Chapter 11

Bony Thorax

Bony Thorax

• 1 _____________

• 12 __________ Vertebrae

• 12 pairs of _________

Bony Thorax

• Protects the ______________organs (heart)

• _____________ during breathing

Sternum

• 3 parts– _____________

• Superior portion 2” long

– _____________• Longest portion 4” long

– _____________• Smallest most distal. Cartilage as an infant and

ossifies by age 40

Sternal Landmarks

• ___________(suprasternal or manubrial)– Correlates to T2-3

• _________________– Correlates to T4-5

• Xiphoid tip– Correlates to T9-10

Sternal Articulations

• ____________

• _____________– Sternoclavicular joint

• 7 ribs – Through ______________

• 1st rib costocartilage on _______________

Ribs• Numbered by the thoracic vertebrae they attach

posteriorly• 12 pairs• ______________

– Costocartilage connection anteriorly to the sternum

• __________– 8,9,&10 costocartilage attach to the 7th

– ___________(11 &12) – No costocartilage articulation

Rib AnatomyPosterior

• Vertebral end–__________–Neck–____________

– Articulates with transverse process of vertebrae

Rib AnatomyAnterior

• Sternal end

• ____________

• Shaft

• ____________–Artery, vein, and nerve

Rib ArticulationsAnterior

• __________________Union

– Rib and costocartilage join

• Sternoclavicular – Sternum and clavicle

Rib ArticulationAnterior

• ____________ – Costocartilage to sternum.

• _______________– Costocartilage of 6th – 10th

Rib ArticulationPosterior

• ________________– Head of rib to vertebrae

• _________________– Rib tubercle to transverse process

Sternum Imaging

Routine• RAO• Lateral• 40” SID** RAO• 60-72” SID Lateral• 60 – 70 kVp

RAO Sternum

• Moves sternum away from _______ into homogenous __________

• ___________

• CR to mid sternum– Palpate for _______________– Center to mid sternum

RAO Sternum

• ________________– Blurs pulmonary markings

• Collimate about __________

Lateral Sternum

• Increase ______ to compensate for increased ___________

• If erect have pt hold arms back• CR to mid sternum

– Place cassette ___________________• Center more anterior on chest ________

sternum

Rib Imaging

Routine• PA Chest• AP above diaphragm• AP below diaphragm• RPO/LPO above diaphragm• 60 kVp for above diaphragm• 70 kVp for below diaphragm• 40-72” SID (Unilateral or Bilateral)

AP Above Diaphragm

• Center on affected side• CR longitudinal ___________• Cassette _______________center to

cassette• Suspend respiration on _____________

AP Below Diaphragm

• Center to ____________• CR mid way between ________________• Suspend respiration on ____________

– Move diaphragm up and away

RPO / LPO Above Diaphragm

• 45° Oblique• CR between spine a lateral rib margins• Cassette _____________and center to

cassette• Suspend respiration on _________• If Rt side affected ___________right ribs.

Lt side shows more _______

Helpful Tip

• Some radiologists want a marker indicating area of pain

• Ribs are a large area• Place a _____________on area of interest

to help the radiologist focus on an area.