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705 > Thoracic > Flashcards

Thoracic Flashcards

1
Q

How many vertebrae does the thoracic spine have?

A

12

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2
Q

How many apophyseal (facet) joints does the thoracic spine have?

A

24 (12 on each side)

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3
Q

Which 2 structures have costal articulating surfaces?

A

1) vertebral body

2) transverse process

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4
Q

What are some characteristics for T1 vertebrae?

A
  • characterisitc of cervical spine
  • full articular facet for the head of the 1st rib and demi-facet for upper half of 2nd rib
  • body transvers diameter is 2x size of AP diameter
  • spinous process is long and prominent
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5
Q

Typical thoracic vertebrae have:

A
  • V. body is equal in the transverse and AP diameters
  • V.bodies are wedged shaped. Posterior height is greater than anterior height
  • Wedge shape = kyphotic posture
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6
Q

In thoracic structures: width increases_______, spinous processes angle ________, transverse processes angle _______ and the disc height ratio to the V. body is _________ in the spine.

A

caudally
inferiorly
posteriorlaterally
smallest

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7
Q

Apophyseal joints (plane synovial joints) in the thoracic spine, lie at ~ ___ off Frontal and 60* from the __________ plane.

A

~20*

horizontal

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8
Q

Superior facets face _________ and slightly ____________.

A

posteriorly

superiolaterallly

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9
Q

Inferior facets face __________ and slightly ____________.

A

anteriorly

inferiormedially

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10
Q

Where does the direction of the facets change?

A

@ T10-11 to the sagital plane (from frontal)

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11
Q

Thoracic flexion includes: superior anterior slide of ______________ of the superior vertebrae on the ____________ of the inferior vertebrae.

A

inferior facet

superior facet

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12
Q

Thoracic flexion is limited by tension in connective tissues __________ aspect of thoracic region.

A

posterior

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13
Q

Thoracic extension includes: posterior inferior slide of ________________ of the superior vertebrae on the _____________ inferior vertebrae

A

inferior facet

superior facet

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14
Q

Thoracic extension is limited by tension _________ connective tissues and _____________ body structures.

A

anterior

posterior

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15
Q

Frontal plane orientation in rotation: inferior articular facet of superior vertebrae ___________ against superior facet below

A

slides

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16
Q

Frontal plane orientation in lateral flexion: inferior facet on the _________ side slides inferiorly. Inferior facet on the _____________ side slides superiorly

A

ipsilateral

contralateral

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17
Q

Spinal coupled motion in the thoracic spine occurs in one axis while another motion occurs in another axis. It is highly _________ and ______________.

A

Variable and controversial

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18
Q

What is scoliosis?

A

deformity of the vertebral spine

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19
Q

Scoliosis is characterized by:

A

abnormal curvatures

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20
Q

The deformities of scoliosis can be found in:

A

all three planes; frontal, horizontal, and sagittal

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21
Q

Where is scoliosis most commonly found?

A

thoracic spine

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22
Q

What demographic is scoliosis mostly commonly found in?

A

adolescent females

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23
Q

What are the two types of scoliosis?

A

1) structural

2) Non-structural

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24
Q

Structural scoliosis is:

A

a fixed deformity in which 80% of the cases are idiopathic. There is a lateral curvature and vertebral rotation component involved.

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25
Q

What are the known causes for the other 20% of structural scoliosis cases?

A
  • neuromuscular diseases - cerebral palsy, muscular dystrophy
  • congenital spinal defects.
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26
Q

Non-structural scoliosis is:

A

normal spine with a lateral curvature, there is no spinal rotation.

