How much rotation and which oblique position are required to best demonstrate the left SC joint?

1

The suprasternal, manubrial, or jugular notch all correspond to the level of:

2

The xiphoid process corresponds to the vertebral level of:

3

What is the primary term for the superior margin of the sternum?

4

At approximately what age does the xiphoid process become totally ossified?

5

Which of the following structures connects the anterior aspect of the ribs to the sternum?

6

The tubercle portion of a typical rib connects the anterior end of the rib to the sternum.

7

The only bony connection between the shoulder girdle and the bony thorax is the acromioclavicular joint.

8

The sternal angle is a palpable landmark at the level of:

9

Which pair of ribs attaches to the sternum at the level of the sternal angle?

10

In the erect adult bony thorax, the posterior portion of a typical rib is ____ higher or more superior to the anterior portion.

to 5 inches (7.5 to 13 cm)

11

Which of the following ribs is considered to be a false rib?

12

Which of the following statements is true about floating ribs?

They do not possess costocartilage.

13

The widest aspect of the thorax generally occurs at the level of:

the eighth or ninth ribs.

14

What is the joint classification and type of movement for the sternoclavicular joints?

Synovial with diarthrodial (gliding) movement

15

What is the joint classification and type of movement for the costotransverse joint?

Synovial with diarthrodial (plane) movement

16

Which aspect of the rib articulates with the thoracic vertebral body?

17

Which ribs are considered to be true ribs?

First through seventh ribs

18

The degree of rotation for the right anterior oblique (RAO) projection of the sternum is dependent on the size of the thoracic cavity.

19

The left anterior oblique (LAO) position of the sternum provides the best frontal image of the sternum with a minimal amount of distortion

20

Which of the following techniques is most effective in preventing lung markings from obscuring the sternum on an oblique projection?

Use an orthostatic (breathing) technique.

21

Why is the RAO sternum preferred to the LAO position?

The RAO projects the sternum over the shadow of the heart.

22

Which of the following statements is true about radiography of ribs located above the diaphragm?

Suspend breathing upon inspiration

23

Which of the following positions will best demonstrate the axillary portion of the left ribs?

Left posterior oblique (LPO)

24

Which of the following positions will best demonstrate the axillary portion of the right ribs?

25

A right or left marker may be taped over the area of interest to indicate the location of the trauma to the ribs.

26

A recommended practice is to decrease the SID to less than 40 inches (102 cm) for the oblique sternum projection to increase the magnification and resultant unsharpness of overlying ribs.

27

Which of the following conditions may occur with trauma to the ribs

28

What is the recommended degree of obliquity for an RAO projection of the sternum for an asthenic type of patient?

29

Which position can replace the RAO of the sternum if the patient cannot lie prone?

30

What is the recommended SID for the lateral sternum position?

60 to 72 inches (152 to 183 cm)

31

Where is the CR centered for a PA projection of the sternoclavicular joints?

Three inches (7 cm) distal to vertebra prominens (T2-3)

32

How much rotation and which oblique position are required to best demonstrate the left sternoclavicular joints?

33

Which two projections must be taken for an injury to the right anterior upper ribs?

34

Which two projections must be taken for an injury to the left posterior lower ribs?

35

Which analog kV range is recommended for an AP study of the ribs found below the diaphragm?

36

Which disease or condition may be associated with postoperative complications of open heart surgery

37

Fracture of adjacent ribs in two or more places with associated pulmonary injury is known as a(n) _____ rib fracture.

38

The radiographic appearance of the erosion of bony rib margins is a possible indication of:

39

Which of the following conditions, if severe, requires a decrease adjustment of manual exposure factors?

a.Osteoblastic metastases b.Osteomyelitis c. Flail chest d. None of the above

40

Both nuclear medicine and MRI (magnetic resonance imaging) studies can be performed to evaluate metastatic rib lesions before conventional rib radiographic examination.

41

A congenital defect characterized by anterior protrusion of the lower sternum and xiphoid process is termed:

42

Multiple myeloma is seen often in the flat bones of the bony thorax.

