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Title: BONTRAGER CH10 BONY THORAX QUESTIONS AND ANSWERS(LATEST UPDATE)
Description: Three (3) Structures that make up the bony thorax - CorreCt Answers - 1.Sternum 2.Thoracic Vertebra 3.12 pairs of ribs Alternative imaging modality to be performed if repeat PA projections of the SC joints do not clearly demonstrate them - CorreCt Answers -CT Three projections required for a Pt with trauma to sternum and left SC region - CorreCt Answers -1.15°-20° RAO sternum with breathing technique 2.Lateral Sternum on inspiration 3.10°-15° LAO of SC joint on inspiration Correction to be made on an x-ray of the upper ribs if the diaphragm is superimposed over the 8th ribs, which is in the area of interest - CorreCt Answers -Have the Pt suspend respiration during inspiration enough to move the diaphragm below the 8th ribs

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BONTRAGER CH10 BONY THORAX
QUESTIONS AND ANSWERS(LATEST
UPDATE)
...
Sternum 2
...
12 pairs of ribs
Alternative imaging modality to be performed if repeat PA projections of
the SC joints do not clearly demonstrate them - CorreCt Answers -CT

Three projections required for a Pt with trauma to sternum and left SC
region - CorreCt Answers -1
...
Lateral Sternum on inspiration 3
...
LPO
2
...
Sternoclavicular 2
...
8th Interchondral

Two (2) joints that are Synarthrodial or immovable - CorreCt Answers -1
...
3rd Costochondral

Breathing instructions for projections of ribs above the diaphragm CorreCt Answers -Suspend on Inspiration

kV range for projections of ribs above the diaphragm - CorreCt Answers Low to medium - 65-70kVp

Ideal body position for projections of ribs above the diaphragm - CorreCt
Answers -Upright if possible

Minimum SID for Sternum due to radiation safety - CorreCt Answers -40
inches (minimum 15" between Pt skin and collimator)

Breathing instructions for RAO Sternum - CorreCt Answers -Breathing
Technique to maximize visibility

Two (2) most important considerations for Rib Routines - CorreCt Answers
-1
...
Rotate the spine away
from the area of interest for axillary ribs

Two (2) chest pathologic conditions that may result from a rib injury CorreCt Answers -1
...
Hemothorax

Two (2) projections to be included in a rib routine when either
pneumothorax or hemothorax is suspected - CorreCt Answers -1
...
Lateral Chest

Average degree of rotation for RAO sternum - CorreCt Answers -15°-20°

Three (3) conditions for which bony thorax nuclear medicine bone scans
are normally performed - CorreCt Answers -1
...
Osteoporosis 3
...
Artery
2
...
Nerve

The end of the rib that is most superior - CorreCt Answers -Posterior
vertebral end

The end of the rib that is most inferior - CorreCt Answers -Anterior sternal
end

Difference in height between the two ends of a rib - CorreCt Answers -3 to 5
inches

Rib that articulates with the upper lateral aspect of the manubrium of the
sternum - CorreCt Answers -First (1st) rib - anterior sternal end

What rib attaches to the sternal angle? - CorreCt Answers -Second rib

Ribs at which the bony thorax is the widest at the lateral margins - CorreCt
Answers -Eighth (8th) or Ninth (9th) ribs

Minimum number of rib pairs that must be demonstrated on an acceptable
radiograph (PA cxr) - CorreCt Answers -10 posterior ribs

Movement type of the 1st sternocostal joint - CorreCt Answers -Immovable
- synarthrodial

Movement type of the 1st sternocostal joint (between 1st rib and sternum) CorreCt Answers -Cartilagenous, synarthrodial

Movement type of the 1st through 12th costovertebral joints - CorreCt
Answers -Movable - diarthrodial (plane or gliding)

Movement type of the 1st through 10th costochondral unions (between
costocartilage and ribs) - CorreCt Answers -Immovable - synarthrodial

Movement type of the 1st througth 10th costotransverse joints (between
ribs and transverse processes of T vertebrae) - CorreCt Answers -Movable diarthrodial (plane or gliding)

