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Bony Thorax and Peds

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