Chapter 4-- Thoracic

Question 1

What are the general functions of the Ribs

Answer 1

stabilizers of the spine
decrease general mobility of the thoracics
protect the thoracic viscera
function in respiration

Question 2

Does the thoracic spine have more or less pain syndromes or traumatic injuries

Answer 2

no, exceptions to this:
scoliosis
postural myofacial pain syndrome
kyphosis (scheurmanns disease)
compression fractures

Question 3

What shape are the the throracic vertebrae bodies

Answer 3

wedge shaped– leads to kyphotic curve

Question 4

What site on the thoracic spine is the common site of anomaly

Answer 4

The SP

Question 5

What are the location of the SPs to TPs from T1-4 and T8-12

Answer 5

up 1 interspinous and lateral

Question 6

What is the location of the SPs to the TPs from T5-7

Answer 6

Up 2 interspinous and lateral

Question 7

What is the disc:vertebral body height ratio in the thoracic spine

Answer 7

1:5

Question 8

What does this low ratio lead to

Answer 8

Decreased flexibility in the thoracic spine

Question 9

What angles are formed by the articular facets in the horizontal plane and the vertical plane

Answer 9

Horizontal: 60
Vertical: 30

Question 10

What are the shapes of the articular facets

Answer 10

Flat

Question 11

What direction do the superior facets face

Answer 11

Posterolateral and superior

Question 12

What direction do the inferior facets face

Answer 12

anteromedial and inferior

Question 13

Which ribs articulate in some kind of costochondral joint

Answer 13

R1-10

Question 14

Which ribs articulate directly with the sternum

Answer 14

R1-7

Question 15

What is the range of kyphotic curve of the thoracic spine

Answer 15

25-45 degrees

Question 16

What provides extra stiffness to the thoracic spine

Answer 16

rib cage

Question 17

What rib adds the most stiffness to the thoracic spine

Answer 17

rib 2

Question 18

How many more times stiffer is the thoracic spine with the ribs

Answer 18

2.5 times more stiff

4 times more resistant to compression

Question 19

What is the GROM of flexion in the thoracics

Answer 19

50 degrees

Question 20

What is the GROM of extension in the thoracics

Answer 20

not included in the AMA guideline

Question 21

Which direction does the SROM of the increase in thoracics with flexion

Answer 21

S->I
4 degree upper
6 degrees middle
12 degrees lower

Question 22

What is the IAR for the flexion of thoracics

Answer 22

central superior portion of the subadjacent body

Question 23

What is the IAR of extension in the thoracics

Answer 23

central inferior portion of the vertebral body

Question 24

Which direction does the disc bulge and retract during movement

Answer 24

bulges on the concave side

retracts on the convex side

Question 25

What is the GROM during lateral flexion of the thoracics

Answer 25

38 degrees to each side

Question 26

What is the trend from SROM in the thoracics during lateral flexion

Answer 26

generally uniform with slight increase in lower thoracics T1-9: 6 degrees T10-12: 8-9 degrees

Question 27

What is the IAR of lateral flexion in the thoracics for lateral flexion

Answer 27

contralateral subadjacent vertebral body

Question 28

What are the patterns of movement in the upper thoracics for lateral flexion

Answer 28

Lateral flexion is coupled with rotation to the same side | SPs rotate to the convexity

Question 29

What is the pattern of motion in the mid thoracics for lateral flexion

Answer 29

minimal coupled movement | slight coupled rotation may go in either direction

Question 30

What is the pattern of motion in the lower thoracics for lateral flexion

Answer 30

coupled rotation may go in either direction

Question 31

Is there a significant shift in the nucleus during lateral flexion of the thoracics

Answer 31

No

Question 32

In the upper thoracics what does the coupled motion mean for arthrokinematics for lateral flexion

Answer 32

additional lateral glide of inferior facet on the contralateral side and medial glide on the ipsilateral side

Question 33

What is the GROM for rotation in the thoracics

Answer 33

74 degrees total

Question 34

What is the trend for SROM in rotation of the thoracics

Answer 34

uniform until the last 3-4 lower segments T1-9: 7-9 degrees T10-12: 2 degrees

Question 35

What is the IAR for rotation of the thoracics

Answer 35

contralateral center of the corresponding vertebral body

Question 36

What is the pattern of motion in the upper thoracics for rotation

Answer 36

rotation coupled with minimal lateral flexion to the same side This coupling diminishes in the mid and lower thoracics

Question 37

What occurs arthrokinematically on the side of rotation in the thoracics

Answer 37

facet opens and inferior facet glides medially and inferiorly

Question 38

What occurs arthrokinematically on the opposite side of rotation in the thoracics

Answer 38

facets approximate and the inferior facet glides laterally and superiorly

Question 39

What are the two movements of the rib cage during respiration

Answer 39

bucket handle | pump handle

Question 40

What happens during the bucket handle phase of rib movement

Answer 40

increase the transverse diameter of the rib cage by elevating the rib and its costochondral arch

Question 41

Which ribs is the bucket handle movement the greatest

Answer 41

lower ribs

Question 42

What is occurring in the pump handle movement in the ribs

Answer 42

increase the A-P diameter of the rib cage by elevating the anterior aspect of the rib cage with the upward and forward movement of the sternum

Question 43

Which ribs is the pump handle movement the greatest

Answer 43

the upper ribs

Question 44

What happens to ribs during lateral flexion

Answer 44

ribs open on the convex side | ribs close on the concave side

Question 45

What happens to the ribs during rotation

Answer 45

Movement occurs at both ant/post joints angle accentuation on side of rotation angle flattens on side opposite rotation

Question 46

What happens to the rib cage during flexion

Answer 46

rib cage flattens superiorly and inferiorly decreasing the sternal angle the A-P angle diameter increases

Question 47

When watching GROM for lateral flexion in the rib cage what are we looking for

Answer 47

normal C shape curve | observe for broken stick appearance

Question 48

Why is the cervical spine a common site of injury

Answer 48

flexible rod between the stable thoracic spine and head

Question 49

What is the cervical spine rich in

Answer 49

proprio- and mechanoreceptors for righting reflexes

Question 50

What is the normal lordotic curve of the cervical spine

Answer 50

30-40˚

Question 51

What are the potential effects of a hyperlordotic curve

Answer 51

posterior disc compression tensile strength anteriorly to the disc and myofascial structures shortening of posterior musculature possible predisposition to facet syndrome

Question 52

What are common causes for a hypolordotic curve

Answer 52

Hyperplastic pillars (congenital) Compensation for flat back posture Result of CAD trauma (post traumatic) Acute Facet Syndrome (antalgic)

Question 53

What are the potential effects of a hypolordotic curve

Answer 53

Increased compression of the anterior disc prolonged tensile strength on posterior ligaments Increased workload on paravertebral mm shortening of anterior cervical muscles decreased shock absorption protective muscle splinting

Question 54

What is the GROM for flexion in the cervical spine

Answer 54

60˚

Question 55

What is the GROM for extension in the cervical spine

Answer 55

75˚

Question 56

What is the GROM for lateral flexion in the cervical spine

Answer 56

45˚ to each side

Question 57

What is the GROM for rotation of the cervical spine

Answer 57

80˚

Question 58

What do the cervical segmental muscles do

Answer 58

coordinate and integrate segmental motion acting as involuntary integrators of overall movement

Question 59

What do cervical non-segmental muscles do

Answer 59

produce integrated global movement as a result of the heads moving in relation to the trunk