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Ribs & Sternum
(Bontrager & Lampignano) 7th Edition
| Question | Answer |
|---|---|
| Bony Thorax Function? | Serve as an expandable enclosure for lungs Protects important organs of the respiratory system |
| The Bony thorax consist of? | Sternum (anteriorly) Thoracic vertebrae (posteriorly) 12 pairs of ribs (connects the sternum with the vertebral column) |
| The sternum consist of? | Manubrium (Jugular notch, suprasternal or manubrial notch) Body (Corpus, gladiolus) Xiphoid process |
| Palpable landmarks? | Jugular notch (@ level of T2 - T3) Sternal angle (@ level of T4 - T5) Xiphoid process (@ level of T9 - T10) |
| What are the positioning considerations when performing sternum? | Rotation of the patient 15° to 20° RAO Exposure factors: 65 to 70 kV Minimun SID: 40" |
| Why is the Patient rotated when performing sternum? | To shift the sternum to the left of the thoracic vertebrae & into the homogenous heart shadow |
| Patient with a greater AP measurement requires how much rotation for a sternum proj? | Less rotation (15°) |
| Patient with a lesser AP measurement requires how much rotation for a sternum proj? | More rotation (20°) |
| If the patient history is not provied by the physician, what the tech. must do? | Obtain a clinical history that includes: The nature of the patient's complaint Location of the rib pain or injury Wheter the injury was caused by trauma Verify if the patient is able to stand |
| What are the positioning considerations when performing ribs AD? | Above Diaphragm (AD): Take radiograph patient erect (gravity asists in lowering diaphragm) Minimun of upper 10 posterior ribs Suspend respiration & expose on inspiration Select LOW kV (65 to 70) |
| What are the positioning considerations when performing ribs BD? | Below Diaphragm (BD): • Take radiograph with patient recumbent (supine, diaphragm rises) • Suspend radiation & exposure on expiration • Select MEDIUM kV (70 to 80) |
| What are the recommended projections when performing ribs? | Select the proj that place the area of interest CLOSEST to the IR & ROTATE the spine away from area of interest |
| If a patient has a history of trauma to the left posterior ribs, what are the 2 proj routine? | AP (places the site of injury closest to the IR) & a LPO |
| If a patient has a history of trauma to the right anterior ribs, what are the 2 proj routine? | PA (places the site of injury closest to the IR) & a LAO |
| Patient with a history of rib injuries may require? | Erect PA & Lateral projection of the chest |
| When there is presence of air - fluid levels & patient cannot assume an erect position. What should the tech do? | Horizontal beam with patient in a decubitus position |
| Pathologic condition caused by blunt trauma. Associated with underlying pulmonary injury | Flail chest |
| Pathologic condition caused by blunt trauma.Associated with underliyng cardiac injury | Sternum |
| Congenital defect with anterior protrusion of the lower sternum & xiphoid process | Pectus carinatum (pigeon breast) |
| Deformity characterized by a depressed sternum | Pectus excavatum (funnel chest) |
| Destructive lesions with irregular margins | Osteomelytic |
| Proliferative bony lesions of increased density | Osteoblastic |
| Apperance of bone resulting on destructive & blastic lesions | Osteoblastic & Osteolytic "moth - eaten" |
| Infection of bone & marrow caused by bacterial infection | Osteomyelitis |
| Basic projections for sternum? | RAO & Lateral |
| Right Anterior Oblique Sternum (RAO) | Patient prone/erect in RAO & rotated 15° - 20° to the right side... Top of the film is 1 ½” above jugular notch... CR perpendicular to IR |
| Lateral Sternum | Patient is in a right or left lateral... Top of the film is 1 ½” above jugular notch... SID of 60" - 72"... Shoulders & arms drawn back |
| What is the best view to see a sternum fracture? | Lateral view |
| Basic projections for Ribs? | AP (upper & lower)... Oblique (upper & lower)... PA Chest (upright) |
| AP Upper ribs (AD) unilateral projection | Top of film is 3" above the acromion process (1 ½” above shoulders)...Inspiration... Low kVp (65-70) |
| AP Upper ribs (AD) bilateral projection | Top of film is 3" above the acromion process (1 ½” above shoulders)...Inspiration... Low kVp (65-70) |
| AP Lower ribs (BD) unilateral projection | Bottom of film @ the top of Iliac crest...Expiration...Medium kVp (75-85) |
| AP Lower ribs (BD) bilateral projection | Bottom of film @ the top of Iliac crest...Expiration...Medium kVp (75-85) |
| What is the difference between bilateral & unilateral projections on ribs? | Bilateral basic projections on ribs requires: AP (upper & lower)... AP (upper & lower) unilateral of affected side... Oblique (upper & lower)... Oblique (upper & lower) unilateral of affected side... Chest |
| Tangential view Ribs | Same as obliques except you are looking at the opposite side |
| What does LPO of tangential view demonstrate? | Tangent of the right side |
| What does RPO of tangential view demonstrate? | Tangent of the left side |
Created by:
nenejuyuya
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