Thoracic Spine and Costal Cage (2)

Question 1

how many ribs does the costal cartilage have

Answer 1

24 ribs

Question 2

what does the sternum include

Answer 2

sternum with the xiphoid

costal cartilage and 12 thoracic vertebrae

skin associated fascia & muscle makes up thoracic wall

Question 3

ribs 1-7

Answer 3

true ribs

attach directly to the sternum

Question 4

ribs 8-10

Answer 4

false ribs

attach to cartilage which attaches to sternum

Question 5

ribs 11-12

Answer 5

floating ribs

no anterior attachment

Question 6

thoracic girdle

Answer 6

T1-2

ribs 1-2

manubrium and sternum

Question 7

articulation of costal cartilage –> exhaling

Answer 7

internal torsion

bucket/pump handle

Question 8

articulation of costal cartilage –> inhaling

Answer 8

external torsion

bucket/pump handle

Question 9

what moves the ribs

Answer 9

tspine

Question 10

thoracic extension is accompanied by

Answer 10

rib external torsion

Question 11

thoracic flexion is accompanied by

Answer 11

rib internal torsion

flexion of the rib

Question 12

flexion, SB and rotation to the left

Answer 12

causes internal torsion of the ribs on the right

Question 13

costovertebral joint

Answer 13

plane synovial joint

head of ribs & 2 demi-facets on the inferior body of one vertebrae and on superior body of vertebrae below it

Question 14

where is energy stored during exhalation –> costovertebral joint

Answer 14

radiate ligament

Question 15

what happens to the facet joints during flexion/extension –> costovertebral joint

Answer 15

flex: move anteriorly

extend: move posteriorly

Question 16

what happens to the facet joints when you SB to the right –> costovertebral joint

Answer 16

right side closes

left side opens

Question 17

what happens to the facet joint in neutral –> costovertebral joint

Answer 17

SB to right

rotation left

Question 18

what happens to the facet joints when you flex and rotate to the left –> costovertebral joint

Answer 18

everything opens

rotate left

right side opens

Question 19

costotransverse joint

Answer 19

plane synovial joint

Question 20

how is the costotransverse joint formed

Answer 20

articulation of costal tubercle on the rib with the costal facet of the transverse process

Question 21

how is the costotransverse joint strengthened

Answer 21

3 major ligaments

Question 22

costo-sternal joint

Answer 22

ribs 1-7 articulate with costal cartilages

which then articulate with the manubriosternal at the costosternal joint

Question 23

costo-sternal joints of ribs 2-7

Answer 23

synovial

divided by intra articular ligaments (like CV joint)

Question 24

manubriosternal joint

Answer 24

synchondrosis

has a fibrocartilaginous disk b/w manubrium and sternum

Question 25

where does movement at the rib occur

Answer 25

xiphisternal joint

Question 26

rib motion associated w/ flexion

Answer 26

internal torsion

Question 27

rib motion associated w/ extension

Answer 27

external torsion

Question 28

breathing in the upper ribs

Answer 28

pump handle motion

Question 29

breathing in the middle to lower ribs

Answer 29

bucket handle motion

Question 30

breathing in ribs 11-12

Answer 30

caliper motion

Question 31

first rib AROM

Answer 31

C/S rotation, SB shoulder ABD

Question 32

1st rib during breathing

Answer 32

upper/middle/lower

Question 33

how do we ID dysfxn in the TS and costal cage

Answer 33

what they tell us visually type 1, kyphosis, scap AROM testing (including breathing) PIVMT testing (overpressure) spring tests - accessory motion

Question 34

dx related to tx of tspine (1)

Answer 34

thoracic pain rib dysfxns/resp restriction cervical pain (cervicalgia) C/S HNP

Question 35

dx related to tx of tspine (2)

Answer 35

headaches shoulder dysfxn lumbar pain-lumbago L/S HNP SI dysfxn

Question 36

ROM testing includes

Answer 36

breathing flexion/ext SB R & L Rot R & L

Question 37

PIVMT

Answer 37

palpate interspinous for opening/closing with flexion/extension palpate TP for further opening/closing

Question 38

thoracic springs --> PIVMT

Answer 38

springing on the joint/spinous process as the pt is in prone

Question 39

decision trees for eval and intervention

Answer 39

components 1-4

Question 40

component 1 --> decision trees for eval and intervention

Answer 40

initial observation concerns for problems/stories

Question 41

component 2 --> decision trees for eval and intervention

Answer 41

determine irritability levels (high, moderate, low)

Question 42

component 3 --> decision trees for eval and intervention

Answer 42

physical exam to rule out or rule in most relevant conditions

Question 43

most relevant conditions --> component 3 --> decision trees for eval and intervention

Answer 43

mid back with radiating pain thorax pain and mobility deficits thoracic cage - resp mobility deficits 1st rib pain w/ mobility deficits

Question 44

component 4 --> decision trees for eval and intervention

Answer 44

most relevant physical impairment and strategies to implement