Sternum/Ribs Flashcards

1
Q

What are the 3 main parts of the sternum?

A

manubrium, body, xiphoid process

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2
Q

Obliquity for RAO sternum

A

15-20 degrees

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2
Q

For an RAO sternum, the sternum should be visualized over the:

A

heart shadow

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2
Q

For an RAO sternum, the sternum should be visualized next to the ___ with no superimposition

A

vertebral column

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2
Q

Where should the top of the IR be for a lateral sternum?

A

1.5 inches above the jugular notch

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3
Q

Breathing instruction for lateral sternum exposure

A

suspend on inspiration

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4
Q

T/F: SC joints can be taken either recumbent or erect

A

True

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5
Q

SID for SC joints

A

40 inches

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6
Q

CR for SC joints

A

T3 (jugular notch)

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7
Q

Patient rotation for PA oblique SC joints

A

10-15 degrees

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8
Q

CR centering for PA oblique SC joint

A

T2-T3 and 1-2 inches lateral (towards upside)

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9
Q

Number of true ribs

A

7

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10
Q

Number of false ribs

A

5

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11
Q

Number of floating ribs

A

2

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12
Q

Ribs that articulate directly with the sternum and their costal cartilages

A

True ribs

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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

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14
Q

Ribs that do not attach to the sternum or to another rib (technically false ribs)

A

Floating ribs

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15
Q

If the patient’s ROI is ___, a PA projection is used with the patient’s front against the IR

A

anterior

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16
Q

If the patient’s ROI is ___ , an AP projection is used with the patient’s back against the IR

A

posterior

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17
Q

Ribs above the diaphragm - suspend respiration on ___ to visualize ribs 1-9

A

inhalation

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18
Q

Ribs below the diaphragm – suspend respiration on ___ to visualize ribs 10-12

A

exhalation

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19
Q

AP/PA bilateral ribs SID

A

40-72 inches

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20
Q

Above diaphragm ribs: supine or erect

A

Erect

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21
Q

Below diaphragm ribs: supine or erect

A

Supine

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22
Q

Projection for bilateral ribs for anterior pain

A

PA

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23
Q

Projection for bilateral ribs for posterior pain

A

AP

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24
Q

CR centering for bilateral ribs (above diaphragm)

A

3-4 inches below jugular notch (T-7)

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25
Q

CR centering for bilateral ribs (below diaphragm)

A

Midway between xiphoid process and lower rib margin

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26
Q

Ribs that should be visualized for upper rib image

A

1-9

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27
Q

Ribs that should be visualized for lower rib image

A

10-12 (minimum)

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27
Q

For an oblique ribs image, the affected side should be away from the IR for ___ rib pain

A

anterior

27
Q

Patient rotation for AP/PA oblique unilateral ribs

A

45 degrees

28
Q

For an oblique ribs image, the affected side should be closest to the IR for ___ rib pain

A

posterior

29
Q

For sternum exam, __ degree obliquity recommended for large, barrel chested thorax

A

15

30
Q

For sternum exam, __ degree obliquity recommended for thin chested thorax

A

20

31
Q

False ribs’ costal cartilages connect with the ____ costal cartilage by the _____ joint

A

7th; costochondral

32
Q

Ribs normally heal themselves within:

A

1-2 months

33
Q

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

A

parallel

34
Q

Exposure taken on [inspiration/expiration] for SC joints

A

Expiration

35
Q

The bony thorax consists of:

A

sternum, thoracic vertebrae, and 12 ribs

36
Q

The vertebral end of the rib (articulates with one or two thoracic vertebral bodies)

A

Head

37
Q

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:

A

Foreshortening

38
Q

For an oblique rib exam, if the sternum is demonstrated next to the vertebral column, the chest was:

A

Not rotated enough

39
Q

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:

A

more than 45 degrees

40
Q

False ribs are connected to the sternum via the costocartilage of the [x] rib.

A

7th

41
Q

The central ray enters [x] for an AP projection of bilateral ribs for an injury located above the diaphragm

A

3 to 4 inches below the jugular notch

42
Q

The fifth rib is a [x] rib

A

True

43
Q

The [x] of the ribs are most superior.

A

posterior vertebral ends

44
Q

Which specific oblique positions can be used to elongate the left axillary portion of the ribs?

A

LPO, RAO

45
Q

A radiograph of an RAO sternum shows that part of the sternum is superimposed over the thoracic spine. The patient was:

A

Under rotated

46
Q

The only connection between the bony thorax and shoulder girdle is the:

A

SC joint

47
Q

The curved portion of a rib is termed the:

A

Angle

48
Q

T/F: Floating ribs only attach to the sternal cartilage of T-7

A

False

49
Q

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.

A

RPO

50
Q

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].

A

LAO

51
Q

A PA chest image obtained with the patient rotated into an RAO position demonstrates:

A

the left posterior ribs have a greater length than the right posterior

52
Q

What is the central ray entrance point for the lateral projection of the sternum?

A

Lateral border of the midsternum

53
Q

What is the main purpose of the Lordotic Chest exam?

A

To better visualize the apices of the lungs clear of clavicular superimposition for possible pathology

54
Q

T/F: When looking at radiographs of the ribs, posterior ribs appear to arch downwards while anterior ribs appear to be arching upwards

A

False

55
Q

We take upper ribs images on a full inspiration to depress the diaphragm in order to get more even visualization of ribs 1-?

A

9

56
Q

T/F: When imaging the oblique SC joints, it is the downside SC joints that are the focus of interest.

A

True

57
Q

Except possibly for extremely rare and outlying cases, the lowest floating rib articulates with which vertebral body?

A

T-12

58
Q

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

A

Chest

59
Q

How is the patient positioned to demonstrate the right posterior axillary ribs?

A

RPO

60
Q

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

A

1 and 2

61
Q

How are the upper limbs positioned when the patient is in the upright position for the lateral projection of the sternum?

A

Behind the back, with the shoulders rolled posteriorly

62
Q

Floating ribs only articulate with:

A

the thoracic vertebrae

63
Q

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

A

2, 3 and 4

64
Q

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

A

1, 2 and 4

65
Q

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

A

1, 2 and 4

66
Q

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

A

1 and 2

67
Q

An AP oblique rib image obtained with the patient rotated less than 45 degrees demonstrates:

A

the sternal body next to the vertebral column

68
Q

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

A

2, 3 and 4

69
Q

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

A

1 and 2

70
Q

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

A

1 and 3