Radiographic Techniques - Thoracic Bones

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Questions and Answers

Where should the lower edge of the cassette be positioned when conducting an X-ray of the lower ribs?

At the level of the diaphragm

At a level just below the lower costal margin (correct)

At the level of the mid-clavicular line

Above the projections of the lower ribs

What is the purpose of centering the collimated beam at the level of the lower costal margin?

To maximize rib visibility below the diaphragm (correct)

To reduce the exposure time needed

To focus on the sternum during exposure

To ensure even exposure on the entire cassette

When should exposure be made to achieve the best results in lower rib examinations?

On full inspiration

On full expiration (correct)

At the end of normal breathing

When the patient is positioned supine

What is the correct angle of trunk rotation for a posterior oblique examination of the lower ribs?

45° Signup and view all the answers

What is the recommended size for the cassette used during the right or left posterior oblique examination?

35 × 43 cm Signup and view all the answers

Which position is NOT appropriate for the patient during a lower rib examination?

Prone Signup and view all the answers

What should be done to ensure the central ray is correctly aimed during rib imaging?

Angle it cranially after centering at the lower costal margin Signup and view all the answers

What should be done to the patient's hips and knees during a rib examination?

They should be flexed for comfort. Signup and view all the answers

What is the primary consideration in cases of severe thoracic injury?

Maintenance of respiratory function Signup and view all the answers

Which view is suggested for assessing rib fractures from trauma?

Oblique rib views Signup and view all the answers

What imaging method may be particularly useful for assessing internal organ damage after rib trauma?

Ultrasound or CT scan Signup and view all the answers

What might occur if there is damage to multiple ribs, sternum, and lungs?

Flail chest Signup and view all the answers

If a pneumothorax is suspected but not clearly visible on a supine radiograph, what should be done?

Acquire a lateral radiograph using a horizontal beam Signup and view all the answers

What complication can arise from overexposure during radiographic imaging of the thorax?

Obscured pulmonary lesions Signup and view all the answers

What type of injury to the clavicle and 1st ribs may indicate significant vascular injury?

Fractures Signup and view all the answers

When would an optimal PA or AP radiograph be most critical?

During evaluation of chest wall injury and pleural changes Signup and view all the answers

What is the proper cassette size for imaging the upper ribs?

18 × 24 cm or 24 × 30 cm Signup and view all the answers

Where should the image receptor be centered when performing an X-ray of the upper ribs?

To the middle of the clavicle Signup and view all the answers

What is the correct X-ray beam direction for upper rib imaging?

Perpendicular to the image receptor Signup and view all the answers

Which setup is appropriate for imaging the cervical ribs?

Patient sitting or standing with trunk against vertical Bucky Signup and view all the answers

What size CR cassette is typically used for viewing the upper ribs?

18 × 24 cm Signup and view all the answers

Which anatomical structures should be included when positioning the CR cassette for cervical rib imaging?

From the 5th cervical to the 5th thoracic vertebrae Signup and view all the answers

What technique is primarily used to diagnose the presence of disease in the thorax?

Radiographic techniques Signup and view all the answers

What is the proper position for a patient when performing an X-ray for lower ribs?

Lying supine on the imaging table Signup and view all the answers

Study Notes

Radiographic Techniques - Bones of the Thorax

The thorax comprises ribs, sternum, and thoracic spine
Radiographic assessment of trauma often focuses on PA or AP views to rule out intrathoracic complications
Oblique rib views are used less frequently unless needed for diagnosis alterations
Anterior and posterior ribs are visible in PA or AP projections, above the diaphragm
Chest trauma may injure ribs, sternum, lungs, thoracic spine, or a combination.
Severe injury necessitates maintaining respiratory function and optimal PA/AP radiographs for comprehensive assessment of chest wall injury, pleural changes, or pulmonary damage.

Radiological Considerations

Pain after rib trauma necessitates minimizing rib fracture and pulmonary contusion visibility through exposure optimization
Overexposure clarifies rib trauma but obscures associated pulmonary lesions and should be avoided
Fluoroscopy may assess peripheral chest lesions' origins (rib-related), though CT is preferred for confirmation

Upper Ribs

18 x 24cm or 24 x 30cm CR cassettes are used.
Patient standing or supine position is selected on the Bucky table
Cassette placement is in a cassette holder
Sagittal plane alignment is perpendicular with the image receptor.
Image receptor centered at clavicle midpoint.
X-ray beam is perpendicular & centered to clavicle midpoint

Cervical Ribs (AP)

24 x 30 cm CR cassette, placed transversely on the Bucky tray
Patient stands/sits with posterior aspect on Bucky, or lies supine.
Median sagittal plane aligns with image receptor and Bucky midline.
Cassette size is sufficient for cervical vertebrae 5 to thoracic vertebrae 5
X-ray angle 10° cranially from perpendicular, aiming for the sternal notch

Bones of the Thorax (Lower Ribs) - Antero-Posterior (Basic)

35 x 43 cm CR cassette is used, encompassing whole right and left sides from sternum mid-point to lower costal margin.
Patient lies supine on imaging table, median plane coinciding with couch midline.
Superior iliac spines positioned equidistant from table top.
Cassette placed transversely in Bucky tray, positioned below lower costal margin.
X-ray beam centered on area of interest with its center coincident with central beam.

Lower Ribs

X-ray beam collimated vertically, centered on lower costal margin, and angled cranially to receptor center
Positioning assists in displaying ribs below the diaphragm
Full exhalation recommended for optimal imaging

Right and Left Posterior Oblique

Use 35 x 43 cm CR cassette, inclusive of ribs from sternum mid-point to lower costal margin of relevant side.
Patient positioned supine or standing, midline of Bucky tray aligned with mid-clavicular line of targeted side.
Trunk rotated 45° toward targeted side, supported on non-opaque pads.
Hips and knees are flexed for patient comfort and stability during imaging
Cassette positioned below the lower costal margin to encompass the region of interest, and the X-ray beam is angled cranially to its center.
X-ray exposure during full arrested expiration is needed.

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Description

Explore the essential radiographic techniques for assessing the thorax, including ribs, sternum, and spine. This quiz covers important projection methods, considerations for trauma assessment, and how to optimize exposure to visualize injuries effectively. Test your understanding of chest imaging and related complications.