Thorax and Ribcage

Question 1

Muscles involved in neutral grouped curve SD

Answer 1

Semispinalis dorsi and multifidus cause bow string effect

Question 2

Muscles involved in non-neutral SD

Answer 2

rotatores

Question 3

Supraspinal ligament

Answer 3

connects spinous processes

tender in flexion and extension SD

Question 4

Rule of Three’s

Answer 4

T1-3: SP at level of TPs
T4-6: SP located half a segment below TPs
T7-9: SP located at level of TPs of vertebrae below

T10: like T7-9
T11: like T4-6
T12: like T1-3

Question 5

Thoracic anatomical landmarks

Answer 5

T3 - spine of scapula

T7 SP (level below)- inferior angle of scapula

T2 - sternal notch

T4 - angle of Louis (sternal angle, attachment of 2nd rib)

T4 dermatome - nipple

T10 dermatome - umbilicus

Question 6

Triaxial dysfunction of T spine

Answer 6

Remember rules of 3 “At level of…” refers to spinous process unless specifically says TP level

Check in N, F, E

Question 7

Typical rib anatomy

Answer 7

Tubercle - articulates w/ corresponding TP

Head - articulates w/ vertebra above and corresponding vertebra

Neck

Angle

Shaft

Question 8

Atypical ribs

Answer 8

1, 2, 11, 12, sometimes 10 - if it has a 1 or 2 in it

Rib 1: articulates only w/ T1, has no angle

Rib 2: large tuberosity on shaft for serratus anterior

Rib 11 and 12 - articulate only w/ corresponding vertebrae and lack tubercles

Rib 10: sometimes - only articulates w/ T10

Question 9

True vs False ribs

Answer 9

Ribs 1-7 - attach to sternum via costal cartilage

Ribs 8-10 - do not attach directly to sternum, attach via cartilage of rib above

11 and 12 are floating ribs

Question 10

Rib motions

Answer 10

Rib 1-5 primarily pump handle motion (sagittal plane, transverse axis)

Ribs 6-10 primarily bucket handle motion (coronal plane, AP axis)

Ribs 11-12 primarily caliper motion

Question 11

Primary muscles of respiration

Answer 11

Diaphragm
Intercostals (external, internal, innermost, subcostal)

Question 12

Secondary muscles of respiration

Answer 12

scalenes - ribs 1, 2
pectoralis minor - ribs 3-5
serratus anterior and posterior - ribs 4-9
quadratus lumborum - rib 12
latissimus dorsi ribs 10-11

Question 13

Diaphragm

Answer 13

attachments: xyphoid process, ribs 6-12, bodies and intervertebral discs of L1-L3

Contracts w/ inspiration creating negative pressure to return lymph, venous blood back to thorax

Phrenic n. C3-5

Question 14

Intercostals action

Answer 14

elevate ribs during inspiration

prevent retractions during inspiration

Question 15

Inhalation SD

Answer 15

Ribs 1-10 - stuck up - treat bottom rib

Ribs 11-12 - out and down

Question 16

Exhalation SD

Answer 16

Ribs 1-10 - stuck down - treat top rib

Ribs 11-12 - in and up