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S2 Biomechanics > Thoracic Spine and Ribs > Flashcards

Thoracic Spine and Ribs Flashcards

1
Q

T spine apophyseal joints

  • type of joint
  • facet orientation
  • where does facet orientation change?
A

plane synovial joints
-guides intervertebral motion
facet orientation face generally in the frontal plane
-60 degrees from transverse place, 20 degrees from frontal plane
orientation changes around T10-11 to sagittal plane

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2
Q

intracervical (and upper thoracic) region

  • facet orientation
  • favors what motions
A

bewteen horizontal and frontal planes
favors
-combination of axial rotation and lateral flexion

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3
Q

mid-thoracic region

  • facet orientation
  • favors what motions
A

near frontal plane
favors
-lateral flexion, although not fully expressed because of ribs’ splinting action

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4
Q

lumbar (and lower thoracic) region

  • facet orientation
  • favors what motions
A

near sagittal plane

favors flexion and extension (and limits axial rotation)

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5
Q

kinematics of thoracic flexion

-limited by…

A

superior anterior slide of the inferior facet of the superior vertebrae on superior facet of the vertebrae below
limited by
-tension in connective tissues of posterior aspect of thoracic region

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6
Q

kinematics of thoracic extension

-limited by…

A

posterior inferior slide of the inferior facet of the superior vertebrae on superior facet of the vertebrae below
limited by
-tension in anterior connective tissues and posterior bony structures

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7
Q

kinematics of thoracic rotation

A

frontal plane orientation

-inferior articular facet of superior vertebrae slides against superior facet below

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8
Q

kinematics of thoracic lateral flexion

A

frontal plane orientation

  • inferior facet on the ipsilateral side slides inferiorly
  • inferior facet on the contralateral side slides superiorly
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9
Q

sternum osteology

A 
osseous protective plate for the heart
3 components
-manubrium
-body
-xiphoid process
manubriosternal joint
-junction bewteen the manubrium and the body
-location of 2nd rib
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10
Q

structure of the ribs

A

1-7 true ribs
-articulate directly with sternum through chondrosternal joints
8-10 false ribs
-indirect with sternum through costal-cartilages of the adjacent superior rib at the interchondral joints
11, 12 floating ribs
-no anterior attachment

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11
Q

typical ribs

  • which ones are these?
  • components
A 
2-9
head
-attaches to V. body at the costovertebral joint
--2 demifacets with crests between them
neck
-distal to head
tubercle
-distal to neck
-articulates with the transverse process - costotransverse joint
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12
Q

thoracic-rib articulations

A

costovertebral joint

costotransverse joint

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13
Q

costovertebral joint

-convex/concave rule

A

convex rib facets
-superior/inferior facet of rib head (demifacets)
concave vertebral facet
-inferior/superior facet of adjacent vertebra

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14
Q

costotransverse joint

A 
10 pairs of joints T1-T10
convex rib tubercle T1-T6
concave facet on transverse process
-T1-T6 slight rotation
-T7-T10 articular surfaces are flat; permits a gliding motion
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15
Q

rib angle

  • location
  • muscle attachment
  • why do we care?
A 
location
-posterolateral aspect
-lateral to spinous process
iliocostalis muscle attachments
key landmark for rib dysfunction
-tender
-soft tissue restrictions
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16
Q

numbered rib location

A

costovertebral facets
superior facet articulates with vertebral body above - T6
inferior facet articulates with superior facet of the vertebral body below - T7
-articulation occurs at the ribs own numberes vertebrae - rib 7

17
Q

costovertebral ligaments

-categories

A

interosseous aka capsular ligaments
-crest of the rib head to the IVD)
Radiate ligament
-3 bands (superior, intermediate, inferior)

18
Q

atypical thoracic/rib articulations

A

T1 and T10-12; ribs 1, 10-12

19
Q

T1 characteristics

A

full costal facet superiorly
-accepts the entire head of 1st rib
demifacet inferiorly to accept part of the head of the second rib

20
Q

T10-12 characteristics

A

may have full costal facet (pedicles)

21
Q

T11-12 characteristics

A

typically lack costotransverse joints

22
Q

kinematics of the upper ribs

-inspiration

A 
1-6
motion occurs in the sagittal plane
inspiration
-upper ribs and sternum increase the AP diameter of the thorax
-"pump-handle" motion
23
Q

kinematics of the lower ribs

A

motion occurs in the frontal plane
inspiration
-lower ribs increase the transverse diameter
-“bucket-handle” motion

24
Q

diaphragm parts based on bony attachments

A 
costal part
-upper margins of lower six ribs
sternal part
-posterior side of the xiphoid process
crural part
-attached to the bodies of the upper 3 lumbar vertebrae
--right and left crus
25
Q

action of the diaphragm during inspiration

  • innervation
  • importance
A

phrenic nerve
most important muscle of inspiration
-60-80% of the work

26
Q

action of the diaphragm during inspiration

-what happens

A

dome lowers and flattens
-increases the vertical diameter of the thorax
diaphragm descends and central tendon moves inferiorly
central tendon becomes static
diaphragm continues to contract, resulting in lower 6 ribs elevation and posterior rotation

27
Q

descent of diaphragm resisted by…

-purpose

A

resisted by abdomen

stabilizes the position of the dome of the diaphragm

28
Q

expiration

  • quiet expiration
  • forced expiration
A

quiet expiration
-passive process
-elastic recoil of the thorax, lungs and diaphragm
forced expiration
-activation of abdominals and intercostals

29
Q

inspiratory muscles

-primary muscles

A

diaphragm
intercostals
scalene muscles

30
Q

muscles used during forced inspiration

A 
serratus posterior
SCM
lat
iliocostalis thoracic
pectoralis muscles
QL
upper trap
31
Q

expiratory muscles

A 
abdominal muscles
-rectus abdominus
-external oblique
-internal oblique
-TA
internal intercostals
transverus thoracis
32
Q

rib movement during forward bending (flexion)

A

osteokinematics
-anterior rotation T3-T7
arthrokinematics
-superior glide with anterior roll

33
Q

rib movement during extension

A

osteo
-posterior rotation T3-T7
arthro
-inferior glide with posterior roll

S2 Biomechanics (13 decks)

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