LECTURE 4: T-SPINE AND RIBS Flashcards
What is the anterior column of the spine?
vertebral bodies
IVDs
*SHOCK ABSORPTION
What is the posterior column?
articular processes
facet joints
*GLIDING MECH FOR MVMT
Thoracic spine: articular processes are oriented…
vertical (but in frontal plane, so more rotation than lumbar)
intervertebral disc is ___ in thickness in thoracic spine
UNIFORM
*kyphosis is NOT due to disc
What are the big 2 important spinal junctions in T-spine treatment?
STIFF CT (mobile c with stiff t)
TL (t-spine rotation w/ l spine limited rot)
with hitting a ball or playing golf, kicking or punching….what junction is important?
TL junction for rotation!!!
*if limited, ppl compensate with ribs
thoracic spine is all about mobility or stability?
STABILITY–> most rigid region of the spine
(c-spine MOBILITY)
each thoracic vertebra has ___ articulations depending on segment
6-13 (identifying cause of dysfunction not always possible)
what are the two big functions of thoracic spine?
protect thoracic viscera
transfer load between upper and lower body regions
Why is the thoracic spine kyphotic?
VERTEBRAL BODY!
posterior height is about 2mm taller than anterior
Which are the typical costal facets
T2-T9 (ribs articulate w/ costal facets above and below and w/ disc)
Which are the atypical demi facets?
T1, T10, T11, T12
*ribs articulate with respective vertebrae
upper thoracic spine acts like
neck
*lower t spine acts like back
T-Spine Rule of 3s
T1-3: SP same level as TP
T4-6: SP ½ level down from TP
T7-9: SP 1 level down from TP
T10: 1 level down from TP
T11: ½ level down from TP
T12: SP same level as TP
how are the facet (ZP) joints angled in the t-spine?
coronal/frontal plane
*favor rotation, SB
T-spine IV discs are ___ and ___ than cervical and lumbar discs
narrow and thinner
IV foramina are ___ in the t-spine
larger (less compression of nerve roots)
where is the spinal canal narrowest?
T4-T9
*increased chance of SC compression
upper facet joints in t-spine are oriented ___ degrees
45-60 degrees from horizontal
middle facet joints in t-spine are oriented ___ degrees
90 degrees from horizontal
lower facet joints in t-spine are oriented
inclined towards sagittal plane (similar to lumbar spine)
Why is it unlikely to have a disc herniation in the t-spine?
very strong ALL and PLL ligaments and thin discs (2:5 disc to body ratio)
Name the ribs and attachments
1-7 (true): sternum
8-10 (false): costochondral cartilage
11-12 (floating): unattached anteriorly
What is a cervical rib and where is it usually attached?
C7: most commonly reported
occur in 0.5-1% of pop
For people with TOS, __% have one or bilateral cervical ribs
66-80%
What are the costo-sternal joints?
attachments in the front!
T1, T6, T7 costo-sternal joints are what
synchondrosis joints
T-25 costo-sternal joints are
synovial joints
Review muscles: what are two buckets of thoracic muscles?
spinal/extremity motion
respiration
what is the critical zone where nerve blood supply sucks/is vulnerable?
T4-9
SC is poorly vascularized
T1-2 nerve sympathetic innervation
head
T3-7 nerve sympathetic innervation
UEs
T1-12 nerve sympathetic innervation
trunk/thoracic
T7-T12 nerve sympathetic innervation
lower extremities
Is radiculopathy common in thoracic spine?
no not that common, pretty rare.
Dermatomes are fuzzy…
bc IV foramina are big
how are biomechanics in t-spine?
rotation w/ ipsi SB
where does pure axial rotation occur?
CT and TL junction (everywhere else in t-spine is coupled motions)
which part of t-spine has pump handle motion? (elevation= AP diameter)
upper t-spine T1-6
which part of t-spine has bucket handle motion? (elevation= ML diameter)
lower t-spine T7-10
review T spine ROM
