Sternum/Ribs Flashcards
1
Q
What are the 3 main parts of the sternum?
A
manubrium, body, xiphoid process
2
Q
Obliquity for RAO sternum
A
15-20 degrees
2
Q
For an RAO sternum, the sternum should be visualized over the:
A
heart shadow
2
Q
For an RAO sternum, the sternum should be visualized next to the ___ with no superimposition
A
vertebral column
2
Q
Where should the top of the IR be for a lateral sternum?
A
1.5 inches above the jugular notch
3
Q
Breathing instruction for lateral sternum exposure
A
suspend on inspiration
4
Q
T/F: SC joints can be taken either recumbent or erect
A
True
5
Q
SID for SC joints
A
40 inches
6
Q
CR for SC joints
A
T3 (jugular notch)
7
Q
Patient rotation for PA oblique SC joints
A
10-15 degrees
8
Q
CR centering for PA oblique SC joint
A
T2-T3 and 1-2 inches lateral (towards upside)
9
Q
Number of true ribs
A
7
10
Q
Number of false ribs
A
5
11
Q
Number of floating ribs
A
2
12
Q
Ribs that articulate directly with the sternum and their costal cartilages
A
True ribs
13
Q
Ribs that indirectly connect with the sternum. Their costal cartilages connect with the seventh costal cartilage by the costochondral joint
A
False ribs
14
Q
Ribs that do not attach to the sternum or to another rib (technically false ribs)
A
Floating ribs
15
Q
If the patient’s ROI is ___, a PA projection is used with the patient’s front against the IR
A
anterior
16
Q
If the patient’s ROI is ___ , an AP projection is used with the patient’s back against the IR
A
posterior
17
Q
Ribs above the diaphragm - suspend respiration on ___ to visualize ribs 1-9
A
inhalation
18
Q
Ribs below the diaphragm – suspend respiration on ___ to visualize ribs 10-12
A
exhalation
19
Q
AP/PA bilateral ribs SID
A
40-72 inches
20
Q
Above diaphragm ribs: supine or erect
A
Erect
21
Q
Below diaphragm ribs: supine or erect
A
Supine
22
Projection for bilateral ribs for anterior pain
PA
23
Projection for bilateral ribs for posterior pain
AP
24
CR centering for bilateral ribs (above diaphragm)
3-4 inches below jugular notch (T-7)
25
CR centering for bilateral ribs (below diaphragm)
Midway between xiphoid process and lower rib margin
26
Ribs that should be visualized for upper rib image
1-9
27
Ribs that should be visualized for lower rib image
10-12 (minimum)
27
For an oblique ribs image, the affected side should be away from the IR for ___ rib pain
anterior
27
Patient rotation for AP/PA oblique unilateral ribs
45 degrees
28
For an oblique ribs image, the affected side should be closest to the IR for ___ rib pain
posterior
29
For sternum exam, __ degree obliquity recommended for large, barrel chested thorax
15
30
For sternum exam, __ degree obliquity recommended for thin chested thorax
20
31
False ribs' costal cartilages connect with the ____ costal cartilage by the _____ joint
7th; costochondral
32
Ribs normally heal themselves within:
1-2 months
33
After the injury is localized for a rib exam, the next step is to determine the position required to place the affected rib region ____ with the plane of the IR
parallel
34
Exposure taken on [inspiration/expiration] for SC joints
Expiration
35
The bony thorax consists of:
sternum, thoracic vertebrae, and 12 ribs
36
The vertebral end of the rib (articulates with one or two thoracic vertebral bodies)
Head
37
If the chest is rotated away from the affected side for an AP oblique ribs projection instead of toward the affected side, the axillary ribs will demonstrate:
Foreshortening
38
For an oblique rib exam, if the sternum is demonstrated next to the vertebral column, the chest was:
Not rotated enough
39
If the sternum is demonstrated lateral to the midpoint between the vertebral column and anterior ribs for an oblique rib exam, the chest was rotated:
more than 45 degrees
40
False ribs are connected to the sternum via the costocartilage of the [x] rib.
7th
41
The central ray enters [x] for an AP projection of bilateral ribs for an injury located above the diaphragm
3 to 4 inches below the jugular notch
42
The fifth rib is a [x] rib
True
43
The [x] of the ribs are most superior.
posterior vertebral ends
44
Which specific oblique positions can be used to elongate the left axillary portion of the ribs?
