Overview
Normally, six anterior ribs and nine posterior ribs should be seen above the diaphragm.
Hyperinflation
Look For
- Hyperlucency of the lung fields
- Diaphragmatic flattening
- Ten or more posterior ribs visible above the diaphragm
- Mediastinal narrowing
Example
- Hyperinflation in a patient with emphysema
![Hyperinflation in a patient with emphysema]()
Significance
- Hyperinflation is a sign of emphysema, though can rarely occur with other obstructive diseases such as asthma and bronchiectasis.
Underinflation
Look For
- Less than eight posterior ribs visible above the diaphragm.
Causes of Underinflation
- Poor inspiratory effort
- Restrictive lung disease
- Atelectasis
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