Bones, Joints, and Movements of the Thoracic Cage Flashcards

1
Q

What is the distribution of vertebrae?

A

cervical: 7
thoracic: 12
lumbar: 5
sacral: 5 (fused - form sacrum)
coccygeal: 5 (forming coccyx)

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2
Q

define: sacralization

A

L5 fuses to sacrum so that theres 4 lumbar vertebra and 6 sacral

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3
Q

define: lumbarization

A

first segment of sacrum fails to fuse with sacral bodies and appears like a lumbar vertebrae

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4
Q

List some of the common features of the typical cervical vertebrae (C3-C6)

A
  • small vertebral bodies but large compared to rest of vertebrae. saddle shaped at superior and inferior surfaces
  • large and triangular vertebral foramen
  • transverse foramina (contain vertebral vessels) in transverse process
  • superior facets are superoposterior while inferior facets are infero-posterior
  • short bifid dorsal spinous process
  • most mobile portion of the spine
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5
Q

Describe C1

A

AKA atlas

Has only an anterior arch and posterior arch; no spinous process and a body

no disc between C1 and C2

superior articular facets receive the occipital condyles of the skull

atlantooccipital joint: flexion / extension

atlantoaxial joint: head rotation

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6
Q

Describe C2

A

AKA axis

dens/odontoid process projects from body

articulate in 3 places with C1 to form atlanto-axial joints (synovial) to permit head rotation (shake no)

medial atlantoaxial joint is held together by transverse ligament of atlas

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7
Q

Describe C7

A

largest cervical vertebrae. long, palpable, non-bifid spinous process

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8
Q

What ligament holds the dens to the facet of the atlas?

A

transverse ligament of the atlas

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9
Q

List some of the common features of the thoracic vertebrae

A
  • demi facets on lateral aspect of vertebral body where the head of the ribs articulate
  • costal facets on transverse process for the tubercle of the ribs
  • long spinous process that slope inferiorly, overlapping the adjacent vertebral body below
  • Long and strong transverse processes
  • Vertebral foramen is relatively small compared to body

Nearly vertical articular facets allowing for less movement than in cervical spine.

Limited flexion and extension in thoracic spine due to spinous process and articular facet shape

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10
Q

List some of the common features of the lumbar vertebrae

A

large vertebral bodies

Articular facets are nearly vertical but oriented differently; directed (facing) primarily medially and laterally
. located on vertical articular process bilaterally

allows for flexion, extension, lateral flexion of spine

does not allow for a lot of rotation

Transverse and spinous process are short and blunt

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11
Q

describe the 2 major components of the intervertebral discs

A

annulus fibrosus: fibrocartilage ring

nucleus pulposus: gelatinous filling of disc

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12
Q

function of IV discs

A

absorb shock

support weight of rostral segments

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13
Q

sacrum
- function
- characteristics

A

function: stability and strength

contains sacral canal which permits passage of cauda equina

4 pairs of sacral foramina allowing passage of spinal nerves

sacral hiatus
- gap produced by lack of spinous process of S5

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14
Q

What is the emphasized importance of coccyx

A

anchor point for muscles such as gluteus maximus and coccygeus

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15
Q

Describe the 2 different types of breast implants

A

Subglandular: implant is inserted over the pectoralis minor and pectoralis major muscles in the chest (replicates natural anatomy)

Submuscular: implant is fully inserted under the pectoralis major muscle above the pectoralis minor muscle (more common now)

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16
Q

Fill in the blank:
the jugular notch is slightly ____ and ____ to the origin of the internal jugular veins

A

caudal

medial

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17
Q

Explain the position of esophagus in reference to the trachea

A

the esophagus is posterior to the trachea

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18
Q

What veins and arteries pass over the first rib causing their grooves?

A

subclavian artery and vein

19
Q

What kind of joint is the 1st sternocostal joint

A

synarthrosis (immobile) and a synchondrosis (hyaline cartilage directly united with sternum)

20
Q

What kind of joints are the 2nd - 7th sternocostal joints

A

synovial plane joints

21
Q

What kind of joint is the sternoclavicular joint

A

synovial plane joint

22
Q

What kind of joints are the manubriosternal joint and xiphisternal joint

A

symphyses (although they typically ossify in adulthood).

