TSPINE and RIBS Review Flashcards
The lateral costal facets of the thoracic vert articulate with what?
articulate with head of rib & tubercle
The thoracic vert has a “waisted cylinder” anterior predisposing these bodies to what?
predispose vert to compression fractures with axial loading
What is often seen at the transition zones with C and L spine?
area of breakdown with repetitive stress over time
The 4th thoracic vert is what shape?
Heart shaped
Thoracic vert are hollow in what areas that predisposed the bodies to compression fractures?
Anterior and lateral
With thoracic kyphosis, CoM moves in which directions increasing the magnitude of moment arm at mid-thoracic spine?
Anterior
Transverse costal facets are found on all thoracic vert except which ones?
All except lower 2-3
T/F Transverse processes will shorten as we move caudally.
True
The spinous process of thoracic vert project in which direction?
Project caudally
Describe the thickness of pedicles of thoracic vert as you move caudally:
Increase in thickness
Describe the inferior and superior notch of the pedicles of thoracic vert:
Deep inferior notch
shallow superior notch
The vert spinal foramen of the thoracic vert is what shape/size?
small and circular
The transverse process of thoracic vert is a level of spinous process of more (caudal/cranial) thoracic vert.
more cranial
Which ribs are considered true ribs?
1-7
Which ribs are false ribs?
8-12
Ribs 8-10 will joint the coast cartilage of more (inferior/superior) vert.
More superior segment
Which ribs are free floating?
11-12 (rib 10 35-70% of individuals)
What are the common abnormalities of the cervical rib?
- Length varies
- May be free-floating or join with 1st rib, costal cartilage, or sternum
- Commonly unilateral
The anatomic abnormalities of the cervical rib can cause what issues?
Compression of neurovascular structures between cervical rib and anterior scalene
The sternum consists of what 3 parts?
Manubrium
Body
Xiphoid process
The sternum slopes in what direction?
Down and slightly forward
How many articulations of a normal thoracic vert? (name them)
(2) intervertebral joints
(2) superior articular processes
(2) inferior articular processes
(2) transverse costal facet
(2) superior costal facet
(2) inferior costal facet
What facet variances of T1?
- Has facets for articulation with whole facets of the first rib
- an inferior facet for articulation with part of the 2nd rib
What variances of T9?
often fails to articulate with the 10th ribs- inferior costal facets are absent
What variances of T10?
- superior costal facets only, as the only costal articulation is with the 10th ribs
- Also may or may not have a facet for the tubercle of the 10th rib
What variances of T11?
- costal facet close to the upper border of the body and extend onto the pedicles
- No articular facet on transverse processes
What variances of T12?
circular facet on body (articulates with head of rib 12)
Describe the superior articular processes of the T vert:
Oval
Slightly convex
Orientation: face posteriorly and slightly superiolaterally
Describe the inferiorr articular processes of the T vert:
Oval
Flat/ slightly concave
Orientation: face anterior and slightly inferiomedially
The zygapophysial joints of T vert are innervated by what?
Medial branch of dorsal rami
what are the referral patterns of c7/T1? (3 seperate)
Posterior delt
medial wall scapula
upper trap
what are the referral patterns of T1/2?
Continuous from angle of scapula to upper trap
what are the referral patterns of T2/3?
Lower half of medial border of scapula
what are the referral patterns of T11/12?
Paraspinal muscles T9-L1
Iliac crest
Costal head with vert is what type of joint?
Synovial joint (roll and glide)
T/F Costal head articulates with the vertebral bodies as well as the disc.
True
Rib 2-9 will articulate with which T vert bodies?
Superior and inferior bodies
Which ribs have costotransverse ribs?
1-10 (sometimes not with ten)
Describe orientation of TP and rib within the costotransverse joint:
Concave TP
Convex Rib
The radiate ligament of the joints of costal heads includes how many bands? What are they and what do they insert on?
3 bands:
- superior band and inferior band insert into adjacent vertebrae
- intermediate band inserts into annulus fibrosus
What does the superior costotransverse ligament of the costotransverse joint attach to?
Inferior border of transverse process -> superior border of neck of underlying rib
- Thick, strong, flat, quadrilateral
The costotransverse joint is innervated by what?
Lateral branch of dorsal rami
What posterior longitudinal ligament spans from where to where? Blends with what membrane near the cranium?
Blends with tectoral membrane
Spans from posterior body of C2 to sacrum
What anterior longitudinal ligament spans from where to where? Blends with what?
Span anterior spine
blending with anterior bodies and anulus/end-plates
The ligamenta flava attaches what?
Adjacent laminae
IV Discs of spine are thinnest in (upper/lower) T-Spine
Upper
Costal cartilage is what type of cartilage giving contributions to what?
Hyaline contributing the thoracic mobility and elasticity
Anterior ribs 1-7 joint what?
Sternum
Anterior ribs 8-10 join what?
with lower border of the more superior cartilage structure (10 can be a free floater)
Sternocostal joint of rib 1 is what type of joint?
Synarthrosis
Sternocostal joint of rib 2-7 is what type of joint?
synovial
Sternocostal joint of rib 8-10 is what type of joint?
interchondral joints
With thoracic extension, upper vert moves in what direction?
posteriorly
Thoracic extension is limited by what?
Impact of articular processes and SP
Anterior longitudinal ligament
What ligaments are slackened with thoracic extension?
Posterior longitudinal ligament (PLL) / ligamentum flava/ interspinous ligament slackened
With thoracic flexion, superior facet moves in what direction?
superior and anterior
Thoracic flexion is checked by what?
- PLL
- ligamenta flava
- capsular ligaments
- ligamentum nuchae
Lateral flexion of thoracic vert is checked by what?
by resistance from ribs and sternum
Rotation of thoracic vert is checked by what?
less limitation, checked by ribs
Axis of rotation in T vert is found where?
body
T/F Superior transverse facet aids in the rotation of T spine.
True
When T spine is positioned in flexion/neutral, what is the coupling motion of rotation and lateral flexion?
Coupled ipsilaterally
When T spine is positioned in extension, what is the coupling motion of rotation and lateral flexion?
contralaterally coupled
Respiration in the upper ribs (pump handle) causes movement in what directions?
coronal plane: A-P
Respiration in the lower ribs (bucket handles) causes movement in what directions?
sagittal plane: increase transverse diameter
How does normal expiration occur?
- passive due to recoil of thorax resulting from elasticity of osteochondral components and pulmonary structures
- Internal intercostals
What are the accessory expiratory muscles?
- Abdominal Muscles: rectus abdominis, external oblique, internal oblique depress the thoracic outlet
- Iliocostalis thoracis
- Longissimus
- Serratus posterior inferior
- Quadratus Lumborum
How does normal inspiration occur?
- Diaphragm
- External intercostals
- Levatores costarium
What are the accessory inspiratory muscles?
SCM Scalenes Pec major Pec minor Serratus anterior Latissimus dorsi Serratus posterior superior Iliocostalis cervicis
Contraction of diaphragm causes lowering of central tendon which has what effect. vertically? Transverse? A-P?
Vertical: lowering the central tendon
Transverse: elevating the lower ribs/ limbs
A-P: elevating the upper ribs with the help of the sternum
What muscles included in erector spinae group?
Spinalis thoracis
Longissimus thoracis
Iliocostalis thoracis
What muscles included in spinotransverse group?
Rotatores thoracis
Multifidus
Semispinalis Thoracis (C6-T4 SP to T6-T10 TP)
Dermatome around nipples? Around umbilical?
Nipples = T4 Umbilical = T10
What degree of thoracic kyphosis is normal?
20-4-
