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Kinesiology Term 1 > Thoracic Spine and Thorax/Chest Wall > Flashcards

Thoracic Spine and Thorax/Chest Wall Flashcards

1
Q

Function of the Thoracic Region

A

Stability

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2
Q

What serves the stability of the Thoracic region?

A

Due to structure:
-rib cage
-spinous processes
-vertebral bodies
-static restraints

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3
Q

Thoracic Body

A

Wedge-shaped Posterior height greater than anterior height
2 demifacets (half facets) for articulation with ribs

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4
Q

Peak anteroposterior height difference occurs…

A

at T7

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5
Q

What does the anterior wedging of the body produce?

A

The normal kyphotic posture of the TS

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6
Q

Arches of the TS vertebrae

A

Pedicles: face posteriorly
Laminae: short, thick, broad
Superior facets: thin, flat (face posterior, superior, lateral)
Inferior facets: thin, flat (Face anterior, inferior, medial)
Transverse processes: large, thickened ends (paired oval facets, decrease in length caudally)
Spinous processes: T1-10 (slope inferiorly, T11-12(triangular shape)
Vertebral foramen: small, circular

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7
Q

IVD of the TS vertebrae

A

Thinner
Smaller ratio of disc size: vertebral body size
Supports the function of stability over mobility

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8
Q

Annulus fibrosis (outer fibers)

A

Resists distraction, translation, and rotation of vertebral bodies

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9
Q

Anterior Long. Ligament

A

Limits extension
Reinforces anterolateral annulus, anterior aspect of IV joint
(thicker than at CS)

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10
Q

Posterior Long. Ligament

A

Limits forward flexion
Reinforces posterior annulus

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11
Q

Ligamentum Flavum

A

Limits forward flexion, particularly in lumbar region
(thicker than at CS)

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12
Q

Supraspinous Ligament

A

Limits forward flexion

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13
Q

Intertransverse Ligament

A

Limits forward flexion, CL flexion

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14
Q

Zygapophyseal Joint Capsule

A

Resists forward flexion, axial rotation

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15
Q

TS Interbody Joints

A

Between flat vertebral surfaces
Allow for translations in all planes
Discs allow for small amounts of tilting

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16
Q

TS Zygapophyseal Joints

A

Plane synovial joints
-Tighter joint capsule compared to CS and LS
Lie approx. 60 deg off the transverse plane and 20 deg off the frontal plane OVERALL
-Somewhat dependent on region of thoracic spine

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17
Q

Orientation of Zygapophyseal Joints of the TS

A

Inferior facets of SUPERIOR vertebrae: Anterior, inferior, medial
Superior facets of INFERIOR vertebrae: Posterior, superior, lateral

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18
Q

Each thoracic vertebra articulates with a set of paired ribs by way of two joints. What are they?

A

The costovertebral and the costotransverse joints.

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19
Q

What are the vertebral components of the costovertebral joints?

A

The demifacets located on most of the vertebral bodies

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20
Q

What are the vertebral components of the costotransverse joints?

A

The oval facets on the transverse processes

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21
Q

Thorax

A

Describes the bones of the rib cage, the fascia and muscles that attach to the rib cage, the visceral organs within the rib cage, and even the skin that covers the rib cage

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22
Q

Rib Cage (thoracic cage or the bony thorax)

A

Consists of the thoracic vertebrae, the ribs, and the sternum

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23
Q

What does the rib cage protect?

A

Heart, lungs and viscera

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24
Q

What does the process of ventilation, including inhalation/exhalation(inspiration/expiration) depend on?

A

Depends on the mobility of the rib cage and the ability of the muscles of ventilation to move it

