Module 2: Thorax & Spine Flashcards
tell me about c1 and c2
c1= atlas & toppiest
c2 = axis & pokeyiest spinous process
yes and no
biggest vertebral foramen?
atlas, gets smaller as down
what special ab atlas superior facets
where occipital condyles of skull attach
how hanging death?
snap at axis lamina (-|- transverse and spinous process), hyperextension & break of c2
what is peg of c2 that c1 sits on?
odontois process or dens, “no” peg
c3-c7 body
- wider than deep
- superior = concave
- inferior = convex
^ :. sit together
c3-c7 facets
superior facets = point sup and pos
inferior facets = point inf and ant
:. sit diagonally together
which section of verte have transverse foramen for vertebral vein & artery
c3-c7
what about anterior tubercle
small or absent in c7
spinous process of c3-c7
pre much horizontal
thoracic spinous process
t1-t4 = horizontal t5-t12 = more verical
thoracic vertebrae facets
- sup & inf facets fit diagonally
- costal facets = rib attachments
thoracic vertebral body
bigger and thicker than cervical, not as big as lumbar
thoracic vertebrae characteristics
t1-t4 = share cervical characteristics
t5-8 = ribs
t9-t12= share lumbar characteristics
- no inf costal facets (past ribs)
- body gets bigger to support weight
-t12 = most commonly fractured vertebrae
-biggest t vert, so like can support weight but like not
enough that it sometimes gets
lumbar vertebrae body
biggest (surface, height, width) for weight support
lumbar vertebrae facets
sup = med
inf = lat
\:. diagonally
- grip allow extend/flex back rotation
-bc ^ stability (also decre mobility)what is mammilary process
lumbar vertebrae, on lamina
muscle insertion site
what makes up thoracic wall/cage
sternum, manubrium, ribs (costal joints), vertebral column (t1-t12), diaphragm (inferior aperture), head & neck (superior aperture)
true ribs
ribs 1-7, attach directly to sternum/sternocostal joint
false ribs
ribs 8-12, connect via cartilage/costochondral joints
floating ribs
ribs 11&12 (sometimes 10, check via chest x-ray), don’t connect in front of thorax
manubrium, sternum, & xiphoid process + ribs - how all connect?
rib 1 attach manubrium
rib 2 = -|- manu + stern
rib 3-6 = body of stern
rib 7 + 8-10 cartilage = xiphoid
atypical ribs
1, 2, 11, 12
rib 1
shortest
broadest
sharpest curve
1 facet on vertebral end
rib 2
thin, small curve, serratus anterior
all ribs boney landmarks
sternal end w costal cartilage, angle w serratus anterior, @ vertebral end = head, neck, tubercle
spine curvatures
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
- sacral kyphosis
- when all together big flex, individ v little flex
- small at cervical get bigger and bigger to L5 then smaller to coccyx
- bc weight is tranferred to hips
vertebral column flexion muscles
rectus abdominus
int & ext obliques
(if legs fixed) iliopsoas
vertebral column extension muscles
erector spinae
transversospinalis
(if arm is fixed) latissimus dorsi
vertebral column rotation muscles
(opp side) - ext obliques - multifidi (same side) - int oblique
vertebral column lateral flexion muscles
iliocostalis int & ext oblq latissimus dori (assist)
rib/thorax elevation/expansion muscles
scalenes serratus posterior superior (fixed scapula) - pec minor - serratus anterior
ribs/thorax depression/collapse
serratus posterior inferior
internal intercostals
erector spinae group (names + action)
- spinalis
- longissimus
- iliocostalis
- unilat = laterally flex to same side
- bilat = extend
spinalis (O+I)
O
- thoracis = spinous process upper lumbar & lower thoracic vert
- cervicis = ligamentum nuchae & spinous c7
I
- thoracis = spinous process upper thoracic
- cervicis = spinous processe cervicals (sauf c1)
longissimus (O+I)
O
- thoracis = common tendon
- cervicis and capitis = transvers process t1-t5
I
- thoracis = lower 9 ribs & transvers process of t vert
- cervicis = transvers process of c vert
- capitis = mastoid process of temporal bone
iliocostalis (O+I)
O
- lumborum = common tendon
- thoracis & cervicis = pos serface ribs 1-12
I
- lumborum = transverse process L1-L3 & posterior surface ribs 1-6
- thoracis = pos surface rib 1-6
- cervicis = transvers process lower c vert
transversospinalis group
multifidi
rotatores
semispinalis capitis
multifidi (O+I+action)
