Chapter 9: Bony Thorax

BB

A __ should always be placed over the injury area for rib x-rays.

head, neck, tubercle, and body

A typical rib consists of what 4 parts?

twice

For Oblique rib projections, approximately ____ as much distance between vertebral column and lateral border of ribs is seen on affected side.

palms facing up, joint of interest

For a PA Oblique SC joints (CR angulation method), the arms should be extended alongside body with _____ and the head should be rested on chin or rated toward _________.

contrast

For a PA Oblique sternum, expiration helps to moderate the ___ of the image.)

15, 20

For a PA Oblique sternum, use a __ degree angle for thicker patiens and a __ degree angle for thinner patients.

spinous process of T3

For a PA SC joint, the IR should be sentered to the ____________.

MSP

For a PA SC joint, the ___ shold be aligned to the midline of the IR.

10-15 degree

For a PA SC joint, use a ______ RAO or LAO position.

perpendicular, T2-T3, 1-2 inches lateral

For a PA oblique SC joint (body rotation method) the CR should be ______ to the SC joint closer to the IR, entering at the level of _____ and __________ (or toward the joint of interest) from the MSP.

6x8

For a PA oblique SC joint, the collimated field should be at what?

vertebral column, heart

For a PA oblique sternum, the sternum should be free of superimpostion by the _________ and should be projected over the _____.

deep inspiration

For a lateral sternum, suspend respirations after _______ to help increase teh contrast between the sterum and lungs posterly/scatter anteriorly.

sternum, MSP

For a lateral sternum, the ____ should be centered to the midline and the ____ should be vertical.

posteriorly, locked behind back

For a lateral sternum, the shoulders should be rotated _____ and the hands should be ____________.

unaffected

For anterior rib injuries, which side should be closest to the IR fo the oblique?

iliac crests

For lower rib projections, the lowerer border of the IR should be level with what anatomy?

elevate, rest on hip

For posterior and anterior rib obliques, abduct and ____ the arm of affected side, and abduct and _____ for arm of the unaffected side.

MSP and lateral surface of body

For posterior and anterior rib obliques, center the affected side on a longitudinal plane halfway between what?

affected

For posterior rib injuries, which side should be closest to the IR for the oblique?

axillary

For rib obliques, the ____ potion of ribs should be free of superimposition.

1st-10th

For ribs above diaphagm, the entire ____ posterior ribs should be present on both sides.

8-12th

For ribs below the diaphragm, the entire ____ posterior ribs should be present on both sides.

6"

For sternum, use a 10x12 lengthwise but collimate to ___ width.

40 inches, expiration

For the PA Oblique Sternum, we will use a ___ SID and sespended breathing at the end of ____.

1.5 inches, jugular notch

For the sternum, the top of the IR should be ____ above the ______.

PA, AP

For upper ribs, if injury is located anteriorly do a ____ projection or use a ____ projection if injury is posterior.

1.5 inches above upper border of shoulders

How far should the upper border of the IR extend for PA/AP ribs?

12

How many pairs of ribs are there?

12

How many thoracic vertebrae are there?

perpendicular at T7

How should the CR be directed for a PA upper ribs?`

palms out on hips

How should the hands be positioned for a PA/AP upper ribs?

AP

Lower ribs are always done ___.

supine

Lower ribs should be done ____ to permit gravity to have less of an effect on the diaphragm and to allow organs to spread out.

axillary

Oblique projections for the ribs are used to view the _____ surface/portion.

fracture

disruption of the continuity of bone

8-10

Rib pairs ___ attach indirectly to the sternum via costal cartilage.

8-12

Rib pairs ____ are considered false ribs

11 and 12

Rib pairs ____ are considered floating ribs.

1-7

Rib pairs ____ are considered true ribs

attachment

Ribs are classified by _____.

flat bones

Ribs are considered what classification of bone/

length and breadth

Ribs vary in _____ and ______.

gladiolus

The Body of the sternum is also known as what?

15 degrees

The CR for a PA Oblique SC joints (CR angulation method) should be angled _______ toward the MSP.

perpendicular, 1 inch lateral, T7

The CR for a PA Oblique Sternum should ble ______ to the IR entering the elevated side of the posterior throax ________ to the MSP at the level of __.

perpendicular, lateral border of sternum, midsternum

The CR for a lateral sternum should be _______ to the IR and entering the _________ at the ______.

RAO, LPO

The PA Oblique sternum is usually done in ____ position or ____ position for trauma patients.