Movement type of the 2nd through 7th sternocostal joints (between 2nd
and 7th ribs and sternum) - CorreCt Answers -Movable - diarthrodial
(plane or gliding)

Movement type of 6th through 10th interchondral joints (between anterior
6th through 10th costal cartilage) - CorreCt Answers -Movable diarthrodial (plane or gliding)

Classification for rib joints that have diarthrodial movement - CorreCt
Answers -Synovial

Numbered pairs of ribs that are classified as True - CorreCt Answers -1st
through 7th ribs

Numbered pairs of ribs that are classified as false - CorreCt Answers -8th
through 12th ribs

Numbered pairs of ribs that are classified as floating - CorreCt Answers 11th through 12th ribs

Characteristic that makes a rib a true rib - CorreCt Answers -It attaches to
the sterum anteriorly by its own cartilage

Characteristic that makes a rib a floating rib - CorreCt Answers -It has no
anterior attachment in the bony thorax

Name of the most posterior end of the rib - CorreCt Answers -Vertebral end

Name of the process on the rib that articulates with the vertebrae - CorreCt
Answers -Tubercle

Most lateral portion of a rib where it essentially curves the most - CorreCt
Answers -Axillary portion (angle of rib)

Medially facing surface of the rib containing arteries, veins and nerves CorreCt Answers -Costal groove

Name of the most anterior end of the rib - CorreCt Answers -Sternal end

Location (end) of the rib cotaining the neck and the head - CorreCt
Answers -Vertebral end (posterior)

What forms the costovertebral joint? - CorreCt Answers -The head of the
rib and the body of the thoracic vertebra

What forms the costotransverse joint? - CorreCt Answers -The tubercle of
the rib and the transverse process of the thoracic vertebra

Which ribs do not have costotransverse joints? - CorreCt Answers -11th and
12th

What is pectus carinatum? - CorreCt Answers -A congenital defect with an
anterior protrusion of the lower sternum
-pigeon chest / breast

What is pectus excavatum? - CorreCt Answers -A congenital defect with an
depressed sternum
- funnel chest

Reason why it is impossible to visualize the sternum with a direct PA or AP
projection - CorreCt Answers -The spine would superimpose - requires
slight rotation

Amount of obliquity (more or less) required for a frontal view of the
sternum on a hypersthenic patient - CorreCt Answers -15* (Less obliquity)

Amount of obliquitiy (more or less) required for a frontalview of the
sternum on an asthenic patient - CorreCt Answers -20* (More obliquity)

Amount of rotation to be used for the oblique position of the sternum for a
large or deep-chested patient - CorreCt Answers -15°

Ideal range for kV exposure factors as they apply to an oblique position of
the sternum - CorreCt Answers -Low - 65kVp - 70kVp

Ideal range for mA exposure factors as they apply to an oblique position of
the sternum - CorreCt Answers -Low

Best exposure time for an oblique position of the sternum - CorreCt
Answers -High - 3-4 seconds with breathing technique

Advantage of performing breathing technique for radiography of the
sternum - CorreCt Answers -Blurs lung markings and ribs, which improves
the visibility of the sternum

Reason for maintaining at least 40" SID during sternum radiography CorreCt Answers -Increase in patient dose, especially skin dose

Other imaging options available to study the sternum if routine RAO and
lateral radiographs do not provide sufficient information - CorreCt
Answers -CT or Nuclear Medicine

Ideal general body position to demonstrate an injury to the ribs found
below the diaphragm - CorreCt Answers -Recumbent

Ideal breathing instructions to demonstrate an injury to the ribs found
below the diaphragm - CorreCt Answers -Suspend on Expiration

Ideal kV range for demonstrating an injury to the ribs below the diaphragm
- CorreCt Answers -70kVp-80kVp (medium)

Type of radiographic technique required for an injury to the region of the
8th or 9th rib (above or below diaphragm) - CorreCt Answers -Above the
diaphragm

Rotation of the spine required to properly elongate and visualize the
axillary aspect of the ribs with respect to the area of interest - CorreCt
Answers -Away from the area of interest

Projections which should be performed for an injury to the anterior aspect
of the ribs - CorreCt Answers -AP or PA and Anterior or Posterior Oblique

