland
B.
thyroid cartilage
C.
vocal cords
D.
pharynx

B.
thyroid cartilage

53

The AP axial projection of the chest for pulmonary apices

requires 15 to 20 degrees of cephalad angulation

projects the apices above the clavicles

should demonstrate the medial ends of the clavicles equidistant from the vertebral column

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

C.
1 and 3 only

54
card image

Which of the following statements is (are) correct regarding the chest radiograph in Figure 6–19?

Figure 6–19.
Courtesy of Stamford Hospital, Department of Radiology.

Rotation of the chest is demonstrated.

The pulmonary apices are not visualized.

The costophrenic angles are demonstrated.

A.
1 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

B.
1 and 3 only

55

Differences between body habitus types are likely to affect all the following except
A.
the size and shape of an organ.
B.
the position of an organ.
C.
the position of the diaphragm.
D.
the degree of bone porosity.

D.
the degree of bone porosity.

56

Which of the anatomic structures listed below is seen most anteriorly in a lateral projection of the chest?
A.
Esophagus
B.
Trachea
C.
Cardiac apex
D.
Superimposed scapular borders

C.
Cardiac apex

57

Which of the following statements is (are) correct with respect to evaluation criteria for a PA projection of the chest for lungs?

Sternal extremities of clavicles are equidistant from vertebral borders.

Ten posterior ribs are demonstrated above the diaphragm.

The esophagus is visible in the midline.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

B.
1 and 2 only

58

Aspirated foreign bodies in older children and adults are most likely to lodge in the
A.
right main stem bronchus
B.
left main stem bronchus
C.
esophagus
D.
proximal stomach

A.
right main stem bronchus

59

Imperfect expansion of the lungs, often accompanied by dyspnea, is called
A.
atelectasis.
B.
pneumothorax.
C.
pneumonia.
D.
COPD.

A.
atelectasis.

60
card image

Which of the following statements regarding Figure 2–10 is (are) true?

Figure 2–10.
Courtesy of Stamford Hospital, Department of Radiology.

Correct degree of rotation is present.

Midphalanges are foreshortened.

Fingers are parallel to the IR.

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

B.
1 and 2 only

61

The ridge that marks the bifurcation of the trachea into the right and left primary bronchi is the
A.
root.
B.
hilus.
C.
carina.
D.
epiglottis.

C.
carina.

62

The RAO position is used to project the sternum to the left of the thoracic vertebrae in order to take advantage of
A.
pulmonary markings
B.
heart shadow
C.
posterior ribs
D.
costal cartilages

B.
heart shadow

63

Which of the following pathologic conditions require(s) a decrease in exposure factors?

Pneumothorax

Emphysema

Multiple myeloma

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

64

Using the PA projection, which of the following tube angle and direction combinations is correct for an axial projection of the clavicle?
A.
5 to 15 degrees caudad
B.
5 to 15 degrees cephalad
C.
15 to 30 degrees cephalad
D.
15 to 30 degrees caudad

D.
15 to 30 degrees caudad

65

Which of the following positions is required to demonstrate small amounts of fluid in the pleural cavity?
A.
Lateral decubitus, affected side up
B.
Lateral decubitus, affected side down
C.
AP Trendelenburg
D.
AP supine

B.
Lateral decubitus, affected side down

66

During atrial systole, blood flows into the

right ventricle via the mitral valve

left ventricle via the bicuspid valve

right ventricle via the tricuspid valve

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

67

Tracheotomy is an effective technique most commonly used to restore breathing when there is
A.
respiratory pathway obstruction above the larynx
B.
crushed tracheal rings owing to trauma.
C.
respiratory pathway closure owing to inflammation and swelling
D.
all the above

A.
respiratory pathway obstruction above the larynx

68

Which of the following positions will demonstrate the right axillary ribs?
1. RAO
2. LAO
3. RPO

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

69
card image

Which of the following statements is/are true regarding Figure A?
1. The radiograph was made in the LAO position.
2. The central ray should enter more inferiorly.
3. The sternum is projected onto the left side of the thorax.