15-20

The PA Oblique sternum requires a _____ degree RAO.

first

The ____ rib is the shortest and broadest.

affected, SC joint

The ____ side should be placed closer to the IR with the _____ in the center for a PA SC joint.

posterior, anterior

The ______ portion of the thorax is longer than the _____ portion.

lower

The anterior ends of the ribs lie ____ than the posterior/vertebral ends.

sternal angle

The body is joined to the manubrium at what?

4 inches (10.2 cm)

The body of the sternu is approximately ________ long.

conical

The bony thorax is ____ in shape, meaning that it is narrrow at top and wider on the bottom.

upright or recumbent

The general patient position for ambulatory patients is _____ or ______.

altered positioning to maximize comfort

The general patient position for nonambulatory patients is ______________.

vertebral bodies

The head of ribs articulates with what?

T2-T3

The jugular notch lies at the _______ interspace.

PA oblique sternum

The lateral portion of the manubrium and SC joint should not be overlapped by the vertebrae in which sternum projection?

jugular notch

The manubrium has a ________ at the superior border.

lateral sternum

The manubrium should be free of superimpostition by soft tissue of shoulders and the sternum should be free of superimposition by ribs in which sternum projection?

45 degrees

The patient should be obliqued how many degrees for rib obliques?

expiration

The respirtation for a PA oblique SC joint should be done on suspended breathing at the end of ______.

costovertebral joints

The rib head and vertebral bodies articulate to form what?

thoracic vertebrae

The rib number coresponds the the __________ to which it attaches.

costotransverse joints

The rib tubercle and thoracic spine transverse processes articulate to form what?

1-7, 12

The ribs increase in length from ______, then decrease to ___.

true ribs

The ribs that attach directly to the sternum are called what?

floating ribs

The ribs that attach only to the vertebrae posteriorly are called what?

false ribs

The ribs that have no direct attachment to the sternum are called what?

transverse plane

The shoulders should be in the same________ for a PA SC joint.

T4-T5

The sternal angle is palpable and lies at the _____ interspace.

sternoclavicular joints

The sternum and clavical meet and form what joints?

6 inches (15 cm)

The sternum is _______ long.

flat bone

The sternum is classified as what type of bone?

seven pairs, lateral

The sternum provides attachment for the costal cartilages of the first ________ of ribs at the ____ borders.

manubrial angles

The sternum supports the clavicles at the __________.

thoracic spine transverse processes

The tubercles of ribs articulate with what?

descend, air-fluid levels

The upright position for ribs allows the diaphragm to ______ and demonstrates ________.

T10

The xiphoid process lies over what?

30 inches (76.2 cm)

What SID is recommended for PA oblique sternums?

72 inches (183 cm)

What SID is recommended for lateral sternum to reduce magnification and distortion caused by OID?

40 inches (102 cm)

What SID is recommended when not specified under a projection?

ribs

What anatomy of the bony thorax has 12 pairs that are numbered superiorly to inferiorly?

protects heart and lungs, supports wall of pleural cavity and diaphragm, and is made to vary the volume during respiration

What are the 3 main functions of the bony thorax?

manubrium, body, and xiphoid process

What are the 3 portions of the sternum in order (superior to inferior)

PA oblique and lateral

What are the essential projections for a sternum?

body rotation or CR angulation methods

What are the two types of methods used for PA oblique SC joints?

sternal and manubrial notch

What are two other names for the jugular notch?

sternum, ribs, and thoracic vertebrae

What bones make up the bony thorax?

sternum

What bony structure is centered on the midline of the anterior thorax?

ensiform process

What is another name for the xiphoid process?

Breathing technique

What is the best respirtation to use for a PA Oblique Sternum?

body

What is the longest portion of the sternum?

xiphoid process

What part of the sternum is the distal, smallest portion that often deviates from the midline?

suspended at end of full expiration

What respiration should be used for lower rib projections?

suspended at end of full inspiration

What respiration should be used for upper rib projections?

MSP

What should be centered to the grid on a PA/AP ribs?

RAO and LAO

What two oblique positions are used for anterior rib injuries?

RPO and LPO

What two oblique positions are used for posterior rib injuries?

PA and PA oblique

What two projections are needed for SC joints?

osteoporosis

loss of bone density

multiple myeloma

malignant neoplasm of plasma cells involving the bone marrow and causing destruction of bone.

chondrosarcoma

malignant tumor arising fro mcartilage cells

tumor

new tissue growth where cell proliferation is uncontrolled

paget disease

thick soft bone marked by bowing and fractures

metastases

transfer of a cancerous lesion from one area to another

osteopetrosis

increased density of atypically soft bone

osteomyelitis

inflammation of bone owing to a pyrogenic infection