- unilat = rotation vert col to opp side
- bilat = extend vert col
- O = sacrum & transverse process of L and C vert
- I = spinous process L-c2 vert
- span 2-4 vert
rotatores (O+I+action)
- unilat = rotate vert col opp side
- bilat = extend vert col
- O = transverse process L-C vert
- I = spinous process L-c2 vert
- 1-2 vert
- deep to multifidi
semispinalis capitis (O+I+action)
- extend vert col & head
- O = transverse process c4-t5
- I = -|- sup & inf nuchal lines of occiput
- speed bumps on back of neck
quadratus lumborum (I+O+A) \+ 2 fun fact
- deepest abdominals
- hip hike & ball room dancing
(unilat) - laterally tilt pelvis
- laterally flex vert col same side
- (assist) extend vert col
(bilat) - fix last rob w forced breathing
O = posterior iliac spine
I = rib 12, transverse process L1-4
what are the abdominals
rectus
external O
internal O
transverse
rectus abdoninis (I+O+A) \+ 1 fun fact
- flex vert col
- tilt pelvis posteriorly
O = pubic crest, pubis symphysis
I = cartilage of rib 5,6,7 & xiphiod process - 3x wider @ top (insertion) than bottom (origin)
external obliques (I+O+A) \+ fiber direction & 1 fun fact
- unilat = lat flex vert col to same side, rotate vert col to op side
- bilat = flex vert col, compress abdom contents
O = external surfaces rib 5-12
I = anterior part of iliac crest, rectus sheath to linea alba - hand in pocket
- almost vert @ bott (instertion) & almost horizontal @ top (origin)
internal oblique (I+O+A) \+ direction & placement
- unilat = lat flex vert col to same side; rotate vert col to same side
- bilat = flex vert col; comp vert col
O = lateral inguinal lig, iliac crest, thoracolumbar fascia
I = internal surface of lower 3 ribs, rectus sheath to linea alba - hands to chest
- superiormedial
transverse abdominis (I+O+A) \+ 1 fun fact
- compress abdominal contents
O = lat inguinal ligament, iliac crest, thoracolumbar fasica & internal surface of ribs 6-12
I = rectus sheath to linea alba
+ drives internal pressure to prevent injury
diaphragm (I+O+A)
- draw down = central tendon of diaphragm to increa vol of thoracic cavity during inhalation
O - costal attachment = inner surface rib 6-12
- lumbar attachment = L1&2-3
- sternal attachment = inner part of xiphoid process
I = central tendon - invol contract = hiccup
intercostals (I+O+A)
- external inter = draw ribs sup (incre vol thoracic cav) assist w inhalation
- internal inter = draw ribs inf (decre vol throacic cav) assist w exhalation
O = inferior border of rib above
I = superior border of rib above
serratus posterior superior (I+O+A)
- elevate ribs inhalation
O = spinous processes C7-T3
I = posterior surface ribs 2-5
serratus posterior inferior (I+O+A)
- depress ribs exhalation
O = spinous processes T12-L3
I = posterior surface rib 9-12
intertraversarii (O+I+A)
+ 1 fun fact & function
- unilat = lat flex to same side
- bilat = extend vert col
O (bottom) - cervical = transverse processes C2-C7
- Lumbar = transverse processes L1-L5
I (top) - cervical = transverse processes C2-C7
- Lumbar = transverse processes L1-L5
- too deep to palpate
- no thoracic bc ribs on trans pro
- O on bottom of ea trans pro and I on top :. pull up
interspinalis (O+I+A)
+ fun fact & function
- extend vert col O (bottom) - cervical = spinous process C2-T3 - lumbar = spinous process T12-L5 I (top) - cervical = spinous process C2-T3 - lumbar = spinous process T12-L5 * too deep to palpate * O on inf aspect of spin pro and I on sup aspect of spin pro :. pull up
Trapezius action
Upper fibers - bilat = extend head and neck - unilat = lat flex head and neck same side, rotate head and neck to op side, elevate scap, upwardly rotate scal Middle fibers - adduct scap - stabilize scap Lower fibers - depress scap - upwardly rotate scap
Trapezius (I+O+N)
+ function
O - external occipital protuberance - medial portion of sup nuchal line of occiput - ligamentum nuchae - spinous processes c7-t12 I - lat 1/2 of clavicle - acromion - spine of scap N - spinal portion of cranial nerve XI (accessory) - ventral ranus C2,3,4 * shrug to test innervation connect pectoral girdle to trunk
latissimus dorsi (I+O+A) \+ palpate & fun fact
- extend, adduct, medially rotate shoulder
- directly affect humerus; indirect = scap (downward rotation)
O - inf angle scap
- spin pro T6-12
