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AA RIBS
Radiology
| Question | Answer |
|---|---|
| Rib joints that are not synovial joints | 1st rib to manubrium, cartilaginous synarthrodial 1st - 10th sternal ends of ribs to costocartilage; unique union synarthrodial Interchondral joint b/w 9th and 10th rib, fibrous synarthrodial |
| Sternoclavicular joint exam | Pt. Prone RAO/LAO, 10-15 degrees, cr prep. To IR at 2" from MSP to the upside at T2-T3 or 3" from vertebral prominens, side closest to IR is demonstrated, SID 40" |
| 2 images for the sternum | Left lateral or Oblique RAO |
| Lateral sternum position | Pt. erect left lateral with hands at back to stick chest out , CR prep to IR at mid sternum or 1/2 way b/w xiphoid process and lower rib margin, SID 72" ; image on inspiration |
| Oblique sternum RAO | Pt. erect at RAO 15 - 20 degrees, CR at T7 and 1" left of MSP, 20 degrees for thin and 15 for thick. SID 40" ; Image on ORTHOSTATIC BREATHING |
| Upper Oblique ribs | Anterior or posterior oblique at 45 degrees, CR same as chest at mid region of interest; affected anterior side away, affected posterior close to IR, SID 72" HOLD BREATH ON INSPIRATION |
| Lower ribs | Only done AP; CR at point b/w xiphoid process and lower rib margin , light field at iliac crest SID 40", HOLD BREATH ON EXPIRATION |
| 2 views rule for ribs | Need area of interest closest to IR and need spine moved away; get an AP/PA and the oblique that moves spine away |
| Cervical levels c1-c7 | C1 mastoid process; C3 Hyoid bone, Gonion; C3-C6 area of larynx; C6 area of larynx joining to trachea ; C7 vertebral prominens |
| Names of sternum | Manubrium; body of sternum, gladiolus,corpus; xiphoid process, Ensiform |
| Thorax and pelvis levels | T1-T2 1"above jugular notch T2-T3 jugular notch T4-T5 sternal angle T7 mid thorax T9-T10 xiphoid process L2-L3 lowerrib margin L4-L5 iliac crest S1-S2 ASIS |
| Elongation of ribs | RPO elongates right LPO elongates left RAO elongates left LAO elongates right |
| Lateral upper airway | Pt. Lateral at WB, CR at C6-C7 prep to IR, AML plane prep to IR, light field to external auditory meatus, slow deep inspiration SID 72" |
| Angles for bony thorax | SC JOINTS 10 -15 degrees RAO STERNUM 15 - 20 degrees OBLIQUE RIBS 45 degrees |
| Which ribs do not have costotransverse joints | Ribs 11 and 12 |
| Difference b/w bilateral ribs and unilateral ribs | Bilateral is 72" at MSP. And Unilateral is done at 40" with CR at mid clavicular line |
| Lower ribs exam | Pt. In recumbent position like abdomen ; CR perp to IR at b/w the xiphoid process and lower rib margin, only done bilateral, only AP, imaged on expiration at SID 40" |
| Most common error with RAO sternum | Over rotation |
| Ribs in upper region | 1 - 9 ribs; ; 10,11,12 below diaphragm |
| AP Upper airway | Pt. erect at WB, AP position, AML perp to IR, CR at T1-T2 or 1" above jugular notch, image on slow deep inspiration SID 40", light field up to EAM |