Ch 10 Ribs and sternum review Flashcards
Exam:
Posterior pain is what projection?
What side is in interest?
AP
Downside (side that’s down)
Exam:
Anterior pain is what projection?
What side is in interest?
PA
Upside
Exam:
Patient walks in the ER with anterior left upper pain what oblique would we use?
What is the projection?
RAO
PA projection
Exam:
Patient walks in the ER with right anterior pain what oblique would we use?
What is the projection?
What is the side of interest?
LAO
PA
Upside ribs
Exam:
Patient walks in the ER with left lower posterior pain, what oblique best shows this?
What is the projection?
LPO
AP projection
Exam:
Patient walks in the ER with right lower posterior pain, what oblique best shows this?
What is the projection?
RPO
AP projection
Exam:
RAO best shows what axillary?
left axillary
Exam:
LPO shows what axillary?
left axillary
Exam:
RPO best shows what axillary?
right axillary
Exam:
LAO best shows what axillary?
right axillary
Exam:
If patient is in a RPO position, what pain are they experiencing?
right posterior pain
(AP = side down)
Exam:
If patient is in a LPO position what pain are they experiencing?
Left posterior pain
(AP = side down)
Exam:
If patient is in a LAO position, what pain are they experiencing?
right anterior pain
(PA = Away)
Exam:
If patient is in a RAO position, what pain are they experiencing?
left anterior pain
(PA = Away)
Exam Review:
What position best shows the ribs below the diaphragm?
recumbent
(can move the belly out of the way)
Exam Review:
What is the breathing technique for lower (below) rib views?
expose of expiration
Exam Review:
What is the breathing technique for upper ribs/ above diaphragm projections?
Expose on inspiration
Exam Review:
What pathologies can you see specifically from expiration x-rays?
pneumothorax
hemothorax
&
Pulmonary contusions
Exam Review:
What happens to the diaphragm on expiration?
diaphragm moves up
Exam Review:
What happens to the diaphragm on inspiration?
diaphragm moves down
Exam Review:
Why does the expiration breathing technique show pneumothorax?
expiration shows the escaped air in the pleura cavity
Exam Review:
Which part of the rib attaches to the transverse process?
What is this joint called?
What type of joint is it?
tubercle of the rib
costotransverse
plane or gliding
Exam Review:
Which part of the rib attaches to the vertebral body?
What is this joint called?
What type of joint is it?
head of the rib
(“head to the body”)
costovertebral
plane or gliding
Exam Review:
what is the most important part of setting up for a rib exam?
locating where the pain is
Exam Review:
(t/f)
We should interview the patient and get an accurate history when it comes to rib exams
true
Exam Review:
which of the following positions will best demonstrate the ribs of the left thorax?
RAO & LPO
Exam Review:
What kind of joint is the sternoclavicular joint?
synovial
plane or gliding (diarthrodial)
Exam Review:
What kind of joint are the first to tenth costochondral joints?
synarthrodial (immoveable)
Exam Review:
what kind of joint is the first sternocostal joint?
(immoveable)
cartilaginous
synarthrodial
Exam Review:
what kind of joints are the second to seventh sternocostal joints?
synovial
diarthrodial
plane or gliding
Exam Review:
what kind of joints are the sixth to ninth interchondral joints?
synovial
diarthrodial
plane or gliding
Exam Review:
what kind of joints are the costotransverse joints? (1-10)
plane or gliding
Exam Review:
What kind of joints are the costovertebral joints? (1-12)
plane or gliding
Exam Review:
Why are there only 10 costotransverse joints?
last 2 ribs “floating ribs” don’t contain tubercles
Exam Review:
how many costotransverse joints are there?
10
(last two floating ribs don’t have tubercles)
Exam Review:
How many costovertebral joints are there?
12
Exam Review:
What is the costochondral union?
where bone and cartilage meet on ribs 1-10
Exam Review:
Costochondral exists on which ribs?
ribs 1-10
Exam Review:
What is the sternoclavicular joint?
What level is this located at?
where the sternum and clavicle meet
T2-T3
Exam Review:
What is the first sternocostal joint?
What type of movement is this?
joint articulation between first rib and sternum
immoveable movement
Exam Review:
what is the second to seventh sternocostal joints?
What kind of movement is this?
joint articulation between 2-7 ribs and sternum
Plane or gliding? *
Exam Review:
What are the interchondral joints?
joint in between the cartilages of 6th-9th ribs
Exam Review:
what are the costotransverse joints?
articulation between tubercle of rib and the transverse process of the spine
Exam Review:
what are the costovertebral joints?
articulation between the vertebral body of the spine and the head of the rib
“head to body”
Exam Review:
What are the views for the sternum?
RAO
lateral
(LPO if patient is unable to achieve RAO)
Exam Review:
What level are the SC joints at?
