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Bony Thorax-Sternum

Questions and Answers

QuestionAnswer
List the three structures that make up the bony thorax? A. Sternum B. Thoracic VertebraC. 12 Pairs of Ribs
What is the term for the long,middle aspect of the sternum? The Body
The most distal aspect of the sternum does not ossify until a person is approximately _______ years of age. 40 years
The total sternum length on an average adult is about _______ inches. 6 Inches
The xiphoid end of the sternum is at the approximate level of the ________ vertebra. T9 or T10
The sternal angle is at the level of ________ vertebra. T4 and T5
What is the name of the joint that connects the upper limb to the bony thorax (the only bony connection between the bony thorax and upper limbs?) The Sternoclavicular Joint.
What is the name of the section of cartilage that connects the anterior end of rib to the sternum? The Costocartilage.
What distinguishes a true rib from a false rib? True ribs connect to the sternum by their own costocartilage.
How are false ribs connected to the sternum? They are connected to the sternum via the costocartilage of the seventh rib.
{True/False} The eleventh and twelfth ribs are classified as false and floating ribs. True
{True/False} The anterior end of the ribs is called the vertebral end. False It is called the sternal end.
Which aspect of the ribs articulates with the transverse process of the thoracic vertebrae? The Tubercle
List the three structures found within the costal groove of each rib. A. The Artery B.The Vein C. The Nerve
The bony thorax is widest at the lateral margins of which ribs? The eighth or ninth.
How many posterior ribs are shown above the diaphragm? Eleven
What type of movement does the first sternocostal joint have? Immovable--synarthrodial
What type of joint movement does the first through twelfth costovertebral joint have? Movable--diarthrodial
What type of movement does the first through tenth costochondral unions have?(Between costocartilage and ribs.) Immovable--synarthrodial
What type of joint movement does the first through the tenth costotransverse joints have?(Between ribs and transverse processes of T vertebrea.) Movable--diarthrodial
What type of joint movement does the second through seventh sternocostal joints have?(Between second through seventh ribs and sternum.) Movable--diarthrodial
What type of joint movement does the sixth through tenth interchondral joints have?(Between anterior sixth through tenth costal cartilage.) Movable--diarthrodial
(True/False)It is virtually impossible to visualize the sternum with a direct PA or anteroposterior (AP) projection. True
(True/False)A large,"deepchested"(hypersthenic)patient requires more obliquity for a frontal view of the sternum as compared with a "thin chested"(asthenic)patient. False (less obliquity)
How much rotation should be used for the oblique position of the sternum for a large, "deep-chested"patient? Approximately 15 degrees.
What is the advantage of performing a breathing technique for radiography of the sternum? It blurs lung markings and ribs which improves the visibility of the sternum.
What is the primary reason that a source image receptor distance(SID) of less than 40 inches should "NOT" be used for sternum radiography. Increase in patient dose, especially skin dose.
What other imaging option is available to study the sternum if routine RAO and lateral radiographs do not provide sufficient information. CT or Nuclear Medicine.
Identify the perfered positioning factors to demonstrate an injury to the ribs found BELOW the diaphragm: A. General body position (RECUMBENT)B. Breathing instructions(EXPIRATION)C.Recommended kilovoltage range(MEDIUM 75 to 85)
An injury to the region of the eighth or ninth rib would require the_________ diaphragm technique. ABOVE
To properly elongate and visualize the axillary aspect of the ribs, the patient's spine should be rotated___________the area of interest. Away from
Which projections (AP or PA and anterior or postieror oblique) should be preformed for an injury to the anterior aspect of the ribs. PA and anterior obliques (Placing the area of interest closest to the I.R. is one recomended routine).
Which two rib projections should be performed for an injury to the RIGHT POSTERIOR ribs? AP and RPO (To shift spine away from area of interest).
How can the site of injury be marked for a rib series? By taping a small, metallic "BB" over the site of the injury.
If the physician suspects a pneumothorax or hemothorax has occured as a result of a rib fracture, which additional radiographic projection(s) should be performed in addition to the routine rib projections? Erect PA and lateral chest.
A flail chest is defined as a(an): Pulmonary injury caused by blunt trauma to two or more ribs.
Osteolytic metastases of the ribs produce which of the following radiographic appearances? Irregular bony margins.
Which of the following definations applies to pectus excavatum. Depressed sternum due to congential defect.
A proliferative bony lesion of increased density is generally termed. Osteoblastic
(True/False)MRI provides a more diagnostic image of rib metastases as compared with a nuclear scan. False
Patients can develope osteomyelitis as a postoperative complication following open heart surgery? True
Which is preferred for a study of the sternum--RAO or LAO? RAO
Why is a RAO preffered for a study of the sternum? It places the sternum over the heart to provide a uniform background for added visibility of the sternum.
Where is the central ray centered for the oblique and lateral projections of the sternum? Midsternum (midway between jugular notch and xiphoid.
What other position can be performed if the patient cannot assume a prone position for the RAO sternum? LPO (oblique supine position)
What is the recommended SID for a lateral projection of the sternum? 60 to 72 Inches.
Why is the recommended SID for a lateral projection of the sternum 60 to 72 inches? It reduces magnification created by the long object image receptor distance. OID
What criteria applys to a radiograph for an evaluation of the oblique sternum? The entire sternum should lie over heart shadow and be adjacent to the spinal column.
Where is the Central Ray centered for a PA projection of the sternoclavicular joints? The Level of T2-T3.
What type of breathing instructions should be given to the patient for a PA projection of the sternoclavicular joints? Suspend respiration on inspiration.
How much rotation of the thorax is recommended for an anterior oblique of the sternoclavicular joints? 15 Degrees
Which specific oblique position best demonstrates the LEFT sternoclavicular joint next to the spine? LAO Left Anterior Oblique
What are the three points that must be included in the patient's clinical history prior to a rib series? A.The nature of the trauma or patient complaintB. The location of the rib pain or injuryC.Wether or not the patient has been coughing up blood.
Where is the central ray centered for an AP projection of the ribs for an injury located above the diaphragm. 3 to 4 inches below the jugular notch, the level of T7.
Which two specific oblique positions can be used to demonstrate the LEFT axillary portion of the ribs? RAO or LPO elongates the left axillary ribs, and shifts the spine away from the injury site.
How many degrees of rotation are needed for a routine oblique projection of the ribs. 45 Degrees.
Both the patient thyroid dose and the breast dose for a correctly colliminated PA sternoclavicular (SC) joint projection are in the _________ range. The 1 to 5 mrad range.
(True/False) The thyroid dose for an anterior oblique rib projection is only about 5 percent of what it would be for a posterior oblique rib projection. False (Only about 1/3, or 33 percent)
(True/False)The breast dose for an anterior oblique rib projection is only about 5% of what it would be for posterior oblique rib projection. True
(True/False)The gonadal dose given for rib projections is less than 1 mrad. True
A radiograph of an RAO sternum is superimposed over the thoracic spine. Which specific positioning error is visible on this radiograph? Underrotation of the patient.
A radiograph of an RAO sternum reveals that the sternum is difficult to visualize because of excessive density. The following factors were used for this image:75kV,25mA, 3-sec. exp.40in. SID,Bucky,and 100 speed screens.What is needed for a better picture Lower the kilovoltage to 65 for higher contrast and to prevent overrotation of the sternum.
Created by: Jerrie Lee on 2008-12-16



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