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Radiologic Positioning > Radiology Psotioning Chest Sternum And Ribs > Flashcards

Radiology Psotioning Chest Sternum And Ribs Flashcards

1
Q

Sternum

A

12 pairs of ribs
12 thoracic vertebrae
Conical in shape

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2
Q

Functions of bony thorax

A

*Protects heart and lungs
*Supports wall of pleural cavity and diaphragm
* made to vary the volume of thoracic cavity during respiration

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3
Q

Anatomy of the sternum

A

Narrow flat bone

Approximately 6 inches long

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4
Q

What are the 3 parts to the sternum

A

Manubrium
Body
Xiphoid process

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5
Q

What does the sternum do

A

Supports clavicles at maunbrial angles

Provides attachment for costal cartilages of first seven pairs of ribs at lateral borders

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6
Q

Palpable landmark
Lies at T2-T3 interspace

A

Manubrium

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7
Q

Palpable
Lies at T4-T5 interspace

A

Sternal

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8
Q

Palpable landmark
Distal smallest portion
Lies over T-10
Deviates from midline

A

Xiphoid process

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9
Q

Not as hard as bone

A

Costal cartilage

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10
Q

Long narrow curved bones

First is the shortest

Anterior ends lower than posterior ( vertebral) ends)

Increase in length from 1-7 then decrease to 12

A

Ribs

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11
Q

False ribs

A

Pairs 8 to 12- attach indirectly to the sternum via costal cartilage

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12
Q

True ribs

A

Pairs 1 to 7- attach directly to sternum

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13
Q

Floating ribs

A

Pairs 11 and 12- attach only to the vertebrae

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14
Q

Typical ribs consist of

A

Head
Neck
Tubercle
Body

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15
Q

Costco=

A

Rib

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16
Q

Vertebral=

A

Spine

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17
Q

Transverse=

A

Joint

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18
Q

What is recommend SID for PA oblique sternum

A

30 inches

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19
Q

What is the recommend SID for lateral sternum to reduce magnification and distortion caused by increased OID

A

72 inches

20
Q

Essential projections of sternum

A

Pa oblique
Right anterior oblique (RAO) position

Collimated field size for both projections 10 X 12

21
Q

Essential projections of sternum

A

Lateral
> upright
> recumbent

22
Q

Patient position for oblique RAO recumbent

A

15-20 degrees
> Ensure shoulders and hips rotated equal amount
> long axis aligned to midline
> top of IR 1 1/2 inches above jugular notch
> entire sternum from jugular notch to tip of Xiphoid process
> sternum projected over the heart but free of superimposition from the thoracic spine

23
Q

How does your patient need to breath for a PA oblique sternumn

A

Slow shallow breaths during exposure

  • you do this to blur out the lungs and show the bone more
  • if short exposure time is used suspend breathing at the end of expiration (alternative to 1st technique)
24
Q

What position do you do in a lateral sternum

A

Upright or standing

  • dorsal decubitus may be used to accommodate patient’s condition
25
Q

How do you set up the patient for a lateral sternum

A

Rotate shoulders posteriorly and lock hands behind back

Center sternum to midline

Line beam up at T7

26
Q

How to take the picture of a lateral sternum

A

Collimated field 10 X 12

Suspend respirations after deep inspiration

SID at 72 inches- decreased magnification

27
Q

Essential projections for ribs

A

Pa- upper ,anterior ribs

Ap- posterior ribs

Ap oblique- axillary portion

Pa oblique- axillary portion

28
Q

How to set up for Pa ribs

A

Put patient in upright position

MSP centers to the grid at T7

Rest hands palms out on hips and roll shoulders forward

If patient is prone, rest head on chin and adjust MSP to vertical

29
Q

How to breath for Pa ribs and collimation field

A

14 X 17

Respirations suspended at end of full inspiration ( depresses diaphragm)

30
Q

How to set up for Ap ribs

A

Patient upright for upper ribs to allow diaphragm to drop lower

Msp centered to midline of grid at T7

Put patients hand behind head elbows up

31
Q

Ap and pa obliques positioning patient

A

45 degree angle RPO or LPO affected side close to IR

Abduct and elevate arm of affected side

Abduct opposite limp and rest hand on hip

32
Q

Collimation and breathing for Ap and Pa obliques

A

CR perpendicular to IR

Collimation field 14 X 17

Respirations suspended at the end of deep inspiration for upper ribs

Respirations suspended at the end of full expiration for lower ribs

33
Q

Recommend SID for chest

A

72 inches to minimize magnification of heart and increases recorded detail

34
Q

Essential projections for chest

A

PA
Lateral
PA oblique
AP oblique
AP Pa axial

35
Q

Pa chest position

A

Upright if possible to demonstrate air fluid levels and allow diaphragm to move to lowest position

36
Q

How to set up patient for Pa chest

A

MSP faces grid have beam at T7

Exposure should be made at the end of the second deep inspiration

37
Q

Lateral chest

A

Side placed closest to IR is side demonstrated in image. Left lateral is routinely used to minimize magnification of the heart.

38
Q

Lateral chest patient position

A

Patient upright if possible as same reasons as PA

Shoulder should be in contact with grid

Exposure made at the end of second deep inspiration

39
Q

AP and Pa oblique chest

A

Patient is an upright or recumbent

Position their feet 45° LPO or RPO

Perpendicular to IR

Exposure made on second full inspiration

CR enters 3 inches below jugular notch

40
Q

Ap chest

A

Patient is usually in upright

Supine is used when patient is too ill for upright positions

Top of IR 1 1/2 to 2 inches above shoulders

41
Q

AP axial chest Lordotic position (Lindblom position)

A

Patient in upright position face tube

IR placed 3 inches above shoulder

Feet 1 foot in front of grid

42
Q

Ap axial chest

A

When patient can’t tilt backwards you angle tube 15-20° cephalad

43
Q

Essential projections lungs and pleurae

A

Ap or Pa- right or left decubitus
position

Lateral- ventral or dorsal decubitus position

44
Q

Ap/Pa lateral decubitus position

A

Place patient on affected side to demonstrate fluid

To demonstrate air place patient on non affected side

Must be in position for five minutes for optimal pathology visualization

45
Q

Lateral ventral or dorsal decubitus position

A

Patient can be prone or supine body elevated 2-3 inches
Top of IR at level of thyroid cartilage

Patient should wait 5 minutes before exposure to allow fluid to settle or air to rise

T7

Radiologic Positioning (1 decks)

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