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Positioning 1 > Ch. 10 Bony Thorax - Sternum and Ribs Workbook > Flashcards

Ch. 10 Bony Thorax - Sternum and Ribs Workbook Flashcards

1
Q

what 3 structures make up the bony thorax

A
  • sternum
  • thoracic vertebrae
  • 12 pairs of ribs
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2
Q

term for the long, middle aspect of the sternum

A

body

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3
Q

the most distal aspect of the sternum does not ossify until a person is about how old

A

40

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4
Q

the total sternum length on an average adult is about how long

A

7” (18 cm)

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5
Q

the xiphoid process of the sternum is at what approximate level

A

T9-T10

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6
Q

the sternal angle is at what level

A

T4-T5

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7
Q

what is another name for the sternal angle

A

manubriosternal joint

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8
Q

what is the name of the joint that connects the upper limb to the bony thorax (only bony connection between the bony thorax and upper limb)

A

sternoclavicular joint

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9
Q

what is the name of the section of cartilage that connects the anterior end of the rib to the sternum

A

costocartilage

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10
Q

T/F - the 11th and 12th ribs are classified as false and floating ribs

A

true

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11
Q

the anterior aspect of the ribs is called what

A

sternal end

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12
Q

the posterior aspect of the ribs is called what

A

vertebral end

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13
Q

which aspect of the ribs articulates with the transverse process of the thoracic vertebrae

A

tubercle

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14
Q

what are the 3 structures found within the costal groove of each rib

A

artery, vein, nerve

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15
Q

which end of the ribs is most superior

A

vertebral end

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16
Q

approximately how much difference in height is there between these two ends of the ribs

A

3-5”

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17
Q

which ribs articulate with the upper lateral aspect of the manubrium of the sternum

A

first ribs

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18
Q

the bony thorax is wider at the lateral margins in which ribs

A

8th and 9th

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19
Q

how many posterior ribs are shown above the diaphragm

A

10

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20
Q

what type of movement is the first sternocostal

A

synarthrodial

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21
Q

what type of movement is the 1st-12th costovertebral joints

A

diarthrodial - plane (gliding)

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22
Q

what type of movement is the 1st-10th costochondral unions

A

synarthrodial

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23
Q

what type of movement is the 1st-10th costotransverse joints

A

diarthrodial - plane (gliding)

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24
Q

what type of movement is the 2nd-7th sternocostal joints

A

diarthrodial - plane (gliding)

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25
Q

what type of movement is the 6th-9th interchondral joints

A

diarthrodial - plane (gliding)

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26
Q

what type of movement is the 9th and 10th interchondral joints

A

fibrous - syndesmosis

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27
Q

what are the joints that have diarthrodial movements classified as

A

synovial

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28
Q

what is unique about the true ribs

A

they attach to the sternum by their own costocartilage

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29
Q

what is unique about the floating ribs

A

they have no costocartilage

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30
Q

how much rotation should be used for the oblique position of the sternum for a large, deep-chested patient

A

15 degrees

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31
Q

what is the recommended kVp range for the oblique position of the sternum

A

70-85 kVp

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32
Q

what is the advantage of performing an orthostatic technique of radiography of the sternum

A

blur out the ribs and lung markings

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33
Q

what is the primary reason that a SID of less than 40” should not be used for sternum radiography

A

increases patient dose, especially skin dose

34
Q

what other imaging option is available to study the sternum if routine RAO adn lateral radiographs do not provide sufficient information

A

CT or nuclear medicine

35
Q

what is the general body position for an injury to the ribs found below the diaphragm

A

recumbent

36
Q

what breathing instructions is used for an injury to the ribs found below the diaphragm

A

expiration

37
Q

what is recommended kVp range for an injury to the ribs found below the diaphragm

A

75-85

38
Q

an injury to the region of the 8th or 9th rib requires an above or below technique

A

above

39
Q

to elongate and visualize the axillary aspect of the ribs properly, the patient’s spine should be rotated away or toward the area of interest

A

away from

40
Q

which projections should be performed for an injury to the anterior aspect of the ribs

A

PA and anterior oblique

41
Q

which two rib projections should be performed for an injury to the right posterior ribs

A

AP and RPO

42
Q

how can the site of injury be marked for a rib series

A

taping a metal bb or other type of lead marker to mark site of pain

43
Q

if the physician suspects a pneumothorax or hemothorax has occurred as a result of a rib fracture, which additional radiographic projection should be performed in addition to the routine rib projections

A

erect PA and lateral chest

44
Q

a flail chest is define as what

A

pulmonary injury caused by blunt trauma to two or more ribs

45
Q

if a flail chest injury is suspected, the tech should perform rib study in which position

A

erect

46
Q

osteolytic metastases of the ribs produce which of the following radiographic appearances

A

irregular bony margins

47
Q

what defines pectus excavatum

A

depressed sternum caused by congenital defect

48
Q

a proliferative bony lesion of increased density is generally termed what

A

osteoblastic

49
Q

which bony landmark is most easily palpated on the obese patient for sternum and rib projections