43

Which condition of the sternum is often termed “funnel chest?”

44

Both bony and soft tissue anatomy may be evaluated by CT for pathology involving the sternum or the sternoclavicular joints.

45

The condition, flail chest, is most commonly caused by:

46

A radiograph of an RAO sternum reveals that it is partially superimposed over the spine. What must be done to eliminate this problem during the repeat exposure?

Increase rotation of the body.

47

A radiograph of a lateral projection of the sternum reveals that the patient’s ribs are superimposed over the sternum. What needs to be done to correct this problem during the repeat exposure?

Ensure that the patient is not rotated.

48

A radiograph of an RAO projection of the sternum demonstrates excessive lung markings obscuring the sternum. A 1-second exposure time and an orthostatic (breathing) technique were used. Which of the following will produce a more diagnostic image of the sternum?

Increase the exposure time; decrease the mA.

49

A PA radiograph of the sternoclavicular (SC) joints demonstrates unequal distance from the SC joints to the midline of the spine. The left SC joint is farther from the sternum than the right. What specific positioning error is present on this radiograph?

Slight right rotation (right side toward the image receptor)

50

A young female patient from the emergency department (ED) is brought to radiology for rib examination. She is able to sit up or stand for the procedure. She indicates that the region of pain is to the right anterior-to-mid axillary region. Which rib projections should be performed to minimize the effective dose to this patient?

51

A patient enters the ED with an injury to the left anterior lower ribs. Which of the following projections should be taken to demonstrate the involved area?

52

An ambulatory patient enters the ED with a possible injury to the right upper posterior ribs. Which of the following routines should be taken to demonstrate the involved area?

53

A patient enters the ED with blunt trauma to the sternum. The patient is in great pain and cannot lie prone on the table or stand erect. Which of the following routines would be best for the sternum examination in this situation?

LPO and horizontal beam lateral projections

54

A patient enters the ED with trauma to the bony thorax. The initial radiographs reveal that there are fractured ribs and a possible pneumothorax of the left thorax. The physician orders a chest study to confirm the pneumothorax; however, the patient cannot stand. Which of the following positions would best demonstrate the pneumothorax?

55

Initial PA projections of the SC joints indicate a possible defect involving the left SC joint. The vertebral column is preventing a clear view of it. Which of the following projections will demonstrate the right SC joint without superimposition over the spine?

56

The use of 125 kV is recommended for AP and PA projections of the ribs to reduce skin dose.

57

What is the minimum number of ribs that must be demonstrated for a unilateral rib study above the diaphragm?

58

A lateral projection of the sternum requires that respiration be suspended on expiration.

59

A radiograph of an RAO projection of the ribs demonstrates the left axillary ribs are foreshortened, whereas the right side is elongated. Which of the following is the most likely reason for this radiographic outcome?

An LAO was performed rather than the RAO position

60

A patient with metastatic disease in the ribs comes to radiology following a nuclear medicine scan. The radiologist orders a right, upper posterior rib study performed. Which of the following positioning factors should be followed for this specific study?

a.Perform positions erect if the patient’s condition permits. c. Include the RPO position as part of the positioning routine. d. Both A and C are correct.

61

Which of the following positioning considerations does NOT apply for a study of the lower ribs?

Use a digital kV range between 65 and 70 kV.

How much rotation and which oblique position are required to best demonstrate the left sternoclavicular joints?

the patient is preferably laid prone with a 10 to 15-degree anterior oblique rotation this is normally achieved with a wedge sponge helping the patient maintain position.

Which of the following patient positions will best demonstrate the sternoclavicular joints?

The sternoclavicular joints are best demonstrated with the patient PA and: In a slight oblique position, affected side adjacent to the image receptor.

Which SC joint is demonstrated on a PA oblique Rao?

A PA oblique sternal projection (RAO position) with poor positioning demonstrates the right SC joint and manubrium superimposed by the thoracic vertebrae.

Which 2 positions will demonstrate the axillary portion of the left ribs?

SJC Zerbe Procedures Semester 2 Unit 3.