Thoracic Spine/Ribs Flashcards
What makes ribs T1, T10-12 atypical?
Full costal facets (1 rib per vertebra)
What is the structural makeup of a typical thoracic vertebrae?
- Body - greater stability/decrease mobility
- Intervertebral Disc - smallest ratio of disc height to vert height
- Pedicles - face posterior to narrow vert canal - less motion
- Articular pillar (facets) - coronal for lateral flexion and rotation
- Spinous process - tip at level of caudal vertebra
- Joint capsule - taut
Where is the costovertebral joints?
Typical -
- 2-9
- head of rib, 2 adjacent vert bodies and intervertebral disc
Where is the costovertebral joints?
Atypical -
- 1, 10-12
- Head of rib, one vert body (more mobile)
Describe articulation of costotransverse joints?
Promotes what movement?
T1-T6
- Concave transverse process and convex costal tubercle
- Promotes rotation
Describe articulation of costotransverse joints?
Promotes what movement?
T7-T10
- Flat
- Promotes gliding
Describe articulation of costotransverse joints?
Promotes what movement?
T11-T12
Do not articulate at costotransverse
Describe the structure of costochondral and chonrdosternal joints.
-Costochondral (rib with cartilage) - synchondrosis, no ligament support
-Chondrosternal (cartialge with sternum)
1: synchondrosis
2-5: synovial
6-7:synchondrosis or synovial
Describe the available osteokinematics at the thoracic spine.
- Flex/Ext
- Lateral flex/sidebending
- Rotation
What limits the motion in the flexion?
Limited by tension in PLL, ligamentum flavum, interspinous ligaments and capsule of facet joints
What limits the motion in the extension?
Limited by contact of spinous processes, laminae, facet joints and tension from ALL, facet joint capsule and abdominal muscles
What limits the motion in the lateral flexion?
Limited by facets and ribs
What limits the motion in the rotation?
Rib cage
Describe the arthrokinematics at the interbody joints and facet joints for Flex/ext
Flex - facet glides superior and anterior
Ext - facet glides inferior and posterior
*T1-T6 limited flex/ext
*Lower thoracic facet joints have more sagittal orientation
Describe the arthrokinematics at the interbody joints and facet joints for sidebending
- Superior glide in facet contralateral to side bend
- Inferior glide in facet ipsilateral to side bend
- coupling relationship = rotate slight posterior ipsilateral and anterior contralateral
Describe the arthrokinematics at the interbody joints and facet joints for rotation
-Anterior glide in facet contralateral to rotation
-Posterior glide in facet ipsilateral to rotation
Coupling = slight inferior glide ipsilateral and superior contralateral
What is the arthrokinematic coupling relationship in the upper thoracic spine?
Upper = rotation and side bending coupled in same direction
What is the arthrokinematic coupling relationship in the lower thoracic spine?
Lower = rotation and side bending coupled in opposite direction
Describe the motions that occur at the ribs during breathing in upper ribs
- Diameter changes occur anterior/posterior (sagittal plane)
- Pump handle motion
Describe the motions that occur at the ribs during breathing in lower ribs
- Diameter changes occur medial/lateral
- Bucket handle motion
Describe the muscle activation that occurs when I am doing diagonal sit-up.
- External oblique on one side acts synergistically with internal oblique on the other side
- Transversus abdominus acts as a stabilizer for the obliques
What are the primary axial rotators?
External and Internal obliques
What are the secondary axial rotators?
Ipsilateral lats, iliocostalis lumborum
Contralateral transversospinal muscles
What muscles crucial for extension stability in lumbar region during axial rotation?
Multifidi
-Loss may also result in visualization of flexion bias of unopposed oblique muscles (excessive movement in lumbar spine)
What are the overall functions of the thoracic spine and ribs?
- Less flexible and more stable
- Motion is limited
- Stable base for muscles
- Protection for the thoracic organs
Describe scoliosis
- Most often involves thoracic spine
- May be single curve or 2 (compensatory) curve
- Rib hump associated on convex side
Functional therapy vs structural
Functional - strengthen muscles to move out
Structural - bones crate scoliosis and can’t be moved out
Describe hyperkyphosis
May be due to what?
- Excessive thoracic kyphosis
- May be due to trauma, abnormal growth/development of vert, severe osteoporosis
True/False: hyperkyphosis will not increase inter body joint compression and will not result in fracture
False will increase inter body joint compression and may result in fracture
