Spinal Lecture 7 Flashcards
What are the main functions/purpose of the ribs?
Protection of lungs, heart, pericardium
Muscle attachment
Force transferal / attenuation
Stability to the thoracic as a result of it’s circular ring it forms
What are the main functions of the ribs?
Protection and movement
What occurs to the ribs as we age?
elasticity decreases with age therefore ribs become more rigid and fragile
How many pairs of ribs are there?
12
What is the ribs function with regard to breathing?
Help guide breathing and resist the elastic recoil of the lungs
During inspiration the ribs spin and rotate because the costocartilages can spin and twist allowing full movement
How many superior “true” ribs are there?
7
What connects the superior 7 ribs to the sternum?
Costal cartilages
Which ribs have costal cartilages that join?
Which ones don’t attach to the cartilage?
8-10 rib cartilages join
11 & 12 have free ends not attaching to the cartilage (floating ribs)
What is the implications of ribs 8-10 merging with the costal cartilage above?
dislocate easier
What is the purpose of the intercostal muscles?
Add a layer of protection
Protect and guide ribs through their movement
What can rib one cause narrowing of?
Rib one influences the thoracic outlet space – when it moves it changes the angle and can lead to narrowing of this area
What is the intercostal spaces between ribs filled with?
intercostal spaces between ribs filled with intercostals muscles, nerves, veins and arteries
What plane are the superior ribs on?
superior ribs are on a more horizontal plane, less oblique than inferior ribs
Which rib is most oblique?
9th
Which ribs increase in length and at which rib do they start decreasing in length again?
ribs 1-7 increase in length and then decrease down to 12
Describe the movement of ribs 1-5
ribs 1-5 mov’t is more pump-handle like….axis of movement is posterior, anterior ends move up and down
Describe the movement of ribs 6-10
ribs 6-10 movement is bucket-handle like….axis of movement is medial, lateral sides move up and down
Describe the shaft of a typical rib
thin and flat external convexity grooved internally near it’s lower border—costal groove for intercostal nerve lower border is sharp upper border is rounded
A typical rib articulates with how many vertebral bodies
2
What angle does the rib come out from the vertebral body at?
Posterior and lateral angle
What is the purpose of the costal groove. What is an implication with regard to fracture?
The costal groove is where the nerve typically sits for protection
Implication: can be displaced during fracture which could affect the nerve, artery and vein
Describe the anterior end of a typical rib?
costal end small concave depression for it’s cartilage’s lateral end forms costochondral joint can dislocate (Like an ice cream cone)
How many ribs attach to the sternum?
7
Costal =
Chondra =
Rib = Costal Cartilage = Chondra
What are the 4 articulations of the rib?
Sternochondral
Costochondral
Costotransverse
Costovertebral
describe the posterior end of a typical rib
vertebral end
has a neck, head, tubercle
the head has 2 facets which are separated by a transverse crest
In a typical rib what does the larger and smaller facets articulate with?
Lower, larger facet articulates with body of the corresponding vertebrae
the superior and smaller facet articulates with the body of the superior vertebrae
Forms costovertebral jt
Describe the neck of a typical rib
the neck is the flat part beyond the head
is oblique and faces superior and anterior
posterior inferior surface is rough and pierced by a foramina
Describe the tubercle of a typical rib
tubercle is posterior, external at junction of the neck and shaft
separated into medial articular facet and lateral non-articular facet
anterior to the TP of it’s corresponding vertebrae
forms the costotransverse joint
EXAM Q: T/F you can have an isolated costal problem without it affecting the vertebral segment but you can’t have an isolated vertebral problem without it affecting the rib
True
EXAM Q: deep inspiration and expiration keeps ribs 1 and 2 moving therefore decreases chances of ___________ occurring
thoracic outlet syndrome
Describe the costal cartilage
flat bars of hyaline cartilage
extend from the anterior ends of the ribs
allows for the elasticity and mobility of the thoracic cage
What do the upper 7 costal cartilage articulate with
The sternum
What do the 8-10th costal cartilages articulate with?
