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PHTH 518 > Intro T-spine > Flashcards

Intro T-spine Flashcards

1
Q

background info

A

poorly studied
transition between CS and LS
MOST RIGID REGION

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2
Q

function

A

transfer and transmit load
protection

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3
Q

movement

A

any movement around any joint has the possibility to influence motion at other joints within the ring

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4
Q

posterior aspect of v-bodies

A

get thicker the lower you go
ribs also get bigger

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5
Q

end plates

A

become bigger (higher compressive forces) as you go distally

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6
Q

rib articulation

A

6-13 articulations per level
- hard time pinpointing the pathology

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7
Q

rigidity of the spine

A

the most rigid part of the spine
protection over anything

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8
Q

vertebral body

foundations

A

equal in width and depth
EXCEPT CT and TL junction

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9
Q

disc

foundations

A

narrower and flatter with least amount of motion + small NP w/ more central location = less swelling

BETTER ABLE TO WITHSTAND TORSION FORCES

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10
Q

typical and atypical

A

typical = T2-T9
atypical = T1, T10-T12

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11
Q

T1

foundations

A

same as C7

32 structures attach to the first rib and body of t1

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12
Q

Flexibility

A

less flexibility

because of rib articulation, smaller disc to v-body ration, shape and length of spinous process

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13
Q

ligaments

in regard to flexibility

A

ligamentum flavum and ALL are thicker + facet capsule is less flexible

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14
Q

stability

A

costotransverse + costovertebral joints

6-13 articulations per level

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15
Q

joints of t-spine

A

intervertebral
costovertebral
costotransverse
sternocostal
intercostal
facet

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16
Q

costotransverse

A

tubercle of neck rib and TP
- not there at t10-12

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17
Q

sternocostal

A

costochondral joints
- sites of spain and injuries of ribs 1-7 (costochondritis)

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18
Q

zygapophyseal joints

A

more in the coronal plane

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19
Q

upper t-spine facet

A

limits flexion and extension

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20
Q

T9-12

A

more sagittal to allow flexion/extension

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21
Q

vertebral body

anatomy

A
  • equal AP and lateral
  • heart shaped (born = slightly wedge shaped)
  • body: height, end plate x-sectional area, bone mass increase cranial to cephalad
  • 2 demi-facet for rib articulation
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22
Q

IVD

anatomy

A

smallest height to body ratio = least amount of motion
- increase in size in distal direction
- small NP

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24
Q

central disc protrusion

A

more common than post/lateral herniations but herniated disc patholgy is RARE in TS

25
spinal canal
restricted in size by pedicles (still in the vertebra)
26
spinal canal compression
more predisposed for compression - because of the oval shape of the canal and smaller SC
27
spinal canal vascular
1 radial artery = poor supply - making the SC vulnerable to damage by extra dural masses or overzealous manip
28
nerve root
located behind the inf-post aspect of upper v-body decrease nerve root compression impairements ventral rami from CNS innervate all around to the anterior portion
29
transverse process
located behind v-body oriented post (except upper and lower 3) located between inferior articulating process and superior articulating process of the facet at each level
30
orientation of lower 3 and upper transverse process
horizontal
31
t1-10 | transverse process
have a costal facet - articulate with costaltransverse joint)
32
t11-t12 | transverse process
no costotransverse joint since there ribs 11-12 to articulate with v-body
33
spinous process
long and slender point obliquely down - most obvious around T7
34
ALL
narrower but thicker than anywhere else in the spine
35
PLL
wider level IVD but narrower at vertebral body than LS
36
facet joints
angled at 60deg angulation from the transverse plane 20deg angulation from frontal plane
37
upper facet | orientation
45-60 deg
38
mid facets | orientation
inclined 90 deg
39
lower facets | orientation
inclined 90 deg but with a 90 deg change in orientation
40
capsular pattern | facet
lateral flexion and rotation equally limited extension less than flexion
41
places where ribs joint the vertebrae
head tubercle of the rib costovertebral complex is vital biomechanic of the chest wall movement
42
ligament attachment | costovertebral and costotransverse
because of ligaments, not able to palpate head of rib more likely to fx than dislocate
43
innervation of the t-spine canal
sinuvertebral nerve peripheral nerves that travel through T/S and chest wall: - dorsal scapular - thoracodorsal - long thoracic
44
spinal motion stabilizers
paraspinals (responsible for both trunk and UE movements + stability) pec major lats serratus
45
respiration muscles
diaphragm intercostals scaleni SCM trap Serratus pecs lats all abdominals QL iliocostalis lumborum
46
common dx in T/S
kyphosis scoliosis compression fx burst fx fx-dislocation injuries | more likely in mid and lower TS regions
47
flexion ROM
total: 20-45 segmental (all in deg): - upper: 4-5 - middle: 6-8 - lower: 9-15
48
extension ROM
total: 15-20 segmental: 1-2 extension is important for normal shoulder girdle function
49
side flexion ROM
total: 25-45 segmental: 3-4 until lower segments avg 7-9 @ lower segments
50
rotation ROM
total: 35-50 almost pure rotation is at mid T/S - upper and lower happen with SB
51
segmental rotation
upper = 7deg middle = 5deg last 2-3 segments = 2-3 deg t1-2 = 14deg
52
flexion biomechanics
superior vertebra translates anterior + anterior rotation of ribs costotransverse = superior glide anterior ribs get closer posterior ribs seperate
53
extension biomechanics
superior vertebra translates and rotate posteriorly costotransverse = inferior glide + posterior roll of rib stopped by stiffnes of anterior IVDs, PLL and posterior elements
54
T/S coupled motion
ipsilateral SB + contralateral rotation - below T2-3
55
headaches in T/S
dysfunction at T4
56
non-msk pain in T/S
heart, stomach, liver, pancreas, gallbladder, tumors clinically: pain reproduction is mandatory prior to treatment secondary to risks of underlying pain
57
special questions to ask
* pain with full inspiration, experitation, coughing or sneezing * bilat tingling in the feet or trouble walking * general health and relevant weight loss * recent x-rays * medications - current and before

PHTH 518 (8 decks)

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