Podcast
Questions and Answers
What part of the sternum is the upper portion called?
What part of the sternum is the upper portion called?
- Manubrium (correct)
- Body
- Costocartilage
- Xiphoid process
Which type of ribs connect directly to the sternum via costocartilage?
Which type of ribs connect directly to the sternum via costocartilage?
- True ribs (correct)
- False ribs
- Floating ribs
- Inferior ribs
What is the level of the xiphoid process?
What is the level of the xiphoid process?
- T2-T3
- T9-T10 (correct)
- T4-T5
- L2-L3
At what level does the sternal angle occur?
At what level does the sternal angle occur?
How many facets on the sternum accept costocartilage for rib attachments?
How many facets on the sternum accept costocartilage for rib attachments?
What is the recommended KVp for imaging the lateral sternum?
What is the recommended KVp for imaging the lateral sternum?
Which ribs are categorized as floating ribs?
Which ribs are categorized as floating ribs?
In the RAO position for sternum imaging, where should the central ray be directed?
In the RAO position for sternum imaging, where should the central ray be directed?
What is the recommended SID for performing an AP rib examination?
What is the recommended SID for performing an AP rib examination?
Which position best demonstrates the sternoclavicular joint on the downside?
Which position best demonstrates the sternoclavicular joint on the downside?
When performing an AP rib study for ribs above the diaphragm, what is the recommended respiration phase?
When performing an AP rib study for ribs above the diaphragm, what is the recommended respiration phase?
At what level should the CR be positioned for an LAO or RAO view of the SC joints?
At what level should the CR be positioned for an LAO or RAO view of the SC joints?
Which anatomy is best demonstrated with a PA bilateral anterior ribs examination?
Which anatomy is best demonstrated with a PA bilateral anterior ribs examination?
In posterior oblique positions for rib examinations, which side is placed toward the IR for posterior-lateral injuries?
In posterior oblique positions for rib examinations, which side is placed toward the IR for posterior-lateral injuries?
What is the correct CR positioning for a rib exam focused below the diaphragm?
What is the correct CR positioning for a rib exam focused below the diaphragm?
What is the appropriate IR size for performing a rib examination?
What is the appropriate IR size for performing a rib examination?
Flashcards
Bony Thorax Structure
Bony Thorax Structure
The bony thorax is composed of the sternum, thoracic vertebrae, and 12 pairs of ribs, connecting the sternum to the vertebral column.
Sternum Parts
Sternum Parts
The sternum has three parts: manubrium (upper), body (middle), and xiphoid process (lower).
Rib Types
Rib Types
Ribs are categorized into true ribs (1-7), false ribs (8-10), and floating ribs (11-12) based on their connection to the sternum.
True Ribs Attachment
True Ribs Attachment
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False Ribs Attachment
False Ribs Attachment
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Floating Ribs Connection
Floating Ribs Connection
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Jugular Notch Location
Jugular Notch Location
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Sternal Angle Location
Sternal Angle Location
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Xiphoid Process Location
Xiphoid Process Location
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Costal angle location
Costal angle location
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Sternal Rib Articulations
Sternal Rib Articulations
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First Rib Location
First Rib Location
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Second Rib Location
Second Rib Location
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PA Sternum Radiographic Technique
PA Sternum Radiographic Technique
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PA Sternoclavicular Joints Radiographic Technique
PA Sternoclavicular Joints Radiographic Technique
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SC joint position
SC joint position
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Ribs 1-9 position
Ribs 1-9 position
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Ribs 10-12 position
Ribs 10-12 position
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CR for ribs (AP)
CR for ribs (AP)
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CR for Ribs (PA)
CR for Ribs (PA)
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Posterior Oblique Ribs (CR)
Posterior Oblique Ribs (CR)
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Anterior Oblique Ribs (CR)
Anterior Oblique Ribs (CR)
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CR position for SC joint
CR position for SC joint
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Study Notes
Bony Thorax
- Consists of the sternum (anterior) and thoracic vertebrae (posterior)
- 12 pairs of ribs connect the sternum to the vertebral column
Sternum
- Flat bone, divided into three parts:
- Manubrium (upper portion)
- Body (middle portion)
- Xiphoid process (inferior portion)
- Approximately 7 inches long in adults
Ribs
- Numbered based on the thoracic vertebra they attach to (top-down)
- True ribs (1-7): connect directly to the sternum via costal cartilage
- False ribs (8-10): connect indirectly to the sternum via the costal cartilage of rib 7
- Floating ribs (11-12): have no connection to the sternum, lacking costal cartilage
Palpable Landmarks
- Jugular notch (level of T2-T3 vertebrae)
- Sternal angle (manubriosternal joint, level of intervertebral disk between T4 and T5)
- Xiphoid process (inferior tip of sternum, located at T9-T10)
- Inferior rib (costal) angle (aka inferior costal margin, L2-L3)
- Locating lower ribs and abdomen
- First 7 pairs of ribs (true ribs) connect to the sternum through costocartilage
- Sternum has 7 facets to accommodate the cartilage for each rib attachment
Sternum (RAO Position)
- Technique factors: SID 40 inches, IR size 10 x 12 inches, portrait, Grid, KVp: 70-85
- CR: Perpendicular to the IR, centered to the sternum, midway between the jugular notch and xiphoid process.
