Thoracic inlet

Question 1

What are the borders of the thoracic inlet?

Answer 1

First ribs bilaterally
First thoracic vertebrae
The superior end of the manubrium

Question 2

What is the operculum?

Answer 2

The (lid) manubrium

Question 3

What is the “functional” thoracic inlet?

Answer 3

First five thoracic vertebrae
First five ribs and their costocartilages
The manubrium
The sternum

Question 4

The ring of the thoracic inlet is formed by what?

Answer 4

T1, the first rib, and the manubrium

Question 5

Why is the ring of the thoracic inlet act as a unit?

Answer 5

Because it has a single costovertebral and costotransverse articulation

Question 6

What type of joints are the sternocostal joints of ribs 2-12?

Answer 6

Plane gliding/synovial except the first rib

Question 7

The costal cartilage of the first rib is of what type?

Answer 7

Typical synchondrosis

Question 8

The thoracic cavity is lined by what?

Answer 8

The endothoracic fascia

Question 9

How does the endothoracic fascia connected to the rest of the body?

Answer 9

Through the aortic hiatus

Also connected to the cervical fascia

Question 10

What is the eponym of the endothoracic fascia?

Answer 10

Sibson’s fascia

Question 11

What is the upper diaphragm in OMM?

Answer 11

Endothoracic fasica

Question 12

Where does the brachial plexus emerge through? Where does it go?

Answer 12

Anterior and middle scalene, goes underneath the clavicle

Question 13

What is responsible for thoracic outlet syndrome?

Answer 13

Impingement of the brachial plexus between the clavicle and the first rib

Question 14

Why is the thoracic inlet important?

Answer 14

Site of lymphatic drainage of the entire body

Question 15

What are the nerves that course through the inlet? (4)

Answer 15

Phrenic
Vagus
Recurrent laryngeal
Symp trunks

Question 16

What are the 3 arteries that go through the thoracic inlet?

Answer 16

Carotids
Brachiocephalic trunk
Subclavian

Question 17

What are the 3 veins that drain through the thoracic inlet?

Answer 17

IJV
Brachiocephalic
Subclavian

Question 18

What are the two structures that we are treating (pushing on) when treating the thoracic inlet?

Answer 18

T1 and the first rib

Question 19

To fully treat the thoracic inlet, what vertebrae and ribs must be treated?

Answer 19

First five

Question 20

When the thoracic inlet is acting as a unit, rotation and sidebending of the thoracic vertebrae related to each other how?

Answer 20

Same side

Question 21

What should be done before addressing the inlet?

Answer 21

Relax the musculature around it

Question 22

Where should the patient have their arms and hands when addressing the inlet?

Answer 22

Fingers crossed over the abdomen

Question 23

What happens when you place your hand on top of their shoulders, and push their shoulder down toward their feet?

Answer 23

Draws the trap and levator scap away from the inlet, and reduces the chances of misdiagnoses

Question 24

What are the two components of the thoracic unit?

Answer 24

Sidebending and rotation

Question 25

When checking sidebending, we are evaluating what structure?

Answer 25

Rib 1

Question 26

To diagnose rotation of the T1 vertebra, what do we do?

Answer 26

Pads of fingers on the clavicle and compress

Question 27

Treatment of the thoracic inlet should start with what?

Answer 27

Balancing of the upper thoracic cavity (the first five thoracic vertebrae and five ribs)

Question 28

Selection of treatment of a pt is based on what?

Answer 28

Pts medical history

Question 29

ME and HV/LA maby be indicated when?

Answer 29

Whenever there is a lack of acuteness, resistive myofascial tension, and tissue hypersensitivity

Question 30

When dragging the fascia of the sternum, which way should it drag?

Answer 30

easier to drag into the concavity (harder to drag towards the convexity)

Question 31

Treatment of the sidebending component of the thoracic inlet with muscles energy primarily uses which muscles?

Answer 31

Scalenes

Question 32

Treatment of the rotational component of the thoracic inlet with muscles energy primarily uses which muscles?

Answer 32

Rotatores

Question 33

What happens to the upper thoracic cage after treatment of the inlet?

Answer 33

Increased expansion in the anterosuperior direction

Question 34

What happens to the breathing pattern after treatment of the thoracic inlet?

Answer 34

rate decrease, depth increases

Question 35

What happens to external respiration after treatment of the thoracic inlet?

Answer 35

External respiration becomes more abdominal, and less costal

Question 36

What happens to the angle of louis after treatment?

Answer 36

Becomes more prominent

Question 37

True or false: After treatment of the thoracic inlet, the arm length discrepancies and pelvis asymmetries may disappear

Answer 37

True (?)