Spinal Mechanics- Thoracic spine

Question 1

Thoracic spine and breathing

Answer 1

Ribs 1-7- pump handle
Ribs 8-10- bucket handle
Ribs 11 and 12- calliper

– most mechanically stable part of the spine
—- to allow secure attachments for the ribs to articulate from during breathing

– the thorax and rib cage are a closed, sealed system which allows it to act as a bellows
—- due to you having the pleural tissue, pleural membrane, Sibson’s fascia.
—- this all creates a closed seal system and this is why there ribs is able to change in volume to inhale and exhale and also allows the ribs to act as a bellows

Question 2

Diaphragm

Answer 2

Innervation- phrenic nerves (C3-C5) (C3,4,5 keep the diaphragm alive)

Peripheral attachments:
– lumbar vertebrae and arcurate ligaments
– costal cartilages of ribs 7-10 (attach directly to ribs 11-12)
– xiphoid process of the sternum

Left crus- arises from L1-L2 and their intervertebral discs
Right crus- arises from L1-L3 and their intervertebral discs

So if someone has low back pain, always ask them if they have recently had a cough or a cold.
– as if someone has had a cold or a UTI, that could put huge strain through the crus of the diaphragm

– rib mobilisation is a great help with asthma, to improve the breathing of a patient

Question 3

Limiting factors to breathing

Answer 3

Age- leads to increased muscle stiffness which leads to reduced compliance

Scoliosis- can lead to excessive side bend and rotation affecting the thoracic compliance and rib extension

Scheurman’s kyphosis- leads to excessive kyphosis, resulting in reduced rib excursion and thoracic expansion

RA- leads to increased stiffness and inflammation of the cartilage of sternocostal joints, resulting in rib excursion

Obesity