IV. Biomechanics Of The Thoracic Spine And Rib Cage Flashcards Preview

Spinal Kinetics & Kinematics > IV. Biomechanics Of The Thoracic Spine And Rib Cage > Flashcards

Flashcards in IV. Biomechanics Of The Thoracic Spine And Rib Cage Deck (98)
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1
Q

Function of Ribs?

A

Stabilizers to the spine Decrease the general mobility of thoracic Protect thoracic viscera Function in respiration

2
Q

Quiet Respiration is mostly:

A

Diaphragmatic

3
Q

Forced Respiration is

A

External intercostals become very active to elevate ribs, as well as activationg of many other secondary muscles

4
Q

What are some common clinical pain syndromes or traumatic injuries associated with the thoracic spine and ribs?

A

scoliosis postural myofascial pain syndrome kyphosis compression fractures

5
Q

Describe the vertebral body in the thoracics

A

AP and transverse diameters are equal wedge shaped vertically with from 1-2 mm shorter

6
Q

TPs in the thoracic region point in which direction?

A

lateral and posterior

7
Q

TPs are stronger in the lumbar or thoracic region?

A

thoracic

8
Q

Describe the SPs in the thoracics

A

long vertically, less in the upper and lower thoracics common site of spinal anomaly

9
Q

For T1-T4, where are the TPs in relation to the SPs?

A

up 1 interspinous space and lateral

10
Q

For T5-T7, where are the TPs in relation to the SPs?

A

up 2 interspinous space and lateral

11
Q

For T8-12, where are the TPs in relation to the SPs?

A

up 1 interspinous space and lateral

12
Q

What is the average IVD height in the thoracics?

A

5mm

13
Q

What is the ratio of IVD to disc in the thoracics?

A

1:5

14
Q

What is the ratio of IVD to disc in the cervicals?

A

2:5

15
Q

What is the ratio of IVD to disc in the lumbars?

A

1:3

16
Q

Articular facets in the thoracics form what angle with the horizontal plane and vertical plane?

A

60º with horizontal

30º with vertical

17
Q

In the thoracics, what is the general orientation of the articular facets and how do they change superiorly and to inferiorly?

A

Overall they are in the coronal plane but they become more sagittal inferiorly

18
Q

In the cervical region, what plane are the articular facets in?

A

Oblique and transition to coronal inferiorly

19
Q

In the lumbar region, what plane are the articular facets in?

A

Sagittal and transition to coronal inferiorly

20
Q

Is there any concavity/convexity to the articular facet surfaces in the thoracics and if so what?

A

No, they are flat unlike the cervical and lumbars

21
Q

What direction do the superior articular facets face in the lumbars?

A

posterolateral, superior

22
Q

What direction do the inferior articular facets face in the lumbars?

A

anteriomedial, inferior

23
Q

How do ribs articulate to the vertebral bodies?

A

Costovertebral joint: via demi facets on vertebral body above and below

24
Q

Describe the articulation of a constotransverse joint

A

the rib articulates the the TP of the corresponding vertebrae

25
Q

Which ribs terminate anteriorly with costal cartilage?

A

1-10

26
Q

Which ribs are free floating (no costal cartilage)?

A

11-12

27
Q

Which ribs attahc via their costal cartilage to the seternum through true synovial joints?

A

1-7

28
Q

Which ribs attach to the sternum via common costal cartilage?

A

8-10

29
Q

What is the range the thoracic kyphosis?

A

25-45º

30
Q

What is happening to the articulation?

A

distraction

31
Q

What is happening to the articulation?

A

approximation

32
Q

Which rib is the stiffest?

A

2

33
Q

Which rib is the most flexible?

A

10

34
Q

The stiffness of the rib cage is how many times more than that of any single rib?

A

10-20

35
Q

Resection of the costovertebral joints lead to what?

A

instability of the involved motion segment

36
Q

Stiffness of the thoracic spine is ________ times greater with the rib cage?

A

2.5

37
Q

The thoracic spine is ______ times more resistant to compression with the rib cage

A

4

38
Q

Tensile properties of the thoracic spine are increased ____ % with the rib cage

A

40

39
Q

What is the global range of motion for flexion of the thoracic spine?

A

50º

40
Q

What is the global range of motion for extension of the thoracic spine?

A

not included in AMA guidelines

41
Q

How does the segmental range of motion for combined flexion/extension change in the thoracic spine?

A

it increases caudally, especially below T9

42
Q

What is the average segmental range of combined (flexion/extension) motion in the upper thoracics?

A

43
Q

What is the average segmental range of combined (flexion/extension) motion in the mid thoracics?

A

44
Q

What is the average segmental range of combined (flexion/extension) motion in the lower thoracics?

A

12º

45
Q

What is the IAR for flexion in the thoracics?

A

central superior portion of the subadjacent vertebral body

46
Q

What is the IAR for extension in the thoracics?

A

central inferior portion of the vertebral body

47
Q

What is the kinematic pattern of motion for flexion and extension in the thoracics?

A

sagittal rotation (+/- θ x) coupled with sagittal plane translation (+/- z)

48
Q

What happens to the IVF during flexion?

A

it opens

49
Q

What happens to the IVF during extension?

A

it closes

50
Q

What is the global range of motion for lateral flexion in the thoracics?

A

38º to each side

51
Q

What is the pattern of segmental range of motion in the thoracics?

A

generally uniform, increasing in the lower thoracics

52
Q

What is the average segmental range of motion for lateral flexion for T1-T9?

A

6º to each side

53
Q

What is the average segmental range of motion for lateral flexion for T10-T12?

A

8-9º to each side

54
Q

What is the IAR for lateral flexion in the thoracics?

A

contralateral subadjacent vertebral body

55
Q

What is the kinematic pattern of motion for lateral flexion in the upper thoracics?