T2-T3
Exam Review:
LPO best demonstrates what axillary?
Where is the pain located?
What projection is that?
left axillary
left posterior pain
AP projection
Exam Review:
which ribs are the false ribs?
8-12
Exam Review:
which ribs are the true ribs?
1-7
Exam Review:
which ribs are the floating ribs?
11 &12
Exam Review:
What makes the ribs true ribs?
the connect directly to the sternum
Exam Review:
If the patient is having left side anterior rib pain which views, would you perform?
RAO position/ oblique
Exam Review:
what is the only articulation between the upper extremity and the bony thorax?
Sternoclavicular joint
Exam Review:
what are the primary curves?
thoracic & sacrum
Exam Review:
what are the secondary (compensatory) curves?
cervical & lumbar
Exam Review:
what are the views for SC joints?
2 projections
PA & RAO/LAO
(PA projections)
Exam Review:
What does inspiration and expiration do to the diaphragm?
expiration moves diaphragm up *
Inspiration moves the diaphragm down
Exam Review:
Why do we use inspiration on the upper rib projections?
inspiration on upper ribs cause the diaphragm to move down causing more thorax space
(gets diaphragm out of the picture)
Exam Review:
why do we use expiration on lower rib projections?
expiration of lower ribs causes diaphragm to move up creating more space
(gets diaphragm out of the picture)
Exam Review:
Where is the sternal angle located at?
T4-T5
Exam Review:
Where is the lower costal margin (inferior rib) located at?
L2-L3
Exam Review:
Where is xiphoid tip located at?
T9-T10
Exam Review:
when do you see the z joints of the thoracic spine?
70-75 degree oblique
Exam Review:
LAO will best demonstrate which SC joint the best?
left SC joint
(downside)
Exam Review:
RAO will best demonstrate which SC joint the best?
Right SC joint
(downside)
Exam Review:
What is the obliquity of the SC joints?
10-15 degree AO oblique
Exam Review:
What is Flail chest?
fx of the adjacent ribs in two or more places
cause by blunt trauma
Exam Review:
If a patient exhibits hemothorax on the right side and cannot stand what view could that best be shown in?
right lateral decubitus
(on expiration)
Exam Review:
If the patient is able to stand what view best shows hemothorax in the right lung?
PA chest on expiration
Exam Review:
What is the ideal positioning, technique, and breathing instruction for a below diaphragm rib x-ray?
patient supine
expose on expiration
70-80 kvp
Exam Review:
What is the ideal positioning, technique, and breathing instructions for a above diaphragm x-ray?
patient erect
expose on inspiration
70-80 kvp
Exam Review:
Why are upper ribs best taken erect?
allows gravity to lower the diaphragm even more
Exam Review:
Why are lower ribs best taken supine?
allows for the diaphragm to raise higher and less thick abdomen
Exam:
Why are ribs 11 & 12 considered floating ribs?
they are not connected anteriorly
Exam:
What is the name of the posterior end of the rib?
vertebral end
Exam:
What is the name of the anterior end of the ribs?
sternal end
Exam:
The vertebral end sits ____ ____ inches _______ the sternal end
3-5 inches
higher
Exam Review:
The ___________ _____ is the only articulation between the shoulder girdle (upper extremity) and the bony thorax
sternoclavicular joint
Exam Review:
How much do we oblique for Sternum?
What position do we oblique in?
What is the CR?
What is the SID?
What is the breathing technique?
15-20 RAO oblique (LPO if not possible)
CR mid sternum (1 inch from midline)
SID 40-48 inches
shallow breathing (expiration if not possible)
Exam Review:
What is the SID for Lateral sternum?
What is the CR?
What is the breathing technique?
What is the essential patient position for a better image?
72 SID
lateral border of mid-sternum
expose on inspiration
patients arms DRAWN back
Exam Review:
What is the CR for PA sternoclavicular joints?
What is the breathing technique?
What is the SID?
T2-T3 (3 inches inferior to vertebral prominens)
expose on inspiration 40-inch SID (table top)
Exam Review:
How much do we oblique for SC joints?
What position do we oblique in?
What is the CR?
Breathing technique?
10-15 degree oblique
RAO or LAO
T2-T3 1-2 inches lateral from Mid-sagital
expose on inspiration
Exam Review:
Anterior bilateral ribs is what projection?
CR?
What is breathing technique?
Minimum SID? Ideal?
PA (side affect towards board)
T7
Above is inspiration
Below is expiration
40 inches
72 inches
Exam Review:
Bilateral posterior lower ribs are what projection?
What is the CR?
AP projection
Mid-way between xiphoid process and lower rib margin
Exam Review:
What are views for sternum? Oblique?
What are views for SC joints? Oblique?
Sternum: RAO (LPO) & Lat 15-20 oblique
SC: PA & LAO/RAO 10-15 oblique