Bontrager Chapter 10

Front 1

List structures that make up the bony thorax

Back 1

Sternum,Thoracic Vertebrae, 12 pairs of ribs

Front 2

What is the term for the long, middle aspect of the sternum?

Back 2

Body

Front 3

The most distal aspect of the sternum does not ossify until a person is approx. ____ years of age.

Back 3

40

Front 4

The total sternum length on a average adult is about _____ inches.

Back 4

6

Front 5

The xiphoid process is located ____.

Back 5

T9-T10

Front 6

The sternal angle is at the level of ________.

Back 6

T4-T5

Front 7

Another name for sternal angle?

Back 7

Manubriosternal joint

Front 8

Joint that connects the upper limb to the bony thorax? ( It's the only bony connection between the bony thorax and upper limbs)

Back 8

Sternoclavicular joint

Front 9

Name of section of cartilage that connects the anterior end of the rib to the sternum?

Back 9

Costocartilage

Front 10

What distinguishes a true rib from a false rib?

Back 10

True ribs -connx sternum to costocartilage.

False ribs -are connx t o the sternum via costocartilage of 7th rib.

Front 11

(T or F) The 11th and 12th ribs are classified as false and floating ribs?

Back 11

True

Front 12

(T or F) The anterior end of the ribs are called the "Vertebral End"?

Back 12

False ( It's called Sternal end )

Front 13

Which aspect articulates with the transverse process of the thoracic vertebrae?

Back 13

Tubercle

Front 14

What are 3 structures found within the costal groove of each rib.

Back 14

Artery, Vein, Nerve

Front 15

Which end of the ribs is most superior - the posterior vertebral ends or the anterior sternal ends?

Back 15

Posterior Verbal Ends

Front 16

Approx how much difference in height is there between these 2 ends of the ribs?

Back 16

3 to 5 inches

Front 17

Which ribs articulate with the upper lateral aspect of the manubrium of the sternum?

Back 17

FIRST ( Anterior Sternal end )

Front 18

The bony thorax is widest at the lateral margins of which ribs?

Back 18

8th or 9th

Front 19

How many posterior ribs are shown above the diaphragm?

Back 19

11

Front 20

1st Sternal costal is what type of movement?

Back 20

Immovable - Synarthrodial

Front 21

1st -12th Costovertebral joints

Is what type of movement?

Back 21

Movable - Disathrodial ( Plane or gliding )

Front 22

1st-10th Costochondral Unions

(Between Caltilages & Ribs)

Is what type of movement?

Back 22

Immovable - Synarthrodial

Front 23

1st-10th Costotransverse joints

(between ribs & transverse processes of T-Vertebre)

Is what type of movement?

Back 23

Movable - Diarthrodial ( plane or gliding )

Front 24

2nd-7th Sternocostal joints

(between 2nd -7th ribs and sternum)

Is what type of movement?

Back 24

Movable - Diarthrodial ( plane or gliding )

Front 25

6th - 9th inter10chondral joints

(Between anterior 6th - 9th costal cartilage)

Is what type of movement?

Back 25

Movable - Diarthrodial ( plane or gliding )

Front 26

9th-10th interchondral joints between the cartilages

Is what type of movement?

Back 26

Fibrous - Syndesmosis

Front 27

True Ribs are from ____ to ____.

Back 27

1-7

Front 28

False ribs are from ____ to ____.

Back 28

8-12

Front 29

False FLOATING Ribs are from ____ to _____.

Back 29

11-12

Front 30

(T or F) It is virtually impossible to visualize the sternum with a direct PA or AP position?

Back 30

TRUE

Front 31

A large, deep chested (Hypersthenic) patient requires more obliquity for s frontal view of the sternum as compared with a "thin-chested" (Asthenic) patient.

Back 31

False - LESS

Front 32

How much rotation should be used for the oblique position of the sternum for a large, "deep-chested" patient?

Back 32

approx. 15 degree

Front 33

What is the advantage of performing an orthostatic (breathing) technique for radiography of the sternum?

Back 33

It blurs out the lung markings & ribs, which improves the visibility of the sternum

Front 34

What is the primary reason that a SID of less than 40" should not be used for sternum radiography?

Back 34

Increase in patient dose, especially skin dose

Front 35

What other imaging option is available to study the sternum if routine RAO and lateral radiographs do not provide sufficient information?

