Thoracic spine region

Question 1

what happens if the thoracic spine increaes

Answer 1

if the thoracic spine increases (kyphotic) then the cervical spine become more ath the xtreme extension- become degenerate

Question 2

thoracic cage- structure

Answer 2

vertebral column- posteriorly, 12 sets of ribs, intercostal space, costal cartilage- bond anterior ends of ribs to sternum or other CC, sternum

Question 3

thoracic cage- function- protection

Answer 3

protection of the vital organs from external trauma due to strength and flexibility- heart, ungs liver

Question 4

thoracic cage- function- muscle attachment

Answer 4

provide muscle attachment on irregular bones of thoracic spine and long bones of ribs and sternum

Question 5

thoracic cage- function- assist respiration

Answer 5

internal volume of thoracic is altered by action and movement of ribs/diaphragm increase the AP, vertical and lateral dimensions to draw air in, and increase intrathoracic pressure to expel air

Question 6

thoracic spinal column

Answer 6

12 thoracic vertebrae, 12 pairs of ribs, sternum

Question 7

typical thoracic vertebra- characteristics

Answer 7

body, pedicles- 2X- create articular pilar, vertebral foramen, articular process, costal facets, TP, lamina- 2X- blend to form posterior inferior incline and slender SP

Question 8

typical thoracic vertebra- costal facets

Answer 8

2 demi facets take articulation for ribs, articulare aspect of tubercle of ribs with transverse costal facets- synovial plane

Question 9

atypical vertebra

Answer 9

T1- articulates with a single facet f it own ribs, has costotransverse facet on its own TP T10/11- lack inferior demifacets on their bodies, T11/12- lack transverse costal facets, articulating only with heads of their own ribs

Question 10

thoracic vertebra rule of 3

Answer 10

T1,2,3- SP and TP equal
T4,5,6- TP 1/2 level above SP
T7,8,9,10- TP 1 level above TP
T11- TP 1/2 level above SP
T12- SP and TP equal

Question 11

ribs

Answer 11

true ribs- upper 7 ribs articulate via CC with sternum false ribs- remaining 5 ribs- no direct communication with sternum
floating ribs- ribs 11 and 12- CC

Question 12

costal cartilage

Answer 12

costal cartilage is mobile- has hydroelastic properties- flex in all directions equally, communication of anterior aspect of each rib to sternum via CC, intercostal space between ribs

Question 13

ribs- joints

Answer 13

coastal cartilaginous joint- primary cartilaginous- no movements at joint, rib 1 sternocostal is primary cartilaginous, ribs 2-7 are synovial plane joints
intercostal joints are synovial plane

Question 14

typical ribs

Answer 14

ribs 3-9, head-has crest in centre- ligament comes of crest to articulate at intervertebral ribs, neck and shaft, 2 demifacets- articulate as synovial plane facets with articular with demi facets on vertebra above and below, tubercle- posterior tubercle has articular area- TP of own vertebra, adn non articular process- just lateral= posterior angle where it wraps around thoracic, costochondral junction- PC joint- synchondrosis

Question 15

first rib

Answer 15

has standard head with articular facet- single facet with T1, has anterior aspect of ribs- synchondrosis- PC- with cartilage which blends to sternum via PC joint, has marking for insertions of anterior and middle scalene muscles, between this si the exit for brachial plexus, marking for subclavian vein/ artery superior aspect

Question 16

ribs 1,2, 10-12

Answer 16

rib 1- slopes inferiorly attach to manubrium, contains the scalene tubercle and 2 seperate grooves (rib 2 is the same but twice as long), ribs 11-12- floating ribs, small facets for articulation for vertebra, no. costotransverse articulation tubercle,, have free standing ends- no CC

Question 17

intercostal space- contents

Answer 17

space between ribs, contents- intercostal arteries, veins, nerve

Question 18

intercostal space- muscles

Answer 18

external intercostal, internal intercostal, innermost intercostal, fibres run at 90° to each other- helps to change internal diameters of cage to effect intrathoracic pressure for respiration

Question 19

spinal nerves of thoracic vertebra

Answer 19

spinal canal very narrow in thoracic spine- as vertebral body gets larger- implication for spinal cord injuries with spinal fractures in this area
thoracic spinal nerve (ventral ramus) runs in intercostal space

Question 20

spinal nerves of thoracic vertebra- clinical case note

Answer 20

irritation of thoracic nerve root can produce pain radiating around chest wall is sloping in direction following path of ribs

Question 21

intercostal nerve

Answer 21

dorsal rami- supply skin and muscles of back

anterior rami- in between innermost and internal intercostal supplying muscles

Question 22

sternum

Answer 22

manubrium, body, xiphoid process, attachment of ribs- all synovial plane joints from 2-7, sternocostal articulation for first rib

Question 23

joints of thoracic cage

Answer 23

joints between thoracic vertebra- intervertebral and zygapophyseal, joints between rib and spine- costovertebral and costotransverse, joints between. cartilage and ribs/sternum- costochondral, interchondral, and sternocostal
joints of sternum- sternoclavicular, manubriosternal, xiphisternal

Question 24

joints between thoracic vertebra

Answer 24

intervertebral disc with hyaline end plate on either aspect- intervertebral joints, facet/ zygapophyseal joint- vertical

Question 25

joints between ribs and vertebra

Answer 25

costovertebral joint- head of rib and costal facet on vertebral body- synovial plane joints
costotransverse joint- posterior facing tubercle of rib with TP of vertebra- synovial plane

Question 26

joints between cartilage and ribs

Answer 26

costochondral- between sternal end of rib and CC- PC joint interchondral joint- between the CC of last few ribs- synovial plane

Question 27

joints of sternum

Answer 27

sternocostal joints- ribs 1+ manubrium is PC joint, synovial plane joints between ribs 2-7 and sternum
xiphisternal joint- symphysis- ossifies as we age

Question 28

movements of thoracic spine

Answer 28

relatively less mobile than cervical and lumbar spine, rotation greatest range, flexion and lateral flexion more restricted

Question 29

movements of thoracic spine ROM and limiting factor- flexion

Answer 29

20-45, limited by orientation of facet joints, PLL and supra-spinous and interspinous

Question 30

movements of thoracic spine ROM and limiting factor- extension

Answer 30

25-45, orientation of facet joint, ALL, lig flavum

Question 31

movements of thoracic spine ROM and limiting factor- rotation

Answer 31

30-35, lig flavum

Question 32

movements of thoracic spine ROM and limiting factor-side flex

Answer 32

20-40, inter transverse, orientation of facet joints

Question 33

spinalis thoracis and longismius thoracis origin and insertion

Answer 33

spinalis- SP T11-L2 to SP upper thoracic vertebrae,

longissimus- TP lumbar vertebrae and blends with iliocostalis in lumbar reigion to TP of all thoracic vertebrae