PT3 - Thorax And Breathing

Question 1

What are the functions of the thoracic spine?

Answer 1

• force transmission + dissipation
• protection + support of thoracic viscera + CNS
• ventilation
• purposeful movement
• shoulder function

Question 2

What are the specialisations of the thoracic spine?

Answer 2

• mobility => ribs for ventilation volume
• facet orientation => transverse => rotation for upper limb and c-spine
• attachments for upper limb => enhances shoulder movement + stability
• dissipation of forces through thorax

Question 3

What are the key movements of the thorax?

Answer 3

• t1-t10 = rotation (more than lumbar)
• t10-t12 = flexion/extension + lateral flexion (less than c-spine)

Question 4

What are the specialisations of the rib cage?

Answer 4

• boney attachment points
• Myofascial attachment points => redirection + dissipation of forces into thorax
• ribs deform under increased force => healthier => increased deformation available

Question 5

Describe the specialisations of the t-spine for rib integration

Answer 5

• long pedicels => large spinal canal + TPs further from axis to enhance rotation
• VB motion is circular to protect IVD
• posterior angled TP => en chance rotation muscle action

Question 6

What are the actions of the rib cage?

Answer 6

• ribs 2-6 => pump handle
• ribs 6-9 => bucket handle
• rib 1 => similar movement, but limited

Question 7

What are the primary muscles of inspiration

Answer 7

• diaphragm
• external intercostal muscles

Question 8

What are the functions of the diaphragm?

Answer 8

• control of breathing
• postural control
• force production e.g. Val salva => coughing, lifting, bowel movements

Question 9

What happens to the diaphragm as aging occurs?

Answer 9

• thoracic wall movement decreases => diaphragm weakens => reduction in thoracic volume

Question 10

What are the accessory muscles of inspiration (and postural function)?

Answer 10

• SCM
• scalenes
• pec major + minor
• serratus anterior
• latissimus dorsi
• serratus posterior superior

Question 11

What are the primary muscles of expiration?

Answer 11

• relaxation of muscles of inspiration

Question 12

What muscles are involved in forced exhalation?

Answer 12

• internal intercostals
• innermost intercostals
• abdominal wall muscles => raising intra abdominal pressure + pulling ribs down

Question 13

What is the thoracic pump?

Answer 13

• blood drawn into right atrium + inferior vena cava during inspiration (pressure differential between thorax and abdomen during inspiration + expiration)

Question 14

What happens when the pelvic floor fails?

Answer 14

• urinary incontinence
• pelvic organ prolapse
• faecal incontinence
• sensory + emptying abnormalities of lower urinary + GI tract