Thoracic Spine and Ribs AEP

Question 1

t-spine transitional vertebrae

Answer 1

T1 vertebrae

• characteristics of cervical spine
• full articular facet for the head of the 1st rib and demi facet for the upper half of the 2nd rib
• body transverse diameter is 2x side of AP diameter
• spinous process is long and prominent

Question 2

typical thoracic vertebrae

Answer 2

v. body is equal in the transverse and AP diameters
-greater stability
V. bodies are wedge-shaped. posterior height is greater than anterior height
-produces the 40-45 degrees of kyphosis

Question 3

thoracic structures

Answer 3

width increases caudally
spinous processes angle inferiorly
transverse processes angle posteriolaterally
disc height ration to the V. body is smallest in the spine
-greater stability, less mobility

Question 4

apophyseal joints

-orientation

Answer 4

lie 20 off frontal plane and 60 from the horizontal plane
superior facets
-face posteriorly, slightly superolaterally
inferior facets
-face anteriorly, slightly inferiomedially
orientation changes around T10, T11 to sagittal plane

Question 5

arthrokinematics of thoracic flexion

Answer 5

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

Question 6

arthrokinematics of thoracic extension

Answer 6

posterior-inferior slide of the inferior facet of superior vertebrae on superior facet of inferior vertebrae

Question 7

arthrokinematics of thoracic rotation

Answer 7

frontal plane orientation

-inferior articular facet of superior vertebrae slides against superior facet below in the direction of rotation

Question 8

arthrokinematics of thoracic lateral flexion

Answer 8

frontal plane orientation
-inferior facet on the ipsilateral side slides inferiorly
-inferior facet on the contralateral side slides superiorly
same occurs with the ribs on each side

Question 9

spinal coupled motion in the T spine

Answer 9

highly variable and highly controversial

more research is required

Question 10

scoliosis definition

Answer 10

deformity of the vertebral spine
characterized by abnormal curvatures
deformity can be found in all three planes
most often in T-spine
affects adolescent females

Question 11

types of scoliosis

Answer 11

structural scoliosis

non-structural scoliosis

Question 12

structural scoliosis

• what is it
• what percent are idiopathic
• known causes

Answer 12

fixed deformity in which 80% of the cases are idiopathic
there is a lateral curvature and vertebral rotation component involved
known causes
-neuromuscular diseases - cerebral palsy, muscular dystrophy
-congenital spinal defects

Question 13

non-structural scoliosis

• what is it?
• possible causes

Answer 13

normal spine with a lateral curvature
-no spinal rotation
possible causes
-postural
-leg length discrepancy
-pain

Question 14

scoliotic curves

• what are the levels
• chance of each progression

Answer 14

minor curves
-less than 20
-better chance for not progression
intermediate curves
-25-45
-difficult to predict progression and requires close follow-up
major curves
-greater than 50
-high rist for progression
-may need surgical intervention

Question 15

how do you describe a scoliotic curve

Answer 15

location
-where in the spine
direction
-define by the convex side of the lateral curve
# of fixed frontal plane lateral curves

Question 16

types of scoliotic curves

Answer 16

C-curve

S-curve

Question 17

C-curve

Answer 17

single lateral curve

typically found in the thoracic spine

Question 18

S-curve

Answer 18

one primary curve with a second compensatory curve

secondary curve typically found in the thoracolumbar or lumbar region of the spine

Question 19

Cobb angle

• what is it
• purpose

Answer 19

radiographic drawing
measures the magnitude of the lateral curve
-measure like you would measure a kyphosis angle, but in the frontal plane

Question 20

forward bend test

Answer 20

have individual bend forward

-look for protrusions (i.e. rib hump) that indicate a convex curvature on that side

Question 21

contralateral coupling patterns

Answer 21

• lateral flexion and rotation
• spinous process usually rotates toward side of concavity (transverse plane
• rib hump typically on the convex side (frontal plane)

Question 22

other issues related to scoliosis

Answer 22

breathing function
back pain
muscle imbanances
psychosocial issues

Question 23

scoliosis interventions

Answer 23

depends on the severity of the curvature
scoliosis brace
-does not reverse scoliosis, but my slow down progression
surgery
-spinal fusion

Question 24

aging effect on the T-spine and ribs

Answer 24

degenerative changes in the spine
loss of muscle mass and strength
reduced compliance of the rib cage and ventilatory effectiveness
imbalance of bone synthesis and resorption
-osteoclasts break down bone faster than osteoblasts can rebuild bone
–leads to osteoporosis
–autoimmune diesease can affect this as well (ankylosing spondylitis, arthritis, stenosis, COPD)