iRA/tRA - T Spine and Ribs A&P Review

Question 1

All the thoracic vertebrae have _______ costal facets and all but the lowest 2-3 have __________ costal facets.

Answer 1

• lateral

- transverse

Question 2

Looking from the side or front of the vertebrae we can see the thoracic vertebrae have a “______ _______” shape which can predispose them to what?

Answer 2

• “waisted cylinder”

- compression fractures with axial loading

Question 3

What are the transitional zones of the thoracic vertebrae?

Answer 3

• cervicothoracic junction

- thoracolumbar junction

Question 4

What is a site of breakdown when we have a change in curvature of the spine?

Answer 4

transitional zones

Question 5

• What are the transverse costal facets articulating with?

- What happens to the transverse processes as we move more caudally?

Answer 5

• corresponding rib

- shorten

Question 6

The spinous processes of the thoracic vertebrae project ________ and overlap at vertebrae __-__.

Answer 6

• caudally

- 5-8

Question 7

• The pedicles of the thoracic vertebrae _______ in thickness as we move more caudally.
• They also have a deep _______ notch and a shallow _________ notch.

Answer 7

• increase

- inferior, superior

Question 8

What are the 2 foramen of the thoracic vertebrae?

Answer 8

• Spinal (small and circular)

- Intervertebral

Question 9

The transverse processes of the thoracic spine are typically at the level of the _____ of the more cranial segment.

Answer 9

SP (spinous process)

Question 10

• What are our true ribs?

- What does this mean?

Answer 10

• Ribs 1-7

- They articulate with the sternum (costal cartilage)

Question 11

-What are our false ribs?

Answer 11

• Ribs 8-12
• Ribs 8,9, and 10 typically join superjacent costal cartilage
• Ribs 11 and 12 (rib 10 35-75% of individuals) are free floating

Question 12

What is a cervical rib and what are its implications?

Answer 12

• Anatomical abnormality (free floating or joined with 1st rib) common unilaterally that is an “extra rib” just above the clavicle.
• Can cause compression of neurovascular structures between cervical rib and anterior scalene.

Question 13

• What are the 3 parts of the sternum?

- The sternum slopes _____ and slightly _______.

Answer 13

• Manubrium, Mesosternum (Body), Xiphoid process

- down and forward

Question 14

What are all the articulations of the thoracic vertebrae?

Answer 14

• (2) intervertebral joints
• (2) superior articular processes
• (2) inferior articular processes
• (2) transverse costal facet
• (2) superior costal facet
• (2) inferior costal facet

Question 15

What are the variances of T1?

Answer 15

Has facets for articulation with whole facets of the first rib and an inferior facet for articulation with part of the 2nd rib.

Question 16

What are the variances of T9?

Answer 16

Often fails to articulate with the 10th ribs, inferior costal facets are absent.

Question 17

What are the variances of T10?

Answer 17

• Superior costal facets only, as the only costal articulation is with the 10th ribs.
• Also may or may not have a facet for the tubercle of the 10th rib.

Question 18

What are the variances of T11?

Answer 18

• Costal facet close to the upper border of the body and extend onto the pedicles.
• No articular facet on transverse processes.

Question 19

What are the variances of T12?

Answer 19

• Circular facet on body (articulates with head of rib 12).

- Transverse process replaced by superior, lateral, and inferior.

Question 20

• The superior articular processes are ____ shape, slightly _______ transversely, and face ___________ and slightly _______________.
• The inferior articular processes are _____ shape, flat/slightly ________ transversely, and face __________ and slightly _____________.

Answer 20

• oval
• convex
• posteriorly and slightly superiorlaterally
• oval
• concave
• anterior and slightly inferiomedially

Question 21

The z-joints of the thoracic spine are innervated by what?

Answer 21

medial branch of dorsal rami

Question 22

Joints of the costal head are _________ joints (roll and glide) and ribs __-__ articulates with superior and inferior bodies.

Answer 22

• synovial

- 2-9

Question 23

Costotransverse joints are _______ TP on ________ rib. These joints are located at ribs __-__.

Answer 23

• concave, convex

- Ribs 1-10

Question 24

The joints of the costal heads have a radiate ligament composed of 3 bands. The superior and inferior bands insert into ________ ________ and the intermediate band inserts into ________ ________.

Answer 24

• adjacent vertebrae

- annulus fibrosis

Question 25

The superior costotransverse ligament goes from the _______ border of the transverse process to the superior border of the neck of the underlying ______.

Answer 25

- inferior | - rib

Question 26

The costotransverse joint are innervated by what?