A

lateral flexion with ipsilateral coupled rotation

SPs rotate to the convexity

56
Q

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

A

minimal couple movement

slight coupled rotation in either direction

57
Q

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

A

coupled rotation may go in either direction

58
Q

What happens to the IVFs with lateral flexion of the thoracics?

A

IVF opens on contralateral side and closes on ipsilateral side

59
Q

What happens to the IVDs with lateral flexion of the thoracics?

A

disc bulges on the concave side and retracts on the convex side

60
Q

The nucleus pulposus shifts with lateral flexion of the thoracic spine. True or False?

A

False, there is no significant shift in the nucleus

61
Q

What happens to the articular facets with lateral flexion of the thoracics?

A

they glide apart on the contralateral side and approximate on the ipsilateral side

62
Q

In the upper thoracics, the ipsilateral coupled rotation with lateral flexion affects the glide of articular facets how?

A

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

63
Q

What is the global range of motion for rotation of the thoracic spine?

A

37º to each side

64
Q

What is the segmental range of motion for rotation of T1-T9?

A

7-9º

65
Q

What is the segmental range of motion for rotation for T10-T12?

A

66
Q

What is the pattern of segmental range of motion for rotation in the thoracics?

A

generally uniform until the lower 3-4 segments, which have less rotation (motion resembles lumbars)

67
Q

What is the IAR for rotation in the thoracics?

A

contralateral center of the corresponding vertebral body

68
Q

Waht is the kinematic pattern of motion for rotation of the thoracics?

A

upper thoracic rotation is coupled with minimal ipsilateral lateral flexion

the coupling dminishes in the mid thoracics and below

69
Q

What happens to the articular facets with rotation of the thoracics?

A

on the side of rotation, they open and the inferior facet glides medially and inferiorly

on the opposite side of rotation, they approximate and the inferior facet glides laterally and superiorly

70
Q

Non-segmental muscles can act ______

A

segmentally

ex: erector spinae, rectus abdominus

71
Q

What type of contraction always initiates a motion?

A

concentric

72
Q

What type of contraction controls a motion?

A

eccentric

73
Q

Concentric contraction of _______ inititates flexion of the thoracic spine

A

rectus abdominis

74
Q

Eccentric contraction of _______ controls flexion of the thoracic spine

A

erector spinae

75
Q

What limits flexion of the thoracic spine?

A
  • elastic limits of erector spinae and segmental muscles of the spine
  • PLL, flaval, interspinous, supraspinous & capsular ligaments
  • posterior IVD
  • bony impact of the vertebral bodies
76
Q

Concentric contraction of _______ inititates extension of the thoracic spine

A

erector spinae

77
Q

Eccentric contraction of _______ controls extension of the thoracic spine

A

rectus abdominis

78
Q

What limits extension of the thoracic spine?

A
  • ALL
  • bony impact of spinous and articular processes
  • anterior IVD
  • elastic limits of anterior abdominals
79
Q

Concentric contraction of _______ inititates lateral flexion of the thoracic spine

A

ipsilateral erector spinae and quadratus lumborum

80
Q

Eccentric contraction of _______ controls lateral flexion of the thoracic spine

A

contralateral erector spinae and quadratus lumborum

81
Q

What limits lateral flexion in the thoracic spine?

A
  • impact of articular facets
  • intertransverse and flaval ligaments
  • elastic limits of the contralateral segmental and non-segmental muscles
82
Q

Rotation of the thoracic spine is initiated and controlled by the concentric and eccentric contraction of what muscles?

A

abdominal obliques

erector spinae

multifidi

rotatores

83
Q

What are the respiratory movements of the rib cage?

A

bucket handle

pump handle

84
Q

In respiratory movement of the rib cage, bucket handle movement increases _______ diameter of the rib cage by elevating the lateral aspects of the ribs.

A

transverse (M-L)

85
Q

In respiratory movement of the rib cage, pump handle movement increases _______ diameter of the rib cage by elevating the anterior aspect of the rib cage with the upward and forward movement of the sternum

A

A-P

86
Q

Other than rib movement, normal respiratory movement is also dependent on what?

A

healthy costochondral and sternochondral joints

costal cartilage

sternum

diaphragm

87
Q

How do the ribs move with lateral flexion?

A

open on the convex side

close on the concave side

88
Q

What happens to the rib angle during rotation?

A

accentuated on the side of rotation

flattened on the opposite side of rotation

89
Q

During rotation, at what joints does movement of the ribs occur?

A

both posterior and anterior joints

90
Q

The posterior intercostal spaces _____ with flexion and _____ with extension

A

open : close

91
Q

During flexion the superior and inferior aspects of the rib cage _______ and during extension the superior and inferior aspects of the rib cage ________?

A
  • flatten, becoming more horizontal
  • become more angulated, less horizontal
92
Q

During flexion the A-P diameter of the rib cage ______ and during extension the A-P diameter ______ (increases or decreases)

A

increases : decreases

93
Q

During flexion, the sternal angle ______ and during extension the sternal angle ______ (increases or decreases)

A

decreases : increases

94
Q

What happens to the 12th rib during quiet respiration?

A

quadratus lumborum fixes it to provide stability

95
Q

Vertebra vs. rib dysfuction can be difficult to differentiate. True or False?

A

True, they often occur together

96
Q

Other than P-A and lateral, what postural evaluation should be done of the thoracic spine?

A

Adam’s test (scoliosis)

97
Q

What is “broken stick” when referring to observational evaluation of the global ROM of the thoracic spine?

A

when lateral flexion does not have the normal C-shaped curve but rather a more dramatic curve in one area

98
Q

The majority of trunk rotation occurs in the _____ spine

A

thoracic