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