LPO, RAO
45
A radiograph of an RAO sternum shows that part of the sternum is superimposed over the thoracic spine. The patient was:
Under rotated
46
The only connection between the bony thorax and shoulder girdle is the:
SC joint
47
The curved portion of a rib is termed the:
Angle
48
T/F: Floating ribs only attach to the sternal cartilage of T-7
False
49
A patient with an injury to the right lower posterior ribs comes to the emergency room.
Due to their medical history a [x] would be the correct oblique to perform.
RPO
50
A patient with trauma to the right upper anterior ribs enters the ER.
Due to their injury, the correct oblique to order would be the [x].
LAO
51
A PA chest image obtained with the patient rotated into an RAO position demonstrates:
the left posterior ribs have a greater length than the right posterior
52
What is the central ray entrance point for the lateral projection of the sternum?
Lateral border of the midsternum
53
What is the main purpose of the Lordotic Chest exam?
To better visualize the apices of the lungs clear of clavicular superimposition for possible pathology
54
T/F: When looking at radiographs of the ribs, posterior ribs appear to arch downwards while anterior ribs appear to be arching upwards
False
55
We take upper ribs images on a full inspiration to depress the diaphragm in order to get more even visualization of ribs 1-?
9
56
T/F: When imaging the oblique SC joints, it is the downside SC joints that are the focus of interest.
True
57
Except possibly for extremely rare and outlying cases, the lowest floating rib articulates with which vertebral body?
T-12
58
If a patient comes to your room with only rib images ordered but you suspect pulmonary involvement or complication, you should contact the ordering provider and suggest a ____________ exam might be needed
Chest
59
How is the patient positioned to demonstrate the right posterior axillary ribs?
RPO
60
During imaging of the ribs, the area of interest must first be localized to enable the radiographer to:
(1) Choose the appropriate patient position
(2) Give the proper breathing instructions to the patient
(3) Determine the correct central ray angle needed
1 and 2
61
How are the upper limbs positioned when the patient is in the upright position for the lateral projection of the sternum?
Behind the back, with the shoulders rolled posteriorly
62
Floating ribs only articulate with:
the thoracic vertebrae
63
On a PA oblique (RAO) sternal image with accurate positioning, the:
1. manubrium is demonstrated to the left of the heart shadow
2. posterior ribs are magnified
3. sternum is demonstrated within the heart shadow without vertebral superimposition
4. the lung markings are blurred
2, 3 and 4
64
For an AP oblique (RPO or LPO) rib image obtained to evaluate upper posterior rib pain:
1. 14x17 IR, portrait
2. the 7th axillary rib is centered to the collimated field
3. the patient is rotated 30 degrees away from the affected side
4. the image is obtained after deep inspiration
1, 2 and 4
65
For a PA oblique (RAO) sternal image:
1. a 40-inch (76-cm) SID is used
2. the patient's midcoronal plane is angled 15 to 20 degrees with the IR
3. the image is obtained on inspiration
4. the image is obtained on expiration
1, 2 and 4
66
An above-diaphragm AP or PA rib image with accurate positioning demonstrates:
1. the scapulae outside the lung field
2. the seventh posterior rib at the center of the collimated field
3. the ninth through twelfth posterior ribs below the diaphragm
4. more distance from the right SC joint to the vertebral column than from the left SC joint to the vertebral column
1 and 2
67
An AP oblique rib image obtained with the patient rotated less than 45 degrees demonstrates:
the sternal body next to the vertebral column
68
A lateral sternal image:
1. is obtained with hands interlocked in front of the patient
2. demonstrates the sternum without humeral soft-tissue superimposition
3. is obtained after a deep inspiration
4. requires placement of the top edge of the IR 1-1/2 inches (4 cm) above the jugular notch
2, 3 and 4
69
A below-diaphragm AP oblique (RPO) rib image with accurate positioning demonstrates:
1. the ninth through twelfth ribs below the diaphragm
2. the axillary ribs without foreshortening
3. the seventh axillary rib at the center of the collimated field
4. the inferior sternal body just to the right of the vertebral column
1 and 2
70
For a radiograph of the sternum in the RAO position, the CR is directed halfway between the:
1. Jugular notch
2. Sternal angle
3. Xiphoid process
1 and 3
