Bony Thorax - AC Joints, SC Joints, Ribs

Question 1

Bony Thorax

The bony thorax supports the ____ of the _____ cavity and ____ used in ____.

The job of the thorax is to _____ the ____ and ____.

The bony thorax is formed by the _____, ______, and _____.

The bony thorax is ____ in shape.

Answer 1

Bony Thorax

The bony thorax supports the WALLS of the PLEURAL cavity and DIAPHRAGM used in RESPIRATION.

The job of the thorax is to PROTECT the HEART and LUNGS.

The bony thorax is formed by the STERNUM, 12 PAIRS OF RIBS, and 12 THORACIC VERTEBRAE.

The bony thorax is CONICAL in shape.

Question 2

Identify

Answer 2

Question 3

Identify

Answer 3

Question 4

Acromioclavicular Joint

The acromioclavicular (AC) joint is created by the articulation between the _____ of the _____ and the ______ extremity of the _____ forming a _______ that permits both _____ and ____

Answer 4

Acromioclavicular Joint

The acromioclavicular (AC) joint is created by the articulation between the ACROMION PROCESS of the SCAPULAR and the ACROMIAL extremity of the CLAVICLE forming a SYNOVIAL GLIDING JOINT that permits both GLIDING and ROTARY

Question 5

Acromioclavicular Joints

Routine Projections =

SID =

KVP =

Answer 5

Acromioclavicular Joints

Routine Projections = AP WITHOUT WEIGHTS AND AP WITH WEIGHTS

SID = 72”

KVP = 80 GRID

Question 6

Acromioclavicular Joints

Why is a 72” SID used for AC joints?

Answer 6

1. Reduces magnification, enabling both joints to be included on one image
2. Reduces distortion of joint space

Question 7

AC Joint Without Weights

Position patient ____ at vertical grid for ___ projection. These projections are taken upright because _____ of the AC joint tends to _____ itself in the _____ position.

Have patient’s arm hanging unsupportive by the ___ of body.

Direct CR to _____ of body at the level of the _____ so that the CR will be just above the ___.

Center __ to __.

Cone to ____ and use markers to show ___.

This projection should demonstrate _____ AC joints.

Answer 7

AC Joint Without Weights

Position patient UPRIGHT at vertical grid for AP projection. These projections are taken upright because DISLOCATION of the AC joint tends to REDUCE itself in the RECUMBENT position.

Have patient’s arm hanging unsupportive by the SIDE of body.

Direct CR to MIDLINE of body at the level of the AC JOINT so that the CR will be just above the JUGULAR NOTCH.

Center IR to CR.

Cone to AC JOINTS and use markers to show LATERALITY.

This projection should demonstrate BILATERAL AC joints.

Question 8

AC Joint With Weights

Keep patient in ___ position as AP without weights and have patient hold _____ weights (usually __-__ lbs) in each hand.

______ images of the AC joints are demonstrated to show _____, _____, or ____ of joints.

All images should be marked ___ or ___, and ___ or ___ weights.

Answer 8

AC Joint With Weights

Keep patient in SAME position as AP without weights and have patient hold EQUAL weights (usually 5-10 lbs) in each hand.

BILATERAL images of the AC joints are demonstrated to show DISLOCATION, DYSFUNCTION, or SEPARATION of joints.

All images should be marked RIGHT or LEFT, and WITH or WITHOUT weights.

Question 9

Identify

Answer 9

Question 10

Identify

Answer 10

Question 11

Sternum

The sternum, or ___, is directed ____ and ____ and is centered over the midline of the anterior ____.

A ____, ____ bone about __ inches in length and ___, ___, and ___ make up the sternum.

The sternum supports the clavicles at the _____ angles and provides attachment to the _____ of the _____ of ribs at the ___ borders.

The manubrium slants ____ and ____ on each side of the jugular notch and an oval articular facet called the _____ articulates with the ___ extremity of the clavicle.

The ___ is the longest part of the sternum and is joined to the manubrium at the ____.

Both the manubrium and body contribute to the attachment of the ____. The succeeding ___ pairs of _____ are attached to the _____ of the body.

The ____ is the distal and smallest part of the sternum.

It lies over the ___ ____ vertebra and serves as a useful bony landmark for locating the superior portion of the ____ and inferior border of the ___.

