The variations that we see from normal here are the fact that first, there is a great amount of swelling in the chest wall which we know was due to bleeding and bruising of the tissues of the chest wall, and we also see that there is air in the tissues of the chest wall here and here. It is rather obvious.
Mr. Specter. When you say here and here, you are referring to the outer portions, showing on the X-ray moving up toward the shoulder area?
Dr. Shaw. Yes; going from the lower chest up to the region near the angle of the shoulder blade.
The boney framework of the chest, it is obvious that the fifth rib, we count ribs from above downward, this is the first rib, second rib, third rib, fourth rib, fifth rib, that a portion of this rib has been shattered, and we can see a few fragments that have been left behind.
Also the rib has because of being broken and losing some of its substance, has taken a rather inward position in relation to the fourth and the sixth ribs on either side.
Mr. Specter. What effect was there, if any, on the upper portion of that rib?
Dr. Shaw. This was not noticed at the time of this examination, Mr. Specter. However, in subsequent examinations we can tell that there was a fracture across the rib at this point due to the rib being struck and bent.
Mr. Specter. When you say this point, will you describe where that point exists on the X-ray?
Dr. Shaw. This is a point approximately 4 centimeters from its connection with the transverse process of the spine.
Mr. Specter. And is the fracture, which is located there, caused by a striking there or by the striking at the end of the rib?