Sternum and Ribs. Ch.11

The second rib attaches to the ________ to form the second _______ joint.

sternal angle, sternocostal

How is insufficient rotation visualized for oblique sternum?

superimposition of sternum and spine

Positioning for oblique below the diaphragm ribs places the patient ____ with the CR between the ______ and ______. Exposure is taken on ______.

supine, xiphoid, lower rib cage, expiration

How is lateral side decided for images to visualize pneumothorax or pleural effusion

suspected air side up, fluid side down

costochondral joints exhibit what degree of movement

synarthrodial

sternocostal joints are classified as what movement category

synarthrodial

Why are some false ribs also called floating ribs?

they do not have and anterior attachment unlike the other false ribs which are attached to the costocartilage of rib 7

Which ribs attach to sternum by their own costocartilage

true, 1-7

Costotransverse joints are formed by...

tubercle of rib and transverse process

Interchondral joints are classified as what movement type

plane

sternoclavicular joints are what type of joint concerning movement

plane

What classification of movement are the costovertebral and costotransverse joints?

plane, gliding, diarthrodial

Obliquing the rib cage ensures the _____ will not be superimposing the rib areas of interest.

spine

What ribs are visualized in the above diaphragm ribs?

1 - 9

What degree oblique is used for SC Joint oblique and where is the CR?

15-20 deg., Level of T2-3

Posterior end of ribs are __ to ___ inches higher than anterior ends of ribs. They are widest at ribs ____ .

3-5, 8-9

Ribs visualized in below diaphragm ribs, position, IR orientation, breathing, kvp and CR

8 - 12, Recumbent AP, CW, expiration, 75-85 kvp, CR midway between xiphoid and lower rib cage (bottom of IR at iliac crest)

Position for right posterior upper rib injury?

AP, RPO

Three positions to obtain lateral of sternum

Erect, recumbent, cross-table

The ____ ribs that attach to the costocartilage of rib 7 and are ribs ___ thru ___.

False, 8 - 10, (Ribs 11 and 12 are also false ribs and "floating ribs")

Substitution for RAO of sternum if patient can't lie prone on table

LPO

Initial radiographs reveal that there are fractured ribs and a possible pleural effusion of the left thorax. The physician orders a chest study to confirm the pleural effusion, however, the patient cannot stand. Which position will best demonstrate the left pleural effusion?

Left lateral decubitus

View done to rule out pneumothorax or plueral effusion

PA chest (high kvp) or lateral decubitus

Name the position for right anterior upper rib injury.

PA, LAO

Oblique sternum position, Patient position, SID, CR and angle if any, breathing instructions and collimation

RAO (alt LPO)15-20 deg., 40 inches, Midway between jugular notch and xiphoid,breathing or expiration, collimate to sternum

The RPO for above diaphragm ribs shows which ribs?

Right axillary

Physician orders a chest study to confirm the pneumothorax on left side, patient cannot stand, which position should be used?

Right lateral decubitus

Union between the manubrium and the body of the sternum is at what verterbral level?

T4-5

Above diaphragm ribs CR and kvp, breathing instructions?

T7, 65-75 kvp, full second inspiration (helps push diaphragm down)

______ ribs attach to the sternum by their own costocartilage and are ribs __ thru ___.

True, 1-7

Anterior or posterior: sternal end of rib

anterior

The anterior oblique ribs above the diaphragm are for injuries to the ____ surface of the body. They demonstrate the side of the body _(closest to or further from)__ the IR

anterior, further from (upside)

Ribs 3 - 7 connect to the ____.

body of the sternum

RAO sternum reveals excessive lung markings, correction?

breathing technique for at least 3 seconds

chondro means

cartilage

Groove for blood vessels and nerve

costal groove

Ribs attach to the sternum by ________

costocartilage

Tubercle of a rib and the transverse process of the vertebral body articulate to form the :

costotransverse joint

Portable study of sternum. Patient cannot lie prone. What 2 projections should be performed?

cross table lateral, LPO 15-20 deg rotation

Oblique ribs for below the diaphragm show which side ribs?

downside

The anterior oblique SC joint view demonstrate which joint

downside

Criteria for lateral sternum

entire sternum, no superimposition of humerus, shoulder, ribs

For the oblique ribs above the diaphragm, the patient is in the ____ position, and the CR is at ____ midway between the ______ and the ________. The degree of rotation is ___ degrees and the exposure is taken _____.

erect, T7, spine, lateral border of side of interest, 45, on second inspiration

What is the preferred position for above the diaphragm ribs?Why is this preferred for above dia. ribs? What determines AP or PA?

erect, erect position allows gravity to help diaphragm to drop to its lowest position, area of injury (closest to IR) determine AP or PA

Most proximal end of rib

head

Costovertebral joints are formed by...

head of rib and vertebral body

If the body of the sternum is seen over the spine do you need to increase or decrease rotation?

increase

The purpose of the oblique sternum is to place the sternum ...

into the heart shadow

most superior portion of the sternum: corpus, sternal angle, manubrium, jugular notch

jugular notch

15 degree oblique for sternum in ____, 20 deg. for ____

large chest, thinner chest

CR for PA sternoclavicular joints

level of T2-3 the jugular notch which is 3 inches below vertebra prominens

The 1st rib attaches to the _______, _____ to the clavicle to form the 1st _____ joint.

manubrium, inferior, sternocostal

CR for Lateral sternum erect, recumbent or cross table, patient position,breathing

midway between jugular notch and xiphoid, arms drawn back for erect or above head for recumbent, inspiration

Criteria for PA Sternoclavicular joints

no rotation, equal distance between clavicle and sternum

What projection is done to view the axillary portion of the ribs?

oblique

In the oblique rib position, the anterior oblique shows the _____ side ribs.

opposite

Anterior or posterior: vertebral end of rib

posterior

Posterior oblique position for above diaphragm ribs are for injuries close to the _____ surface of the body. They demo the ______ of the body __(closer to or further from)__ the IR.

posterior, downside

How does positioning and breathing of below diaphragm ribs help the image obtained?

recumbent and expiration both allow diaphragm to be higher up and out of the way of the lower ribs

Costo means

rib

The LAO oblique position for above diaphragm ribs shows the ____ ribs.

right axillary

The RAO SC joint demonstrates

right side

Position for oblique ribs

rotate spine 45 deg. away from side of interest

The posterior oblique rib position demonstrates the ______ side position.

same

Which rib attaches to the sternum at the sternal angle?

second

Why is RAO used for oblique sternum?

shifts sternum to the left of spine and into homogenous heart shadow