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Thoracic Flashcards

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1
Q

How many vertebrae does the thoracic spine have?

A

12

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2
Q

How many apophyseal (facet) joints does the thoracic spine have?

A

24 (12 on each side)

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3
Q

Which 2 structures have costal articulating surfaces?

A

1) vertebral body

2) transverse process

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4
Q

What are some characteristics for T1 vertebrae?

A
  • characterisitc of cervical spine
  • full articular facet for the head of the 1st rib and demi-facet for upper half of 2nd rib
  • body transvers diameter is 2x size of AP diameter
  • spinous process is long and prominent
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5
Q

Typical thoracic vertebrae have:

A
  • V. body is equal in the transverse and AP diameters
  • V.bodies are wedged shaped. Posterior height is greater than anterior height
  • Wedge shape = kyphotic posture
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6
Q

In thoracic structures: width increases_______, spinous processes angle ________, transverse processes angle _______ and the disc height ratio to the V. body is _________ in the spine.

A

caudally
inferiorly
posteriorlaterally
smallest

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7
Q

Apophyseal joints (plane synovial joints) in the thoracic spine, lie at ~ ___ off Frontal and 60* from the __________ plane.

A

~20*

horizontal

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8
Q

Superior facets face _________ and slightly ____________.

A

posteriorly

superiolaterallly

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9
Q

Inferior facets face __________ and slightly ____________.

A

anteriorly

inferiormedially

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10
Q

Where does the direction of the facets change?

A

@ T10-11 to the sagital plane (from frontal)

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11
Q

Thoracic flexion includes: superior anterior slide of ______________ of the superior vertebrae on the ____________ of the inferior vertebrae.

A

inferior facet

superior facet

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12
Q

Thoracic flexion is limited by tension in connective tissues __________ aspect of thoracic region.

A

posterior

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13
Q

Thoracic extension includes: posterior inferior slide of ________________ of the superior vertebrae on the _____________ inferior vertebrae

A

inferior facet

superior facet

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14
Q

Thoracic extension is limited by tension _________ connective tissues and _____________ body structures.

A

anterior

posterior

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15
Q

Frontal plane orientation in rotation: inferior articular facet of superior vertebrae ___________ against superior facet below

A

slides

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16
Q

Frontal plane orientation in lateral flexion: inferior facet on the _________ side slides inferiorly. Inferior facet on the _____________ side slides superiorly

A

ipsilateral

contralateral

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17
Q

Spinal coupled motion in the thoracic spine occurs in one axis while another motion occurs in another axis. It is highly _________ and ______________.

A

Variable and controversial

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18
Q

What is scoliosis?

A

deformity of the vertebral spine

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19
Q

Scoliosis is characterized by:

A

abnormal curvatures

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20
Q

The deformities of scoliosis can be found in:

A

all three planes; frontal, horizontal, and sagittal

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21
Q

Where is scoliosis most commonly found?

A

thoracic spine

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22
Q

What demographic is scoliosis mostly commonly found in?

A

adolescent females

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23
Q

What are the two types of scoliosis?

A

1) structural

2) Non-structural

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24
Q

Structural scoliosis is:

A

a fixed deformity in which 80% of the cases are idiopathic. There is a lateral curvature and vertebral rotation component involved.

