Thoracic Biomechanics Flashcards by Amanda Romeu

What are the three principles of Fryette model?

One = opposite
Two = together
Alter motion in one place, affects motion in all planes

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What are some biomechanic properties unique only to thoracics?

Dysfunctions can occur in only one plane
Usually flexed for extended
Little sidebending or rotations

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What is a sign for thoracic somatic dysfunction?

Tenderness

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Where would you be likely to feel tenderness in thoracic somatic dysfunction?

Lateral to the tips of the transverse processes

On the tip of the spinous process

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Which way to do the thoracic facets face and what movement does this allow for?

Coronal, rotation

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What is the limiter of rotation?

Ribs

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Name the ribs types which promotes the greatest movement from greatest to least.

Floating ribs
False ribs
True ribs

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What are the degrees of the flexion and extension (sagittal pane) for thoracic vertebrae?

T1-5: 4 degrees
T6-10: 6 degrees
T11-L1: 12 degrees

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What are the degrees of sidebending (coronal plane) of motion for thoracics?

T1-10: 6 degrees

T11-12: 8-9 degrees

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What are the degrees of rotation (horizontal plane) of motion for thoracics?

T1-T9: 8-9 degrees
T10: 10 degrees
T11: 12 degrees
T12: 14 degrees

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How was thoracic motion measured?

Gregerson & Lucas inserted Steinman pins into the spinous processes of the thoracic vertebrae of six medical students, left them protruding through the skin and measured the available motion

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What is the main effect of the ribs and sternum on the thoracic spine?

Stiffen the spine

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What are the motions stiffened by the ribs?

Flexion – stiffened by 27%
Extension – stiffened by 132%
Sidebending – stiffened by 45%
Rotation – stiffened by 31%

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Why is T12 more susceptible to mechanical influences or trauma?

Upper facet joints coronally oriented

Lower facet joints sagittally oriented

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What are the rule of threes?

T1-3:	 TP at the same level as SP	
T4-6: TP one half level above the SP
T7-9: TP one full level above the SP
T10: Like T7-9
T11: Like T4-6
T12: Like T1-3

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What do the costal ligaments do?

Stiffen the thoracic spine

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What is the superficial layer of muscle in the thoracic area?

Trapezius
Latissimus dorsi
Rhomboideus major and minor

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Trapezius: attachment

Spinous process of T1-T12

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Trapezius: actions

Scapular retraction and depression

Trapezius: innervation

Spinal accessory (C1-C6), ascends though the foramen magnum and exits via jugular foramen in petrosquam suture

Trapezius: motion loss

Hypertonicity causes loss of scapular protrusion and elevation

Trapezius: symptoms

Interscapular pain, shoulder pain, pectoral region pain, lateral rib cage pain

Latissimus dorsi: attachments

Lower 6 thoracic spinous processes lumbar and sacral spinous processes, supraspinous ligament and iliac crest via lumbodoral fascia

Latissimus dorsi: action

Humeral adduction, medial rotation, extension

Latissimus dorsi: innervation

C6, C7, C8

Latissimus dorsi: thoracic dysfunction

T7, T8 | Results in limited humeral external rotation, flexion (reaching)

Latissimus dorsi: symptoms

Infrascapular mid-thoracic backache

Rhomboid major and minor: Attachment

Major-T2 to T5 and supraspinous lig | Minor - C7 & T1

Rhomboid major and minor: Action

Scapular retraction, elevation

Rhomboid major and minor: Innervation

C4, C5

Rhomboid major and minor: Thoracic dysfunction

Scapular protrusion is limited and painful

Rhomboid major and minor: Symptoms

Pain along vertebral border of the scapula extending into the supraspinous fossa of scapula Muscle tends to ache at rest (postural pain) Look for tense shortened pectoralis muscles

What is the intermediate layer of muscle in the thoracic area?

Erector spinae

Erector spinae: attachments: Longissimus thoracis

Lumbar transverse processes to all of the thoracic thransverse processes and lower 9-10 ribs just lateral to costotransverse articulation

Erector spinae: attachments: Longissimus cervicis

T1-T5 transverse processes to C2-C6

Erector spinae: attachments: Longissimus capitis

Transverse processes of C4 to T5, extends up to mastoid process

Erector spinae: action: longissimus thoracic and cervicis

Backbend and sidebend the vertebral column

Erector spinae: action: Longissimus capitis

Extends the neck and rotates the head to the same side

Erector spinae: innervation

Dorsal rami of thoracic and upper lumbar and lower cervical nerve roots

Erector spinae: Segmental dysfunction

Longissimus hypertonicity locally with restricted flexion and sidebending Neck motion would be limited in contralateral rotation

Erector spinae: symptoms: longissimus thoracis

Local muscle tenderness and pain, extends over approx. 4 thoracic segments T10-T12 range can refer pain down to the lower portion of the buttock

What is the deep layer of muscle in the thoracic area?

Rotatores | Levator Costae

What is the action of the rotatores?

They function mostly in sidebending and extension of the thoracic segments, contrary to their name Their attachment is too close to the base of the spinous process to effect much rotation

What would cause a type II segmental dysfunction of the rotatores?

Spasm or hypertonicity

What muscle can cause sidebending if anchored to a rib?

Levator costae