Thoracic Spine Flashcards
The thoracic spine is thought to have been designed for what purpose?
Rigidity/protection of viscera
What is least mobile part of the spinal column?
Thoracic spine
What does the upper thoracic spine tend to resemble? The lower thoracic spine?
Upper thoracic - resembles cervicals
Lower thoracic - resembles lumbars
What makes the thoracic region unique?
Rib articulations
The thoracic spine is prone to what kind of problems?
Chronic postural problems
Myofascial pain syndromes
What is the clinical importance of the kinds of effects that biomechanical changes in the thoracic spine can have?
Can affect sympathetic nervous system (T1-L2)
What motion is limited in the thoracic spine due to the elongated spinous processes?
Extension
What is the angle of the facet orientation associated with the thoracic spine?
60 degrees from the horizontal plane
What is the orientation of the superior articular facet in the thoracic spine? Inferior?
Superior = Posterior, superior, lateral (BUL) Inferior = Anterior, inferior, medial (ForMed)
What is unique about the IVDs of the thoracic spine?
Comparatively thin
What area of the spine has the smallest IVD height to body height ratio?
Thoracic spine (1:5)
What is unique about the position of the nucleus pulpous in the thoracic spine?
More centrally located within the annulus
What is the range and average kyphotic thoracic curve?
20-50 degrees; average = 45 degrees
What location in the thoracic spine makes the apex of the kyphotic curve?
T6-7
Is the thoracic curve known as a primary or secondary curve?
Primary (structural)
What maintains the thoracic curve?
Wedge-shaped vertebral bodies
What is another name for juvenile kyphosis?
Scheuermann’s disease
How can an increased thoracic kyphosis interfering with normal physiologic functioning?
Crowds the thoracic viscera
What is the primary movement of the thoracic spine?
Lateral bending coupled with axial rotation
Where in the thoracic spine is lateral bending coupled with axial rotation most apparent?
Upper thoracic spine
During lateral bending coupled with axial rotation, to which direction do the T1-T4 spinouses move?
Contralateral side (like cervical spine)
During lateral bending coupled with axial rotation, to which direction do the T5-T8 spinouses move?
Either contralateral OR ipsilateral
During lateral bending coupled with axial rotation, to which direction do the T9-T12 spinouses move?
Ipsilateral side (like lumbar spine)
Thoracic flexion and extension is always coupled with what other motion?
SLIGHT +/- Z translation
What type of thoracic flexion and extension coupled with slight Z translation is most common in the thoracic spine?
- θX
- Z translation
Why is - θX coupled with - Z translation in the thoracic spine the most common?
Facets prevent anterior movement
Gravity allows posterior movement
During a walking study, where was the greatest amount of rotation observed in the thoracic spine?
Middle thoracic (minimal)
How does the rib cage play a significant role in spinal stability?
Enhances stiffness of thoracic spine especially during extension
What is the definition of stiffness in terms of the thoracic spine?
The amount of translation and rotational deformation under the application of force
What are the two kinds of rib articulations?
Costovertebral - connecting heads of ribs to vertebral body
Costotransverse - connecting necks and tubercles of ribs to transverse process
Which ribs articulate with a single vertebral body?
1 and 10-12
Which ribs have heads that also articulate with adjacent vertebral bodies?
2-9
Which ribs do not have costotransverse articulations?
11 and 12 (floating ribs)
Which ribs connect to the sternum directly?
1-7
Which ribs attach to the sternum indirectly via costocartilage?
8-10
Which ribs have no anterior attachment?
11 and 12
Rib humping is seen following which motion and on which side of the body?
Following body rotation on the same side of rotation
What segments make up the thoracocervical junction?
C6-T3
What changes in terms of motion in the thoracocervial junction?
Movements are the same but decreased
Why is the thoracocervical junction considered a difficult area to adjust?
1 transition from most mobile area of spine to least mobile
2 body fat (dowager hump)
3 shoulder/scapular muscles
What segments make up the thoracolumbar junction?
T10-L1
What is the most significant structural characteristic in the thoracolumbar junction area?
Change from coronal facet plane in thoracic spine to sagittal plane facets in lumbar spine (T11-T12)
What are the nerves formed from the posterior primary rami of the spinal roots of T12-L2 that innervate the skin and superficial structures of the upper posterolateral buttock, posterior iliac crest, and groin area?
Cluneal nerves
Why can some dysfunction within the lower thoracic spine be mistake for disorders of the lumbar spine or SI regions?
Cluneal nerves refer pain into the region of the buttock, posterior iliac crest, and groin area
Maigne believes that what area of the spine can account for up to 60% of chronic and acute low back pain?
Cluneal Nerve Entrapment Syndrome
