Thoracic Spine Anatomy Flashcards
Where is the thoracic spine located?
At the behind of the neck and towards the bottom of the spine. At the vertebra prominensandspinous process of TXII
Name all of the surface anatomy in order, from top to bottom.
Ligamentum nuchae
Vertebra prominens
Acromion of scapula
Spine of scapula
Inferior angle of scapula
Spinous process of TXII
Iliac crest
Sacral dimple at posterior superior iliac spine
Explain the surface markings of T1
T1: 5cms above sternal (jugular) notch
Explain the surface markings of T2/3
At level of sternal (jugular) notch
Explain the surface markings of T4/5
At level do sternal angle/midway between sternal notch and xiphoid process
Explain the surface markings of T7
At level of inferior scapular angle
Explain the surface markings of T9/10
At level of xiphoid process
How many thoracic vertebrae are there?
T1-T12
What is there to remember about thoracic vertebrae?
They increase in size from T1 - T12
Why are thoracic vertebrae larger than the cervical vertebrae?
due to the increased amount of weight they support
How are thoracic vertebrae characterised?
By their articulations with the ribs
What are the 2 bilateral partial facets? Explain them
Superior facet: articulates with the head of the associated rib
Inferior facet: articulates with the head of the rib below
What is the additional facet?
it is there for the tubercle of the associated rib on each transverse process
How many Demi facets does the typical vertebra have?
There are 3. Superior, inferior and transverse costal. However this isn’t always true.
What are the 3 different thoracic vertebrae articulations?
T1: The rib doesn’t articulate with C7 but the structure of the vertebra is typical.
T9 and T10: Only articulates with its own rib and has no inferior demifacet.
T11 and T12: Only articulates with the head of its own rib. Has no transverse costal facet and only 1 single facet on each side of the body.
How are costovertebral joints formed?
The ribs articulate with the appropriate demifacets on the respective vertebral bodies to the form cosfovertebral joints.
What are the 3 associated ligaments?
Costotransverse ligament
Superior costotransverse ligament
Lateral costotransverse ligament
How do you decide which lateral to do?
To check if lateral should be L or R, do an AP first.
If it is noted on the AP that the patient is suffering from a scoliosis of the thoracic spine
then it is important to select the correct lateral in order to maximise the effects of the diverging beam passing through the joint spaces.
If it is concluded from the AP projection that the patient has a scoliosis to the left then the patient should have a left lateral in order that the divergent beam passes through the joint spaces.
This will not happen if the patient lies on their right
How do you know for a lateral it the beam will pass through the joint spaces
Note how the diverging beam will or will not pass through the joint spaces
What is a main imaging issue when imaging the thoracic spine?
the lateral projection
usually the patient would hold their breath during the exposure
however there is an issue of the ribs obscuring the vertebrae due to their position in relation to the vertebrae
How do you fix the imaging issues with the thoracic spine?
a long exposure time is selected and the patient is asked to breath normally.
This has the effect of ‘blurring’ the ribs
and minimising the issue of superimposition over the vertebral bodies.
What are the 2 common pathologies?.
Kyphosis
osteoporotic wedge fracture
What is kyphosis?
This is an excessive curvature of the thoracic spine giving the patient a ‘hunchback’.
How can kyphosis affect imaging? How do we fix this?
This can lead to the AP projection being difficult for the patient in terms of comfort.
Technique may need to be adapted by either using foam pads to support the patient or by imaging the patient erect