23
Q

Define: intervertebral foramen

A

contains spinal nerves which exit and branch off the spinal cord off each spinal segment
Inferior vertebral notch and superior vertebral notch

24
Q

Define: Zygapophysial joint

A

formed by inferior articular process of superior vertebra + superior articular process of inferior vertebra

25
Q

Describe the difference between the atlanto-occipital joint and atlanto-axial joint

A

atlanto-occipital joint: occipital condyles of the skull and the superior articular facets of the C1; allow for flexion/extension (nodding yes)

atlanto-axial joint: formed by 3 articulations between atlas and axis that permit rotation (shake head no)

26
Q

What are the 3 atlantoaxial joints?

A

2 lateral atlanto-axial joints

Median pivot joint: dens and anterior arch of the atlas (transverse ligament snugs dens into anterior arch of atlas)

27
Q

What is a hangman’s fracture?

A

Den’s fracture
- abrupt hyperextension of the neck

28
Q

What is the portion where the sacrum articulates with the iilium called?

A

auricular surface

29
Q

xiphersternal joint

A

where the body of the sternum and the xiphoid process meet.

30
Q

sternocostal joint vs costochondral joint vs costotransverse joint vs costovertebral joints

A

sternocostal: where the sternum meets the costal cartilage

costochondral: where the rib meets the costal cartilage

costotransverse joint refers to the articulation of the facet of the costal tubercle on the neck of the rib with the transverse processes of a corresponding vertebra. allows for rib cage expansion

costovertebral joint: collective term for costotransverse joint and joints of costal head. the joints that connect the ribs and the thoracic vertebrae.

joints of costal head: made up of head of rib, body of vertebra superior to rib, intervertebral disc, and body of vertebra same number as rib

31
Q

What reinforces the costotransverse joints

A

Lateral costotransverse ligament. Limits gliding

32
Q

Fill in the blank: the 7th rib articulates at its head with _____

At its tubercle, it articulates with ______

A

the body of T7 and T6

transverse process of T7

33
Q

How do the shape of the costotransverse articulations in the rib change from rostral to caudal? What are the ramifications for movement?

A

middle costotransverse joints:

Articular surfaces on the tubercles of ribs 1-6 are cancave. These concave tubercles fit into the convex surface on the transverse processes of the same-numbered vertebrae.

allows for a pump handle movement of the ribs producing elevation and depression at the sternal end of the ribs in the sagittal plane.

lower costotransverse joint:

Articular surfaces of the tubercles of rib 7-10 are flat

Flat tubercles glide over the flat transverse processes of the same numbered vertebrae

Gliding movement produces elevation and depression of the lateral ribs in the transverse plane (bucket handle movement)

Lower ribs are the handle of the bucket tilting up and out.

The combination of rib movements increases the anterior posterior and transverse dimensions of the thoracic cage

34
Q

What is flail chest?

A

Extreme case of rib fracture

Flail segment is an isolated segment of rib cage where 3 or more ribs break at both ends and the isolated section moves paradoxically.

During inspiration it gets sucked into the chest and during expiration it is pushed out

35
Q

how many IV discs are there

A

23

36
Q

define: herniated disc

A

structural failure of the annulus fibrosus leads to bulging (or extrusion) of the nucleus pulposus (ruptured or “slipped”)

37
Q

Where is it most common for discs to be herniated?

A

L4-L5

L5-S1

38
Q

Where do the sacral spinal cord segments arise from?

A

T12-L1

39
Q

define: dermatome

A

portion of the skin innervated by a single spinal nerve.

40
Q

define: myotome

A

portion of musculature innervated by a single spinal nerve

41
Q

Spinal cord injury vs spinal nerve injury

A

Spinal cord injury affecting sensory and motor function at and below the level of injury

Spinal nerve injury affecting sensory and motor function within a specific dermatome and myotome

42
Q

List the myotomes

A

C5 - elbow flexors
C6 - wrist extension
C7 - elbow extensors
C8 - finger flexors
T1 - finger abductors
L2 - hip flexors
L3 - knee extensors
L4 - ankle dorsiflexors
L5 - long toe extensors
S1 - ankle plantarflexors

43
Q

Where do the spinal nerves exit from?

A

C1-C7 spinal nerves emerge from the vertebral canal above corresponding vertebra

All other ones, spinal nerves exit through the vertebral canal below the corresponding vertebra

vertebral canal is created by intervertebral foramen

44
Q

What does a typical rib’s heads articulate with?

A

Example: T6

Rib 6 superior facet articulates with T5 and inferior facet articulates with T6

At Demi facets