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Questions and Answers

What part of the sternum is the upper portion called?

  • Manubrium (correct)
  • Body
  • Costocartilage
  • Xiphoid process
  • Which type of ribs connect directly to the sternum via costocartilage?

  • True ribs (correct)
  • False ribs
  • Floating ribs
  • Inferior ribs
  • What is the level of the xiphoid process?

  • T2-T3
  • T9-T10 (correct)
  • T4-T5
  • L2-L3
  • At what level does the sternal angle occur?

    <p>T4-T5</p> Signup and view all the answers

    How many facets on the sternum accept costocartilage for rib attachments?

    <p>7</p> Signup and view all the answers

    What is the recommended KVp for imaging the lateral sternum?

    <p>75-85</p> Signup and view all the answers

    Which ribs are categorized as floating ribs?

    <p>11-12</p> Signup and view all the answers

    In the RAO position for sternum imaging, where should the central ray be directed?

    <p>To the left of midline, equidistant to the jugular notch and xiphoid process</p> Signup and view all the answers

    What is the recommended SID for performing an AP rib examination?

    <p>40 inches</p> Signup and view all the answers

    Which position best demonstrates the sternoclavicular joint on the downside?

    <p>Anterior oblique</p> Signup and view all the answers

    When performing an AP rib study for ribs above the diaphragm, what is the recommended respiration phase?

    <p>Suspend on deep inspiration</p> Signup and view all the answers

    At what level should the CR be positioned for an LAO or RAO view of the SC joints?

    <p>Level T2-T3</p> Signup and view all the answers

    Which anatomy is best demonstrated with a PA bilateral anterior ribs examination?

    <p>Ribs 1-9 above the diaphragm</p> Signup and view all the answers

    In posterior oblique positions for rib examinations, which side is placed toward the IR for posterior-lateral injuries?

    <p>Affected side</p> Signup and view all the answers

    What is the correct CR positioning for a rib exam focused below the diaphragm?

    <p>Midway between xiphoid process and lower rib margin</p> Signup and view all the answers

    What is the appropriate IR size for performing a rib examination?

    <p>14 x 17 inches</p> Signup and view all the answers

    Study Notes

    Bony Thorax

    • Consists of the sternum (anterior) and thoracic vertebrae (posterior)
    • 12 pairs of ribs connect the sternum to the vertebral column

    Sternum

    • Flat bone, divided into three parts:
      • Manubrium (upper portion)
      • Body (middle portion)
      • Xiphoid process (inferior portion)
    • Approximately 7 inches long in adults

    Ribs

    • Numbered based on the thoracic vertebra they attach to (top-down)
      • True ribs (1-7): connect directly to the sternum via costal cartilage
      • False ribs (8-10): connect indirectly to the sternum via the costal cartilage of rib 7
      • Floating ribs (11-12): have no connection to the sternum, lacking costal cartilage

    Palpable Landmarks

    • Jugular notch (level of T2-T3 vertebrae)
    • Sternal angle (manubriosternal joint, level of intervertebral disk between T4 and T5)
    • Xiphoid process (inferior tip of sternum, located at T9-T10)
    • Inferior rib (costal) angle (aka inferior costal margin, L2-L3)
    • Locating lower ribs and abdomen
    • First 7 pairs of ribs (true ribs) connect to the sternum through costocartilage
    • Sternum has 7 facets to accommodate the cartilage for each rib attachment

    Sternum (RAO Position)

    • Technique factors: SID 40 inches, IR size 10 x 12 inches, portrait, Grid, KVp: 70-85
    • CR: Perpendicular to the IR, centered to the sternum, midway between the jugular notch and xiphoid process.
    • Superimposition: Sternum superimposed on the heart shadow, not superimposed by vertebrae

    Sternum (Lateral Position)

    • Technique factors: SID 40 inches, IR size 10 x 12 inches, portrait, Grid, KVp: 75-85
    • CR: Perpendicular to the IR, centered on the sternum midway between jugular notch and xiphoid process.
    • Respiration: suspend respiration on inspiration
    • Superimposition: Entire sternum, no superimposition of ribs

    Sternoclavicular Joints (PA)

    • Technique factors: SID 40 inches, 8 x 10 inches, landscape, Grid, KVp: 75-85
    • CR: Perpendicular
    • Plane: Midsagittal plane at level of T2-T3, or 3 inches distal to vertebra prominens (C7).
    • Respiration: suspend on expiration
    • Anatomy Demonstrated: Bilateral left and right SC joints, lateral aspect of manubrium and medial portions of clavicles, seen through superimposing ribs and lungs.

    Anterior Obliques (LAO/RAO) SC Joints

    • Technique factors: SID 40 inches, IR size 8 x 10 inches, landscape, Grid, KVp 75-85
    • CR: Perpendicular to T2-T3, or 3 inches distal to vertebra prominens.
    • Plane: 1–2 inches lateral to midsagittal plane
    • Respiration: suspend on expiration
    • Anatomy demonstrated: Manibrium, medial portion of clavicles, sternoclavicular joint best demonstrated on the downside, downside SC joint with no superimposition of vertebral column/manibrium.

    Ribs (AP Bilateral Posterior)

    • Technique factors: SID 40 inches; 72 inches can be used to minimize magnification, IR size is 14 x 17 inches, landscape, Grid, KVp: 75-85
    • CR: Perpendicular to IR; Mid-sagittal plane at level 3/4 inches below the jugular notch.
    • Respiration: suspend on deep inspiration for above diaphragm, full expiration for below.
    • Anatomy demonstrated: above, Ribs 1-9. Below, Ribs 10-12

    Ribs (PA Bilateral Anterior)

    • Technique factors: SID 40 inches; 72 inches can be used to minimize magnification, IR size 14 x 17 inches, landscape, Grid, KVp: 75-85
    • CR: Perpendicular to IR; Mid-sagittal plane at level of T7.
    • Respiration: Inspiration
    • Anatomy demonstrated: Ribs 1–9 above diaphragm.

    ###Posterior Oblique (RPO, LPO) Ribs

    • This section does not contain a consistent method for determining CR and technique.
    • Specific factors are given, but with no mention of specific methods for determining best results.

    Posterior-lateral/Anterior-Lateral Injuries

    • Technique factors: SID 40 inches; 72 inch can be used to minimize magnification, IR size 14 x 17 inches, landscape, Grid, KVp 75-85
    • CR: Perpendicular to IR
    • Above diaphragm: Level 3/4 inches below jugular notch (T7) for posterior oblique, or 7-8 inches below vertebra prominens (T7) for anterior oblique.
    • Below diaphragm: Midway between xiphoid process and lower rib margin.
    • Respiration: Inspiration (above), exhalation (below).
    • Anatomy demonstrated: Above Ribs 1-9, below Ribs 10-12. Axillary ribs in profile.

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