Module 10 Boney Thorax

Question 1

ARTICULATION OF THE BONY THORAX

Answer 1

• Sternoclavicular = synovial gliding ( freely movable)( manubrium and clavicles )
• Costovertabral= synovial gliding ( between rib heads )
• Costotransverse= synovial gliding (between tubercles)
• Costochonrdal= cartilaginous synchondroses( immovable)( between ribs)
• Interchondral synovial gliding ( between costal cartilage)
• Sternocostal= sychondrosis ( between costal cartilage and sternum)

Question 2

AP PROJECTION RIBS. BELOW DIAPHRAGM

Answer 2

Done for ribs below the diaphragm and down supine

• CR perpendicular to T10 or 12
• IR placed so that the lower edge is on iliac crest
• Respiration on exhalation to elevate the diaphragm

Question 3

AP OR PA UNILATERAL IBS PROJECTION

Answer 3

• Aline part of thorax to the CR and to midline of grid
• CR perpendicular to IR for ribs above the diaphragm and respiration
  On inspiration
• CR perpendicular to IR for ribs below diaphragm with reparation at exhalation

Question 4

POSTERIOR OBLIQUE AXILLARY RIBS PROJECTIONS

Answer 4

• Erect position is preferred for ribs above the diaphragm
• Supine/ recumbent for ribs below the diaphragm
• patient 45deg towards and centred to IR
• Place hand of affected side on the head to remove scapula
• IR 4 cm above the relaxed shoulder
• CR in middle of the IR
• Res for upper ribs in full inhalation
• Res for lower ribs is on full exhalation

Question 5

AP OBLIQUE RIB PROJECTION

Answer 5

Patient 45deg away from IR

• IR4 cm above the relaxed shoulder and above the iliac crests
• CR centred to the middle of IR
• Res for Upper Ribs= inspiration
• Res for Lower Ribs= exhalation

Question 6

PA OBLIQUE STRNUM PROJECTION

Answer 6

• Palce patient in right anterior oblique with sternum centred to buckyor table
• Rotate the patient 15-20 deg
• CR perpendicular toT7
• Res shallow and exposure at exhalation
• Structures demonstrated = sternum to the left of the spine superimposed by the heart

Question 7

LATERAL STERNUM PROJECTION

Answer 7

• Patient seated or standing
• top of IR placed 4cm above the jugular notch
• Rotate patients shoulders posterior with hands locked behind back
• CR midsternum at the level of T7
• Res at suspended deep inspiration
• Dorsal decubitus can done for trauma patients

Question 8

PA STERNOCLAVICULAR JOINT PROJECTION

Answer 8

• Done in prone position with MSP in the mid line of table
• For bilateral study place pts chine on table
• For unilateral study have the patients head facing the affected side
• CR perpendicular to T2-T3
• Res suspended at the end of exhalation

Question 9

PA OBLIQUE STERNOCLAVICULAR JOINT PROJECTION

Answer 9

• Oblique the patient Pa 10-15 deg with the affected side on the IR
• CR perpendicular to T2- T3and 3-5 cm lateral to the MSP towards the upside