Bony Thorax

Question 1

what is the function of the bony thorax?

Answer 1

to protect the organs contained within

Question 2

what structures form the bony thorax?

Answer 2

ribs sternum thoracic vertebrae

Question 3

Are the posterior ribs more superior or inferior to the anterior portion of the same rib?

Answer 3

superior by 3-5”

Question 4

What are the routine projections of the sternum?

Answer 4

RAO and Lateral

Question 5

What is the SID, Breathing instructions, degree of obliquity for an RAO sternum and where does this place the sternum in the radiograph?

Answer 5

40” SID
Use a breathing technique with a long exposure time
15-20 degree oblique
this places the sternum to the left of the T spine and into the homogenous heart shadow

Question 6

What are the routine projections of the SC joints?
SID?
How are they performed?
CR?
Breathing instructions?

Answer 6

PA and bilateral anterior obliques

• All at 40” SID
• Obliques are done prone w/ 15 degree rotation with the affected side arm down and other arm up, CR is 3” distal to the vertebral prominens and 1-2” lateral to MSP
• expose on expiration
• Obliques demonstrate the downside

Question 7

What views are required for an anterior rib injury?

Answer 7

PA, Anterior Oblique centered to the upside,

Question 8

What views are required for a posterior rib injury?

Answer 8

AP and a posterior oblique centered to the down side

Question 9

Why is a PA chest included in a ribs routine?

Answer 9

to rule out lung pathology

Question 10

When is the affected side in a ribs position up? when is it down?

Answer 10

up=anterior

down=posterior

Question 11

ABOVE THE DIAPHRAGM RIBS:
errect or supine?
breathing instructions?
kvp range?

Answer 11

-erect to lower the diaphragm
-full inspiration
-low kvp, 65-70
visualizes ribs 1-9

Question 12

BELOW THE DIAPHRAGM RIBS:
errect or supine?
breathing instructions?
kvp range?

Answer 12

-supine to raise the diaphragm
-full expiration
-medium kvp 75-80
visualizes ribs 8-12

Question 13

What are fractures to the first rib associated with?
Lower ribs?
Any rib fx?

Answer 13

• injury to the arteries and veins
• injury to the spleen, liver or kidneys
• lungs or cardiovascular structures

Question 14

What is flail chest?

Answer 14

fx of adjacent ribs, in 2 or more places caused by blunt trauma and associated with cardiac injury

Question 15

What are metastases?

Answer 15

Malignant neoplasms which spread to the ribs from a primary site.

Question 16

How does an osteolytic metastases appear radiographically?
Osteoblastic?
Combination?

Answer 16

osteolytic-destructive lesion with irregular margins
osteoblastic-bony lesions of increased density
combo-moth eaten appearance

Question 17

What is osteomyelitis?

Answer 17

an infection of a portion of the bone and marrow.

*may be associated with post op open heart surgery

Question 18

What is the place where the clavicles connect to the sternum called?

Answer 18

facet

Question 19

How are the anterior ribs attached to the sternum?

Answer 19

attached to each anterior rib is a piece of costocartilage which is what attaches them to the sternum.

Question 20

Where does the second costocartilage connect at?
3rd-7th?
8-10?
11th-12th?

Answer 20

2nd-at the level of the sternal angle
3rd-7th-directly to the body of the sternum
8th-10th-costocartilage of the 7th rib
11th-12th-do not connect anteriorly

Question 21

Which ribs are true ribs?
false?
floating?

Answer 21

true-1-7
false-8-12
floating-11-12

Question 22

What does the head of the rib articulate with?

Answer 22

the vertebral body at the costovertebral joint

Question 23

Where is the bony thorax widest at?

Answer 23

level of 8th or 9th ribs

Question 24

What does the tubercle articulate with?

Answer 24

the transverse process of the vertebra at the costotransverse joint