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

T2-3.

The xiphoid process corresponds to the vertebral level of:

T9-10.

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

Jugular notch

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

40 years old

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

Costocartilage

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

False

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

False

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

T4-5.

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

Second

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)

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

Ninth

Which of the following statements is true about floating ribs?

They do not possess costocartilage.

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

the eighth or ninth ribs.

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

Synovial with diarthrodial (gliding) movement

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

Synovial with diarthrodial (plane) movement

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

Head

Which ribs are considered to be true ribs?

First through seventh ribs

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

True

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

False

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.

Why is the RAO sternum preferred to the LAO position?

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

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

Suspend breathing upon inspiration

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

Left posterior oblique (LPO)

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

LAO

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

False

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.

False

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

Hemothorax

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

20

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

LPO

What is the recommended SID for the lateral sternum position?

60 to 72 inches (152 to 183 cm)

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

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

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

10 to 15 LAO

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

PA and LAO

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

AP and LPO

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

70 to 80 kV

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

Osteomyelitis

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

flail chest

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

Osteomyelitis.

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

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

False

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

pectus carinatum.

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

True

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

Pectus excavatum

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

True

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

blunt trauma.

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.

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.

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.

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)

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?

PA and LAO

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?

PA and RAO

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?

Erect AP and RPO

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

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?

Right lateral decubitus

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?

RAO

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

False

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

Ribs 1 through 10

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

False

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

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.

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.