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25
Structure of the Rib Cage
Anterior Border: the sternum Lateral Borders: the ribs Posterior Border: formed by the thoracic vertebrae Superior Border: formed by the manubrium of the sternum, superior borders of the first costal cartilages, and by the first ribs and their contiguous first thoracic vertebra Inferior Border: formed by the xiphoid process, the shared costal cartilages of ribs 7-10, the inferior portions of the 11th and 12th ribs, and the 12th thoracic vertebra
26
True Ribs attaching directly to the sternum
Ribs 1-7
27
False ribs attaching indirectly to the sternum via rib 7
Ribs 8-10
28
Floating ribs that have no attachment to the sternum
Ribs 11th and 12th
29
What are the articulations that join the bones of the rib cage?
Manubriosternal, xiphisternal, costovertebral, costotransverse, costochondral, chondrosternal, and the interchondral joints
30
Manubriosternal Joint
Manubrium and body of sternum "sternal angle" or Angel of Louis" Asynchondrosis and has a fibrocartilaginous disc between the articulating ends of the manubrium and the body of the sternum
31
Xiphisternal Joint
Xiphoid process and body of sternum Asynchondrosis
32
Costovertebral Joint
Synovial joint Head of rib + two adjacent vertebral bodies + intervertebral disc
33
Typical costovertebral joints
Ribs 2-9: Head of ribs fit snugly into the surface formed by the adjacent demifacets
34
Atypical costovertebral joints
Ribs 1, 10, 11, 12 Articulate with only one vertebral body Numbered by that body More mobile
35
Inert tissue support (regional differences) of the Costovertebral joint
Fibrous joint capsule Intra-articular ligament: attach to annulus fibrosus Radiate ligament: firm attachment to anterolateral portion of capsule
36
Costotransverse Joints
Synovial joint Costal tubercle of rib + costal facet on TP of corresponding vertebrae 10 pairs: T1-T10 with rib of same number
37
Inert tissue support of Costotransverse Joint
Thin, fibrous joint capsule 3 Major ligaments: lateral costotransverse: short, stout band costotransverse: short fibers that run within the costotransverse foramen superior costotransverse: crest of the neck of the rib to the inferior border of the cephalad transverse process
38
Costochondral Joint
Synchondroses 1-10th ribs articulate anterolaterally with costal cartilages
39
Chondrosternal Joints
Costal cartilages of ribs 1-7 articulate anteriorly with sternum -Rib 1 with lateral facet of manubrium -Rib 2 with 2 demifacets at manubriosternal junction -Ribs 3-7 with lateral facets of sternal body Joints at ribs 1, 6, 7: synchondroses Joints at ribs 2-5: synovial
40
Interchondral Joints
Synovial joints Costal cartilages of ribs 7-10 articulate with the cartilage immediately above
41
Sagittal Plane
Flexion: ribs approximate (exhalation) Extension: ribs separate (inhalation)
42
Frontal Plane
Lateral flexion: Ipsilateral rib approximation Contralateral rib separation
43
Transverse Plane
Rotation: Ipsilateral rib separate Contralateral rib approximation
44
Kinematics of the ribs and manubriosternum
Based on: Types and angles of the articulations Movement of manubriosternum Elasticity of costal cartilage
45
Costovertebral and costotransverse joints are mechanically linked
Upper ribs: Frontal axis / Sagittal plane motion Lower ribs: Sagittal axis / Frontal plane motion
46
Kinematics of the ribs and manubriosternum forms a closed chain with connections to vertebrae __________ and costal cartilages ____________
posteriorly; anteriorly
47
Rib 1
Anterior articulation is large and thicker First costal cartilage stiffer Chondrosternal joint is synchondrosis Lies just inferior and posterior to SC joint (very lil movement ant. at manubrium) Costovertebral joint has a single facet (Increase mobility post., can elevate w/inhalation as a result)
48
Ribs 2-7
Increase in length and mobility caudally Most movement occurs anteriorly due to frontal axis Pump-handle motion
49
Pump-handle Motion
Elevation of the upper ribs at the costovertebral and costotransverse joints Results in anterior and superior movement of the sternum Increases AP diameter of thorax
50
Ribs 8-10
Have a more angles shape Indirect attachment to the sternum Sagittal axis Bucket-handle motion
51
Bucket-handle Motion
Elevation of the lower ribs at the costovertebral and costotransverse joints Results in lateral motion of the rib cage (lateral and inferiorly)
52
Ribs 11-12
Only have one posterior articulation with a single vertebrae Do not participate in closed chain motion of thorax
53
Ventilation - Primary muscles of inhalation
Diaphragm: Primary; 70-80% of inhalation force at rest Intercostals (parasternals, external intercostals) Scalenes
54
Ventilation - Primary muscles of exhalation
N/A Passive function
55
Tidal Breathing
During inhalation, the diaphragm contracts, the dome descends from its resting position, compressing the abdominal contents. The resulting increase in intra-abdominal pressure limits further descent of (i.e., stabilizes) the central tendon of the diaphragm so that continued contraction of the costal fibers of the diaphragm on the stabilized central tendon results in expansion (bucket-handle motion) of the lower ribs
56
Ventilatory Sequence During Breathing
The diaphragm contracts and the central tendon moves caudally. The parasternal, external intercostals, and scalene muscles elevate the ribs and move the sternum anteriorly and superiorly. The muscles also stabilize the anterior upper chest wall to prevent a paradoxical inward movement caused by the decreasing intrapulmonary pressure. As intra-abdominal pressure increases, the abdominal contents are displaced so that the anterior epigastric abdominal wall is pushed anteriorly. Further outward motion of the abdominal wall is countered by the abdominal musculature, with that resistance allowing the central tendon to stabilize on the abdominal viscera. With continued shortening of the appositional (costal) fibers of the diaphragm, the lower ribs are pulled cephalad and laterally, which results in the bucket-handle movement of the lower ribs. With continued inhalation, the parasternal, scalene, and levatores costarum muscles actively rotate the upper ribs and elevate the manubriosternum, which results in an anterior (pump-handle) motion of the upper ribs and sternum. The lateral motion of the lower ribs and anterior motion of the upper ribs and sternum can occur simultaneously. Exhalation during breathing at rest is mostly passive, using the elastic recoil properties of the lungs and the cessation of inspiratory muscle contraction.
57
Skeletal changes that occur with aging impact pulmonary function
Interchondral and costochondral joints can fibrose Manubriosternal and xiphisternal joints ossify
58
Overall chest wall compliance decreases with age
Affects length-tension relationship of muscles of ventilation
59
With age, pulmonary compliance ______and elastic recoil of lung tissue ______.
increases; decreases
60
Age Net effect:
The lungs retain more air at the end of exhalation Inspiratory capacity decreases Ventilation becomes less energy-efficient

Kinesiology Term 1 (16 decks)

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