Biomechanics - Thoracic

Question 1

What type of mechanics is in the thoracic region?

Answer 1

Fryette (T1-T12)
1 - neutral, coupling occurs in opposite sides
2 - non-neutral coupling flexed, extended, same sides

Question 2

What is unique to thoracics?

Answer 2

Thoracic can occur in one plane.

• usually flexed or extended
• mid-thoracis
• little or no sidebending

Question 3

Where does the site of tenderness usually present?

Answer 3

-lateral to tips of transverse processes
- tip of spinous process
Tenderness can serve as a more accurate guide

Question 4

What motion is permitted by the facets of the thoracic region?

Answer 4

Facets have a coronal orientation so rotation should be greatest but ribs limit this rotation.

• Floating - greatest motion
• false - moderate motion
• true - least motion

Question 5

What stiffens the thoracic spine?

Answer 5

ribs and sternum

Question 6

How many axis of vertebral motion are there in sidebending ?

Answer 6

2

Question 7

Describe the transitional segments of T12.

Answer 7

Upper facets: coronal
Lower facets: sagitally
This segment is vulnerable to mechanical influences or trauma.
(Change in facet changes has been documented as high as T9)

Question 8

Remember rule of 3s.

Where are the transverse processes in relation to spinous process?

Answer 8

T1-T3 TP at same level as SP
T4-T6 TP 1/2 level above SP
T7-T9 TP one segment up
T10 - Like T7-T9
T11 - Like T4-T6
T12 - Like T1-T3

Question 9

Which ligaments stiffen the thoracic spine?

Answer 9

• costal ligaments

- Costotransverse ligament

Question 10

Which ligaments are in the thoracic region?

Answer 10

• intertransverse ligament
• superior costotransverse
• radiate ligament

Question 11

Where is trapezius attached? action?

Answer 11

T1-T12

-scapular retraction & depression

Question 12

What is the innervation of trapezius?

Answer 12

Spinal accessory C1-C6

• somato-somato reflex
• can result in cranium dysfunction

Question 13

What symptoms will result from trapezius dysfunction?

Answer 13

• interscapular pain
• shoulder pain
• pectoral region pain
• lateral rib cage pain

Question 14

Where is latissimus attached? action?

Answer 14

• lower 6 thoracic spinous processes
• lumbar & sacral spinous processes
• supraspinous ligament
• iliac crest via lumbodorsal fascia

Action - humoral adduction, medial rotation, extension

Question 15

What is the innervation of latissimus dorsi?

Answer 15

C6, C7, C8

Question 16

Where is the latissimus most vulnerable to dysfunction?

Answer 16

T7, T8 - Results in limited humoral external rotation, flexion (reaching)

Question 17

What are the symptoms of latissimus dorsi ?

Answer 17

infrascapular mid-thoracic backache, pectoral pain

Question 18

Why would pectoral region hurt when latissimus is too tight?

Answer 18

pectorals become hypertonic to fight backward pull

Question 19

Where does the Rhomboid major attach? action?

Answer 19

T2-T5

scapular retraction, elevation

Question 20

Where does the Rhomboid minor attach? action?

Answer 20

C7 & T1

scapular retraction, elevation

Question 21

Where is most of the symptomatology (Rhomboid major or minor)?

Answer 21

Rhomboid minor

Question 22

What is the innervation of the Rhomboids?

Answer 22

C4, C5

Question 23

Where is pain when there is dysfunction in Rhomboids?

Answer 23

scapular protraction; pain along vertebral border of scapula extending into the supraspinatous fossa.
- muscles ache at rest

Question 24

If pectoralis muscles are overworked or overdeveloped what will happen to Rhomboids?

Answer 24

pain

Question 25

List three erector spinae?

Answer 25

Longissimus thoracis - lumbar tp to thoracic tp and lower 9-10 ribs lateral to costotransverse articulation
Longissimus cervicis - T1-T5 tp to C2-C6
Longissimus capitis - tp of C4 to T5, up to mastoid process

Question 26

What is the action of the erector spinae?

Answer 26

Longissimus thoracic and cervicis back bend (bilateral) and sidebend the vertebral column (unilateral)
Longissimus capitis - rotate head ipsilateral

Question 27

What innervates the erector spinae?

Answer 27

dorsal rami of thoracic, upper lumbar and lower cervical nerve roots

Question 28

What does thoracic segmental dysfunction of erector spinae result in?

Answer 28

longissimus hypertonicity locally with restricted flexion and sidebending
- neck motion would be limited in contralateral rotation

Question 29

What are the symptoms for longissimus thoracis dysfunction?

Answer 29

• local muscle tenderness and pain, extends over approx. 4 segments
• T10-12 can refer pain down to the lower portion of buttock.
• Upper lumbar fibers refer to the mid-lumbar region (Lumbago)

Question 30

Where is trigger point for iliocostalis lumborum? longissiums thoracis?

Answer 30

L1 - iliocostalis lumborum

T10, T11, L1 - longissimus thoracis

Question 31

What is the action of the rotatores?

Answer 31

sidebending and extension of the thoracic segments (contrary to name)

Question 32

What can rotatores spasm or hypertonicity result in?

Answer 32

development and maintenance of Type II segmental dysfunction

Question 33

What is the action of levator costae?

Answer 33

elevation of ribs

Question 34

What can occur if rib is anchored?

Answer 34

segmental sidebending

Question 35

What is the pain pattern of rotatores?

Answer 35

picture - T4-T5
Dr. E -“anywhere along the column”
- exquisitely painful

Question 36

When was EMG activity seen in the postural study?

Answer 36

within 1/2 hour