Thoracic Spine Flashcards
Typical Vertabrae
Articulations
12 separate articulations:
* 4 Zygapophyseal
* 2 costotransverse
* 4 costovertebral
* 2 body -IV- body
Atypical Vertebrae
Articulations
T1: 1 demifacet, one full facet each side
* No rib above T1
T10: Single costal facet on each side
T11, T12: Single costal facet each side, non costotransverse joints
Ribs
- Arc-shaped flat bones
- Protect thoracic organs
- Attachment points for muscles of the back, chest and upper arms
- Divided into different groups based on structure articulated
True Ribs
- First 7 pairs
- Articulate directly with sternum through costal cartilages
- Joints between ribs and cartilages called costochondral joints
- Joints between cartilages and sternum called sternochondral joints
Costochondral joints
Joints between ribs and cartilages
Sternochondral joints
Joints between cartilages and sternum
False Ribs
- Ribs 8, 9, 10
- Unite anteriorly via costal cartilage from Rib 7
Floating Ribs
- Ribs 11, 12
- Do not attach to sternum
- Short
- Do not have neck or tubercle
Sternum
3 Parts
* Manubrium
* Body
* Xiphoid Process
Manubrium
Bony Landmarks
* Jugular Notch
* Clavicular Notch
* 1st Costal Notch
* 2nd Costal Notch
Articulates with 1st Rib and Clavicle to create Sternoclavicular Joint
Articulates with body of sternum with Manubriosternal Joint
Intervertebral Symphysis
Type: Cartilaginous joint; symphysis
**Ligaments: **
* Longitudial (Anterior/Posterior
* Ligamenta Flava
* Interspinous Ligaments
* Intertransverse Ligaments
* Suprapinous Ligaments
Innervation Sinuvertebral nerve
Movements Flexion, extenson, lateral flexion, axial rotation of vertebral column
Facet Joints
(Zygapophysial)
Type Synovial Plane, nonaxial, uniplaner
Innervation Sinuvertebral Nerve, Medial brance of posterior ramus of spinal nerve
Movements Flexion, extension, lateral flexion, rotation
Costocorporeal Joints
Type Synovial Plane
Articular Surfaces
* Costal demifacets on T1-T9
* Full Costal facets on T1, T10, T11, T12
* Heads of ribs 1-12
Movements
* Internal Rotation and elevation of head of rib
Costotransverse Joints
Type Synovial Plane
Articular Surfaces
- Tubercle of ribs 1-10
- Transverse Costal facets on Transverse Processes of # equivalent vertebrae
Movements
* 1-6: Internal rotation of neck of rib
* 7-10 Posteriomedial translation of neck of rib
Chostochondral Joints
Type Primary hyaline cartilaginou joint (synchondrosis); snathrosis
Articular Surfaces Sternal (medial) end of rib, lateral end of costal cartilage
Innervation Intercostal nerves
Movement None
Sternochondral Joints
(Sternocostal)
Type
* Joint 1: Primary cartilaginous joint (synchondrosis)
* Joint 2-7: Synovial planar joints, nonaxial, uniplanar
Articular Surfaces Sternal ends of costal cartilages of true ribs, costal notches on sternum
Innervation Intercostal nerve
Movement
Joint 1: almost no movement
Joints 2-7: Translation, mainly inferiorly
Serratus Posterior Inferior
Serratus Posteiror Inferior
Extrinsic: Intermediate Later
Origin Inferior Aspect ribs 9-12
Insertion Spinous processes of T11-12 vertebrae
Innervation Anterior rami of T9-T12 spinal nerves
Action
* Depresses Ribs
* Aids in proprioception, rather than motor function
* Thin, weak, superficial respiratory muscle
* Deep to Latissimus dorsi
Extrinsic: Intermediate Layer
Origin Nuchal Ligament, Spinous Process of vertebrae C7-T3
Insertion Superior Borders of ribs 2-5
Innervation Anterior rami of T2-T5 spinal nerves
Action Elevates ribs,
Thin, weak, superficial respiratory muscle
Iliocostalis Thoracis
Deep Intrinsic: Intermediate - Erector Spinae
Origin Angle of ribs 7-12
Insertion Angles of ribs 1-6
Innervation Posterior Rami of spinal nerves
Action Bilateral contraction Extension of Spine
Unilateral Contraction Lateral flexion of spine (ipsilateral)
Longissimus Thoracis
Deep Intrinsic: Intermediate - Erector Spinae
Origin
* Thoracic: Spinous and transverse processes of L1-L5, median sacral crest, posterior surface of sacrum, posterior Iliac crest
* Lumbar: Lumbar intermuscular aponeurosis, medial part of sacropelvic surface of ilium, Posterior sacroiliac ligament
Insertion
* Thoracic Transverse process of T1-T12, Angles of ribs 7-12
* Lumbar Accessory and transverse processes of L1-L5
Action
* Bilateral Contraction - Extension of Spine
* Unilateral Contraction - Lateral flexion of spine (ipsilateral)
Spinalis Thoracis
Deep Intrinsic: Intermediate - Erector Spinae
Origin Spinous Process of T11-L2
Insertion Spinous Process of T2-T8 vertebrae
Innervation Posterior rami of spinal nerves
Action
* Bilateral Contraction - Extension of Thoracic Spine
* Unilateral Contraction - Ipsilateral lateral flexion of thoracic spine
Semispinialis Thoracis
Deep Intrinsic: Transversospinalis Group
Origin Transverse process of T6-T10
Insertion Spinous process of vertebrae C6-T4
Innervation Posterior Rami of spinal nerves
Action
* Bilateral Contraction - Extension of Thoracic Spine
* Unilateral Contraction - Ipsilateral lateral flexion of thoracic spine, rotation of thoracic spine (contralateral)
Multifidius
Deep Intrinsic: Transversospinalis Group
Origin Spinous process of C2-L5 vertebrae (2-5 levels above insertion)
Insertion Mammillary process of L1-L5 vertebrae, sacrum, iliac crest
Innervation Posterior Rami of spinal nerves
Action Stabilizes the spine
Rotatores
Deep Intrinsic: Transversospinalis Group
*Origin Spinous Processes of lumbar vertebrae
Insertion Mammillary processes of lumbar vertebrae 2 levels down
Innervation Posterior Rami of spinal nerves
Action Stablize, extend, and rotate spine
Posterior Primary Rami
- Send cutaneous branches through superficial muscle layers.
- Excessive tension in muscle may rub and strip myelin from cutaneious branches
- May present as trigger points
Motion of T Spine
- Frontal - 20 degrees each side (lateral) 40-50 degrees total
- Ribcage and sternum attachements limit ROM
- T1-T12 total sagittal plane motion is
- 16 degrees flexion
- 20 degrees extension
Motion at Ribs
- Upper Ribs - Pump Handle - sagittal plane elevation
- Lower Ribs - bucket handle - frontal plane flaring