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25
What are the known causes for the other 20% of structural scoliosis cases?
- neuromuscular diseases - cerebral palsy, muscular dystrophy - congenital spinal defects.
26
Non-structural scoliosis is:
normal spine with a lateral curvature, there is no spinal rotation.
27
Possible causes of non-structural scoliosis are:
postural, leg length discrepancy, and pain
28
Curves of scoliosis: | minor curves =
= less than 20˚ | - Better chance of not progressing
29
Curves of scoliosis: | intermediate curves =
25*-45*; difficult to predict progression and requires close follow-up
30
Curves of scoliosis: | major curves =
>50*; high risk for progressing
31
Describing the curves: Location = Direction = # of fixed frontal plane lateral curves
``` Location = where in the spine Direction = define by the CONVEX side of the lateral curve ```
32
C-curve:
- single lateral curve | - typically found in the thoracic spine
33
S-curve
- One primary curve w/ a second | - Secondary curve typically found in the thoracolumbar or lumbar region of the spine
34
What does the Cobb angle meausre
radiographic drawing that measures the MAGNITUDE of the lateral curve.
35
What is one postural deviation associated with scoliosis?
forward, bend test = shows raised side of thoracic cage
36
In a postural assessment checking for scoliosis, looking for: contralateral coupling (________________), spinous processes are usually rotated toward the side of ___________ (horizontal plane), and the ribs hump typically on the _________ side (frontal plane)
(lateral flexion and rotation) rotated toward the side of CONCAVITY convex
37
List 4 other common issues related to scoliosis:
1) breathing function 2) back pain 3) muscle imbalance 4) psychosocial issues
38
Interventions for scoliosis include:
1) Scoliosis brace (used to improve exaggerated curvature) 2) Spinal fusion ** depends on severity / PT should be considered
39
What are the effects of aging on the thoracic spine?
- degenerative changes - loss of muslce mass and strength - reduced compliance of the rib cage and ventilatory effectiveness - imbalnce bone synthesis and resorption (osteoclasts break down bone fastser than osteoblasts can rebuild bone -osteoporosis, autoimmune disease)
40
True/False: The thoracic spine is the most rigid region of the spine?
True - because of ribs (protection of vital organs more important than spinal mobility)
41
In the thoracic spine region there is limited: __________ and __________.
lateral flexion and rotation
42
The facets of the intracervical and upper thoracic region are between:
horizontal and frontal planes | favors the combination of axial rotation and lateral flexion kinematics
43
The facets of the mid-thoracic region are:
near frontal plane | favors lateral flexion, although not fully expressed b/c ribs splinting action
44
The facets of the lumbar and lower thoracic region are:
near sagittal plane | favors flexion and extension (and limit axial rotation
45
True false: often times the side of dysfunction is the same as the side of pain.
False: Often times the side of dysfunction is opposite of the side of pain
46
Which ribs are considered atypical ribs?
ribs 1, 11, 12 and sometimes 10
47
During respiration, which ribs demonstrate a bucket handle movement?
lower
48
What are the 3 components of the sternum?
1) manubrium 2) body 3) xiphoid process
49
The sternum functions as a:
osseous protective plate for the heart
50
What is the manubriosternal joint?
junction b/n the manubrium and the body
51
Ribs 1-7 are _____ ribs. They articulare directly with the sternum through :
true | chondrosternal joints
52
Ribs 8-10 are _______ ribs. They are indirect with sternum through costal cartilages of the adjacent superior rib @ the ___________ joints.
false | Interchondral
53
Ribs 11 and 12 are ________ ribs. They have no anterior attachement
floating
54
Typical ribs are _-_
2-9
55
Typical ribs have a head that attaches to the V. body at the ________________ joint. With __ demifacets with crest between them.
costovertebral | 2
56
Typical ribs have a neck that is _____ to the head
distal
57
Typical ribs have a tubercle that is distal to the neck and articulates with the transverse process at the ________________ joint.
costotransverse joint
58
At the costovertebral joint, convex rib facets are _________________facet of rib head (demifacets). The concave vertebral facet is _________________ facet of adjacent vertebra
superior/inferior | inferior/superior
59
The costotransverse joint has 10 pairs of joints (________) and convex rib tubercles (__________)
T1-T10 | T1-T6
60
The concave facet on transverse process has T1-T6 in slight ________. and T7-T10 articular surface are flat permitting a _________ motion.
rotation | gliding
61
What are 4 characteristics of rib angle?
1) posteriolateral aspect 2) lateral to spinous process 3) illiocostalis muscle attachments 4) key landmark for rib dysfunction -tender / soft tissue restrictions
62
The superior facet articulates with. V. body above:
T6
63
Inferior facet articulates with superior facet of v. body below
T7 | * articulation occurs at the ribs own numbered vertebrae- Rib 7
64
Atypical thoracic rib articulations include:
-T1 and T10-T12 and ribs 1, 10-12
65
T1 is full costal face superiorly that accepts the entire head of the ______ rib. Demifacet inferiorly to accept part of the head of the ______ rib.
1st | 2nd
66
T10-12 may have full:
costal facet (pedicles)
67
T11-12 typically lack _______________ joints
costotransverse joints
68
Kinematics or the ribs: upper 1-6 =
motion occurs in the sagittal plane
69
Kinematics or the upper ribs: During inspiration, upper ribs and sternum increase the AP diameter =
pump-handle motion
70
Kinematics or the ribs: lower 7-12 =
frontal plane
71
Kinematics or the lower ribs: During inspiration, lower ribs increase the transverse diameter =
bucket-handle motion
72
What are the 3 parts of the diaphragm?
1) costal part 2) sternal part 3) crural part
73
The costal part of the diaphragm =
upper margins of the lower 6 ribs
74
The sternal part of the diaphragm =
posterior side of the xiphoid process
75
The crural part of the diaphragm =
attached to the bodies of the upper 3 lumbar vertebrae - R & L crus
76
Action of the diaphragm during inspiration is caused by the ________ nerve.
phrenic
77
What is the most important muscle of the inspiration?
diaphragm
78
As the dome (of the diaphragm) lowers and flattens:
increases the vertical diameter of the thorax | ** inhale = pressure decreases
79
As the diaphragm descends, the central tendon moves _________ and becomes _________.
inferiorly | static
80
The diaphragm continues to contract resulting in lower 6 ribs __________ and rotate ________.
elevate postseriorly **interabdominal pressure increases
81
__________ intrathoracic volume __________ intrathoracic pressure, and __________ abdominal pressure
Increase in decreases increases
82
Quiet expiration is _______ process. Elastic recoil of the ________, ________ and __________
passive | thorax, lungs and diaphragm
83
Forced expiration =
activation of abdominals and intercostals
84
What are the primary muscles of inspiration?
diaphragm, intercostals, scalene muscles
85
What muscles are active during forced inspiration?
- serratus posterior - sternocleoidmastoid - lattismus dorsi - iliocostalis thoracis - pectoralis muscles - quadratus lumborum
86
Expiratory muscles include:
- 4 abdominal muscles - Internal intercostals - Transverse thoracis
87
During forward bending (flexion) of the ribs the osteokinematics include _________ rotation of T3-T7. Arthrokinematics include ___________ glide and _________ roll.
anterior superior anterior
88
During backward bending (extension) of the ribs the osteokinematics include _________ rotation of T3-T7. Arthrokinematics include ___________ glide and _________ roll.
posterior inferior posterior
89
Take away: Ribs and T/Spine are mechanically related, there is limited research!
Take away: Ribs and T/Spine are mechanically related, there is limited research!

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