The lower border of the one above
What is unique about the two lowest costal cartilages with regard to what they articulate with?
the lowest two have free ends that end in the abdominal wall
What happens to the length of the costal cartilages as you move inferiorly
Increase in length from 1-7
Then decrease in length down to the 12th
What happens to the chondral bars as we age
Decreased elasticity affecting overall mobility of the ribs
How can we prevent inelasticity in the ribs?
Keep the patient moving and breathing
What is the most curved and shortest rib?
Rib 1
Describe the shape of Rib 1
Broad and flat
What plane is rib 1 on?
Horizontal
Why is Rib 1 flat on top?
No costal muscles on top pulling it up
The head of the first rib only articulates with __
T1
Which rib is by far the smallest rib?
Rib 1
What is the only rib that can move superior?
Rib 1
Which rib articulates with the clavicle?
Rib 1
What muscles elevate the 1st rib during forced inspiration?
Anterior and middle scalenes
What muscle attaches on the inferior portion of rib 1?
Serratus anterior
How many grooves are found on the superior surface of rib 1
2
What are the two grooves on the superior surface of rib 1 separated by?
scalene tubercle
What is the anterior groove on rib 1 for?
Subclavian vein
What is the posterior groove on rib 1 for?
subclavian artery
At what point is rib 1 the highest? Which way does it slope?
Highest at the vertebral end and sloped obliquely downward
An upper chest breather will cause hypertrophy of what muscle? What will this lead to?
Hypertrophy of the scalenes, causing narrowing of the thoracic outlet
Describe the head of Rib 1
the head is small, round, and bears an almost circular facet which articulates with T1 vertebral body
Describe the neck of rib 1
the neck is rounded and ascends posterolaterally
Describe the tubercle of rib 1
the tubercle is wide and prominent and is directed up and backwards
What does the facet of rib 1 articulate with?
the oval facet articulates with the first thoracic transverse process
T/F the lungs will come up and poke higher then the first rib?
True
How long is rib 2 in comparison to rib 1?
2x the length
What tubercle is found on rib 2? What does this provide attachment for?
has a tubercle for the origin of serratus anterior and the insertion of the posterior scalene muscle (posterior to S.A. origin)
When taking deep breaths you should feel movement of the ___ and ____ – if disfunction of rib two there will be alterations to this movement
sternal angle and manubrium
Where is the facet of Rib 10 found?
What does it articulate with?
has a single facet on it’s head which may articulate with the IVD of T10 and it’s upper body
T/F Rib 9 and 10 only articulate with one vertebral body (T9 and T10 respectively)
True
How many facets does ribs 11 and 12 have?
each have a single large articular facet on it’s head
Describe the neck and tubercles of ribs 11 and 12
They have no neck or tubercles
T/F the pointed ends of ribs 11 and 12 have a a lot of cartilage at the tip
False , a tiny bit of cartilage at the tip
Does ribs 11 and 12 articulate with the anterior aspect of the TP? Implications of this?
Don’t articulate with anterior aspect of TP – only articulate with vertebral body of 11 and 12 respectively – this will allow more rotation in the lower T-spine
What dictates rotation of the thoracic vertebrae?
The facet joint
Where does most rotation occur? C, T, L or S? Implications?
Almost all rotation will occur in the lower T-spine – very significant because when we walk you should be getting rotation, sports etc as well so if 9-12 are not rotating properly the consequence is rotation somewhere else where your not supposed to (lumbar spine, SI joint, Hips etc.) this will lead to injury or decreased performance
How rare is a cervical rib?
What are the consequences of having one?
Only seen in 1 in 500 individuals
Even rarer to see it bilateral
What do you think the consequences of having a cervical rib are?
Decreased ROM because the rib will restrict c7 and hightened posibilty of thoracic outlet
