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MSK Thoracic > Thoracic biomechanics > Flashcards

Thoracic biomechanics Flashcards

1
Q

rotation is more available in…

A

The upper and mid thoracic region
As compared to flexion extension and lateral flexion

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2
Q

flexion and extension motion availability increases in

A

Lower thoracic spine

Due to facet orientation more approximating lumbar vertebra

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3
Q

thoracic movement ranges

A

flexion 30-40
extension 20-25
rotation 30-35
lateral flexion- 25-30

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4
Q

thoracic flexion

A

occurs during forward bending and exhalation

anterior rotation and translation of superior vertebrae on inferior vertebrae

Inferior facet slide up and forward on superior facets

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5
Q

thoracic flexion coupled rib motion

A

superior vertebral body motion causes anterior rotation of the rib head (inferior demifacet attachment)

Anterior portion of the rib moves inferiorly

in lower ribs… they elevate

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6
Q

thoracic extension

A

Occurs during backward, bending and inhalation

Posterior rotation and translation of the superior vertebrae on the inferior vertebrae

Inferior facet slides down and backwards on superior facet

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7
Q

thoracic extension, coupled rib motion

A

Superior vertebral body motion causes posterior rotation of the rib head (inferior Demi facet attachment)

Anterior portion of the rib moves superiorly

lower ribs… depression

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8
Q

Thoracic lateral flexion R

A

lateral flexion in frontal plane, sagittal axis

Type one mechanics
Ipsilateral compression on the closing facets; downward glide
Contralateral distraction, opening facets; upward glide
Rotation to the opposite direction

L ribs- move away from each other (posterior rotating) depressing lower ribs
R ribs- move towards each other (anterior rotating) elevating lower ribs

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9
Q

thoracic rotation R

A

rotation occurs in a transverse plane around the vertical axis

Type two mechanics
Causes same side sidebending

The rotate to right, sidebend the right
shifting of the vertebral body to the left-hand side
Ribs on the left are flexed
Ribs on the right extending

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10
Q

Primary muscles of respiration

A

diaphragm
Scalenes
Intercostals

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11
Q

muscles of forced inspiration

A

Serratus posterior Superior and inferior
Levator costarum
Sternocleidomastoid
Latissimus dorsi
Iliocostalis cervicis and thoracis
Pectoralis minor and major
Quadratus lumborum

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12
Q

Muscles of forced expiration

A

abdominals
Transverses thoracis
Internal intercostals

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13
Q

upper ribs mechanics

A

Pump handle movement
Changes AP diameter

Posteriorly means they elevate
Anteriorly means they depress

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14
Q

middle ribs mechanics

A

Bucket handle movement
Changes AP and transverse diameter

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15
Q

lower ribs mechanics

A

caliper like movement

changes transverse diameter
Elevation And depression

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16
Q

Three distinct regions of the T spine

A

Upper- T1-T3 ( functions as part of the lower C spine); more flexion/extension (treated more efficiently with rotational and lateral flexion techniques)

lower- T10-T12 (functions as part of the upper L spine) (favorably treated with rotational or sidebending techniques)

functional T4- T9 ( true T-spine)
The greatest amount of motion tends to be rotational movements
More limitation with flexion extension
Flexion extension techniques tend to work better in a true thoracic spine

17
Q

two common patterns of clinical present

A

Pain from loading- load attenuation

Symptoms related to movement restrictions

18
Q

load attenuation

A

Compressive loads on thoracic spine, increase caudally from 9% bodyweight at T1 to 47% bodyweight at T12

design is to handle increasing low demand by progressive increase in
Vertebral body height
end plate cross-sectional area
Bone content higher in lower than upper

19
Q

upper t spine load

A

76% compressive load transferred through vertebral body disc complex

20
Q

lower t spine load

A

greater load transferred through posterior column via the interlocking lamina and facet joints

21
Q

IVD load

A

thinner than the C spine and L spine discs

Annulus Fibrosis is stronger
greater ability to resist rotational stress

Disc lesions are more evident
73% of asymptomatic population had some form of disc lesion

22
Q

upper and mid thoracic discs

A

Undergo greater deformation and creep

More viscous, mechanical behavior due to structural arrangements of the annular lamellae

23
Q

L spine load

A

Compressive loading evenly distributed across surface of the end plate independent of position of the motion segment

24
Q

t spine load

A

load distribution across the end plate becomes asymmetric when loaded outside the neutral position

Can explain pain associated with sustained loading postures like on computers, driving

25
Q

t spine flexion and extension motion accompanied by very little movement in other planes is due to

A

Symmetrical anterior rotation of the upper ribs constraints couple movements

26
Q

Rotation and lateral flexion are more complex due to

A

asymmetrical movement patterns in the spinal motion segments and the ribs

27
Q

Lateral flexion

A

ipsilateral anterior rotation and
Contralateral posterior rotation of the upper ribs

28
Q

upper T spine rotation to the right

A

posterior rotation of right ribs
Anterior rotation of left ribs

29
Q

Normal mechanics and motion of the cervical spine and shoulder should be dependent

A

upon normal mobility of the upper T spine

30
Q

habitually flexed upper T spine

A

reduce capacity of muscles to provide cervical thoracic retraction

Anteriorly rotated upper ribs, restrict the range of the C spine extension and rotation due to requirement for movement out of the neutral spinal alignment

31
Q

Restricted upper rib mobility has signs and symptoms consistent with

A

Subacromial impingement or thoracic outlet syndrome

32
Q

in the mid thoracic spine, the anterior elements are subject to high compressive loads because

A

Of apex of kyphosis

33
Q

Progressive wedge deformity of vertebral bodies and disc space narrowing are

A

Quite common

Can lead to hypomobility of mid thoracic motion segments, and ribs
Particularly in rotation and extension

34
Q

Anatomical variations are common at

A

The TL junction and need to be considered

Can be gradual or abrupt

35
Q

PA stiffness of the thoracic spine increases from

A

Upper to lower

36
Q

PA applied perpendicular to the spinal curvature causes

A

anterior translation
And extension

37
Q

directed towards body eliminates

A

Extension but induces a longitudinal force of up to half the applied load

MSK Thoracic (4 decks)

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