Bony Thorax- Sternum and Ribs

costotransverse joints are only found on ribs

1-10

how many degrees do you rotate for the anterior oblique of the SC joint

10 to 15 degrees

IR size for sternum

10 x 12

IR size for AP/PA ribs

14 x 17 crosswise

Sternum rotation for the RAO of a large barrel chested patient

15 degrees

Sternum rotation for the RAO of a thin chested thorax

20 degrees

The union of the 4 segments of the body of the sternum begins during puberty and may not be complete until about ______ years of age

25

The posterior or vertebral end of a rib is __________than the anterior or sternal end

3 to 5 inches higher

SID for sternum

40

length of the adult sternum

7 inches

Below the diaphragm standards for ribs

8 and below taken supine suspend on expiration medium kv

IR size for SC joint

8 x 10

Ribs routine projections

AP/PA bilateral or unilateral, oblique (axillary ribs) , and PA chest

The inferior rib (costal) angle also called the inferior costal margin corresponds to the level of

L2-L3

Malignant neoplasms spread to distant sites via blood and lymphatics. The ribs are a common site

Metastases

A localized or generalized infection of bone and marrow that can be associated with post operative complications of open heart surgery, which requires the sternum to be split. The most common cause is bacterial infection

Osteomyelitis

Sternoclavicular Joints routine projections

PA and oblique

Characterized by anterior protrusion of the lower sternum and xiphoid process. It is usually a benign condition but could lead to cardiopulmonary complications rarely

Pectus carinatum (pigeon breast)

Which projection best shows the sternum

RAO (right anterior oblique) (right front side touching IR)

Sternum routine projection

RAO and lateral

Joint type of sternoclavicular joints (between sternum and clavicles)

Synovial, diarthrodial, plane or gliding

The xiphoid process corresponds to the level of

T9- T10

What makes ribs 8, 9, and 10 unique?

They connect to the costocartilage of the 7th rib

Above the diaphragm standards for ribs

Upper nine taken erect suspend on inspiration lower kv

name the type of metastases that can be visualized with by a moth eaten appearance of bne resulting from the mix of destructive and blastic lesions

a combination of osteolytic and osteoblastic

The xiphoid process is made of carilage during infancy and youth and is not totally ossified until

age 40

Joint type first sternocostal joint (between first rib and sternum)

cartilaginous (synchondrosis), synarthrodial (immovable)

the ______ and the ________ of the first seven pairs of ribs connect directly to the sternum

clavicles cartilages

an oval articular facet on each side of the jugular notch where the clavicle articulates

clavicular notches

The anterior ribs unite with the sternum with the

costocartilage

where the tubercle of a rib and transverse process of the lower vertebrae articulate

costotransverse joint

Where the head of a rib articulates with two adjacent vertebral bodies

costovertebral joint

An anterior oblique of the SC joint (RAO or LAO) best demonstrates the joint on the

downside

No rotation of SC joints is shown by

equal distance of SC joints from vertebral column on both sides

Below each clavicular notch and SC (sternoclavicular joint) is a _______ for articulation with the carilage of the first rib

facet

ribs 8 through 12 are considered

false ribs

fractures of the ______ are often associated with injury to the underlying arteries or veins

first rib

The _______ are short and broad and are the most vertical of all the ribs

first ribs

This fracture of adjacent ribs in two or more places is caused by blunt trauma and is associated with underlying pulmonary injury can lead to instability of the chest wall

flail chest

Ribs 11 and 12 are called __________ because they do not possess costocartilage

floating ribs

The body of the rib extends laterally from the tubercle and then angles

forward and downward

Typically associated by blunt trauma and associated with underlying cardiac injury

fractures of the sternum

The vertebral end consists of the _____ which articulates with one or two thoracic vertebral bodies and a flattened _____

head neck

The uppermost border of the manubrium is called the _____, ________, ________ and corresponds to the level of

jugular notch, suprasternal, or manubrial notch T2-T3

SC joint radiograph should show

lateral manubrium, medial portion of clavicles

An LAo of the sc joint best demonstrates the

left sc joint

where do you center for a PA sc joint

level T2-T3 3 inches below the vertebra prominens

Where do you center for the anterior oblique of the SC joint

level of T2-T3 and 1 to 2 inches lateral towards upside

fractures to the _____ are associated with injurty to adjacent organst such as the spleen, liver, or kidney

lower ribs

the upper portion of the sternum, it is 2 inches long

manubrium

With osteoporosis in older patients the technique

must be decreased

breating technique for sternum

orthostatic technique (patient takes shallow breaths, usually don't tell them)

name the type of metastases that can be visualized with proleferative bony lesions of increased density

osteoblastic

name the type of metastases that can be visualized with destructive lesions with irregular margins

osteolytic

If the sternum appears into the auxillary on the RAO it is

over rotated

characterised by a depressed sternum, this condition rarely interferes with respiration but often is corrected surgically for cosmetic reasons

pectus excavatum (funnel chest)

An RAO of the SC joint best demonstrates the

right sc joint

Ribs have no rotation when

spinous process can be see in the middle of vertebrae

The second costocartilage connects to the sternum at the

sternal angle

Where the clavicular notch of the clavicle articulates with the manurium laterally

sternoclavicular joint (the only bony connection between each shoulder girdle and the bony thorax)

a thin narrow flat bone with three divisions

sternum

breathing technique for SC joint

suspend on expiration

Joint type of the first through tenth costochondral unions between cosotcartilage and ribs

synarthrodial, immovable

Joint type first to tenth costotransverse joints (between ribs and transverse processes of thoracic vertebrae)

synovial, diarthrodial, plane or gliding

Joint type first to twelth costovertebral joints (between heads of ribs and thoracic vertebrae)

synovial, diarthrodial, plane or gliding

Joint type second to seventh sternocostal joints (between second and seventh ribs and sternum)

synovial, diarthrodial, plane or gliding

Joint type sixth to ninth interchondral joints (between anterior sixth and ninth costal cartilages)

synovial, diarthrodial, plane or gliding

what is the most commonly fractured part of a rib

the auxillary

the longest part of the sternum, it is 4 inches long

the body

protects important organs of the respiratory system and vital structres within the mediastinum, such as the heart and great vessels

the bony thorax

The inside margin of each rib contains an artery, a vein and a nerve and is called _______-

the costal groove

Where the lower end of the manubrium joints the body of the sternum is called the _____________ and corresponds to the level of

the sternal angle or manubriosternal joint T4-T5

common site for marrow biopsy

the sternum

The bony thorax consists of

the sternum, 12 thoracic vertebrae, and 12 pairs of ribs

the ______________ connect directly to the body of the sternum

third through the seventh costocartilages

Any rib fracture may cause injury to the lung or cardiocascular structures

true

The first seven pairs of ribs are

true ribs

lateral to the neck of a rib is an elevated_______ that articulates with the ___________of a vertebra and allows for attachment of a ligament

tubercle transverse process

If the sternum appears close to the spine on the RAO or in the spine it is

under rotated

Which ribs would be displayed on a proper radiograph of ribs, upper and lower

upper ribs 1-9 lower ribs 8-12

How do you position the arms for an anterior oblique of the SC joint

upside arm in front of patient and downside arm behind the patient

Each rib has a _____ and a ______end, between the two ends is the ________

vertebral sternal shaft

The bony thorax is typically ______ at the lateral margins of the ____________

widest 8th or 9th ribs

The most inferior portion of the sternum is the

xiphoid process