Thoracic

Question 1

Curvature of thoracic vertebrae:

Answer 1

We naturally have a normal kyphotic curvature

As we get older, ‘wedging’ can occur. Normal as bones get weaker, creates increased kyphosis

Question 2

What makes up the thoracic cage?

Answer 2

Vertebral column (12 vertebrae)
12 pairs of ribs
Intercostal spaces - space in between each rib
Costal cartilages
Sternum

Question 3

Function of the thoracic cage -

Answer 3

Protection of vital organs
Provides muscle attachments
Assists in respiration

Question 4

Typical features of thoracic verbtebrae:

Answer 4

Vertebral body
Pedicles
Vertebral foramen
Articular processes - vertical
Costal facets (on transverse)
Demifacets - on vertebrae body - tubercle of rib articulation
Lamina
Spinous processes - long, slender and pointed inferiority (slanted)

Question 5

Atypical thoracic vertebra
T1 -

Answer 5

Only superior demifacet at this vertebrae articulates with a single facet of its own rib

This is because C7 is above, therefore no rib above

Question 6

Atypical vertebra
T10 -

Answer 6

Lack inferior demifacets on their bodies

Question 7

Atypical vertebra
T11, 12 -

Answer 7

Lack transverse costal facets, articulating only with the heads of their own ribs

Question 8

Thoracic rule of 3
T1,2,3, TP?
T4,5,6 TP?
T7,8,9 TP?

Answer 8

T1,2,3 - SP and TP are equal

T4,5,6 - SP 1/2 level below TP

T7,8,9 - SP one level below TP

Question 9

Thoracic rule of 3
T10 -
T11-
T12 -

Answer 9

T10 - SP one level below TP
T11 - SP 1/2 level below TP
T12 - SP and TP are equal

Question 10

Ribs
True ribs -

Answer 10

True ribs - upper 7 ribs
This is because they articulate directly with the sternum

Question 11

Ribs
False ribs -

Answer 11

False ribs - ribs 8-12 as they have no direct communication with the sternum

Question 12

Ribs
Floating ribs -

Answer 12

Ribs 11 and 12
No costal cartilage, so no connection anteriorly with any other ribs or the sternum

Question 13

Typical rib features - what are they and what are the features?

Answer 13

3rd - 9th rib
Head
Crest
Neck
Tubercle
Shaft

Question 14

Rib features
What is the rib angle?

Answer 14

Where the rib starts to change direction - can palpate

Question 15

Rib features
What makes up the tubercle of the rib?

Answer 15

Tubercle is made up of the non-articular and articular area
Articular area articulates with transverse process of its own level

Question 16

Distinct rib features
Rib 1 -

Answer 16

Broad superior and inferior surfaces
Flat, slopes inferiorly attaches to the manubrium
Contains the scalene tubercle and 2 separate grooves
Scalene tubercle - anterior and middle scalene attach
Brachial plexus passes between these

Grooves:
Posterior - subclavian artery sits here
Anterior - subclavian vein sits here

Question 17

Distinct rib features
Rib 2 -

Answer 17

It is flat like rib 1 but is twice as long

Question 18

Distinct rib features
Rib 10 -

Answer 18

Single facet, articulates with its own vertebra

Question 19

Distinct rib features
Ribs 11 and 12 -

Answer 19

Articulates only with own vertebra, no tubercles or necks
Little curve pointed anteriorly

Question 20

Intercostal spaces
What are they?
What are its contents?
What muscles are found here?

Answer 20

Space between the ribs
Have a neurovascular bundle, contents:
Intercostal arteries and veins
Intercostal nerve - sits between internal and inner most intercostal
Thoracic nerve runs through as well

Muscles - external intercostal
Internal intercostal
Innermost intercostal

Question 21

Joints
Intervertebral -

Answer 21

Secondary cartilaginous symphysis joint
Articulation between adjacent vertebral bodies and the disc between. And end plate

Covered in vertebral column lecture

Question 22

Joints
Zygapophyseal joints -

Answer 22

Synovial plane
Inferior articular process of superior vertebrae and superior articular process of the vertebrae below

Covered in vertebral column lecture

Question 23

Joints
Costochondral -

Answer 23

Primary cartilaginous
Lateral end of costal cartilage and sternal end of rib
No movement

Question 24

Joints
Interchonral -

Answer 24

Synovial plane joint
Between costal cartilages of 6/7th 7/8th 8/9th ribs
Joints between 9/10th ribs is fibrous

Question 25

Joints Sternocostal (1st rib)-

Answer 25

First primary cartilaginous (synchondroses) 1st costal cartilage and manurbium of sternum

Question 26

Joints Sternocostal (2-7th rib) -

Answer 26

Synovial plane joints 2nd-7th costal cartilages and sternum

Question 27

Joints Sternoclavicular -

Answer 27

Synovial saddle joint Sternal end of clavicle with manubrium of sternum and first costal cartilage Divided into two compartments by the intraarticular disc

Question 28

Joints Manubrium-sternal -

Answer 28

Symphysis joint Manurbium and body of sternum Often fuses in older people

Question 29

Joints Xiphisternal -

Answer 29

Sychondrosis Xiphoid process and body of sternum Often fuses in older people

Question 30

Movements of thoracic spine General - What is greatest ROM -

Answer 30

Thoracic spine is relatively less mobile than cervical or lumbar spines This is because of facet orientation Rotation is the greatest range Not much extension And flexion and lateral flexion tend to be restricted

Question 31

Joints Costotransverse -

Answer 31

Articulation between the articular area of the tubercle of the rib and the costal facet on the transverse process

Question 32

Good way of locating thoracic vertebra during palpation -

Answer 32

Spine of scapula approx in line with T3 Inferior angle of scapula approx in line with T7

Question 33

Passive physiological movements -

Answer 33

Flexion Extension Side flexion Rotation For all, have model in seated position with their feet on the floor and get them to cross their hands onto their shoulders Perform each movement on them offering support

Question 34

What muscles produce…. Flexion - Extension -

Answer 34

Flexion - rectus abdominus External obliques Internal obliques Extension- erector spine (iliocostalis, longissimus, spinalis) Multifidus Interspinales

Question 35

What muscles produce… Side flexion - Rotation -

Answer 35

side flexion - erector spinae Internal and external obliques Multifidus Inter transversus Rectus abdominis Rotation - internal and external obliques Erector spinae Rotatores Rectus abdominis Rotation Multifidus

Question 36

Accessory movements we can perform at thoracic region -

Answer 36

Central PA - SP Unilateral PA - TP Unilateral PA - on the rib angle