Ch. 10 Bony Thorax - Sternum and Ribs Flashcards by Holly c

main function is to serve as an expandable bellows-like chamber, wherein the interior capacity expands during inspiration and contracts during expiration

bony thorax

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what does the bony thorax consists of

sternum anteriorly
thoracic vertebrae posteriorly
12 pairs of ribs connecting the sternum to the vertebral column

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a thin, narrow, flat bone with 3 divisions

sternum

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what are the 3 divisions of the sternum

manubrium
body
xiphoid process

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total length of the adult sternum

about 7” (18 cm)

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what type of bone does the sternum consists of

highly vascular cancellous tissue covered by a thin layer of compact bone

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this allows for the sternum to be a common site for marrow biopsy

vascular cancellous tissue

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under local anesthesia, a needle is inserted into the medullary cavity of the sternum to withdraw a sample of red bone marrow

marrow biopsy

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upper portion of the sternum

manubrium

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how long is the adult manubrium

2” (5cm)

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longest part of the sternum

body

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how long is the body of the sternum

4” (10cm)

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at birth, the body of the sternum is in how many separate segments

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when does the union of the segments of the body of the sternum take place

starting at puberty and complete possibly at age 25

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most inferior portion of the sternum

xiphoid process

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what is the xiphoid process composed of during infancy and youth

cartilage

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when does the xiphoid process become totally ossified

40 years

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these are the true ribs

1-7

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these are ribs that connect directly to the sternum with a short piece of carilage

true ribs

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what is the short piece of cartilage that connects the ribs to the sternum called

costocartilage

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these are the false ribs

8-12

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these have costalcartilage that joint together at the costocartilage of rib 7

false ribs - 8-10

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these are floating ribs because they do not connect to the sternum

11 and 12

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these ribs do not possess costocartilage

11 and 12

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what is the posterior end of a rib called

vertebral end

what is the anterior end of a rib called

sternal end

what does the vertebral end of a rib consists of

head and flattened neck

lateral to the neck of the rib is this which articulates with the transverse process of a vertebra and allows for attachment of a ligament

elevated tubercle

how does the body of the rib extend from the tubercle

laterally and then angles forward and downward

what is the area of forward angulation termed

angle of the rib

the part at which the shaft of the rib curves forward and downward toward the sternal end

angle of the rib

how much higher is the vertebral end of a rib compared to the sternal end

3-5" (8-13 cm) higher

the lower inside margin of each rib protects this

an artery, a vein, and a nerve

rib injuries may be associated with this

substantial hemorrhage

inside margin, which contains the blood vessels and nerves is called this

costal groove

these are the most vertical ribs

first ribs

the ribs get longer as you go down starting with the first, but starting at this rib they get shorter

7th rib down

these are the most sharply curved ribs

first ribs

the bony thorax is typically widest at the lateral margins of these ribs

8th or 9th

what are the two other names for the jugular notch

- manubrial notch - suprasternal notch

what level is the jugular notch at

T2-T3

this is where the lower end of the manubrium joins the body of the sternum

sternal angle (manubriosternal joint)

what level is the sternal angle at

intervertebral disk space between T4-T5

what level is the xiphoid process at

T9-T10

what level is the inferior costal margin at

L2-L3

each clavicle articulates medially with this at the clavicular notch

manubrium

what is the articulation between the clavicle and the manubrium called

sternoclavicular joint

this is the only bony connection between each shoulder girdle and the bony thorax

sternoclavicular joint

how many facets does the sternum contain

7 pairs located laterally along the manubrium and the body

where is the first pair of facets located in relation to the clavicular notch

just below the clavicular notch

where do the second costocartilage connect to the sternum

level of the sternal angle

these connect directly to the body of the sternum

3rd-7th rib

joint between the costocartilage and the sternal end of a rib

costochondral union/junction

what type of joints are costochondral unions classified as

synarthrodial, unique union - bound together by the periosteum of bone itself

what type of joint is the sternoclavicular joint

synovial - plane (gliding), diarthrodial

what type of joint is the sternocostal joint of the first rib

synarthrodial, cartilaginous joint

what type of joint is the sternocostal joints of 2-7 rib

synovial - plane (gliding), diarthrodial

joint between costocartilage and sternum

sternocostal joint

continuous joint between costal cartilages of the anterior 6th-9th ribs

interchondral joints

what type of joint are the interchondral joints between the 6th-9th costocartilage

synovial - plane (gliding), diarthrodial

what are the interchondral joints between the 9th and 10th cartilages classified as

fibrous - syndesmosis

what type of joints are the costotransverse joints

synovial - plane (gliding)

what type of joints are the costovertebral joints

synovial - plane (gliding)

which ribs are the costotransverse joints found on

1st-10th

instead of an AP/PA of the sternum, how do you visualize the sternum

rotate patient into a 15-20 degree RAO position

a patient with a shallow or thin chest requires how much rotation when visualizing the sternum

more rotation - 20 degrees

a patient with a deep chest requires how much rotation to visualize the sternum

less rotation - 15 degrees

what is the sternum primary made up of

spongy bone

for adult, sthenic patients, what is the kVp range for sternum

70-85

what is the breathing technique for a sternum projection

orthostatic breathing

to minimize dose to the patient, the patient's skin should be how far from the surface of the collimator

at least 15" (40 cm)

are sternoclavicular joints typically performed AP or PA

these represent the minimum number of ribs above the dome or central portion of the diaphragm on full inspiration

upper 9 posterior ribs

to visualize the ribs above the diaphragm what should the tech do

position patient erect if possible and take on inspiration

to visualize the ribs below the diaphragm what should the tech do

position the patient recumbent and take on expiration

what are the preferred projections for someone with history of trauma to the left posterior ribs

AP and an LPO

what are the preferred projections for a patient with trauma to the right anterior ribs

PA and an LAO