Figure A. Courtesy of Stamford Hospital, Department of Radiology.
A.
1 only
B.
2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

70

How should a chest examination to rule out air–fluid levels be obtained on a patient having traumatic injuries?
A.
Perform the examination in the Trendelenburg position.
B.
Erect inspiration and expiration images should be obtained.
C.
Include a lateral chest examination performed in dorsal decubitus position.
D.
Perform the examination AP supine at 44 inches SID.

C.
Include a lateral chest examination performed in dorsal decubitus position.

71

Which of the following criteria are used to evaluate a PA projection of the chest?
1. Ten posterior ribs should be visualized.
2. Sternoclavicular joints should be symmetrical.
3. The scapulae should be lateral to the lung fields.

A.
1 and 2 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

72

The sternoclavicular joints are best demonstrated with the patient PA and
A.
in a slight oblique position, affected side adjacent to the IR
B.
in a slight oblique position, affected side away from the IR
C.
erect and weight-bearing
D.
erect with and without weights

A.
in a slight oblique position, affected side adjacent to the IR

73

In which of the following examinations is exposure on full expiration required?
A.
PA chest
B.
Below diaphragm ribs
C.
AP lordotic chest
D.
Lateral thoracic spine

B.
Below diaphragm ribs

74

The plane that passes vertically through the body, dividing it into anterior and posterior halves, is termed the
A.
median sagittal plane (MSP)
B.
midcoronal plane
C.
sagittal plane
D.
transverse plane

B.
midcoronal plane

75

Which of the following positions can be used to demonstrate the axillary ribs of the right thorax?

RAO

LAO

RPO

A.
1 only
B.
1 and 2 only
C.
2 and 3 only
D.
1, 2, and 3

C.
2 and 3 only

76

The esophagus commences at about the level of
A.
C3.
B.
C6.
C.
T1.
D.
T11.

B.
C6.

77

The body habitus characterized by a long and narrow thoracic cavity and low midline stomach and gallbladder is the
A.
asthenic
B.
hyposthenic
C.
sthenic
D.
hypersthenic

A.
asthenic

78

All the following statements regarding the bony thorax are true except
A.
the first seven pairs of ribs are referred to as vertebrosternal, or true, ribs.
B.
the only articulation between the thorax and the upper extremity is the sternoclavicular joint.
C.
the gladiolus is the upper part of the sternum and is quadrilateral in shape.
D.
the anterior ends of the ribs are about 4 in. below the level of the vertebral ends.

C.
the gladiolus is the upper part of the sternum and is quadrilateral in shape.

79

Blood is returned to the left atrium, from the lungs, via the
A.
aorta.
B.
superior vena cava.
C.
pulmonary veins.
D.
pulmonary artery.

C.
pulmonary veins.

80

Which of the following positions is most likely to offer the best visualization of the pulmonary apices?
A.
Lateral decubitus
B.
Dorsal decubitus
C.
Erect lateral
D.
AP axial lordotic

D.
AP axial lordotic

81

Acceptable method(s) of minimizing motion unsharpness is (are)

suspended respiration.

short exposure time.

patient instruction.

A.
1 only
B.
1 and 2 only
C.
1 and 3 only
D.
1, 2, and 3

D.
1, 2, and 3

82

What are the positions most commonly employed for a radiographic examination of the sternum?
1. Lateral
2. RAO
3. LAO

A.
1 and 2 only
B.
1 and 3 only
C.
2 and 3 only
D.
1, 2, and 3

A.
1 and 2 only

83

The AP axial projection of the pulmonary apices requires the CR to be directed
A.
15 degrees cephalad
B.
15 degrees caudad
C.
30 degrees cephalad
D.
30 degrees caudad

A.
15 degrees cephalad

84

The manubrial notch is at approximately the same level as the
A.
fifth thoracic vertebra.
B.
T2–3 interspace.
C.
T4–5 interspace.
D.
costal margin.

B.
T2–3 interspace.

85

Pacemaker electrodes can be introduced through a vein in the chest or upper extremity, from where they are advanced to the
A.
left atrium
B.
right atrium
C.
left ventricle
D.
right ventricle

D.
right ventricle

86

A frontal view of the sternum is best accomplished in which of the following positions?
A.
AP
B.
PA
C.
RAO
D.
LAO

C.
RAO

87

An acute infection of the lungs is called
A.
atelectasis.
B.
pneumothorax.
C.
pneumonia.
D.
COPD.

C.
pneumonia.


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