- ribs 8/9-12
- thoracolumbar fascia
- posterior iliac crest
I = intertubercular groove of humerus - palpate = in axillary fold (climbers, pull downs), ouchie spot
- widest of back
rhomboid major (O+I+A) \+ describe
- adduct, elevate, downwardly rotate scap
- forcefully lower arms
O = spin pro T2-5
I = med border scap -|- scap spine & inf ang - thin, fat, 2x wider than minor
rhomboid minor (O+I+A) \+ describe & how test
- adduct, elevate, downwardly rotate scap
O = spin pro C7-T1
I = upper portion med border scap, across scap spine - test = hands on hips and push elbows back, client resist
- thicker (than major), deep to trap, harder to palpate (than major)
levator scapula (O+I+A)
unilat - elevate & downwardly rotate scap - lat flex head & neck - rotate head and neck to same side bilat = extend head and neck O= trans pro of C1-4 I = med bord scap, -|- sup ang & sup portion cap spine
serratus anterior (I+O+A) * fun fact & function
w O fixed - abduct, upwardly rotate, and depress scap - pull medial bord of scap to rib cage w scap fixed = maybe elevate thorax w forced inhalation O = external surfaces ribs 1-8/9 I = anterior surface med bord scap * antagonist to rhomboids * rib abs * antagonist to rhomboids
connecting ligaments on spine (LN+SL) (+ connections)
ligamentum nuchae - external occipital protuberance & spin pros c1-c7 -back of neck line boy surpaspinous ligament - cont after lig nu is done - spin pros c7- sacrum
what be thoracolumbar fascia
- almost diamond ligament fascia on back
- t9-sacrum
- anchors = lat dorssi & erectors
joints of spine and thorax
- craniovertebral (head/neck)
- intervertebral (vert-vert)
- costovertebral (rib-spine)
- sternocostal (rib-sternum)
things about craniovertebral joint
atlantooccipital = c1 + occipital condyles
- nod yes + lat flex
- capsule of joint
atlantoaxial = c1+c2
- inf/sup facets c1&c2 + medial facet & dens = no pivot
- pivot joint
- capsule of joint
intervertebral joints structures and ligs
- intervertebral disc
- weak interspinous ligament (-|- spin pros)
- strong supraspinous ligament (on top/overlay spin pros)
- above = nuchea ligamentum
- ant/pos longitudinal lig
- ligamentum flavum (-|- ant aspect of spin pro_
- gets thicker from C-T-L
- decrea injury risk
- gets thicker from C-T-L
costovertebral joint ligaments
- lateral costotransverse ligament = connect rib tubercle to vert via trans pros; increa ant/pos strength
- superior costotransverse ligament = connect rib to trans pro above
- costotransverse ligament = connect neck of rib tp trans pro
movement of thoracic vert vs lumbar vert
t = rotation l = flex/lat
how do ribs move while breathing (anology)
like a bucket handle
muscles for quiet/invol expiration
relaxation of diaphragm & external intercostals
(elastic recoil of thoracic wall, lungs, & bronchi)
(gravity)
(internal intercostals)
muscles for forced/vol expiration
internal intercostals (biggest boy) (-rectus abdominis) (-external & internal obliques) (- quadratus lumborum) (- transvers abdominis) (-serratus posterior inferior)
muscle for quiet/invol inspiration
diaphragm
external intercostals
muscles for deep (invol) inspiration
muscles of quiet inhale +
- sternocleidomastoid
- scalenes
- pectoralis major
- levator costarum
- serratus posterior superior
muscles for forced/vol inspiration
muscles for quiet + deep inhale +
- levator scapula
- upper trap
- rhomboids
- pec minor
which trunk muscles are used most when walking
erectors and abdominals
some extensors
rib 1-6 sternocostal joint ligs + structural sitch
rib 1 = on manubrium
- costoclavicular ligament = rib 1 to clavicle
- interclavicular ligament = clavicle to manubrium to clavicle
- articular disc = -|- clav & manubrium
rib 2 = on manubrium-sternal body junction
rib 1-6 = on sternal body
- costal cartilages
- radiate ligaments = costal cartilages to sternal body (sternocostal joint location)
- articular cavities = cav at stern & cart junction
rib 7-10 sternocostal joint ligs + structural sitch
rib 7-10 = on xiphoid via conjoined cartilage
- (still costal cartilages)
- costoxiphoid ligament = rib cartilage to xiphoid process
dislocated vs separated rib
- dislocated rib = dislocation of specifically the sternocostal joint
- separated rib = separation of cartilage
