LECTURE 4: T-SPINE AND RIBS

Question 1

What is the anterior column of the spine?

Answer 1

vertebral bodies
IVDs
*SHOCK ABSORPTION

Question 2

What is the posterior column?

Answer 2

articular processes
facet joints
*GLIDING MECH FOR MVMT

Question 3

Thoracic spine: articular processes are oriented…

Answer 3

vertical (but in frontal plane, so more rotation than lumbar)

Question 4

intervertebral disc is ___ in thickness in thoracic spine

Answer 4

UNIFORM
*kyphosis is NOT due to disc

Question 5

What are the big 2 important spinal junctions in T-spine treatment?

Answer 5

STIFF CT (mobile c with stiff t)
TL (t-spine rotation w/ l spine limited rot)

Question 6

with hitting a ball or playing golf, kicking or punching….what junction is important?

Answer 6

TL junction for rotation!!!
*if limited, ppl compensate with ribs

Question 7

thoracic spine is all about mobility or stability?

Answer 7

STABILITY–> most rigid region of the spine
(c-spine MOBILITY)

Question 8

each thoracic vertebra has ___ articulations depending on segment

Answer 8

6-13 (identifying cause of dysfunction not always possible)

Question 9

what are the two big functions of thoracic spine?

Answer 9

protect thoracic viscera
transfer load between upper and lower body regions

Question 10

Why is the thoracic spine kyphotic?

Answer 10

VERTEBRAL BODY!
posterior height is about 2mm taller than anterior

Question 11

Which are the typical costal facets

Answer 11

T2-T9 (ribs articulate w/ costal facets above and below and w/ disc)

Question 12

Which are the atypical demi facets?

Answer 12

T1, T10, T11, T12
*ribs articulate with respective vertebrae

Question 13

upper thoracic spine acts like

Answer 13

neck
*lower t spine acts like back

Question 14

T-Spine Rule of 3s

Answer 14

T1-3: SP same level as TP
T4-6: SP ½ level down from TP
T7-9: SP 1 level down from TP
T10: 1 level down from TP
T11: ½ level down from TP
T12: SP same level as TP

Question 15

how are the facet (ZP) joints angled in the t-spine?

Answer 15

coronal/frontal plane
*favor rotation, SB

Question 16

T-spine IV discs are ___ and ___ than cervical and lumbar discs

Answer 16

narrow and thinner

Question 17

IV foramina are ___ in the t-spine

Answer 17

larger (less compression of nerve roots)

Question 18

where is the spinal canal narrowest?

Answer 18

T4-T9
*increased chance of SC compression

Question 19

upper facet joints in t-spine are oriented ___ degrees

Answer 19

45-60 degrees from horizontal

Question 20

middle facet joints in t-spine are oriented ___ degrees

Answer 20

90 degrees from horizontal

Question 21

lower facet joints in t-spine are oriented

Answer 21

inclined towards sagittal plane (similar to lumbar spine)

Question 22

Why is it unlikely to have a disc herniation in the t-spine?

Answer 22

very strong ALL and PLL ligaments and thin discs (2:5 disc to body ratio)

Question 23

Name the ribs and attachments

Answer 23

1-7 (true): sternum
8-10 (false): costochondral cartilage
11-12 (floating): unattached anteriorly

Question 24

What is a cervical rib and where is it usually attached?

Answer 24

C7: most commonly reported
occur in 0.5-1% of pop

Question 25

For people with TOS, __% have one or bilateral cervical ribs

Answer 25

66-80%

Question 26

What are the costo-sternal joints?

Answer 26

attachments in the front!

Question 27

T1, T6, T7 costo-sternal joints are what

Answer 27

synchondrosis joints

Question 28

T-25 costo-sternal joints are

Answer 28

synovial joints

Question 29

Review muscles: what are two buckets of thoracic muscles?

Answer 29

spinal/extremity motion respiration

Question 30

what is the critical zone where nerve blood supply sucks/is vulnerable?

Answer 30

T4-9 SC is poorly vascularized

Question 31

T1-2 nerve sympathetic innervation

Answer 31

head

Question 32

T3-7 nerve sympathetic innervation

Answer 32

UEs

Question 33

T1-12 nerve sympathetic innervation

Answer 33

trunk/thoracic

Question 34

T7-T12 nerve sympathetic innervation

Answer 34

lower extremities

Question 35

Is radiculopathy common in thoracic spine?

Answer 35

no not that common, pretty rare. Dermatomes are fuzzy... bc IV foramina are big

Question 36

how are biomechanics in t-spine?

Answer 36

rotation w/ ipsi SB

Question 37

where does pure axial rotation occur?

Answer 37

CT and TL junction (everywhere else in t-spine is coupled motions)

Question 38

which part of t-spine has pump handle motion? (elevation= AP diameter)

Answer 38

upper t-spine T1-6

Question 39

which part of t-spine has bucket handle motion? (elevation= ML diameter)

Answer 39

lower t-spine T7-10

Question 40

review T spine ROM