Answer 26

lateral branch of dorsal rami

Question 27

- What ligament blends with the tectoral membrane and spans from posterior body of C2 to sacrum? - What ligament spans anterior spine, blending with anterior bodies and anulus/end-plates? - What ligament attaches adjacent laminae?

Answer 27

- PLL - ALL - Ligament flava

Question 28

Where are the IV Discs the thinnest?

Answer 28

upper T-spine

Question 29

What flat hyaline cartilage contributes to thoracic mobility and elasticity as well as forms the attachment of rib 1-7 to the sternum (directly) and 8-10 (indirectly)?

Answer 29

Costal cartilage

Question 30

- Joint type of rib 1? - Joint type of ribs 2-7? - Joint type of ribs 8-10?

Answer 30

- Rib 1 = synarthrosis - Ribs 2-7 = synovial joints - Ribs 8-10 = interchondral joints

Question 31

What are the supporting structures of the sternocostal joints?

Answer 31

- Capsules - Radiate Ligaments - Intra-articular ligament (2nd rib)

Question 32

T Spine Motion: - The flexion movement ________ as we move more caudally. - The extension movement ________ as we move more caudally. - The lateral flexion movement ________ as we move more caudally. - Thoracic rotation is highest in the _____ T-spine.

Answer 32

- increases - stays the same - increases - mid T-spine

Question 33

Thoracic spine motion is generally limited, why is this?

Answer 33

To not interfere with respiration.

Question 34

In T-spine Extension: - The upper vertebrae tilts __________. - It is limited by impact of what? - The ALL is ________. The PLL/ligamentum flava/interspinous ligaments are _________.

Answer 34

- posteriorly - articular processes and spinous processes - stretched, slackened

Question 35

In T-spine Flexion: - The superior facets glide _________ and ___________. - There is a tensile load on the _________ annulus. - The ALL is __________. The PLL/ligamentum flava/capsular ligaments/ligamentum nuchae are ___________.

Answer 35

- superior and anterior - posterior - slackened, stretched

Question 36

T-spine lateral flexion is checked by resistance from the _______ and __________.

Answer 36

ribs and sternum

Question 37

In T-spine Rotation: - There is _____ limitation, checked by the _____. - The axis is in vertebral _______ (mid thoracic spine) or in front of _______ (elsewhere). - Requires some lateral displacement in ____ T-spine.

Answer 37

- less, ribs - bodies, bodies - mid T-spine

Question 38

Traditional Coupling Theory of T-Spine: - When positioned in flexion and in neutral, rotation and lateral flexion are coupled ___________. - When positioned in extension, rotation and lateral flexion are coupled _____________.

Answer 38

- ipsilaterally | - contralaterally

Question 39

Rib Motion: - In the upper ribs (_______ handle) the axis lies almost in the ________ plane, elevation increases the __-__ diameter of the thorax. - In the lower ribs (_______ handle) the axis moves closer to the ________ plane, increasing the __________ diameter.

Answer 39

- pump, coronal, A-P | - bucket, sagittal, transverse

Question 40

- Normal expiration is _________, why? | - Normal expiration involves what main muscle?

Answer 40

- Passive due to recoil of thorax resulting from elasticity of osteochondral components and pulmonary structures - Internal intercostals

Question 41

What are accessory expiratory muscles?

Answer 41

- Abdominal Muscles: Rectus abdominis, External obliques, Internal obliques (depress the thoracic outlet) - Iliocostalis thoracis - Longissimus - Serratus posterior inferior - Quadratus Lumborum

Question 42

Normal inspiration involves elevation of the ribs and sternum via what muscles?

Answer 42

- Diaphragm - External intercostals - Levatores costarium

Question 43

What are accessory inspiratory muscles?

Answer 43

- SCM - Scalenes - Pec major and minor - Serratus anterior - Lats - Serratus posterior superior - Iliocostalis cervicis

Question 44

Contraction of the diaphragm causes _________ of the central tendon.

Answer 44

lowering

Question 45

Superficial back muscles?

Answer 45

- Traps - Lats - Levator scap - Rhomboids -Serratus posterior superior and inferior

Question 46

Intrinsic back muscles?

Answer 46

Erector Spinae - Spinalis thoracis - Longissimus thoracis - Iliocostalis thoracis Spinotransverse Group - Rotatores thoracis - Multifidus - Semispinalis thoracis (C6-T4 SP to T6-T10 TP)

Question 47

Common T-Spine Dermatomes to remember?

Answer 47

- T4 = nipple line | - T10 = umbilicus

Question 48

What is a normal kyphosis curvature?

Answer 48

20-40 degrees