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Ribs & Sternum

(Bontrager & Lampignano) 7th Edition

QuestionAnswer
Bony Thorax Function? Serve as an expandable enclosure for lungs Protects important organs of the respiratory system
The Bony thorax consist of? Sternum (anteriorly) Thoracic vertebrae (posteriorly) 12 pairs of ribs (connects the sternum with the vertebral column)
The sternum consist of? Manubrium (Jugular notch, suprasternal or manubrial notch) Body (Corpus, gladiolus) Xiphoid process
Palpable landmarks? Jugular notch (@ level of T2 - T3) Sternal angle (@ level of T4 - T5) Xiphoid process (@ level of T9 - T10)
What are the positioning considerations when performing sternum? Rotation of the patient 15° to 20° RAO Exposure factors: 65 to 70 kV Minimun SID: 40"
Why is the Patient rotated when performing sternum? To shift the sternum to the left of the thoracic vertebrae & into the homogenous heart shadow
Patient with a greater AP measurement requires how much rotation for a sternum proj? Less rotation (15°)
Patient with a lesser AP measurement requires how much rotation for a sternum proj? More rotation (20°)
If the patient history is not provied by the physician, what the tech. must do? Obtain a clinical history that includes: The nature of the patient's complaint Location of the rib pain or injury Wheter the injury was caused by trauma Verify if the patient is able to stand
What are the positioning considerations when performing ribs AD? Above Diaphragm (AD): Take radiograph patient erect (gravity asists in lowering diaphragm) Minimun of upper 10 posterior ribs Suspend respiration & expose on inspiration Select LOW kV (65 to 70)
What are the positioning considerations when performing ribs BD? Below Diaphragm (BD): • Take radiograph with patient recumbent (supine, diaphragm rises) • Suspend radiation & exposure on expiration • Select MEDIUM kV (70 to 80)
What are the recommended projections when performing ribs? Select the proj that place the area of interest CLOSEST to the IR & ROTATE the spine away from area of interest
If a patient has a history of trauma to the left posterior ribs, what are the 2 proj routine? AP (places the site of injury closest to the IR) & a LPO
If a patient has a history of trauma to the right anterior ribs, what are the 2 proj routine? PA (places the site of injury closest to the IR) & a LAO
Patient with a history of rib injuries may require? Erect PA & Lateral projection of the chest
When there is presence of air - fluid levels & patient cannot assume an erect position. What should the tech do? Horizontal beam with patient in a decubitus position
Pathologic condition caused by blunt trauma. Associated with underlying pulmonary injury Flail chest
Pathologic condition caused by blunt trauma.Associated with underliyng cardiac injury Sternum
Congenital defect with anterior protrusion of the lower sternum & xiphoid process Pectus carinatum (pigeon breast)
Deformity characterized by a depressed sternum Pectus excavatum (funnel chest)
Destructive lesions with irregular margins Osteomelytic
Proliferative bony lesions of increased density Osteoblastic
Apperance of bone resulting on destructive & blastic lesions Osteoblastic & Osteolytic "moth - eaten"
Infection of bone & marrow caused by bacterial infection Osteomyelitis
Basic projections for sternum? RAO & Lateral
Right Anterior Oblique Sternum (RAO) Patient prone/erect in RAO & rotated 15° - 20° to the right side... Top of the film is 1 ½” above jugular notch... CR perpendicular to IR
Lateral Sternum Patient is in a right or left lateral... Top of the film is 1 ½” above jugular notch... SID of 60" - 72"... Shoulders & arms drawn back
What is the best view to see a sternum fracture? Lateral view
Basic projections for Ribs? AP (upper & lower)... Oblique (upper & lower)... PA Chest (upright)
AP Upper ribs (AD) unilateral projection Top of film is 3" above the acromion process (1 ½” above shoulders)...Inspiration... Low kVp (65-70)
AP Upper ribs (AD) bilateral projection Top of film is 3" above the acromion process (1 ½” above shoulders)...Inspiration... Low kVp (65-70)
AP Lower ribs (BD) unilateral projection Bottom of film @ the top of Iliac crest...Expiration...Medium kVp (75-85)
AP Lower ribs (BD) bilateral projection Bottom of film @ the top of Iliac crest...Expiration...Medium kVp (75-85)
What is the difference between bilateral & unilateral projections on ribs? Bilateral basic projections on ribs requires: AP (upper & lower)... AP (upper & lower) unilateral of affected side... Oblique (upper & lower)... Oblique (upper & lower) unilateral of affected side... Chest
Tangential view Ribs Same as obliques except you are looking at the opposite side
What does LPO of tangential view demonstrate? Tangent of the right side
What does RPO of tangential view demonstrate? Tangent of the left side
Created by: nenejuyuya