QUESTIONS AND ANSWERS(LATEST
UPDATE).
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
Two (2) most diagnostic projections of a Pt in the ER on backboard from
MVA with portable study of the sternum ordered - CorreCt Answers -1.LPO
2.Horizontal beam lateral - may use 15°-20° mediolateral CR angle if Pt
cannot assume oblique position
Routine of the ribs to be performed for a Pt with trauma to the right upper
anterior ribs in the ER (Pt is able to sit up) - CorreCt Answers -Erect PA and
LAO (or RPO) position on inspiration
,Routine of the ribs to be performed for a Pt with trauma to the left lower
anterior ribs - CorreCt Answers -Recumbent PA (or AP if Pt cannot do
prone) and RAO (or LPO) on expiration
Routine for elderly Pt with advanced osteoporosis, both upper and lower
posterior rib studies ordered - CorreCt Answers -AP, RPO, LPO - All
positions upright, on inspiration (upper ribs), on expiration (lower ribs) -
Lower kV for osteoporosis
Routine for ER Pt on backboard with blunt chest trauma with suspected
flail chest - CorreCt Answers -Limited rib series will indicate which ribs are
Fx and determine flail chest - oblique positions may not be possible due to
backboard
Name of the palpable junction between the upper and midpoint of sternum
- CorreCt Answers -Sternal angle
Most distal portion of the sternum - CorreCt Answers -Xiphoid Process
Aspect of the sternum containing the jugular notch - CorreCt Answers -
Manubrium
What distinguishes a floating rib from a false rib - CorreCt Answers -
Floating rib contains no cartilage
Type of rib represented by the 5th pair - CorreCt Answers -True Rib
, Part of the sternum that articulates with the 2nd rib - CorreCt Answers -
Sternal Angle
Three (3) joints which are Diarthrodial or plane (gliding) in the bony thorax
- CorreCt Answers -1.Sternoclavicular 2.Costovertebral 3.8th Interchondral
Two (2) joints that are Synarthrodial or immovable - CorreCt Answers -1.1st
Sternocostal 2.3rd 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.Place the area of interest (injury) closest to IR 2.Rotate the spine away
from the area of interest for axillary ribs