Ribs And Sternum Flashcards
Which rib is the widest?
Rib 8/9
What are “true ribs” and which of the ribs is consider true ribs
Ribs 1-7 are considered true ribs b/c it has a direct connection to the sternum via its OWN costocartilage.
What are “false” ribs and which of the ribs is considered so?
Ribs 8-10 are considered false ribs b/c its directly connected to the sternum via the costocartilage of the 7th rib.
What Are “floating” ribs and which ones is considered false?
Ribs 11-12 are floating ribs b/c it does not have cartilage articulation.
Only have 1 connection w/t-spine at the body posteriorly.
also fits into the false rib category
Ribs 1-10 has how many articulations to the t-spine? What are those?
Has 2 connections:
- Demifacets articulate w/head of ribs (costoVERTEBRAL jt.)
- Transverse facet w/ tubercle of ribs (costoTRANSVERSE jt.)
Rib 11-12 has how many articulations with the t-spine? What are those articulations?
Only 1 articulation hence why they are considered as floating ribs:
1: only articulations is w/demifacet (costoVERTEBRAL)
Purpose of the ribs?
The ribs acts as protection for the heart, lungs and spleen.
What kind of bone is the sternum?
A thin, narrow, flat bone.
The sternum consist of how many divisions and what are they?
3 divisions:
- Manubrium (top division)
- Body ( middle division)
- Xiphoid process (inferior portion; found at T9-T10)
SID for sternum
Obliques: 40”
Lateral: 60-72”
kVp for sternum (mAs if known)
75-80 kVp @ 6-8 mAs
Describe the obliquity for a thin patient versus a thicker patient
Thin patient: more obliquity (20-25)
Thicker patient: less obliquity (15)
Breathing instructions for sternum?
Oblique: expiration (or breathing tech.)
Lateral: on inspiration ( to bring sternum anteriorly)
What is the costal groove?
Found on the body of the rib, it is a groove that houses blood vessels and nerves.
kVp for upper rib, breathing instruction, and patient position?
Upper rib:
70-75 kVp on inspiration and done ERECT per book
kVp for lower rib, breathing instruction and patient position?
Lower rib:
75-80kVp, expiration (like abdomen) and done RECUMBENT/SUPINE per book (allow diaphragm to rise and result in less abdomen)
What is the palpable landmark for sternum? There is more than 1.
- At the jugular notch (aka manubrial notch) found at T2-T3
- Sternal angle, found at T4-T5
The manubrium of the sternum articulates with what?
The manubrium articulates with the medial end of the clavicles, forming the sternoclavicular joint.
Define costocartilage
Short piece of cartilage where the ribs 1-10 articulates indirectly with the sternum.
The posterior end of the rib is also known as?
Vertebral end
The anterior end of the rib is also known as?
Sternal end
The area of forward angulation of the rib?
The “angle” portion of the rib
Distance difference b/w the vertebral end to the sternal End of the rib
The vertebral end (posterior end) of the ribs sits 3-5” higher than the sternal end( anterior end)
Facts about the 1st rib.
Most curved
Synarthrodial (immovable)
Joint type and movement of sternoclavicular joint?
Diarthrodial, synovial and gliding/plane
Joint type and movement of the 1st sternocostal joint (sternum and the costocartilage)
Diarthrodial, synovial, plane/gliding
Joint type and movement of the costochondral unions? (Rib and cartilage)
Synarthrodial, no movement
What’s the difference b/w the 1st sternocostal joint to the 2nd to 7th sternocostal joint?
The 1st one articulate between the first costocartilage and sternum, making it cartilaginous while 2-7th is synovial.
What is the obliquity of the sternum?
15-20 degrees RAO
Why do we do a RAO for the sternum?
To shift sternum to the left of the tspine and into the homogeneous heart shadow
The sternum is made up of what kind of bone?
Spongy bone.
kVp for sternum?
75-80
Rib 1 protects what?
Protects the apex of each lung
On each side of the sternum has a point. What are they called?
Insertion points (facets) for each of the sternal ends of the ribs.
What is another name for the breathing technique?
Orthostatic technique
What is another name for the body of the sternum?
Corpus gladiolus
Describe the how you would choose the position of Patient due to trauma incidents.
Choose area of interest (site of injury) closest to the IR and rotate spine away from are of interest.
How do you make the site of injury on a rib trauma?
Metallic BB on direct site of interest.
What is a flail chest?
The fracturing of adjacent ribs in 2 or more places caused by blunt trauma and is associated with underlying pulmonary injury. This type of injury can lead to instability of the chest wall
Pectus carinatum?
Aka pigeon chest. An anterior protrusion of the lower sternum
Pectus excavatum?
Aka funnel chest. It is a depressed sternum.
CR of sternum?
1 inch To the left of midline and halfway between the jugular notch and xyphoid tip
CR of lateral sternum and SID for lateral
Center of sternum, which is half way between jugular notch and xyphoid tip and SID changed to 60-72”
CR for upper rib
3-4” below jugular notch ( roughly at T7) and make sure there is roughly 1 and half inches of light above shoulders
CR for lower rib
Center to level of xiphoid tip and make sure lower margin of IR is at iliac crest
