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Critique of the Sternum and Ribs

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Critique of the Sternum and Ribs

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    1. Critique of the Sternum and Ribs Chapter 9

    3. Sternum (RAO) Contrast & density to see jugular notch, manubrium, sternal body, & xiphoid process (60-70 kVp) This view rotates the sternum from behind the T-spine 30 inch SID/ breathing technique/ 3 to 4 second exposure time Rotation 15-20 degrees, Sternum should be within heart shadow Midsternum in center of field

    4. Sternum (lateral) 70 to 75 kVp manubrium, sternal body & xiphoid process seen in profile with no superimposition of the anterior ribs over the sternum Midsternum in center of field Position getting patient in full inspiration

    7. Ribs ( AP & PA) 65 to 70 kVp (upper) 75 to 80 kVp (lower) When fractures occur, other pathology is closely looked for. Pneumothorax, emphysema, rupture of trachea, bronchus, or aorta For lower pathology, kidney, liver, spleen or diaphragm damage For anterior rib pain, do PA projection to place them closer to film/ and vice versa

    8. AP or PA of Ribs above diaphragm For AP & PA remove scapula from lung field See 9 posterior ribs above diaphragm 7th posterior rib in center of field (halfway between jugular notch & xiphoid process) Full inspiration

    10. AP & PA of Ribs below diaphragm 9th 12th posterior ribs seen below diaphragm Use higher kVp to penetrate abdominal tissue 9th or 10th posterior rib in center of field halfway between sternum and xiphoid process For hypersthenic patient with short, wide thorax, place lower border of cassette 2 inches above the crest, then center central ray to film

    17. Ribs (anterior & posterior obliques) 65 to 70 kVp upper/ 75 to 80 kVp lower Axillary rib detail is best in posterior oblique / axillary ribs closest to film and better view of sternum Thorax rotated 45 degrees/ the inferior sternum is positioned halfway between the vertebral column and anterior ribs

    18. Posterior & Anterior oblique Ribs above & below diaphragm 9 axillary ribs seen/ full inspiration ?7th axillary rib in center of field Below: 9th 12th axillary ribs seen expiration 9th or 10th axillary rib in center of field

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