Spinal Lecture 6 Flashcards
What is the shape of the body of T4
Heart shaped
The left sides of the upper 4-Tspine are flattened for ____
The aorta
What is generally the stiffest segments of the spine?
T1-T6
Are pedicles in the L-Spine different then T-Spine?
The pedicles in the T-spine face more posterior
What is different about the lamina in the T-Spine vs. the L-Spine?
They are wider and overlap
What’s the importance of the inferior and superior articulating process?
They determine movement based on the orientation of the facets
What is the orientation of the facets in the T-Spine?
Superior = posterior and lateral Inferior = anterior and medial
What movement is facilitated or guided by the orientation of the facets in the T-spine?
Side bending and rotation
What restricts side bending and rotation at the T-Spine?
Ribs
What is different about the SP’s in the thoracic region?
Longer
Thinner – less muscle attachment and/or muscle aren’t create as much force as in the lumbar spine
Pointing inferiorly – so much so in the lower portion that they begin to overlap
Why is the fact that the SP’s in the t-spine overlap important for palpation purposes?
They will be found below the level of the vertebral body, so won’t be placed where you think they are
Also the space between the SP’s is extremely small
What is important about the tp’s in the t-spine?
- still stout and thick because they articulate with the ribs
- ribs attach on the anterior aspect of the TP
How many regions is the t-spine broken into
3
what do the ribs articulate with in the t-spine
vertebral body
disc
anterior aspect of TP’s
If you have a vertebrae in disfunction what can this cause with regard to breathing?
a vertebrae in disfunction will ALWAYS cause a rib disfunction, which will negatively impact your breathing
if you have a rib injury what would you also what to treat
the thoracic vertebrae that the rib corresponds with
what happens to the vertebrae of the t-spine as you go lower down, specifically with regard to SP’s
they are no longer overlapping and are a lot like the lumbar spine at this point
What is different between T1 and T2 with respect to the rib articulation?
The rib at that level articulates with one full rib and a bit of rib 2
Thoracic vertebrae of T1 is an ___ vertebrae
atypical
A typical vertebrae has articulation with part of _ ribs
2
Rib 1 articulates solely with ____
T1
If the rib does not articulate with the TP, it is _____
free floating
What ribs in the t-spine have the most mobility
9-12
9-10 variable
11-12 on everybody
Where do you get the most rotation in the T-spine and why?
- Lower t-spine due to the fact the ribs are not articulating with the TP’s
- Ribs restrict side bending and rotation and because they do not attach in the lower t-spine you get more rotation through this area
What movement is restricted in the lumbar spine because of the orientation of the facets?
Rotation
If you get a person to rotate where should you see most of the movement occurring?
Lower t-spine
If you have restriction through T9-T12 what could this cause?
If you don’t get rotation during normal walking then you are going to get more stress on the SI joint and hips. Therefore restriction at 9-12 can cause huge complications elsewhere
The head of the rib articulates with the…..
posterior aspect of the vertebral body, a larger facet on the superior aspect and a smaller facet on the inferior portion of the body along with the intervertebral disc
What is a consequence of the head of the rib articulating right into the vertebral disc in the t-spine?
Decrease mobility of the disc
T2-T8 have a _______ body with the transverse and anteroposterior dimensions being almost _____
T2-8 have a cylindrical body with the transverse and anteroposterior dimensions being almost equal
The vertebral bodies of the t-spine have demifacets. Where is the superior found? Inferior?
on each side of the body are demifacets, the superior usually larger and at the upper border anterior to the pedicles, the inferior at the lower border anterior to the vertebral notches/intervertebral foramen
Do the pedicles in the t-spine increase in thickness as you go caudually or cranially?
caudually
Which segment in the t-spine has a recognizable superior vertebral notch?
the superior vertebral notch is recognizable only in T1
How do the pedicles of the t-spine affect the vertebral foramen?
Extends straight back affecting the size and shape of the foraemen
Describe the lamina of the t-spine
short, thick, broad
overlap from above downwards increasingly as you descend T-spine
face dorsomedially
Describe the superior articular processes of the t-spine
thin plates of bone
almost flat, concave
face dorsally and a little superolaterally
Describe the inferior articular processes of the t-spine
project down from the lamina
facets directed forwards and a little inferomedially
convex
changes to the articular process articulation occur at T11, sometimes at T11 and T12
Describe the vertebral foramen in the t-spine
small and circular as pedicles don’t diverge as they do in the C-spine
Describe the SP’s in the t-spine
slant downwards overlapping
decrease in size caudally to become like spinous processes of L-spine
T11 and T12 Sp’s are triangular, similar to L-spine’s
EXAM Q: Describe the rule of 3’s
Levels:
T1-T3 — SP’s in line with their own TPs
T4-T6 — SP’s ½ body below their own TPs
T7-T9 — SP’s full body below TPs
T10 — SP’s full body below TPs
T11 — SP’s ½ body below their own TPs
T12 — SP’s in line with own TPs
Describe the TP’s of the t-spine
face posterolaterally
near the tips, have anterior oval costal facets articulating with ribs
shorten in caudal succession
in the upper 6 thoracic spine, the TP’s are posterolateral
T12 TP is replaced by three small tubercles:
- superior- is largest, juts upward and corresponds to lumbar mamillary process
- lateral- is the homologue of a lumbar accessory process
- accessory
How many articulations do the vertebrae in the t-spine have? What is found on each side
3 articulations with a rib on each side
What does one rib articulate with in the t-spine?
1 rib will articulate with body of vertebrae above, below and facet on transverse process
what spinal segments in the t-spine have atypical features?
T1, T9 -T12 have atypical features
Which way does the facets on the TP’s of the t-spine face? What does this allow for?
facets are flatter and face more ant/post to allow for rotation
Describe T1 rib articulation
articulate with 1 and ½ ribs
shows circular upper costal facets articulating with the whole facet of the 1st costal head
the inferior costal facet is smaller and semilunar
What direction can the 1st rib go that no other can?
Superiorly
Describe the SP of T1
the Sp is thick, long and horizontal…commonly as prominent as the 7th cervical
For T1 what level should the rib be at ?
rib should be at the level of the Sp, if ½ cm below pathology exists
if rib is ½ cm above it could be a cervical rib
What does T9 often fail to articulate with? What does this indicate? Is it atypical or typical?
often fails to articulate with the 10th rib which indicates that the inferior demifacets are absent (if facets absent, then it is atypical)
If T9 and T10 only articulate with one rib not part of two what will that allow?
Greater rotation and side bending
If we don’t get rotation between T9-12 what is the consequence?
Forcing increased mobility somewhere else that is not designed to do it – going to cause pain discomfort, joint will wear down over time etc. So you NEED rotation through 9-12
Describe the rib articulation, superior facets and TP’s of T10
articulates only with the 10th rib and is excluded from the 11th costovertebral joint
has only superior facets which are large, semilunar or oval, when the 10th rib fails to join with the 9th vertebrae and intervening disc
transverse process may or may not be facetted for the 10th rib
Describe rib articulation, facet location and TP’s of T11
articulates only with the heads of the 11th ribs
circular facets are close to the upper border of the body and extend on to the pedicles
small Tp lacks facets
facet is more posterior, approaching the pedicle
Describe the rib articulation, body and TP’s of T12
articulates with the heads of the 12th ribs by circular facets which are somewhat below the upper border, spreading on to the pedicles
large body
small Tp’s which are replaced by three small tubercles