Ribs Flashcards
Rib names and numbers
True Ribs: 1-7
False Ribs: 8-12
Floating Ribs: 11-12
T or F: Anterior (sternal) ends lies 5-7” below the level of the vertebral end
False, it lies 3-5”
Costochondral
•Ribs and costal cartilages
Sternochondral
•Rib costal cartilages and sternum
Interchondral
•Between costal cartilage
T or F: AP/PA best demonstrate ribs closest to the IR.
True
Positions for AP Oblique projection of the ribs
LPO and RPO positions
Positions for PA Oblique projections of the the rib
RAO and LAO positions
PROJECTION is the
path of the central ray as it exits the x-ray tube and goes through the patient to the IR
POSITION is the
placement of the body in relation to the IR
Upper ribs considerations
•Top of IR 1.5” above shoulders
•Full inspiration
Lower Ribs considerations
•Bottom of IR at iliac crests
•Full expiration
Rib considerations Positioning
Upright or Recumbent?
•Upper ribs are best demonstrated when patient is upright
•Lower ribs are best demonstrated when patient is recumbent
•Reality: Rib fractures are painful
•If patient can stand: perform all views upright
•If patient is unable to stand: perform all views recumbent
Rib considerations SID
-Upper: 72” (according to clover) use 40” in lab challenge
-Lower: 40”
T or F: you can use a BB marker to indicate where the spots of pain on the ribs are
True
AP projection upper ribs SID, IR, Position, CR, Collimation, Respiration
-SID: 40”
-IR: 14”x17” (CW for lab challenge)
•Top of IR 1.5” above shoulders
-Position: Upright if possible
•MSP is perpendicular and centered
•Shoulders in same plane
•Move arms away from body or hands on hip and roll shoulders forward
-CR: Perpendicular to center of IR
-Collimation: 14”x17”
-Respiration: Suspend at full inspiration to depress diaphragm
AP projection Upper Ribs UNILATERAL
•Center between MSP and lateral border of ribs
•Collimation: Check lateral border of ribs and include a little past midline
AP projections lower ribs
-SID: 40”
-IR: 14”x17” (CW for lab challenge)
•Bottom of IR at iliac crests
-Position:
•MSP is perpendicular and centered
•Move arms away from side
-CR: Perpendicular to center of IR
•Halfway between xiphoid process and lower rib margin
-Collimation: 14”x17”
-Respiration: Suspend at full expiration to elevate diaphragm
AP Upper ribs Evaluation Criteria
-First through tenth posterior ribs
-Ribs visible though the lungs
-In a unilateral exam, ribs from opposite side not included in entirety
AP lower ribs Evaluation Criteria
-Eighth through twelfth posterior ribs
-Ribs visible though the lungs or abdomen
-In a unilateral exam, ribs from opposite side not included in entirety
AP Oblique projection upper ribs SID, IR, Position, CR, Collimation, Marker, Respiration
-SID: 40”
-IR: 14”x17” LW
•Top of IR 1.5” above shoulders
-Position: RPO or LPO
•Rotate patient 45 degrees
• Affected side closest to IR
•Abduct arms, hands on head/hips
-CR: Perpendicular to center of IR
-Collimation: 14”x17”
-Mark side closest to IR
-Respiration: Full inspiration
AP Oblique Ribs Evaluation Criteria (same as PA oblique Ribs)
-Twice as much distance between the vertebral column and the lateral border of the ribs on the affected side as is present on the unaffected side
-AXILLARY PORTION of the ribs free of superimposition with thoracic spine
-1st-10th for upper ribs
-8th-12th for lower ribs
-Ribs visible through the lungs or abdomen according to the region examined
PA projection upper ribs SID, IR, Position, CR, Collimation, Respiration
-SID: 40”
-IR: 14”×17”
-Position: Upright or recumbent
-MSP is centered to IR
-Hand on hips and rotate shoulders forward (just like Chest x-ray)
-CR: Perpendicular to IR at T7
-Collimation: 14”×17”
-Respiration: Suspend at full inspiration to depress diaphragm
PA projection upper ribs UNILATERAL
•Center between midline and lateral border of ribs
•Collimation: Check lateral border of ribs and include a little past midline
The PA Projection best demonstrates the ________ ribs.
Anterior
PA upper rib evaluation criteria
-First through ninth posterior ribs and first through seventh anterior above the diaphragm
-Ribs visible though the lungs
-In a unilateral exam, ribs from opposite side not included in entirety
PA Oblique Projection Upper ribs SID, IR, Position, CR, Collimation, Respiration
-SID: 40”
-IR: 14”x17” LW
•Top of IR 1.5” above shoulders
-Position: RAO or LAO
•Rotate patient 45 degrees
•Affected side farthest from IR
•Abduct arms, hand on head/hip
-CR: Perpendicular to center of IR
-Collimation: 14”x17”
-Respiration: Suspend at full inspiration to depress diaphragm
PA Oblique projections demonstrate side ________ from the IR
Away
PA Oblique Ribs Evaluation Criteria (same as AP Oblique Ribs)
-Twice as much distance between the vertebral column and the lateral border of the ribs on the affected side as is present on the unaffected side
-AXILLARY PORTION of the ribs free of superimposition with thoracic spine
-1st-10th for upper ribs
-8th-12th for lower ribs
-Ribs visible through the lungs or abdomen according to the region examined
Pathology terminology
-Flail chest
•Multiple adjacent rib fractures in 2+ places results in a portion of the chest wall that is not mechanically connected to the rest of the thoracic cage
•Segment moves outward during expiration and inward during inspiration
Which Radiographic position best demonstrates the Axillary portion of the ribs on the left side WITHOUT vertebral superimposition
RAO
Which Radiographic position best demonstrates the Axillary portion of the ribs on the right side WITHOUT vertebral superimposition
RPO
Ribs position and projection
Which 2 positions show the left axillary ribs?
LPO and RAO
Which 2 positions show the right axillary ribs?
RPO and LAO
For PA ribs, you mark the side that is…
Away from the IR
For AP ribs you mark the side that is…
Touching the IR
Are ribs images with higher or lower kVp than chest?
Lower
