Thoracic Osce

Question 1

Postural curve

Answer 1

Kyphosis

Question 2

Bony points

Answer 2

Transverse processes
Spinous processes
T3
T7

Question 3

Ligaments/soft tissue

Answer 3

Anterior longitudinal 
Posterior longitudinal 
Ligamentum flavum 
Rectus sheath 
Thoracolumbar fascia

Question 4

Muscles

Answer 4

External obliques
Internal obliques
Rectus abdominus
Transversus abdominus

Question 5

Joints

Answer 5

Intervertebral
Facet
Costotransverse
Costovertebral

Question 6

Facet orientation

Answer 6

Start horizontal gradually get vertical

Question 7

Transverse processes - rule of three

Answer 7

1,2,3 – equal level 
4,5,6 – TP ½ level  above
7,8,9 – TP 1 level above 
10- TP 1 level above 
11- TP ½ level above 
12 – level

Question 8

T3 and T7

Answer 8

T3 - level with spine of scapula

T7 - level with inferior angle of scapula

Question 9

Posterior longitudinal ligament

Answer 9

long
runs posterior to vertebral bodies and intervertebral discs
Extends from back of sacrum and gradually broadens

Question 10

Anterior longitudinal ligament

Answer 10

runs down anterior surface of spine, all vertebral bodies and intervertebral discs on ventral side

Question 11

Ligamentum flavum

Answer 11

short but thick ligt, connects lamina over adjacent vertebrae, preserves upright posture and assists vertebral column in resuming shape after flexion

Question 12

Rectus sheath

Answer 12

Anteroabdominal wall
Anterior - EO, IO
Posterior - IO, TA
Layers interlaces at midline - linea Alba

Question 13

Thoracolumbar fascia

Answer 13

It’s the posterior abdominal wall, in a group with illiacus, psoas major and quadratus lumborum, superficial to erector spinae and attaches to spinous processes

Question 14

Intervertebral joints

Answer 14

articulations between the vertebral bodies

symphysis secondary cartilaginous

Question 15

Facet joints

Answer 15

superior articular facet on the vertebrae below articulates with the inferior articular facet on the vertebrae above
Synovial hinge

Question 16

Costotransverse joints

Answer 16

synovial plane joint
Transverse costal facet on transverse process on the vertebrae on the same level joins to the articular facet on the tubercle of the rib

Question 17

Costovertebral joints

Answer 17

Synovial plane joint
Two articular facets on the head of the rib join with the two articular facets on the vertebrae above and below
Proximal end of the ribs correspond with the vertebrae enclosing the thoracic cage from posterior side

Question 18

External obliques

Answer 18

O: 5th-12th ribs and their costal cartilages
I: linea Alba via rectus sheath, tubercles ASIS, anterior 2/3 iliac crest
NS: Anterior Rami T7-T12

Question 19

Internal obliques

Answer 19

O: lower border of the 10th-12th ribs, linea Alba via rectus sheath, pectin pubis
I: lateral 2/3 inguinal ligament, thoracolumbar fascia
L1 nerve
Anterior rami T7-T12

Question 20

Rectus abdominus

Answer 20

O: xiphoid process, 5th-7th costal cartilages
I: pubic symphysis, pubic crest
Anterior rami T6-T12

Question 21

Transversus abdominus

Answer 21

O: internal surface 7th-12th ribs and their costal cartilages, thoracolumbar fascia, iliac crest and lateral 1/3 inguinal ligament
I: linea alba via rectus sheath and pectin pubis
L1 nerve
Anterior rami T7-T12

Question 22

External obliques movements

Answer 22

fixed pelvis - contralateral rotation, trunk flexion, lateral flexion
fixed shoulders - ipsilateral side flexion, posterior pelvic tilt

Question 23

Internal obliques movements

Answer 23

fixed shoulders - posterior pelvic tilt, ipsilateral side flexion, bilateral trunk rotation
Fixed pelvis - contralateral rotation, bilateral posterior rotation of pelvis

Question 24

Rectus abdominus movements

Answer 24

trunk flexion, contralateral rotation, ipsilateral lateral flexion, posterior pelvic rotation

Question 25

Transversus abdominus movements

Answer 25

raises intra-abdominal pressure and stabilising muscle of lumbar spine/ trunk