Answer 11

Sternum

The sternum, or BREASTBONE, is directed ANTERIORLY and INFERIORLY and is centered over the midline of the anterior THORAX.

A NARROW, FLAT bone about 6 inches in length and MANIBRIUM, BODY, and XIPHOID PROCESS make up the sternum.

The sternum supports the clavicles at the SUPERIOR MANUBRIUM angles and provides attachment to the COSTAL CARTILAGES of the FIRST SEVEN PAIRS of ribs at the LATERAL borders.

The manubrium slants LATERALLY and POSTERIORLY on each side of the jugular notch and an oval articular facet called the CLAVICULAR NOTCH articulates with the STERNAL extremity of the clavicle.

The BODY is the longest part of the sternum and is joined to the manubrium at the STERNAL ANGLE.

Both the manubrium and body contribute to the attachment of the SECOND COSTAL CARTILAGE. The succeeding FIVE pairs of COSTAL CARTILAGES are attached to the LATERAL BORDERS of the body.

The XIPHOID PROCESS is the distal and smallest part of the sternum.

It lies over the TENTH THORACIS vertebra and serves as a useful bony landmark for locating the superior portion of the LIVER and inferior border of the HEART.

Question 12

Sternoclavicular Joints

Routine Projections =

SID =

KVP =

Answer 12

Sternoclavicular Joints

Routine Projections = PA, PA obliques

SID = 40”

KVP = 80 grid

Question 13

Sternoclavicular Joints

The sternoclavicular (SC) joints are formed by the articulation of the ____ extremity of the ___ with the ____ of the sternum creating a _________.

Answer 13

The sternoclavicular (SC) joints are formed by the articulation of the STERNAL extremity of the CLAVICLE with the MANUBRIUM of the sternum creating SYNOVIAL DOUBLE GLIDING JOINT.

Question 14

Sternoclavicular Joints PA Projection

Place the patient in the ___ or ___ position with ____ resting on table or bucky.

Place the arms along the sides of the body with the palms facing ___.

Direct the CR ____ to exit the ____, which is at the level of ____.

Center ___ to ___.

Collimate to ___ and use markers.

____ respiration at the ____ of _____ to obtain a more _____.

This extremity demonstrates both _____ and the ____ portions of the ____.

Answer 14

Sternoclavicular Joints PA Projection

Place the patient in the PRONE or UPRIGHT position with CHIN resting on table or bucky.

Place the arms along the sides of the body with the palms facing UPWARDS.

Direct the CR PERPENDICULAR to exit the JUGULAR NOTCH, which is at the level of T3.

Center IR to CR.

Collimate to JOINTS and use markers.

SUSPEND respiration at the END of EXHALATION to obtain a more UNIFORM DENSITY.

This extremity demonstrates both SC JOINTS and the MEDIAL portions of the CLAVICLES.

Question 15

Sternoclavicular Joints PA Obliques (RAO and LAO)

Oblique the patient enough from the ___ position to project the ___ well behind the SC joint closest to the IR, usually about __-__°.

Direct the CR to __ the __.

Center the __ to the __.

___ respiration at the end of ____.

These oblique projections demonstrate a slightly ___ image of the SC joint that is closest to the IR and an ___ joint space.

Side down is side ___.

Answer 15

Sternoclavicular Joints PA Obliques (RAO and LAO)

Oblique the patient enough from the PRONE position to project the VERTEBRAE well behind the SC joint closest to the IR, usually about 10-15°.

Direct the CR to EXIT the JUGULAR NOTCH.

Center the IR to the CR.

SUSPEND respiration at the end of EXHALATION.

These oblique projections demonstrate a slightly OBLIQUE image of the SC joint that is closest to the IR and an OPENED joint space.

Side down is side DEMONSTRATED.

Question 17

Identify

Answer 17

Question 18

Ribs

The __ pairs of ribs are numbered consecutively from ___ to ___.

Each rib is a ___, ___, ___ bone with an anteriorly attached piece of __ cartilage called the ______.

The ___ cartilages of the first through seventh ribs attach directly to the ___.

The ___ cartilages of the eighth through tenth ribs attach to the ___ cartilages of the ___ rib.

The ribs are situated in an ___ plane slanting ___ and ___ so that their anterior ends lie __ to __ inches below the level of their vertebral ends.

The first __ ribs are called ___ ribs because they attach directly to the ___.