Ideal placement of the area of interest with relation to the IR for injuries to
the anterior aspect of the ribs - CorreCt Answers -Closest to the IR

Two (2) rib projections which should be performed for an injury to the right
posterior ribs - CorreCt Answers -AP and RPO (to shift spine away from
area of interest)

Proper marking for the sites of injury when performing a rib series CorreCt Answers -Tape a small metallic "BB" over the site of injury

Projections to be performed in addition to a routine rib series if either
pneumothorax or hemothorax is suspected as a result of a rib fracture CorreCt Answers -Upright PA and Lateral Chest

Definition of a flail chest - CorreCt Answers -Pulmonary injury caused by
blunt trauma to two or more ribs

What osteolytic metastases of the ribs look like on an x-ray - CorreCt
Answers -Irregular bony margins

Criteria for the radiographic evaluation of the oblique sternum - CorreCt
Answers -Entire sternum should lie over the heart shadow and be adjacent
to the spine

Location of CR centering for a PA projection of the sternoclavicular joints CorreCt Answers -Level of T2-T3

Breathing instructions for a PA projection of the sternoclavicular joints CorreCt Answers -Suspend respiration on inspiration

Amount of rotation of the thorax recommended for an anterior oblique of
the sternoclavicular joints - CorreCt Answers -10°-15° from PA

Specific oblique position best demonstrates the left sternoclavicular joint
adjacent to the spine - CorreCt Answers -LAO

Three (3) points which must be included in a patient's clinical history
before a rib series - CorreCt Answers -1
...
Location of rib pain or injury 3
...
RPO 2
...
PA 2
...
On
PA of the SC joint, the area of interest is superimposed over the spine Name the position which would better demonstrate this region - CorreCt
Answers -10°-15° RAO will project the right SC joint adjacent to the spine

Position to be performed for ER Pt with multiple MVA injuries
...
Sternum study ordered - CorreCt Answers
-LPO and horizontal beam lateral positions

Projections to be performed for ER Pt with multiple rib Fx - MD suspects
flail chest and Pt can stand and move - CorreCt Answers -Rib series - PA
and lateral chest study

AEC chambers to be activated for sternum and rib routines - CorreCt
Answers -None - AEC not as accurate as manual exposure controls for
detail

Breathing instructions for any SC joint projections - CorreCt Answers Suspend respiration on expiration

Projections to be performed for a unilateral rib study (ER Pt with right
upper anterior rib injury) - CorreCt Answers -PA and LAO - upright if
possible

Positions to be performed for a unilateral rib study (ER Pt with left lower
posterior rib injury) - CorreCt Answers -Recumbent AP and LPO positions

Recommended positioning routine for Pt with pectus excavatum - CorreCt
Answers -RAO and Lateral sternum (possibly a chest exam as well)

Alternate imaging modality other than radiographic studies for Pt with
widespread metastases involving the bony thorax - CorreCt Answers Nuclear medicine bone scan

Number of vertebral attachments per rib - CorreCt Answers -Four (4)

Location of area of interest (pain) for either AP or PA rib projections CorreCt Answers -Area of pain against the IR

Routine that is always performed if a pulmonary injury is suspected CorreCt Answers -Chest Study


Title: BONTRAGER CH10 BONY THORAX QUESTIONS AND ANSWERS(LATEST UPDATE)
Description: Three (3) Structures that make up the bony thorax - CorreCt Answers - 1.Sternum 2.Thoracic Vertebra 3.12 pairs of ribs Alternative imaging modality to be performed if repeat PA projections of the SC joints do not clearly demonstrate them - CorreCt Answers -CT Three projections required for a Pt with trauma to sternum and left SC region - CorreCt Answers -1.15°-20° RAO sternum with breathing technique 2.Lateral Sternum on inspiration 3.10°-15° LAO of SC joint on inspiration Correction to be made on an x-ray of the upper ribs if the diaphragm is superimposed over the 8th ribs, which is in the area of interest - CorreCt Answers -Have the Pt suspend respiration during inspiration enough to move the diaphragm below the 8th ribs