Thoracic spine anatomy

Question 1

what joints does a rib articulate?

Answer 1

Costvertebral
Costotransverse (synovial) from Rib 1 to 10 (11 and 12 do not articulate with transverse processes)
Costochondral
sternocostal joints (joints 2-6 are synovial, the first is a synchondrosis)
synovial interchondral joints (ribs 5-9)

Question 2

where do you find demifacets? which vertebraes have a whole facet for ribs?

Answer 2

T2-T9 vertebraes have demifacets

T1 and T10 have whole facets

Question 3

Which ones are true, false and floating ribs?

Answer 3

True Ribs 1 through 7
False ribs 8-10
Floating ribs 11,12

Question 4

Action of ribs

Answer 4

pump handle
bucket handle (7-10)
caliper action (8-12)

Question 5

which ribs articulate with single vertebras?

Answer 5

1, 10,11, 12

Question 6

what differences between Round back, Scheuermann’s disease, Hump back, flat back, Dowager’s hump?

Answer 6

• Round back: decreased pelvic inclination (20 degree) with a thoracolumbar or thoracic kyphosis
• Sheuerann’s: structural kyphosis in adolescents, Idiopathic
• Hump back: a localized, sharp, posterior angulation (AKA gibbus), usually structural from wedging of the body of one or two thoracic vertebrae caused by a fracture, tumor, or bone disease
• Flat back: decreased pelvic inclination with a mobile spine. Similar to round back but thoracic spine is mobile. Does not have an excessive kyphotic curve appearance.
• Dowager’s hump: from Postmenopausal osteoporosis. causing a structural scoliosis that also contributes to a decrease in height

Question 7

what is scoliosis of the cervical spine called

Answer 7

torticollis

Question 8

Apexs of 
cervical scoliosis
of cervicothoracic curve
of thoracic curve
of thoracolumbar curve
of lumbar curve
of lumbosacral curve

Answer 8

Cervical C1-C6
Cervicothoracic C7-T1
Thoracic T2-T11
Thoracolumbar T12 or L1
Lumbar L2 - L4
Lumbosacral L5 or S1

Question 9

A severe rotation of the vertebrae, causing a rib deformity is called

Answer 9

a razor back spine

Question 10

pigeon chest

Funnel chest

Answer 10

pectus carinatum

Pectus excavatum

Question 11

ROM of thoracic spine

Answer 11

Flexion (20-45)
Extension (25-45)
Side flexion (20-40)
Rotation (35-50)

Question 12

If a rib stops moving relative to the other ribs on inhalation…

Answer 12

classified as depressed rib

Question 13

If a rib stops moving relative to the other ribs on exhalation

Answer 13

it is classified as an elevated rib.

Question 14

test for mobility of rib relative to thoracic vertebra

Answer 14

one thumb is on the transverse process, and one thumb is on the rib. Patient asked to forward flex the head (for upper) and thorax (for lower). Normally rib anteriorly rotates with vertebras, but if hypermobile, ribs elevate, if hypomobile, ribs stop before vertebraes.

Question 15

How differentiate ankylosing spondylitis and thoracic spinal stenosis

Answer 15

AS: Morning stiffness, intermittent aching pain, male predominance, sharp pain, bilateral sacroiliac pain may refer to posterior thigh. AROM and PROM restricted

TSS: Intermittent aching pain, pain may refer to both legs with walking (neurogenic intermittent claudication). AROM PROM may be normal.