1. The three structures that make up the bony thorax?
Sternum, Thoracic vertebra and 12 pairs of ribs.
2. What is the term for the long, middle aspect of the sternum?
Body
3. The most distal aspect of the sternum does not ossify until a person is approximately how old?
40
4. The total sternum length on an average adult is?
6 inches
5. The xiphoid process of the sternum is approximately at te level of
T9 - T10
6. The sternal angle is at the level of
T4-T5
7. The sternal angle is also called
Manubriosternal joint
8. What is the name of the joint that connects the upper limb to the bony thorax?
SC Joint
9. What distinguishes a true rib from a false rib?
True rib is connected to the sternum by their own costocartilage, false are connected by the costocartilage of the 7th rib
10. True or False: The eleventh and twelfth ribs are classified as false and floating ribs?
True
11. The anterior end of the ribs is called the vertebral end.
False
12. Which aspect of the ribs articulates with the transverse process of the thoracic vertebrae?
Tubercule
13. List the structures found within the costal groove of each rib?
Artery, Vien, and nerves
14. Which end of the ribs is most superior - the posterior vertebral ends or the anterior sternal ends of the ribs?
Posterior vertebral end
15. Approximately how much difference in height is there between the anterior sternal end and posterior vertebral end of the ribs?
3 to 5 inches
16. Which rib articulates with the upper lateral aspect of the manubrium of the sternum?
First (anterior sternal end)
17. The bony thorax is widest at the lateral margin of which ribs?
8th or 9th
18. Joint movement type of: First sternocostal
Immovable - synarthrodial
19. Joint movement type of: First through twelfth costovertebral joints
Movable - diarthrodial (plane or gliding)
20. Joint movement type of: First through tenth costochondral unions (between costicartilage and ribs)
Immovable - synarthrodial
21. Joint movement type of: First through tenth costotransverse joints (between ribs and transverse process of T vertebrae).
Movable - diarthrodial (plane or gliding)
22. Joint movement type of: Second through seventh sternocostal joints (between second and seventh ribs and sternum).
Movable - diarthrodial (plane or gliding)
23. Joint movement type of: Sixth through ninth interchondral joints (between anterior sixth and ninth costal cartilage).
Movable - diarthrodial (plane or gliding)
24. Joint movement type of: Ninth and tenth interchondral joints between the cartilage.
Fibrous - syndesmosis
25. What is unque about the true ribs
Each rib attaches to the sternum by its own costicartilage
26. What is unique about the floating ribs
They do not connect to anything anteriorly
27. True or False: It is virtually impossible to visulize the sternum with a direct PA or anteroposterior projection
True
28. True or False: A large "deep-chested" (hypersthenic) patient requires more obliquity for a frontal view of the sternum as compared with a "thin-chested" (asthenic) patient.
False
29. How much rotation should be used for the oblique position of the sternum for a large, "deep-chested" patient
approximately 15 degrees
30. What is the advantage of performing an ostostatic (breathing) technique for radiography of the sternum
It blurs lung markings and ribs which improves visability of the ribs
31. What is the main reason that a SID of less than 40 inches should not be used for sternum radiography?
Increase in patient dose expecially skin does.
32. What other modality is available to study the sternum of routine RAO and lateral radiographs do not provide suffient information
CT or Nucular medicine
33. An injury to the region of the eighth or ninth rib requires the above or below diaphragm technique
Above
34. To properly elongate and visualize the axially aspect of the ribs, the patients spine should be rotated away or towards the area of intrest?
Away from
35. Which projection AP or PA and anterior or posterior oblique should be performed for an injury to the anterior aspect of the ribs?
PA and anterior oblique
36. Which two rib projections should be performed for an injury to the right posterior ribs?
AP and Posterior oblique RPO to shift the spine away from the area of interest.
37. If the physician suspects a pneumothorax or hemothorax has occured as a result of a rib fracture which additional radiographic projection(s) should be performed in addition to the routine rib projection?
Erect PA and lateral chest
38. A Flail chest is defined as ?
Pulmonary injury caused by blunt trauma to two or more ribs
39. Osteolytic metastases of the ribs produce what radiographic appearences?
Irregular bony margins
40. What is the definition of pectus excavatum?
Depressed sternum caused by congenital defect
41. A proliferative bony lesion of increased density is generally termed?
osteoblastic
42. True or False: MRI provides a more diagnostic image of rib metatses as compared with nuclear medicine
False
43. True or False: patients can develope osteomyelitis as a postoperative complication following open heart surgery.
True
44. What is the perferred study of the sternum RAO or LAO
RAO because it places the sternum over the heart to provide a uniform background for added visibility of sternum
45. Where is the CR centered for the oblique and lateral projections of the sternum?
Midsternum
46. What other position can be performed if the patient cannot assume a prone position for the RAO sternum
LPO
47. What is the recommended SID for a lateral projection of the sternum
60-70 inches to reduce magnification created by long OID
48. What criteria applies to a radiograph of an oblique sternum for evaluation
The entire sternum should lie over the heart shadow and be adjacent to the spine.
49. What is the CR for a PA projection of the sternoclavicular joints
Level of T2 - T3
50. What type of breathing instructions shoud be given to the patient for a PA projection of the sternoclavicular joints
Suspended respiration on inspiration
51. How much rotation is reccomeneded for an anterior oblique of the sternoclavicular joints
10 to 15 from PA position
52. Which specific oblique position best demonstrates the left sternoclavicular joint adjacent to the spine?
LAO
53. What are three points that must be included in the patient's clinical history before a rib series?
The nature of the trauma, the location of the rib pain and whether paitent is coughing up blood.
54. Where is the CR for an AP projection of the ribs for an injury located above the diapragm?
3-4 inches below jugular notch at the level of T7
55. What two specific oblique positions can be used to elongate the left axillary ribs?
RAO or LPO elongates the left axillary ribs
56. What position and projection should be performed for an injury to the right anterior ribs
LAO position and PA projection
57. How many degrees of rotation is required for an oblique projection of the axillary ribs
45 degrees
58. SID for a bilateral rib study on a adult patient
72 inch SID
59. True or False: The recommended kV range for a digital study of the unilateral, lower ribs is 80-90 kv
True