iRA/tRA - T Spine and Ribs A&P Review Flashcards

1
Q

All the thoracic vertebrae have _______ costal facets and all but the lowest 2-3 have __________ costal facets.

A
  • lateral

- transverse

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2
Q

Looking from the side or front of the vertebrae we can see the thoracic vertebrae have a “______ _______” shape which can predispose them to what?

A
  • “waisted cylinder”

- compression fractures with axial loading

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3
Q

What are the transitional zones of the thoracic vertebrae?

A
  • cervicothoracic junction

- thoracolumbar junction

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4
Q

What is a site of breakdown when we have a change in curvature of the spine?

A

transitional zones

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5
Q
  • What are the transverse costal facets articulating with?

- What happens to the transverse processes as we move more caudally?

A
  • corresponding rib

- shorten

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6
Q

The spinous processes of the thoracic vertebrae project ________ and overlap at vertebrae __-__.

A
  • caudally

- 5-8

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7
Q
  • The pedicles of the thoracic vertebrae _______ in thickness as we move more caudally.
  • They also have a deep _______ notch and a shallow _________ notch.
A
  • increase

- inferior, superior

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8
Q

What are the 2 foramen of the thoracic vertebrae?

A
  • Spinal (small and circular)

- Intervertebral

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9
Q

The transverse processes of the thoracic spine are typically at the level of the _____ of the more cranial segment.

A

SP (spinous process)

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10
Q
  • What are our true ribs?

- What does this mean?

A
  • Ribs 1-7

- They articulate with the sternum (costal cartilage)

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11
Q

-What are our false ribs?

A
  • Ribs 8-12
  • Ribs 8,9, and 10 typically join superjacent costal cartilage
  • Ribs 11 and 12 (rib 10 35-75% of individuals) are free floating
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12
Q

What is a cervical rib and what are its implications?

A
  • Anatomical abnormality (free floating or joined with 1st rib) common unilaterally that is an “extra rib” just above the clavicle.
  • Can cause compression of neurovascular structures between cervical rib and anterior scalene.
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13
Q
  • What are the 3 parts of the sternum?

- The sternum slopes _____ and slightly _______.

A
  • Manubrium, Mesosternum (Body), Xiphoid process

- down and forward

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14
Q

What are all the articulations of the thoracic vertebrae?

A
  • (2) intervertebral joints
  • (2) superior articular processes
  • (2) inferior articular processes
  • (2) transverse costal facet
  • (2) superior costal facet
  • (2) inferior costal facet
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15
Q

What are the variances of T1?

A

Has facets for articulation with whole facets of the first rib and an inferior facet for articulation with part of the 2nd rib.

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16
Q

What are the variances of T9?

A

Often fails to articulate with the 10th ribs, inferior costal facets are absent.

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17
Q

What are the variances of T10?

A
  • 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.
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18
Q

What are the variances of T11?

A
  • Costal facet close to the upper border of the body and extend onto the pedicles.
  • No articular facet on transverse processes.
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19
Q

What are the variances of T12?

A
  • Circular facet on body (articulates with head of rib 12).

- Transverse process replaced by superior, lateral, and inferior.

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20
Q
  • The superior articular processes are ____ shape, slightly _______ transversely, and face ___________ and slightly _______________.
  • The inferior articular processes are _____ shape, flat/slightly ________ transversely, and face __________ and slightly _____________.
A
  • oval
  • convex
  • posteriorly and slightly superiorlaterally
  • oval
  • concave
  • anterior and slightly inferiomedially
21
Q

The z-joints of the thoracic spine are innervated by what?

A

medial branch of dorsal rami

22
Q

Joints of the costal head are _________ joints (roll and glide) and ribs __-__ articulates with superior and inferior bodies.

A
  • synovial

- 2-9

23
Q

Costotransverse joints are _______ TP on ________ rib. These joints are located at ribs __-__.

A
  • concave, convex

- Ribs 1-10

24
Q

The joints of the costal heads have a radiate ligament composed of 3 bands. The superior and inferior bands insert into ________ ________ and the intermediate band inserts into ________ ________.

A
  • adjacent vertebrae

- annulus fibrosis

25
Q

The superior costotransverse ligament goes from the _______ border of the transverse process to the superior border of the neck of the underlying ______.

A
  • inferior

- rib

26
Q

The costotransverse joint are innervated by what?