Back 35

CT or Nuclear Medicine

Front 36

To properly elongate and visualize the axillary aspect of the ribs, the patient 's spine should be rotated ________ from the area of interest.

Back 36

Away From

Front 37

Which projections should be performed for an injury to the anterior aspect of the ribs?

Back 37

PA & Anterior Obliques

(because placing the area of interest closest to the IR)

Front 38

Which 2 ribs projections should be performed for an injury to the right posterior ribs?

Back 38

AP and RPO

(because it shifts spine AWAY from the from area of interest)

Front 39

How can the site of injury be marked for rib series?

Back 39

By taping a small metallic "BB" or other opaque marker over the site of the injury.

Front 40

If the physician suspects a pneumothorax or hemothorax has occurred as a result of a rib fracture, which additional radiographic projection(s) should be performed in addition to the routine rib projections?

Back 40

Erect PA & Lateral Chest

Front 41

A flail chest is defined as a(n):

Back 41

Pulmonary injury caused by blunt trauma to 2 or more ribs

Front 42

Osteolytic metastases of the ribs produce which of the following radiographic appearance?

Back 42

Irregular bony margins

Front 43

Which of the following definitions applies to pectus excavatum?

Back 43

Depressed sternum caused by congenital defect

Front 44

A proliferative bony lesion of increased density is generally termed:

Back 44

Osteoblastic

Front 45

MRI provides a more diagnostic image of rib metastases as compared with a nuclear medicine scan.

Back 45

False

Front 46

(T or F) Patients can develop Osteomyelitis as a postoperative complication following open heart surgery

Back 46

True

Front 47

What is the preferred study of the sternum?

Back 47

RAO

Front 48

Why is RAO the preferred study of the sternum?

Back 48

It places the sternum over the heart to provide a uniform background for added visibility of the sternum.

Front 49

Where is the central ray centered for the oblique and lateral projections of the sternum?

Back 49

Midsternum

(Located midway between Jugular notch & Xiphoid process)

Front 50

What other position can be performed if the patient CANNOT assume a prone position for the RAO Sternum?

Back 50

LPO

(Oblique Supine Position)

Front 51

What is the recommended SID for a lateral projection of the sternum?

Back 51

60-72"

(But Mr. Wilson wants us to do it ONLY in 72")

Front 52

Why is lateral projection of the sternum at 72"?

Back 52

Because it reduces magnification created by the long object

Front 53

Which criteria apply to radiograph of an evaluation of the oblique sternum?

Back 53

The entire sternum should lie over the heart shadow and be adjacent to the spine.

Front 54

Where is CR for PA projection of Sternoclavicular joints?

Back 54

Level of T2-T3

Front 55

What type of breathing instructions should be given to the patient for a PA projection of the sternoclavicular joints?

Back 55

Suspend respiration on inspriation

Front 56

How much rotation of the bony thorax is recommended for an ANTERIOR OBLIQUE of the sternoclavicular joints?

Back 56

10-15 degrees from PA position

Front 57

Which specific oblique position best demonstrates the left sternoclavicular joint adjacent to the spine?

Back 57

LAO

Front 58

3 points thst must be included in the pt's clinical history before a rib series?

Back 58

1)Nature of trauma

2)location of rib pain/injury

3)Couching up blood

Front 59

Where is the CR for the AP projection of the ribs for an injury located above the diaphragm?

Back 59

3"-4" below the jugular notch

Front 60

Which 2 specific oblique positions are used to elongate the "left axillary" portion of the ribs?

Back 60

RAO & LPO

Front 61

Which 2 "basic" projections or positions should be performed for an injury to the right anterior ribs?

Back 61

PA & LAO

(Because it elongates the right axillary rib region)

Front 62

How many degrees rotation are required for an oblique projection of the axillary ribs?

Back 62

45 degrees

Front 63

What is the recommended SID for bilateral lower rib study on an adult?

Back 63

72"

Front 64

(T or F) The recommended kV range for a digital study of the unilateral, lower ANTERIOR ribs is 80-90kV.

Back 64

FALSE

(It's 70-80kV)

Front 65

Which region of the ribs is best demonstrated with an RAO projection?

Back 65

True Ribs

Front 66

An RAO of the SC joints projects the left joint closest to the spine

Back 66

False

Front 67

To minimize pt dose for a RAO projection of the sternum the patient's skin should be at least _______ below the collimator.

Back 67

38"

Front 68

Which one of the following conditions may require a chest routine be included along with the study of the ribs?

Back 68

Hemothorax