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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 Anatomy Posterior • Vertebral end – __________ – Neck – ____________ – Articulates with transverse process of vertebrae Rib Anatomy Anterior • Sternal end • ____________ • Shaft • ____________ – Artery, vein, and nerve Rib Articulations Anterior • __________________Union – Rib and costocartilage join • Sternoclavicular – Sternum and clavicle Rib Articulation Anterior • ____________ – Costocartilage to sternum. • _______________ – Costocartilage of 6th – 10th Rib Articulation Posterior • ________________ – 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.
