Its the basic anatomy and x-ray views about ribs and sternum. Which gives a clear image about positions of x ray projections

1. BASICAND SUPPLEMENTARY
PROJECTIONS OF RIBS
KEVIN JOSE
BMIT 2nd Yr

2. The ribs are elastic arches of bone, which form a
large part of the thoracic skeleton. They are
twelve in number on either side; but this number
may be increased by the development of a
cervical or lumbar rib, or may be diminished to
eleven. The first seven are connected behind with
the vertebral column, and in front, through the
intervention of the costal cartilages, with the
sternum (Fig. 115); they are called true ribs. The
remaining five are false ribs ; of these, the first
three have their cartilages attached to the
cartilage of the rib above vertebro-chondral the
last two are free at their anterior extremities and
are termed floating or vertebral ribs
ANATOMY OF RIBS

3. PROJECTIONS
UPPER RIBS
BASIC
Antero-posterior
Cervical antero-posterior
SUPPLEMENTARY
Posterior-oblique
LOWER RIBS
BASIC
Antero-posterior
SUPPLEMENTARY
Posterior-oblique

4. INDICATIONS
•Pneumo thorax
•Hemothorax
•Rib fracture
•Pneumonia

5. ANTERO-POSTERIOR (UPPER RIBS)
POSITION OF PATIENT
The patient stand with the posterior aspect
of the trunk against the vertical CR cassette.
Alternatively the patient lies supine on the
table
The median sagital plane is adjusted at right
angles to the image receptor
 The image receptor is centered to the
junction of the medial and middle 1/3 of the
clavicle

6. X RAY IMAGE OF ANTERIO-POSTERIOR

7. TECHNICAL FACTORS
1)COLLIMATION
• The collimated horizontal beam is
directed perpendicular to the image
receptor and centered over the
junction of the medial and middle 1/3
of the clavicle
2)ORIENTATION
Landscape
3)DETECTOR SIZE
18x24cm
4)EXPOSURE
50-60 kVp
1-5 mAs

8. CERVICAL ANTERO-POSTERIOR (upper rib)
POSITION OF PATIENT
The patient sits or stands with the
posterior aspect of the trunk against
a vertical CR cassette
The median sagital plane should be
at right angles to the image receptor
and coincident with the midline of
the table
The CR cassette if selected is
positioned transversely in the CR
cassette tray and should be large
enough to include the 5th cervical
and 5th thoracic vertebrae

9. X RAY IMAGE OF C.ANTERO-POSTERIOR

10. TECHNICAL FACTORS
1)COLLIMATION
The collimated beam is angled
10 degree cranially from the
prependicular and centered
towards the sternal notch.
2)ORIENTATION
Portrait
3)DETECTOR SIZE
18x24cm
4) EXPOSURE
50-60 kVp
1-5 mAs

11. POSTERIOR OBLIQUE (upper ribs)
POSITION OF PATIENT
 Initially direct the collimated beam
prependicular to the image receptor and towards
the sternal angle
 The beam is then angled caudally so that the
central ray coincides with the centre of the
receptor.This centring assists in demonstrating
the maximum number of ribs above the
diaphragm
 Exposure made on arrested full inspiration
will also assist in maximising the number of ribs
demonstrated

12. X RAY IMAGE OF POSTERIOR OBLIQUE

13. TECHNICAL FACTORS
1)COLLIMATION
Initially direct the collimated beam
prependicular to the image receptor
and toward the sternal angle
The beam is then angled caudally
so that the central ray coincides with
the center of receptor. This centring
assists in demonstrating the
maximum number of ribs above the
diaphragm
Exposure made on arrested full
inspiration will also assist in
maximising the number of ribs
demonstrated
2) ORIENTATIO
Portrait
3)DETECTOR SIZE
18x24cm
4)EXPOSURE
50-60kVp
5-10 mAs

14. POSTERIOR OBLIQUE(lower rib)
POSITION OF PATIENT
 The patient lies supine on the table or stands erect with the mid
clavicular line of the slide under examination coincident with the midline of
the bucky grid
 The trunk is rotated 45degree onto the side being examined with the
raised side supported on non-opaque pads
 The hip and knees are flexed for comfort and to assist in maintaining
patient position
 If selected the caudal edge of the cassette is positioned at a level just
below the lower costal margin otherwise the DDR detector is positioned to
include the area of interest with its centre coincident with the central beam

15. X RAY IMAGE OF POSTERIOR OBLIQUE(lower ribs)

16. TECHNICAL FACTORS
1)COLLIMATION
 The collimated vertical beam is
centered to the midline of the anterior
surface of patient at the level of the
lower costal margin.
 From this position the central ray is
then angled cranially to coincide with
the centre of the image receptor
 Exposure is made on arrested full
expiration
2)ORIENTATION
Portrait
3)DETECTOR SIZE
18x24cm
4)EXPOSURE
50-60 kVp
5-10 mAs

17. ANTERO-POSTERIOR
Position of patient
 The patient lies supine on the imaging
couch with the median plane coincident with
the midline of the couch
 The anterior superior iliac spines should be
equidistant from the couch top
 Cassette is placed transversely in the
bucky tray with its caudal edge positioned at
a level just below the lower costal margin
otherwise the DDR detector is positioned to
include the area of interest with its centre
coincident with central beam

18. X RAY IMAGE OF ANTERO POSTERIOR(lower rib)

19. TECHNICAL FACTORS
1)COLLIMATION
The collimated vertical beam is
centered in the midline at the level
of the lower costal margin and
then is angled cranially to coincide
with the centre of the image
receptor
This centring assists in
demonstrating the maximum
number of ribs below the
diaphragm
Exposure made on full expiration
will also assist in this objective
2)ORIENTATION
Landscape
3)DETECTOR SIZE
18x24
4)EXPOSURE
50-60 kVp
5-10mAs

20. REFERANCE
CLARKS POSITIONING RADIOGRAPHY