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27
Q

Possible causes of non-structural scoliosis are:

A

postural, leg length discrepancy, and pain

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28
Q

Curves of scoliosis:

minor curves =

A

= less than 20˚

- Better chance of not progressing

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29
Q

Curves of scoliosis:

intermediate curves =

A

25-45; difficult to predict progression and requires close follow-up

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30
Q

Curves of scoliosis:

major curves =

A

> 50*; high risk for progressing

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31
Q

Describing the curves:
Location =
Direction =
# of fixed frontal plane lateral curves

A 
Location = where in the spine
Direction = define by the CONVEX side of the lateral curve
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32
Q

C-curve:

A
  • single lateral curve

- typically found in the thoracic spine

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33
Q

S-curve

A
  • One primary curve w/ a second

- Secondary curve typically found in the thoracolumbar or lumbar region of the spine

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34
Q

What does the Cobb angle meausre

A

radiographic drawing that measures the MAGNITUDE of the lateral curve.

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35
Q

What is one postural deviation associated with scoliosis?

A

forward, bend test = shows raised side of thoracic cage

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36
Q

In a postural assessment checking for scoliosis, looking for: contralateral coupling (________________), spinous processes are usually rotated toward the side of ___________ (horizontal plane), and the ribs hump typically on the _________ side (frontal plane)

A

(lateral flexion and rotation)
rotated toward the side of CONCAVITY
convex

37
Q

List 4 other common issues related to scoliosis:

A

1) breathing function
2) back pain
3) muscle imbalance
4) psychosocial issues

38
Q

Interventions for scoliosis include:

A

1) Scoliosis brace (used to improve exaggerated curvature)
2) Spinal fusion

** depends on severity / PT should be considered

39
Q

What are the effects of aging on the thoracic spine?

A
  • degenerative changes
  • loss of muslce mass and strength
  • reduced compliance of the rib cage and ventilatory effectiveness
  • imbalnce bone synthesis and resorption (osteoclasts break down bone fastser than osteoblasts can rebuild bone -osteoporosis, autoimmune disease)
40
Q

True/False: The thoracic spine is the most rigid region of the spine?

A

True - because of ribs (protection of vital organs more important than spinal mobility)

41
Q

In the thoracic spine region there is limited: __________ and __________.

A

lateral flexion and rotation

42
Q

The facets of the intracervical and upper thoracic region are between:

A

horizontal and frontal planes

favors the combination of axial rotation and lateral flexion kinematics

43
Q

The facets of the mid-thoracic region are:

A

near frontal plane

favors lateral flexion, although not fully expressed b/c ribs splinting action

44
Q

The facets of the lumbar and lower thoracic region are:

A

near sagittal plane

favors flexion and extension (and limit axial rotation

45
Q

True false: often times the side of dysfunction is the same as the side of pain.

A

False: Often times the side of dysfunction is opposite of the side of pain

46
Q

Which ribs are considered atypical ribs?

A

ribs 1, 11, 12 and sometimes 10

47
Q

During respiration, which ribs demonstrate a bucket handle movement?

A

lower

48
Q

What are the 3 components of the sternum?

A

1) manubrium
2) body
3) xiphoid process

49
Q

The sternum functions as a:

A

osseous protective plate for the heart

50
Q

What is the manubriosternal joint?

A

junction b/n the manubrium and the body

51
Q

Ribs 1-7 are _____ ribs. They articulare directly with the sternum through :

A

true

chondrosternal joints

52
Q

Ribs 8-10 are _______ ribs. They are indirect with sternum through costal cartilages of the adjacent superior rib @ the ___________ joints.

A

false

Interchondral

53
Q

Ribs 11 and 12 are ________ ribs. They have no anterior attachement

A

floating

54
Q

Typical ribs are -

A

2-9

55
Q

Typical ribs have a head that attaches to the V. body at the ________________ joint. With __ demifacets with crest between them.

A

costovertebral

2

56
Q

Typical ribs have a neck that is _____ to the head

A

distal

57
Q

Typical ribs have a tubercle that is distal to the neck and articulates with the transverse process at the ________________ joint.

