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 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