Ribs __ to __ are called ___ ribs because they do not attach directly to the ___.

The last two ribs (___ and ___) are often called ___ ribs because they are attached only to the ___.

The spaces between the ribs are referred to as _____.

Answer 18

Ribs

The 12 pairs of ribs are numbered consecutively from SUPERIORLY to INFERIORLY.

Each rib is a LONG, NARROW, LONG bone with an anteriorly attached piece of HYALINE cartilage called the COSTAL CARTILAGE.

The COSTAL cartilages of the first through seventh ribs attach directly to the STERNUM.

The COSTAL cartilages of the eighth through tenth ribs attach to the COSTAL cartilages of the SEVENTH rib.

The ribs are situated in an OBLIQUE plane slanting ANTERIORLY and INFERIORLY so that their anterior ends lie 3 to 5 inches below the level of their vertebral ends.

The first 7 ribs are called TRUE ribs because they attach directly to the STERNUM.

Ribs 8 to 12 are called FALSE ribs because they do not attach directly to the STERNUM.

The last two ribs (ELEVENTH and TWELFTH) are often called FLOATING ribs because they are attached only to the VERTEBRAE.

The spaces between the ribs are referred to as INTERCOSTAL SPACES.

Question 19

Ribs​

Routine Projections =

SID =

KVP =

Answer 19

Ribs​

Routine Projections = AP, AP Obliques

SID = 40”

KVP = 70-UPPER RIBS 80- LOWER RIBS

Question 20

Ribs

Ribs 1-10

Above ___ ribs

• have patient ___ respiration at the end of full inspiration to ___ the diaphragm

Ribs 8-12

Below ___ ribs

• have patient ___ respiration at the end of full inspiration to ___ the diaphragm

Answer 20

Ribs

Ribs 1-10

Above DIAPHRAGM ribs

• have patient SUSPEND respiration at the end of full inspiration to DEPRESS the diaphragm

Ribs 8-12

Below DIAPHRAGM ribs

• have patient SUSPEND respiration at the end of full inspiration to ELEVATE the diaphragm

Question 21

Ribs AP Projection

The patient is positioned either ___ or ___ for an AP projection. The ___ position allows the ___ to move to its ___ position while the ___ position allows the __ to move to its ___ position.

For the above diaphragm ribs, position upper edge of IR ___ inches above the ____.

For the below diaphragm ribs, position lower edge of IR at the level of the ____.

Direct the CR to the midpoint of IR. Midway between the ____ plane and the ____ surface of the body.

This position should demonstrate all __ ribs and include the __.

Answer 21

Ribs AP Projection

The patient is positioned either STANDING UPRIGHT or RECUMBENT for an AP projection. The UPRIGHT position allows the DIAPHRAGM to move to its LOWEST position while the RECUMBENT position allows the DIAPHRAGM to move to its HIGHEST position.

For the above diaphragm ribs, position upper edge of IR 1.5 inches above the SHOULDERS.

For the below diaphragm ribs, position lower edge of IR at the level of the ILIAC CREST.

Direct the CR to the midpoint of IR. Midway between the MIDSAGITTAL plane and the LATERAL surface of the body.

This position should demonstrate all 12 ribs and include the SPINE.

Question 22

Ribs AP Obliques

Position the patient’s body for two __° AP oblique projections using the ____ oblique (___ and ___) positions. The oblique positions must include the area of interest and ___ need to demonstrate all 12 ribs.

___ the arm of the affected side to prevent ___ and to draw the ___ laterally.

Direct the CR to area of interest, at a point midway between the ____ plane and ___ surface of the body and line up __ with __.

This position demonstrates the ___ portion of the ribs projected free of ___. The ___ must be included on both oblique projections.

Answer 22

Ribs AP Obliques

Position the patient’s body for two 45° AP oblique projections using the POSTERIOR oblique (RPO and LPO) positions. The oblique positions must include the area of interest and DO NOT need to demonstrate all 12 ribs.

ABDUCT the arm of the affected side to prevent SUPERIMPOSITION and to draw the SCAPULA laterally.

Direct the CR to area of interest, at a point midway between the MIDSAGITTAL plane and LATERAL surface of the body and line up IR with CR.

This position demonstrates the AXILLARY portion of the ribs projected free of SUPERIMPOSITION. The SPINE must be included on both oblique projections.