- Superimposition: Sternum superimposed on the heart shadow, not superimposed by vertebrae
Sternum (Lateral Position)
- Technique factors: SID 40 inches, IR size 10 x 12 inches, portrait, Grid, KVp: 75-85
- CR: Perpendicular to the IR, centered on the sternum midway between jugular notch and xiphoid process.
- Respiration: suspend respiration on inspiration
- Superimposition: Entire sternum, no superimposition of ribs
Sternoclavicular Joints (PA)
- Technique factors: SID 40 inches, 8 x 10 inches, landscape, Grid, KVp: 75-85
- CR: Perpendicular
- Plane: Midsagittal plane at level of T2-T3, or 3 inches distal to vertebra prominens (C7).
- Respiration: suspend on expiration
- Anatomy Demonstrated: Bilateral left and right SC joints, lateral aspect of manubrium and medial portions of clavicles, seen through superimposing ribs and lungs.
Anterior Obliques (LAO/RAO) SC Joints
- Technique factors: SID 40 inches, IR size 8 x 10 inches, landscape, Grid, KVp 75-85
- CR: Perpendicular to T2-T3, or 3 inches distal to vertebra prominens.
- Plane: 1–2 inches lateral to midsagittal plane
- Respiration: suspend on expiration
- Anatomy demonstrated: Manibrium, medial portion of clavicles, sternoclavicular joint best demonstrated on the downside, downside SC joint with no superimposition of vertebral column/manibrium.
Ribs (AP Bilateral Posterior)
- Technique factors: SID 40 inches; 72 inches can be used to minimize magnification, IR size is 14 x 17 inches, landscape, Grid, KVp: 75-85
- CR: Perpendicular to IR; Mid-sagittal plane at level 3/4 inches below the jugular notch.
- Respiration: suspend on deep inspiration for above diaphragm, full expiration for below.
- Anatomy demonstrated: above, Ribs 1-9. Below, Ribs 10-12
Ribs (PA Bilateral Anterior)
- Technique factors: SID 40 inches; 72 inches can be used to minimize magnification, IR size 14 x 17 inches, landscape, Grid, KVp: 75-85
- CR: Perpendicular to IR; Mid-sagittal plane at level of T7.
- Respiration: Inspiration
- Anatomy demonstrated: Ribs 1–9 above diaphragm.
###Posterior Oblique (RPO, LPO) Ribs
- This section does not contain a consistent method for determining CR and technique.
- Specific factors are given, but with no mention of specific methods for determining best results.
Posterior-lateral/Anterior-Lateral Injuries
- Technique factors: SID 40 inches; 72 inch can be used to minimize magnification, IR size 14 x 17 inches, landscape, Grid, KVp 75-85
- CR: Perpendicular to IR
- Above diaphragm: Level 3/4 inches below jugular notch (T7) for posterior oblique, or 7-8 inches below vertebra prominens (T7) for anterior oblique.
- Below diaphragm: Midway between xiphoid process and lower rib margin.
- Respiration: Inspiration (above), exhalation (below).
- Anatomy demonstrated: Above Ribs 1-9, below Ribs 10-12. Axillary ribs in profile.
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