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GM Biomechanics > Exam 2: Thoracic Spine > Flashcards

Exam 2: Thoracic Spine Flashcards

1
Q

What is the least mobile part of the spinal column designed for rigidity

A

The thoracic spine

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2
Q

What problems is the thoracic spine prone to

A

Chronic postural problems, myofascial pain syndromes

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3
Q

Biomechanical changes to t/s may result in what

A

Effects to sympathetic nervous system (T1-L2)

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4
Q

What limits extension in t/s

A

Imbrication

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5
Q

What is the the facet like for the rib articulation of the t/s

A

Concave facet on the anterior side

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6
Q

What degree is facet orientation

A

60 degrees

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7
Q

From the frontal plane toward midline what is the y axis rotation

A

20 degree

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8
Q

What is the inferior articular process orientation of the t/s

A

Ant, inf, med

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9
Q

What is the superior articular process orientation of t spine

A

Post, sup, lateral

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10
Q

Whats different about t/s ivd

A

They are comparatively thin

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11
Q

What is the disct height to body height ratio in t/s

A

1:5 smallest spinal ratio

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12
Q

What is special about the nucleus

A

Its more centrally located witihin the annulus than other

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13
Q

What is the thoracic curve

A

Kyphotic less than 55 degrees (avg 45)

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14
Q

What maintains the kyphotic thoracic curve

A

Wedge shaped vertebra (higher posteriorly)

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15
Q

Where is the apex of the thoracic curve

A

T6-T7

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16
Q

What problems can result of alteration of thoracic kiyphotic curve

A

Chronic stretch of trap, post back muscles, crowds thoracic viscera, sheurmann disease

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17
Q

What ROM is most limited in t/s

A

Extension due to impaction of articular processes and spinous

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18
Q

What is the primary movement of t/s

A

Lateral bending coupled with axial rotation

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19
Q

What is lateral bend coupled with

A

Axial rotation more apparent in upper t/s

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20
Q

What coupling pattern is seen T1-T4

A

Spinous to contralateral side during coupling

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21
Q

What coupling happens T9-T12

A

Spinous to more ipsilateral side like lumbar

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22
Q

Thoracic flexion and extension combine with what coupled movement

A

Slight +/- z translation

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23
Q

When walking where is the greatest rotation of the spine

A

Mid thoracics

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24
Q

What plays a role in enhancing stiffness of t/s especially in extension

A

The rib cage

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25
Q

When does the rib cage increase Y axis stability

A

During compression

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26
Q

Without muscles and rib cage the ligamentous spine can only support how much force

A

20N

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27
Q

What two groups does rib articulations get divided into

A

Costovertebral joints, costotransverse joints

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28
Q

Which ribs articulate with a single VB

A

Ribs 1 and 10-12

29
Q

What rib heads also articulate with adjacent vertebra

A

Ribs 2-9

30
Q

What ribs don’t have costotransverse articulations

A

Ribs 11-12

31
Q

What rib heads have costotransverse articulations

A

Ribs 1-10

32
Q

What ribs connect to the sternum directly via costal cartilage

A

Ribs 1-7 = true ribs

33
Q

What ribs attach indirectly via shared costal cartilage

A

Ribs 8-10 false ribs

34
Q

What ribs are free floating with no anterior attachement

A

Ribs 11-12 = floating ribs

35
Q

Change from the coronal facet plane in the t spine to the sagittal plane facets in the l spine typically occur where

A

T11-T12

36
Q

What forms the cluneal nerves

A

Posterior primary rami of spinal roots T12-L2

37
Q

What syndrome could account for up to 60% of chronic and acute back pain

A

Maigne syndrome

38
Q

Curves <10% are often just ____ changes

A

Postural

39
Q

If a curve is >10% accompanied by vertebral rotation it is called what?

A

Scoliosis

40
Q

What side scoliosis is mc

A

Right thoracic

41
Q

What scoliosis is often caused by some postural problem, muscle spasm, or leg length inequality, which can often be addressed

A

Functional scoliosis

42
Q

What type of scoliosis is bony distortion, does not reduce with postural maneuves

A

Structural scoliosis

43
Q

At what age does scoliosis most often develop between

A

Ages 10-15

44
Q

Who is mc affected by scolioses

A

Girls

45
Q

Why should kids of parents or siblings are affected by scolisosis should be evaluated

A

Because it can be inherited

46
Q

What idiopathic scoliosis is mc

A

Adolescent idiopathic scoliosis (AIP)

47
Q

What is the ratio of girls to boys with curves >30%

A

10:1

48
Q

What girls are at the highest risk of scoliosis progression

A

Scoliosis greater than 25 degrees and who have not had their first period

49
Q

What is low risk percentage of progression

A

5-15

50
Q

What is moderate risk of curve progression

A

15-40%

51
Q

What is high risk of curve progression

A

40-70%

52
Q

What is very high risk percentage of risk of curve progression

A

70-90%

53
Q

What risser grade is 25% ossified

A

1

54
Q

What risser grade is 50% ossified

A

50%

55
Q

What risser grade is skeletal maturity

A

5

56
Q

When is bracing a treatment option

A

For kids who have not reaching skeletal maturity and who have curves between 25-45%

57
Q

When is surgery a treatment option for scoliosis

A

When curves are >45% and progressive or when it can affect vital funx

58
Q

What are some chiropractic interventions for scoliosis

A

Adjust, exercise, EMS, none should be used alone

59
Q

According to american academy of orthopedic surgeouns when should we screen girls and boys

A

Girls = ages 11 and 13, boys = ages 13 or 14

60
Q

According to american academy of pediatrics when should we screen for scoliosis

A

Screen at 10, 12, 14, 16

61
Q

What test asks patients to bend forward to test assymetry

A

Adams forward bend test

62
Q

What angle between intersecting lines drawn perpendicular to the top of the superior vertebra and bottom of the inferior vertebra

A

The cobb angle

63
Q

What brace also includes a neck ring

A

Milwaukee brace

64
Q

What are the braces at successful at

A

74% success rate at halting curve progression

65
Q

How often should braces be worn

A

23 hours a da at least 16 hours a day

66
Q

Curves growing in children >40 degrees require what

A

Spinal fusion (risser grade 0-1 in girls and 2-3 in boys)

67
Q

What do you lose in thoracic scoliosis surgery

A

Loss of kyphosis

68
Q

Over time thoracic scoliosis surgery can lead to what

A

Loss of lumbar lordosis = flat back syndrome

69
Q

In later years what can happen to discs below the fusion

A

Discs may degenerate below the fusion

GM Biomechanics (5 decks)

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