Thoracic Spine

Question 0

How does a compression fracture in the T/S present?

Answer 0

Anterior compression due to always being hunched over

Question 1

How many articulations does the thoracic vertebrae have?

Answer 1

12

Question 2

Explain the disc to vertebral height ratio in the T/S.

Answer 2

Smallest disc to vertebral height ratio - less movement

Question 3

What is the shape of the disc in the T/S?

Answer 3

Wedge shaped - promotes T/S kyphosis

Question 4

What are the four T/S joints?

Answer 4

1. Interbody
2. Costovertebral
3. Costotransverse
4. Facet joints

Question 5

How are the facet joints oriented in the T/S?

Answer 5

Frontal plane (20 degrees from frontal plane)

Question 6

Explain the joint capsule in the T/S.

Answer 6

More taught than the C/S and L/S

Question 7

What two ligaments are the largest in the T/S?

Answer 7

Ligamentum flavum and ALL - limits mobility

Question 8

What are the movements in the upper T/S?

Answer 8

Lateral flexion and rotation

Question 9

What are the motions in the lower T/S?

Answer 9

Flexion

Question 10

How is lateral flexion and rotation coupled in the upper T/S?

Answer 10

Ipsilateral - similar to C/S where side bending and rotation occur to the SAME side

Question 11

How is lateral flexion and rotation coupled in the lower T/S?

Answer 11

Contralateral - same as the L/S where side bending and rotation occur to the OPPOSITE side

Question 12

Describe left rotation with regards to the ribs.

Answer 12

Left ribs - flattened anteriorly and posteriorly convex

Right ribs - anteriorly convex and flattened posteriorly

Question 13

Which way does the spinous process move with left rotation in the T/S?

Answer 13

To the right

Question 14

Where is the line of gravity positioned in the T/S?

Answer 14

Anterior - promotes flexion (have to resist gravity by using our extensors)

Question 15

Where is the thoracolumbar fascia located?

Answer 15

Surrounds erector spinae and multifidi

Question 16

What is the function of the thoracolumbar fascia?

Answer 16

Compression and stability

Question 17

What tendons are associated with the thoracolumbar fascia?

Answer 17

Lats and glut max

Question 18

What are the deep erector spinae muscles?

Answer 18

Longissimus thoracis and iliocostalis

Question 19

What is the function of the deep erector spinae?

Answer 19

Extension, ipsilateral flexion, and produce a posterior shear force (due to the LOG sitting anteriorly - have to work against gravity to keep body upright)

Question 20

What is the function of the superficial erector spinae?

Answer 20

Primary extensors and lateral flexion

Question 21

What is the flexion relaxation phenomenon?

Answer 21

Relaxation of erector spinae (2/3 of flexion ROM and have to rely on passive structures - muscle is stretched out and cannot contract as well so the erector spinae relax and ligaments get the blunt of the force to hold the body in position)

Question 22

What is the function of the multifidi?

Answer 22

Stabilization and rotation

Question 23

What is the function of the intertransversarii/rotatores?

Answer 23

Proprioceptive muscles

Question 24

What is the function of the thoracic cage?

Answer 24

Stability, protect organs, ventilation, and UE and LE muscle attachment

Question 25

How is scoliosis named?

Answer 25

Side of convexity (rib hump side)

Question 26

Describe rotation with regards to scoliosis.

Answer 26

Contralateral rotation - right scoliosis is due to left rotation in the spine

Question 27

Describe problems with right scoliosis.

Answer 27

Problems side bending to the right, muscles on the right are stretched, muscles on the left are shortened, and lung function can be impaired

Question 28

Explain the orientation of the costovertebral and costotransverse joints.

Answer 28

Lie in the same plane

Question 29

Describe the articulation of the T1-T6 costotransverse joints.

Answer 29

Convex on concave and rotation

Question 30

Describe the articulation of the T7-T10 costotransverse joints.

Answer 30

Flat and gliding (move more laterally during inspiration)

Question 31

Describe the articulation of the T11-T12 costotransverse joints.

Answer 31

No articulation

Question 32

Describe the articulation of the costovertebral joints.

Answer 32

Rotation and gliding

Question 33

Which costovertebral joints are the most mobile?

Answer 33

T1, T10, T11, and T12

Question 34

What does movement in the T/S depend on?

Answer 34

Types and angles of articulation, movement of manubriosternum, and elasticity of costal cartilages

Question 35

Describe the kinematics of the upper ribs.

Answer 35

Axes of rotation is closer to the frontal plane - movement occurs in the sagittal plane

Question 36

Describe the kinematics of the lower ribs.

Answer 36

Axes of rotation closer to the sagittal plane - movement occurs in the frontal plane

Question 37

Describe the kinematics of ribs 11 and 12.

Answer 37

Axes of rotation closer to the frontal plane

Question 38

Describe the kinematics of the 1st rib.

Answer 38

Movement at costotransverse joint - moves superiorly and posteriorly

Question 39

Describe the kinematics of ribs 2-7 with regards to the "pump handle".

Answer 39

Movement superior and anterior - increases AP diameter

Question 40

Describe the kinematics of ribs 8-10 with regards to the "bucket handle".

Answer 40

More motion laterally - increases lateral diameter

Question 41

With regards to the diaphragm, where do the costal fibers attach?

Answer 41

Ribs

Question 42

With regards to the diaphragm, where do the crural fibers attach?

Answer 42

L1-L3 (act as a stabilizer)

Question 43

How does the diaphragm move during inspiration?

Answer 43

Descends which increases abdominal pressure and causes "bucket handle" of lower ribs

Question 44

What are primary inspiratory muscles?

Answer 44

1. Intercostals - lift rib cage (recruited superiorly to inferiorly) 2. Scalenes - lift first two ribs

Question 45

What occurs with COPD?

Answer 45

Flattened diaphragm - pulls ribs in and barrels the chest

Question 46

What is the problem with people who have COPD?

Answer 46

Problem getting air out

Question 47

How do people with COPD compensate when breathing?

Answer 47

Use of accessory muscles (SCM and scalenes) - also suck their stomach in to increase abdominal pressure to try to expel air out