A

lateral branch of dorsal rami

27
Q
  • What ligament blends with the tectoral membrane and spans from posterior body of C2 to sacrum?
  • What ligament spans anterior spine, blending with anterior bodies and anulus/end-plates?
  • What ligament attaches adjacent laminae?
A
  • PLL
  • ALL
  • Ligament flava
28
Q

Where are the IV Discs the thinnest?

A

upper T-spine

29
Q

What flat hyaline cartilage contributes to thoracic mobility and elasticity as well as forms the attachment of rib 1-7 to the sternum (directly) and 8-10 (indirectly)?

A

Costal cartilage

30
Q
  • Joint type of rib 1?
  • Joint type of ribs 2-7?
  • Joint type of ribs 8-10?
A
  • Rib 1 = synarthrosis
  • Ribs 2-7 = synovial joints
  • Ribs 8-10 = interchondral joints
31
Q

What are the supporting structures of the sternocostal joints?

A
  • Capsules
  • Radiate Ligaments
  • Intra-articular ligament (2nd rib)
32
Q

T Spine Motion:

  • The flexion movement ________ as we move more caudally.
  • The extension movement ________ as we move more caudally.
  • The lateral flexion movement ________ as we move more caudally.
  • Thoracic rotation is highest in the _____ T-spine.
A
  • increases
  • stays the same
  • increases
  • mid T-spine
33
Q

Thoracic spine motion is generally limited, why is this?

A

To not interfere with respiration.

34
Q

In T-spine Extension:

  • The upper vertebrae tilts __________.
  • It is limited by impact of what?
  • The ALL is ________. The PLL/ligamentum flava/interspinous ligaments are _________.
A
  • posteriorly
  • articular processes and spinous processes
  • stretched, slackened
35
Q

In T-spine Flexion:

  • The superior facets glide _________ and ___________.
  • There is a tensile load on the _________ annulus.
  • The ALL is __________. The PLL/ligamentum flava/capsular ligaments/ligamentum nuchae are ___________.
A
  • superior and anterior
  • posterior
  • slackened, stretched
36
Q

T-spine lateral flexion is checked by resistance from the _______ and __________.

A

ribs and sternum

37
Q

In T-spine Rotation:

  • There is _____ limitation, checked by the _____.
  • The axis is in vertebral _______ (mid thoracic spine) or in front of _______ (elsewhere).
  • Requires some lateral displacement in ____ T-spine.
A
  • less, ribs
  • bodies, bodies
  • mid T-spine
38
Q

Traditional Coupling Theory of T-Spine:

  • When positioned in flexion and in neutral, rotation and lateral flexion are coupled ___________.
  • When positioned in extension, rotation and lateral flexion are coupled _____________.
A
  • ipsilaterally

- contralaterally

39
Q

Rib Motion:

  • In the upper ribs (_______ handle) the axis lies almost in the ________ plane, elevation increases the __-__ diameter of the thorax.
  • In the lower ribs (_______ handle) the axis moves closer to the ________ plane, increasing the __________ diameter.
A
  • pump, coronal, A-P

- bucket, sagittal, transverse

40
Q
  • Normal expiration is _________, why?

- Normal expiration involves what main muscle?

A
  • Passive due to recoil of thorax resulting from elasticity of osteochondral components and pulmonary structures
  • Internal intercostals
41
Q

What are accessory expiratory muscles?

A
  • Abdominal Muscles: Rectus abdominis, External obliques, Internal obliques (depress the thoracic outlet)
  • Iliocostalis thoracis
  • Longissimus
  • Serratus posterior inferior
  • Quadratus Lumborum
42
Q

Normal inspiration involves elevation of the ribs and sternum via what muscles?

A
  • Diaphragm
  • External intercostals
  • Levatores costarium
43
Q

What are accessory inspiratory muscles?

A
  • SCM
  • Scalenes
  • Pec major and minor
  • Serratus anterior
  • Lats
  • Serratus posterior superior
  • Iliocostalis cervicis
44
Q

Contraction of the diaphragm causes _________ of the central tendon.

A

lowering

45
Q

Superficial back muscles?

A
  • Traps
  • Lats
  • Levator scap
  • Rhomboids

-Serratus posterior superior and inferior

46
Q

Intrinsic back muscles?

A

Erector Spinae

  • Spinalis thoracis
  • Longissimus thoracis
  • Iliocostalis thoracis

Spinotransverse Group

  • Rotatores thoracis
  • Multifidus
  • Semispinalis thoracis (C6-T4 SP to T6-T10 TP)
47
Q

Common T-Spine Dermatomes to remember?

A
  • T4 = nipple line

- T10 = umbilicus

48
Q

What is a normal kyphosis curvature?

A

20-40 degrees