W2 - SCJ, Sternum

Routine Projections for SCJ and Sternum

• SCJ = PA, PA OBL

• Sternum = PA OBL (RAO), LAT

PA SCJ - Positioning

• CP

• CR

• PT Position

• Respiration 

• midline at T3

• perp

• erect/recumbent, slightly elevate chin and avoid turning head

• suspended expiration

Structures Included - SCJ

bilateral med clavs

Critique - PA SCJ

• Rot’n:

  • medial clavs equi from VB

  • SP mid VB

• F/E: medial clavs over T3/4

• Tilt: clavs on the same transverse plane

Positioning - PA OBL SCJ

• CP

• CR

• PT Position

• Respiration

• T2-3 → 2” towards raised side

• perp

• erect/recumbent, affected side in contact, OBL 10-15

Critique - PA OBL SCJ

Rot’n: interested SCJ is free of spine SI and manu

Positioning - PA OBL Sternum

• CP

• CR

• PT Position

• Respiration 

• mid sternum, T7

• perp

• erect or recumebent, OBL = 15-20 RAO

How to determine OBL of PA OBL Sternum

• palpate both SP and RT SCJ, obl until RT SCJ is left of SP

• hypersthenic will require less obl (15), asthenic will require more obl (20)

Structures Included - PA OBL Sternum

entire sternum

IQ - PA OBL Sternum

• breathing tech: pulmonary marking blurred out

• outline of sternum seen thru SI

• sharp bony margins

Critique - PA OBL Sternum

• sternum free of SI and adj to spine

• sternum within heart shadow

• no transverse distortion of the sternum

Under vs. Over Rotation - PA OBL Sternum

• under = spine SI sternum

• over = sternum is lat to heart shadow, transversely distorted

Reason for RAO Sternum

• to reduce mag

• to place sternum over heart shadow to improve visualization

Structures Included - LAT Sternum

• entire sternum

• minimal overlap of ST

• include SCJs and med clavs

IQ - LAT Sternum

• menu and med clavs seen thru Si

• inf. sternum not obscured by ST

• sharp bony margins and trabecular markings = no motion

Critique - LAT Sternum

Rotn:

• sternum SI ant/post

• no SI of ribs and shoulders

Tilt

• SI of ant ribs in sup/inf

LPO vs. LAO - LAT Sternum

• LPO = ant heart shadow

• LAO = post heart shadow

Positioning - LAT Sternum

• CP

• CR

• PT Position

• Respiration

• T7, midway between SN → xiphi

• perp

• erect, left lateral, arms behind and chest propped out

• inspiration

• LEAD use