Bony Thorax Flashcards
what is the function of the bony thorax?
to protect the organs contained within
what structures form the bony thorax?
ribs sternum thoracic vertebrae
Are the posterior ribs more superior or inferior to the anterior portion of the same rib?
superior by 3-5”
What are the routine projections of the sternum?
RAO and Lateral
What is the SID, Breathing instructions, degree of obliquity for an RAO sternum and where does this place the sternum in the radiograph?
40” SID
Use a breathing technique with a long exposure time
15-20 degree oblique
this places the sternum to the left of the T spine and into the homogenous heart shadow
What are the routine projections of the SC joints? SID? How are they performed? CR? Breathing instructions?
PA and bilateral anterior obliques
- All at 40” SID
- Obliques are done prone w/ 15 degree rotation with the affected side arm down and other arm up, CR is 3” distal to the vertebral prominens and 1-2” lateral to MSP
- expose on expiration
- Obliques demonstrate the downside
What views are required for an anterior rib injury?
PA, Anterior Oblique centered to the upside,
What views are required for a posterior rib injury?
AP and a posterior oblique centered to the down side
Why is a PA chest included in a ribs routine?
to rule out lung pathology
When is the affected side in a ribs position up? when is it down?
up=anterior
down=posterior
ABOVE THE DIAPHRAGM RIBS:
errect or supine?
breathing instructions?
kvp range?
-erect to lower the diaphragm
-full inspiration
-low kvp, 65-70
visualizes ribs 1-9
BELOW THE DIAPHRAGM RIBS:
errect or supine?
breathing instructions?
kvp range?
-supine to raise the diaphragm
-full expiration
-medium kvp 75-80
visualizes ribs 8-12
What are fractures to the first rib associated with?
Lower ribs?
Any rib fx?
- injury to the arteries and veins
- injury to the spleen, liver or kidneys
- lungs or cardiovascular structures
What is flail chest?
fx of adjacent ribs, in 2 or more places caused by blunt trauma and associated with cardiac injury
What are metastases?
Malignant neoplasms which spread to the ribs from a primary site.
How does an osteolytic metastases appear radiographically?
Osteoblastic?
Combination?
osteolytic-destructive lesion with irregular margins
osteoblastic-bony lesions of increased density
combo-moth eaten appearance
What is osteomyelitis?
an infection of a portion of the bone and marrow.
*may be associated with post op open heart surgery
What is the place where the clavicles connect to the sternum called?
facet
How are the anterior ribs attached to the sternum?
attached to each anterior rib is a piece of costocartilage which is what attaches them to the sternum.
Where does the second costocartilage connect at?
3rd-7th?
8-10?
11th-12th?
2nd-at the level of the sternal angle
3rd-7th-directly to the body of the sternum
8th-10th-costocartilage of the 7th rib
11th-12th-do not connect anteriorly
Which ribs are true ribs?
false?
floating?
true-1-7
false-8-12
floating-11-12
What does the head of the rib articulate with?
the vertebral body at the costovertebral joint
Where is the bony thorax widest at?
level of 8th or 9th ribs
What does the tubercle articulate with?
the transverse process of the vertebra at the costotransverse joint
