Question 1

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?

Accepted Answer

Increasing the rotation of the body will move the sternum away from the spine, reducing superimposition.

Question 2

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?

Accepted Answer

The answer of A patient enters the ED with an...

Question 3

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?

Accepted Answer

Increasing the exposure time while decreasing the mA will help blur the lung markings due to motion, making the sternum more visible.

Question 4

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

Accepted Answer

For a possible injury to the right upper posterior ribs, the best positioning routine would be an Erect AP and RPO. This would enable visualization of the posterior right rib area, allowing for identification of any potential fractures or injuries. The LPO view would not be preferred as it would cause overlapping of the areas of interest, while the LAO view would not provide a clear visualization of the posterior ribs. The recumbent AP view would also not be optimal as it would not show the rib detail clearly.

Question 5

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

Accepted Answer

The answer of Which of the following positioning considerations does...

Question 6

Initial PA projections of the SC joints indicate a possible bony defect involving the right 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?

Accepted Answer

The RAO projection will show the right SC joint without superimposition over the spine. This is because the RAO projection places the right SC joint closer to the image receptor and away from the vertebral column. The other options may not provide a clear view of the right SC joint. A horizontal beam lateral may still have the vertebral column overlapping with the SC joint, while the LAO and erect lateral projections will not show the right SC joint.

Question 7

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

Accepted Answer

The only bony connection between the shoulder girdle and the bony thorax is the sternoclavicular joint, not the acromioclavicular joint.

Question 8

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

Accepted Answer

For a unilateral rib study above the diaphragm, it is typically required to demonstrate ribs 1 through 9 to ensure adequate visualization of the area of interest.

Question 9

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.Which of the following positioning factors should be followed for this specific study?

Accepted Answer

For a right, upper posterior rib study, it is important to include the RPO (right posterior oblique) position as part of the positioning routine to ensure proper visualization of the affected rib. Additionally, if the patient's condition permits, positions should be taken erect to provide optimal visualization of the affected area. Exposure on full expiration is also important to minimize superimposition of the diaphragm over the affected area. Therefore, both options A and C are correct.

Question 10

The left anterior oblique (LAO) position of the sternum provides the best frontal image of the sternum with it superimposed over the heart.

Accepted Answer

The left anterior oblique (LAO) position actually projects the sternum over the spine, not over the heart. For the best frontal image of the sternum, the right anterior oblique (RAO) position is preferred because it projects the sternum away from the heart and over the lung field, providing a clearer view.

Question 11

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?

Accepted Answer

The RAO (Right Anterior Oblique) position is intended to best demonstrate the left axillary ribs by elongating them. If the left axillary ribs are foreshortened and the right side is elongated, it suggests that an LAO (Left Anterior Oblique) position was mistakenly performed instead of the intended RAO.

Question 12

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

Accepted Answer

The degree of rotation in the RAO projection of the sternum varies depending on the size of the patient's thoracic cavity, as the goal is to best profile the sternum away from the heart shadow for optimal visualization.

Question 13

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?

Accepted Answer

The answer of A young female patient from the emergency...

Question 14

The tubercle portion of a typical rib articulates with the vertebral facet/demifacet.

Accepted Answer

The tubercle of a rib articulates with the facet on the transverse process of a vertebra, not directly with the vertebral body's facet/demifacet.

Question 15

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?

Accepted Answer

A right lateral decubitus position would best demonstrate a left pneumothorax in a patient who cannot stand, as it allows air to rise and be visualized against the lateral chest wall.

Question 16

The condition flail chest is most commonly caused by:

Accepted Answer

Flail chest is most commonly caused by blunt trauma, such as from a car accident or a fall. The ribs are fractured in multiple places, causing a section of the chest wall to become detached and move independently from the rest of the chest during breathing.

Question 17

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?

Accepted Answer

The left SC joint being farther from the sternum indicates slight right rotation, meaning the right side is closer to the image receptor.

Question 18

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 positioning routines would be best for the sternum examination in this situation?

Accepted Answer

The LPO (Left Posterior Oblique) position allows for better visualization of the sternum by projecting it over the heart shadow, and the horizontal beam lateral projection can be performed with the patient in a supine or semi-recumbent position, accommodating the patient's inability to stand or lie prone.

Question 19

Which of the following landmarks can be palpated to locate the upper margin of the sternum on the obese patient?

Accepted Answer

The jugular notch is the indentation at the superior border of the sternum and can be palpated in obese patients to locate the upper margin of the sternum. The other landmarks listed are not useful for locating the upper margin of the sternum.

Question 20

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?

Accepted Answer

If the ribs are superimposed over the sternum, it indicates that the patient was rotated during the initial exposure. To correct this problem, the patient should be repositioned to ensure that they are not rotated. Increasing the SID, angling the CR, or increasing the kV will not necessarily improve the superimposition of the ribs over the sternum.

Quiz 10: Bony Thoraxsternum and Ribs