iRA/tRA - T Spine and Ribs A&P Review Flashcards
All the thoracic vertebrae have _______ costal facets and all but the lowest 2-3 have __________ costal facets.
- lateral
- transverse
Looking from the side or front of the vertebrae we can see the thoracic vertebrae have a “______ _______” shape which can predispose them to what?
- “waisted cylinder”
- compression fractures with axial loading
What are the transitional zones of the thoracic vertebrae?
- cervicothoracic junction
- thoracolumbar junction
What is a site of breakdown when we have a change in curvature of the spine?
transitional zones
- What are the transverse costal facets articulating with?
- What happens to the transverse processes as we move more caudally?
- corresponding rib
- shorten
The spinous processes of the thoracic vertebrae project ________ and overlap at vertebrae __-__.
- caudally
- 5-8
- The pedicles of the thoracic vertebrae _______ in thickness as we move more caudally.
- They also have a deep _______ notch and a shallow _________ notch.
- increase
- inferior, superior
What are the 2 foramen of the thoracic vertebrae?
- Spinal (small and circular)
- Intervertebral
The transverse processes of the thoracic spine are typically at the level of the _____ of the more cranial segment.
SP (spinous process)
- What are our true ribs?
- What does this mean?
- Ribs 1-7
- They articulate with the sternum (costal cartilage)
-What are our false ribs?
- 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
What is a cervical rib and what are its implications?
- 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.
- What are the 3 parts of the sternum?
- The sternum slopes _____ and slightly _______.
- Manubrium, Mesosternum (Body), Xiphoid process
- down and forward
What are all the articulations of the thoracic vertebrae?
- (2) intervertebral joints
- (2) superior articular processes
- (2) inferior articular processes
- (2) transverse costal facet
- (2) superior costal facet
- (2) inferior costal facet
What are the variances of T1?
Has facets for articulation with whole facets of the first rib and an inferior facet for articulation with part of the 2nd rib.
What are the variances of T9?
Often fails to articulate with the 10th ribs, inferior costal facets are absent.
What are the variances of T10?
- 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.
What are the variances of T11?
- Costal facet close to the upper border of the body and extend onto the pedicles.
- No articular facet on transverse processes.
What are the variances of T12?
- Circular facet on body (articulates with head of rib 12).
- Transverse process replaced by superior, lateral, and inferior.
- 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 _____________.
- oval
- convex
- posteriorly and slightly superiorlaterally
- oval
- concave
- anterior and slightly inferiomedially
The z-joints of the thoracic spine are innervated by what?
medial branch of dorsal rami
Joints of the costal head are _________ joints (roll and glide) and ribs __-__ articulates with superior and inferior bodies.
- synovial
- 2-9
Costotransverse joints are _______ TP on ________ rib. These joints are located at ribs __-__.
- concave, convex
- Ribs 1-10
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 ________ ________.
- adjacent vertebrae
- annulus fibrosis
The superior costotransverse ligament goes from the _______ border of the transverse process to the superior border of the neck of the underlying ______.
- inferior
- rib
The costotransverse joint are innervated by what?
lateral branch of dorsal rami
- 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?
- PLL
- ALL
- Ligament flava
Where are the IV Discs the thinnest?
upper T-spine
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)?
Costal cartilage
- Joint type of rib 1?
- Joint type of ribs 2-7?
- Joint type of ribs 8-10?
- Rib 1 = synarthrosis
- Ribs 2-7 = synovial joints
- Ribs 8-10 = interchondral joints
What are the supporting structures of the sternocostal joints?
- Capsules
- Radiate Ligaments
- Intra-articular ligament (2nd rib)
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.
- increases
- stays the same
- increases
- mid T-spine
Thoracic spine motion is generally limited, why is this?
To not interfere with respiration.
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 _________.
- posteriorly
- articular processes and spinous processes
- stretched, slackened
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 ___________.
- superior and anterior
- posterior
- slackened, stretched
T-spine lateral flexion is checked by resistance from the _______ and __________.
ribs and sternum
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.
- less, ribs
- bodies, bodies
- mid T-spine
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 _____________.
- ipsilaterally
- contralaterally
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.
- pump, coronal, A-P
- bucket, sagittal, transverse
- Normal expiration is _________, why?
- Normal expiration involves what main muscle?
- Passive due to recoil of thorax resulting from elasticity of osteochondral components and pulmonary structures
- Internal intercostals
What are accessory expiratory muscles?
- Abdominal Muscles: Rectus abdominis, External obliques, Internal obliques (depress the thoracic outlet)
- Iliocostalis thoracis
- Longissimus
- Serratus posterior inferior
- Quadratus Lumborum
Normal inspiration involves elevation of the ribs and sternum via what muscles?
- Diaphragm
- External intercostals
- Levatores costarium
What are accessory inspiratory muscles?
- SCM
- Scalenes
- Pec major and minor
- Serratus anterior
- Lats
- Serratus posterior superior
- Iliocostalis cervicis
Contraction of the diaphragm causes _________ of the central tendon.
lowering
Superficial back muscles?
- Traps
- Lats
- Levator scap
- Rhomboids
-Serratus posterior superior and inferior
Intrinsic back muscles?
Erector Spinae
- Spinalis thoracis
- Longissimus thoracis
- Iliocostalis thoracis
Spinotransverse Group
- Rotatores thoracis
- Multifidus
- Semispinalis thoracis (C6-T4 SP to T6-T10 TP)
Common T-Spine Dermatomes to remember?
- T4 = nipple line
- T10 = umbilicus
What is a normal kyphosis curvature?
20-40 degrees