A

costotransverse joint

58
Q

At the costovertebral joint, convex rib facets are _________________facet of rib head (demifacets). The concave vertebral facet is _________________ facet of adjacent vertebra

A

superior/inferior

inferior/superior

59
Q

The costotransverse joint has 10 pairs of joints (________) and convex rib tubercles (__________)

A

T1-T10

T1-T6

60
Q

The concave facet on transverse process has T1-T6 in slight ________. and T7-T10 articular surface are flat permitting a _________ motion.

A

rotation

gliding

61
Q

What are 4 characteristics of rib angle?

A

1) posteriolateral aspect
2) lateral to spinous process
3) illiocostalis muscle attachments
4) key landmark for rib dysfunction -tender / soft tissue restrictions

62
Q

The superior facet articulates with. V. body above:

A

T6

63
Q

Inferior facet articulates with superior facet of v. body below

A

T7

* articulation occurs at the ribs own numbered vertebrae- Rib 7

64
Q

Atypical thoracic rib articulations include:

A

-T1 and T10-T12 and ribs 1, 10-12

65
Q

T1 is full costal face superiorly that accepts the entire head of the ______ rib. Demifacet inferiorly to accept part of the head of the ______ rib.

A

1st

2nd

66
Q

T10-12 may have full:

A

costal facet (pedicles)

67
Q

T11-12 typically lack _______________ joints

A

costotransverse joints

68
Q

Kinematics or the ribs: upper 1-6 =

A

motion occurs in the sagittal plane

69
Q

Kinematics or the upper ribs: During inspiration, upper ribs and sternum increase the AP diameter =

A

pump-handle motion

70
Q

Kinematics or the ribs: lower 7-12 =

A

frontal plane

71
Q

Kinematics or the lower ribs: During inspiration, lower ribs increase the transverse diameter =

A

bucket-handle motion

72
Q

What are the 3 parts of the diaphragm?

A

1) costal part
2) sternal part
3) crural part

73
Q

The costal part of the diaphragm =

A

upper margins of the lower 6 ribs

74
Q

The sternal part of the diaphragm =

A

posterior side of the xiphoid process

75
Q

The crural part of the diaphragm =

A

attached to the bodies of the upper 3 lumbar vertebrae - R & L crus

76
Q

Action of the diaphragm during inspiration is caused by the ________ nerve.

A

phrenic

77
Q

What is the most important muscle of the inspiration?

A

diaphragm

78
Q

As the dome (of the diaphragm) lowers and flattens:

A

increases the vertical diameter of the thorax

** inhale = pressure decreases

79
Q

As the diaphragm descends, the central tendon moves _________ and becomes _________.

A

inferiorly

static

80
Q

The diaphragm continues to contract resulting in lower 6 ribs __________ and rotate ________.

A

elevate
postseriorly
**interabdominal pressure increases

81
Q

__________ intrathoracic volume __________ intrathoracic pressure, and __________ abdominal pressure

A

Increase in
decreases
increases

82
Q

Quiet expiration is _______ process. Elastic recoil of the ________, ________ and __________

A

passive

thorax, lungs and diaphragm

83
Q

Forced expiration =

A

activation of abdominals and intercostals

84
Q

What are the primary muscles of inspiration?

A

diaphragm, intercostals, scalene muscles

85
Q

What muscles are active during forced inspiration?

A
  • serratus posterior
  • sternocleoidmastoid
  • lattismus dorsi
  • iliocostalis thoracis
  • pectoralis muscles
  • quadratus lumborum
86
Q

Expiratory muscles include:

A
  • 4 abdominal muscles
  • Internal intercostals
  • Transverse thoracis
87
Q

During forward bending (flexion) of the ribs the osteokinematics include _________ rotation of T3-T7. Arthrokinematics include ___________ glide and _________ roll.

A

anterior
superior
anterior

88
Q

During backward bending (extension) of the ribs the osteokinematics include _________ rotation of T3-T7. Arthrokinematics include ___________ glide and _________ roll.

A

posterior
inferior
posterior

89
Q

Take away: Ribs and T/Spine are mechanically related, there is limited research!

A

Take away: Ribs and T/Spine are mechanically related, there is limited research!

705 (7 decks)

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