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Bony Thorax and Peds
| Question | Answer |
|---|---|
| List the three structures of the bony thorax. | Ribs, Sternum, T-Spine |
| The most distal aspect of the sternum does not ossify until a person is approx. how many years of age? | 40 years old |
| The total sternum length on an average adult is about how many inches? | 6 inches |
| The xiphoid process lies at the level of? | T9-T10 |
| The sternal angle lies at the level of? | T4-T5 |
| What is the only joint that connects the bony thorax to the upper limbs? | Sternoclavicular (SC) joint |
| T/F The anterior end of the ribs is called the vertebral end. | FALSE: Anterior end is called the STERNAL END |
| Which aspect of the ribs articulates with the transverse process of the thoracic vertebrae? | Tubercle |
| Which end of the ribs is most superior? | Posterior vertebral ends |
| Approx. how much difference in height is there between the anterior sternal end and posterior vertebral end? | 3-5 inches |
| Which ribs articulate with the upper lateral aspect of the manubrium of the sternum? | 1st anterior sternal end |
| The bony thorax is widest at the lateral margins of which ribs? | 8th or 9th |
| How many posterior ribs are shown above the diaphragm? | 11 |
| Joint classification: First sternocostal | Immovable- synarthrodial |
| Joint Classification: 1-12 costovertbral joints | Movable- diarthrodial (plane or gliding) |
| Joint Classification: 1-10 costochondral unions (b/tw costicartilage and ribs) | Immovable- synarthrodial |
| Joint Classification: 1-10 costotransverse joints (b/tw ribs and transverse process of T-spine) | Movable- diarthrodial (plane or gliding) |
| Joint Classification: 2-7 sternocostal joints (b/tw ribs and sternum) | Movable- diarthrodial (plane or gliding) |
| Joint Classification: 6-9 interchondral joints (b/tw anterior costal cartilage) | Movable- diarthrodial (plane or gliding) |
| Joint Classification: 9-10 interchondral joints between the cartilages | Fibrous- syndesmosis |
| Which ribs are floating? | 11-12 |
| Which ribs are true ribs? | 1-7 |
| Which ribs are false ribs? | 8-12 |
| T/F: A hyperstenic patient requires more obliquity for a frontal view of the sternum than a asthenic patient? | False: less obliquity (15* for hyperstenic / 20* for asthenic) |
| Technique for RAO sternum: kV range: mA (low or high): Exposure time: | KV: 65-70 kV (5-10 higher for digital) mA: Low time: high (2-3 seconds) with orthostatic breathing technique |
| Recommended kV range for injury to the ribs found below the diaphragm. | 70-80 (lower ribs) |
| What structures are found in the costal grove of each rib? | Vein, Artery, Nerve |
| To properly elongate and visualize the axillary aspect of the ribs, the patients spine should be rotated........(towards or away) from the area of interest? | away from |
| Which rib projections should be performed for an injury to the anterior aspect of the ribs? | PA and both anterior obliques (and CXR) |
| Which rib projections should be performed for an injury to the right posterior ribs? | AP and RPO |
| A flail chest is defined as a(n): | Pulmonary injury caused by blunt trauma to 2 or more ribs. |
| Osteolytic metastases of the ribs produce what radiographic appearances? | Irregular bony margins |
| What is pectus excavatum? | depressed sternum caused by congenital defect ( |
| A proliferative bony lesion of increased density is generally termed: | Osteoblastic |
| T/F: patients can develop osteomyelitis as a postoperative complication following open heart surgery | True |
| Which oblique is prefered for the sternum and why? | RAO because it places sternum over the heart for solid background and added visability |
| what is the recommended SID for a lateral sternum? why? | 60-72 inches to decrease magnification |
| where is the CR directed for a PA projection of the SC joints? | level of T2-T3 |
| what are the breathing instructions for PA SC joints? | suspend respiration in inspriation |
| How much rotation of the thorax is recommended for an anterior oblique of the SC joints? | 10*-15* |
| which position best demonstrates the left SC joint adjacent to the spine? | LAO (see the side down for SC joints) |
| what are the 3 points that must be included in the patients clinical history before a rib series? | Chief complaint, location, is the pt. coughing blood |
| where is the CR centered for an AP projection of the ribs for an injury located above the diaphragm? Where is the patients pain, anterior or posterior? | T7 (or 3"-4" below the jugular notch) Posterior because of the AP projection |
| Which two oblique positions can be used to elongate the left axillary portion of the ribs? | RAO or LPO |
| How many degrees do you rotate the patient for an oblique projection of the ribs? | 45* |
| A radiograph of an RAO sternum reveals that part of the sternum is superimposed over the T-spine. Which specific positioning error is visable on this radiograph? | The patient is under rotated (should be 15*-20*) |
| At which age can a pediatric patient cooperate with radiographer and not necessarily need immobilization? | 24 months or 2-3 years old |
| T/F: The technologist is the one who should make the decision whether a parent remains in the room during a procedure? | True |
| T/F: It is the responsibility of the technologist to make a judgement if child abuse has occurred and then report it to law enforcement. | False: report it to the radiologist |
| What does NAT stand for? | Nonaccidental Trauma |
| what factor should first be considered in controlling motion for a pediatric patient? | short exposure time |
| Which immobilization device is recommended for an erect abdomen projection on an 18 month old? | Pigg-O-Stat |
| fill in the blank: Sandbags for pediatric immobilization should have ........... sand than for normal adult use. | coarser |
| What size stockinette is recommended for a small infant? | 3 inches |
| T/F: Sandbags designed for pediatric exams are more pliable than those used for adults. | True |
| T/F: The mummifying technique is recommended for studies of the lower limbs of children. | False. It is recommended for headwork |
| what exams is the Tam-Em Board used for | recumbent chest, abdomen and upper and lower limbs |
| Where do you center for a peds chest xray? | mid thorax and mammillary line (nipple line) |
| Where do you center for a peds abdomen? | 1" above umbilicus |
| what is another name for the body of the sternum? | corpus or gladiolus |
| What is the landmark found at T2-T3? | Jugular notch |
| What vertebrae is the sternal angle at? | T4-T5 |
| What vertebrae is the SC joint at? | T1 |
| What landmark is found at L1-L2? | inferior boarder of the ribs |
| How many steps is the mummifying method? | four steps |
| the primary center for ossification of long bones is? | Diaphysis |
| the space between the primary and secondary growth centers is? | Epiphyseal plate |
| T/F: Diapers may be left on for pelvis or abdomen xrays if the tech ensures there are no pins in the diaper | False. Diapers must be removed |
| What is the standard SID for a supine AP chest xray on a ped? | 50-60 inches |
| What analog kV range is appropriate for a lateral peds chest | 75-80 kV |
| what are the basic positions for a peds hip exam (non trauma) | AP and bilateral frog legs |
| Which positioning line is perpendicular to the IR for an AP pediatric skull? | OML |
| T/F: its hard to distinguish the small bowel from the large bowel on a peds radiograph | True |
| what kV is recommended for a peds AP abdomen | 65-80 |
| what position demonstrates the prevertebral region of the abdomen | dorsal decub |
| Red bone marrow is produced where? | the sternum |
| Critical thinking: Right posterior ribs are done. They are under penetrated and posterior ribs are foreshortened. What errors need to be corrected? | Increase kV by 10 and the wrong oblique was done. Do the RPO to elongate the right ribs. |
| Which ribs have full facets? | T1, T10-T12 |
| Which ribs have demi-facets? | T2-T9 |
Created by:
rachelreilly
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