A

jugular notch

50
Q

which oblique position is preferred for a study of the sternum and why

A

RAO to place the sternum over the heart

51
Q

what is the most common error for oblique position of the sternum

A

over-rotation

52
Q

where is CR for the oblique and lateral projections of the sternum

A

midway between jugular notch and xiphoid process

53
Q

what other position can be performed if the patient cannot assume a prone position for the oblique position of the sternum

A

LPO

54
Q

what is the recommended SID for a lateral projection of the sternum and why

A

60-72” to reduce magnification and compensate for the OID

55
Q

what criteria apply to a radiograph for an evaluation of the oblique sternum

A

the entire sternum should lie over the heart shadow and should be adjacent to the spine

56
Q

where is the CR centered for a PA projection of the sternoclavicular joints

A

level of T2-T3

57
Q

what type of breathing instructions should be provided to the patient for a PA projection of the sternoclavicular jonts

A

suspend respiration on expiration

58
Q

how much rotation of the thorax is recommended for an anterior oblique of the sternoclavicular joints

A

10-15 degrees from PA position

59
Q

which specific oblique position best demonstrates the left sternoclavicular joint adjacent to the spine

A

LAO

60
Q

what are the 3 points that must be included in the patient’s clinical history before a rib series

A
  • nature of the trauma or patient complaint
  • location of the rib pain or injury
  • if the injury was caused by trauma to the thoracic cavity
61
Q

where is CR centered for an AP projection of the ribs for an injury located above the diaphragm

A

3-4” below jugular notch (T7 level)

62
Q

which two specific oblique positions can be used to elongate the left axillary portion of the ribs

A

RAO and LPO

63
Q

which two basic projections or positions should be performed for an injury to the right anterior ribs

A

PA and LAO

64
Q

how many degrees of rotation are required for an oblique projection of the axillary ribs

A

45 degrees

65
Q

what is the recommended SID for a bilateral lower rib study on an adult

A

72”

66
Q

what is the recommended kVp range for a study of the unilateral, upper anterior ribs

A

70-85 kVp

67
Q

which region of the ribs is best demonstrated with an RAO projection

A

left axillary portion of the ribs

68
Q

which chest position should be performed (pt. can’t stand) for a possible pneumothorax in the left thorax

A

right lateral decub chest

69
Q

an RAO of the sternoclavicular joints projects with joint closest to the spine

A

right

70
Q

to minimize the patient dose for an RAO projection of the sternum, the patients skin should be at least how far below the collimator

A

15” (40 cm)

71
Q

which condition may require that a chest routine be included along with a study of the ribs

A

hemothorax

72
Q

a radiograph of an RAO sternum shows part of the sternum is superimposed over the thoracic spine. Which specific positioning error is visible on this radiograph

A

under rotation

73
Q

a radiograph of an RAO sternum shows the sternum is difficult to visualize because of excessive density. the following factors were used - 100 kVp, 25 mA, 3 seconds, 40” SID and bucky. which factors should be modified

A

lower the kVp to range of 70-85

74
Q

a radiograph of an RAO sternum shows the sternum is poorly visualized because of excessive lung markings superimposed over the sternum. the following factors were used - 75 kVp, 200 mA, 1 second, 40” SID and bucky. what factors need to be altered

A

lower mA and increase time

75
Q

a radiograph of a lateral projection of the sternum shows the patient’s breasts are obscuring the sternum. what can be done

A

ask pt to sperate them

76
Q

repeat PA projections of the sternoclavicular joints do not clearly demonstrate them. what other imaging modality may produce a more diagnostic image

A

CT

77
Q

a patient with trauma to the sternum and the left SC joint region enter the ER. in addition to the sternum routine, the physician asks for a specific projection to better demonstrate the left SC joint. what positioning routine would be used

A

15-20 degree RAO sternum with orthostatic breathing, lateral sternum taken on inspiration, and a 10-15 degree LAO of SC joint on inspiration

78
Q

a patient enters the ER on a trauma board, due to condition of the patient, the physician orders a portable study of the sternum in the ER. what two projections of the sternum would be most diagnostic yet would minimize movement of the patient

A

LPO and horizontal beam lateral

79
Q

a patient with trauma to the right upper anterior ribs enters the ER. he is able to sit in an erect position which positioning routine of the ribs should be performed

A

PA and LAO done erect and taken on inspiration

80
Q

a patient with trauma to the left lower anterior ribs enters the ER. which positioning routine of the ribs should be performed

A

PA and RAO done recumbent and taken on expiration

81
Q

an elderly patient comes to the department for a complete rib series with an emphasis on the posterior ribs. she has advanced osteoporosis and has difficulty moving and lying down. the physician wants both upper and lower ribs examined, what type of positions should be performed

A

AP and both obliques taken erect and with a lowered technique

82
Q

a patient enters the ER with blunt trauma to the chest. he is restricted on a trauma board. the physician suspects a flail chest, beyond initial chest projections, what positioning routine would confirm the flail chest

A

limited rib series

Positioning 1 (52 decks)

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