Thoracic spine Flashcards

1
Q

QQ: during the forward flexion test you notice a moderate rib hump on the right thoracic spine and a smaller hump on the left, how would you describe these curves?

A

right thoracic and left lumber curves

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2
Q

QQ: in normal individuals, flexion/extension in the thoracic spine…

a) increases in lower vertebral segments
b) increases in upper thoracic segments
c) remains the same throughout
d) decreases in lower vertebral segments

A

a) increases in lower vertebral segments

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3
Q

QQ: diaphragms primary mode of action during inspiration

A
  • during inhalation the diaphragms center moves more caudally
  • the edges move more rostrally
  • this compresses the abdominal cavity
  • moves ribs up and out
  • expands thoracic cavity
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4
Q

QQ: kinematics of the ribs during normal inspiration with bucket and pump handle

A
  • with pump handle breathing upper ribs and sternum increase diameter of thoracic cavity in AP direction
  • bucket handle breathing: lower ribs increase diameter of thoracic cavity in horizontal plane
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5
Q

the vertebral body in the thoracic spine is higher posteriorly or anteriorly?

A

posteriorly to give it more of a wedge-like shape

  • this is the reason for the kyphotic curvature in the thoracic spine
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6
Q

the organization of the vertebrae in the thoracic spine allow for flexion/extension but what limits this?

A

the ribs

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7
Q

The most rotation in the thoracic spine can be found in the…

A

upper part of the thoracic spine (less lower due to lumbar transition)

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8
Q

facet orientation in thoracic region is in the ___________ plane

A

frontal

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9
Q

orientation of the facet joints changes at T10-11 to the ________ plane

A

sagittal

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10
Q

Thoracic flexion (arthro)

A

superior and anterior slide of the inferior facet of the superior vertebrae on the superior facet of the inferior vertebrae

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11
Q

thoracic contribution to thoracolumbar flexion (85 degrees total)

A

about 30-40 degrees

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12
Q

thoracic extension (arthro)

A

posterior and inferior slide of the inferior facets of the superior vertebrae on the superior facet of the inferior vertebrae

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13
Q

thoracic extension is limited by

A

anterior connective tissues and posterior bony structures

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14
Q

thoracolumbar extension

A

35-40 degrees total

-thoracic contribution is 20-25 degrees

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15
Q

thoracic rotation (arthro)

A

inferior articular facets of the superior vertebrae slides against the superior facets below

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16
Q

thoracolumbar rotation

A

40 degrees

35 from thoracic

17
Q

thoracic lateral flexion (arthro)

A

contralateral gapping, ipsilateral compression

18
Q

thoracolumbar lateral flexion

A

about 45 degrees

25 degrees from the thoracic region

19
Q

the head of the rib attaches to the vertebral body at the

A

costovertebral joint

20
Q

costovertebral joint

A

convex rib facets articulate with the concave vertebral facets (inferior/superior facet)

21
Q

costotransverse joint

A
  • 10 pairs of joints (T1-T10)

- convex rib tubercles (T1-T6)

22
Q

key landmark for rib dysfunction

23
Q

The superior facets articular with the vertebral bodies ________ T6 while the inferior are articulate with superior facet of V. bodies _______ T7

A

above

below

24
Q

atypical thoracic/rib articulation

A

T1, T10-12 and articulating ribs

25
kinematics of upper ribs (1-6)
- motion occurs in the sagittal plane - with inspiration the upper ribs and sternum increase the AP diameter of the thorax - "pump handle"
26
kinematics of lower ribs
- frontal plane motion - inspiration: lower ribs increase transverse diameter - bucket handle motion
27
3 parts of the diaphragm based on bony attachments
- costal part- upper margins of lower 6 ribs - sternal part- posterior side of the xiphoid - crural part- attached to bodies of upper 3 lumbar vertebrae (right and left crus)
28
action of the diaphragm during inspiration
- 60-80% of work for inspiration - dome flattens and lowers- increases vertical diameter of thorax - diaphragm descends and central tendon moves inferiorly - diaphragm continues to contract resulting in elevation and posterior rotation of the ribs
29
descent of the diaphragm is resisted by the
abdomen for stabilization of the position of the dome
30
expiration
- passive process | - elastic recoil of the thorax, lungs, and diaphragm
31
forced expiration activates
the abdominals and intercostals (internal)
32
Primary inspiratory muscles
diaphragm, intercostals, scalenes
33
forced inspiratory muscles
- serratus posterior - SCM - lats - iliocostalis thoracis - pec groups - QL
34
Expiratory muscles
- rectus abdominus, external oblique, internal oblique, transverse, abdominus - internal intercostals - transversus thoracis
35
rib movement with forward bedning
osteokinematics: anterior rotation of T3-7 Arthrokinematics: superior glide with anterior roll
36
rib movement with extension
- Osteo: posterior rotation with T3-T7 | - arthrokinematics: inferior glide with posterior roll
37
spring test is used to assess
- the first rib (costotransverse joint caudal glide) | - with this test you perform a caudal glide just lateral to T1 transverse process
38
to asses passive mobility of the thoracic spine use the
PA spring test (posterior to anterior)