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Chap 10 Bony Thorax

Procedures 2.

Bony thorax consists of what sternum, thoracic vertebrae, 12 pairs of ribs
Bony thorax does what protects important organs of respiratory system and vital structures in mediastinum
Total length of adult sternum? 7 inches
The body of the sternum has how many segments? When do these begin to fuse and when are they complete? 4 segments, begin union during puberty and may not finish until age 25
what part of sternum is composed of cartilage during infancy? xiphoid
what part of sternum does not become totally ossified until age 40? xiphoid
manubrial notch level? aka jugular notch, T2-T3
Lower end of manubrium joins the body to form a palpable prominence termed sternal angle or manubriosternal joint
sternal angle is at what level T4-5
Inferior rib angle (costal margin) is at level L2-L3
Only bony connection between each shoulder girdle an the bony thorax? sternoclavicular joint
Anterior ribs connect to the sternum with costocartilage
the second costocartilage connects to the sternum at the level of the sternal angle
third through 7th costocartilages connect directly to the body of the sternum
ribs 8-10 connect to the costocartilage 7
each rib has a posterior or ______ end, and an anterior or _______ end. vertebral, sternal
the ______ end consists of a head, which articulates with one or two vertebral bodies, and a neck. vertebral
tubercle of a rib articulates with what? transverse process of a vertebra
The body of a rib extends _____ from the tubercle and then angles forward and ______. The area of forward angulation is termed what laterally, downward. angle of the rib
The posterior or vertebral end of a rib is how many inches higher than the anterior end? 3-5
The lower inside margin of each rib that contains the blood vessels and nerves is called costal groove
The first ribs the most... vertical and sharply curved
from the 7th ribs down, they get shorter
Bony thorax is widest at what point 8th or 9th ribs
Joint between the costocartilage and the stern end is called? Movement? costochondral union or junction. No motion- synarthrodial
sternoclavicular joint type and movement? synovial, gliding motion, diarthrodial
joint between first rib and sternum called what? movement and type? sternocostal joint. no motion, cartilaginous, synchondrosis
sternocostal joint type and movement of 2nd-7th? synovial, plane/gliding, diarthrodial
Joints between costal cartilages of the anterior 6th-9th ribs are called what? type and movement? interchondral. Synovial, plane/gliding, diarthrodial
joints of 1-10 ribs and transverse processes of vertebrae are called? type and movement? costotransverse. plane, diarthrodial.
1st-12th joint between heads of ribs and vertebrae called? type and movement? costovertebral. Plane, diarthrodial.
SUMMARY OF JOINTS: all joints are synovial, diarthrodial, gliding EXCEPT what 2 1-10 costochondral are synarthrodial. First sternocostal joint is cartilaginous, synarthrodial.
Sternum position: shallow or thin chest requires _____ rotation. About how many degrees more or less? more. about 20 degrees more. (larger chest is about 15 degrees less)
To minimize dose, skin should be at least how many inches below the collimator? 38inches
AP above diaphragm for ribs, how many ribs should be seen? below diaphragm? 1-10, 9-12.
kV for above ribs? Below? 65-75 for above, 70-80 for below.
Why is the area of interest closest to the IR and the spine rotated away from the area of interest? prevents spine from superimposing the region of interest, and better demonstrates the axillary portion of the involved region of ribs
If a patient has trauma to the left posterior ribs, what two projections should be done? straight AP, LPO
Patient has trauma to right anterior ribs, what two projections should be done? PA and a LAO
Why might chest PA and lateral be ordered with ribs? rule out hemothorax, pneumothorax
flail chest? fracture of adjacent ribs in two or more places caused by blunt trauma. Associated with underlying pulmonary injury
Pectus carinatum (pigeon breast) congenital defect is characterized by anterior protrusion of lower sternum and xiphoid. Benign.
Pectus excavatum funnel chest, depressed sternum.
RAO sternum rotation degree. CR at? 15-20. CR 1 inch left of midline, IR about 1.5 inches above jugular notch
If breathing technique is not possible for an RAO sternum, what should be done? on expiration
Lateral sternum respiration? SID? inspiration. SID of 72' to reduce magnification of OID, if can only be done at 40" use a larger IR.
PA SC joints. CR at? T2-3, 3 inches below vertebral prominens
RAO and LAO SC joints. Patient rotation degree? CR at? 10-15 degrees, upside arm in front of patient. CR at T2-T3 and 1-2 inches lateral (towards upside)
Oblique SC joints best visualizes joint on ___side down side
RAO SC joint will best demonstrate the ______ joint Right (downside)
With 5-10 degree rotation for SC joints, what would happen? the opposite SC joint would be visualized next the vertebral column. (upside)
AP above diaphragm ribs, CR at? Below? T7, at xiphoid (Lower margin of IR at crest)
IR should be how far above shoulders for upper rib studies? 1.5 inches
What are oblique rib positions for? best demonstrate the axillary portion of ribs.
For a posterior-lateral rib injury, what position? affected side toward/closest IR.
For an anterior-lateral rib injury, what position? affected side away/further from IR.
To demonstrate axillary portion of right ribs, what positions could be done? RPO or LAO
Oblique ribs, rotation degree? 45
RAO position for ribs would be for an injury where? RPO? LPO? Left anterior ribs. Right posterior ribs. Left posterior ribs.
AP projection for scapula. How is patient positioned and why? back against IR, arm abducted 90 degrees and hand supinated to move scapula so lateral portion is free of superimposition
Lateral scapula. Degree of obliquity for lateral body? for lateral acromion or coracoid? body is 45 degrees, acromion is 60.
Created by: Zoest35