The apex, also called the cupola is dome shaped, fitting snuggly into the space created by the soft tissue confluence of the mediastinal parietal pleura with the costal parietal pleura and the bony frame formed by the clavicle and first rib.  It is positioned 2-3cm superior to the medial third of the clavicle where it projects through the superior thoracic inlet.

Parts  – Ribs and Spine

Kyphosis

We are Going and You are Coming

The top row of images from left to right reflect, A-P examination of the immature lumbar spine of very young patient, juxtaposed with the lateral examination of a normal thoracic of a normal young adult and lastly the lateral examination of a severely kyphotic elderly patient. The photograph was taken in Italy showing ages ranging from the youngest child in a stroller perhaps 2 years in age, her brother of about 5 or 6, their mother in her late twenties or early thirties and an elderly couple both suffering from the wraths of aging bones – osteoporosis and severe kyphosis. (the kyphosis couple) Ashley Davidoff Copyright 2011 75578c01.8s

75675c04

75675c04 spine cervical spine c-spine thoracic spine T-spine interspinous ligaments anterior longitudinal ligaments dx ankylosing spondylitis kyphosis CTscan Courtesy Ashley Davidoff MD

Chest Deformity from Rib Fractures

Parts Lungs 

Size Narrow -AP

 

Normal Thoracic Spine

73290c01 bone spine thoracic spine spinous processes normal interspinous ligament spine vertebral bodies CTscan Courtesy Ashley Davidoff MD

Narrow A-P and Spontaneous Pneumothorax

Shape

Severe Pectus Excavatum

Pectus Excavatum and Pectus Carinatum

Position Character 

Time

Associated Findings

Infection

Inflammation Malignancy Mechanical/Atelectasis Trauma Metabolic Circulatory- Hemorrhage Immune Infiltrative Idiopathic Iatrogenic Idiopathic

Pectus Carinatum Hyperinflation from Cystic Fibrosis –
19 year old female

Pectus Excavatum and Carinatum

Barrel Shaped Chest Pectus Carinatum