How many thoracic vertebrae are there?
12
Which two thoracic vertebrae are transitional?
0
T1 is more like the...
C-spine
T12 is more like the...
L-spine
Thoracic vertebrae articulate with a pair of ribs at..
#NAME?
True or False? T11 and T12 do not have costotransverse joints.
True. They are floating ribs.
Spinous processes and ribs increase..
Stability
True or False? The thoracic spine is less flexible than the C-spine.
TRUE
What is normally exhibited in the thoracic spine?
Mild kyphosis
What two ligaments are thicker in the T-spine than in the C-spine?
1) Ligamentum Flavum
2) ALL
When you flex, which ligament becomes taut first because it is the farthest away?
Supraspinous ligament
What are some posterior ligaments in the T-spine?
1) Supraspinous ligament
2) Interspinous ligament
3) Ligamentum flavum
4) Intertransverse ligament
5) PLL
The body of the thoracic vertebrae has..
Equal transverse and anteroposterior diameters
The transverse processes of the thoracic vertebrae..
Widen at the end to articulate with the costal tubercles
T1 articulates with..
Rib 1 and 2
The spinous processes of the thoracic vertebrae are..
Long and sharp
The spinous processes of the T2-T6 vertebrae slope..
Downward (1 level)
The spinous processes of the T2-T6 vertebrae overlap..
The spinous processor the next vertebrae
The spinous processes of T7, T8 project ____ level(s) caudally
1 1/2 to 2 levels
T11 and T12 spinous processes project..
One level caudally
T2-T11 superior facets face mostly __A__ and slightly __B__
A) Posteriorly
B) Laterally
T2-T11 inferior facets face mostly __A__ and slightly __B__
A) Anteriorly
B) Medially
The facets of T2-T11 are oriented in what plane?
Coronal plane
T1 facets are similar to..
Those in the C-spine
T1 facets are still oriented in a(n) _____ plane
Oblique
T1 superior facets face..
#NAME?
T1 inferior facets face..
#NAME?
T11 and T12 facets are similar to..
Those in the L-spine
T11 and T12 facets are oriented in a(n) ____ plane
Sagittal
T11 and T12 superior facets face..
More medially
T11 and T12 inferior facets face..
More laterally
Types of Thoracic Intervertebral movement
1) Flexion
2) Extension
3) Side-bending
4) Rotation
In the thoracic spine, there is about ____ degrees of FLEXION allowed
45
During flexion, T1-T6 movement is limited because..
Facets are more oriented in a frontal/coronal plane
Facet mobility during flexion in the T-spine _______ caudally
Increases
Why does facet mobility during flexion in the T-spine increase caudally?
Because the facets become more sagittally oriented (esp. T11 & T12)
Flexion in the T-spine is limited/checked by..
1) Supraspinous ligament
2) Interspinous ligament
3) LIgamentum flavum
4) PLL
In the thoracic spine, there is about ___ degrees of EXTENSION allowed
25
The facet mobility during extension includes..
The inferior facet of the superior vertebrae gliding caudally
Extension in the T-spine is limited/checked by..
1) ALL
2) Spinous processes
3) Facet capsule (but it doesn't play a huge role)
In the thoracic spine, there is about ____ degrees of SIDE-BENDING allowed
20
In the T-spine, facet mobility ______ after T7-T8 during side-bending
Increases
Why does the facet mobility increase after T7-T8 during side-bending?
Because the ribs are not directly attached to the sternum
True or False? In the T-spine, side-bending is always accompanied with some rotation.
True.
From T4 down, if you were to lateral flex to the right, you would get a little ____ rotation at the segmental level
Left
Side-bending in the T-spine is limited/checked by..
1) Intertransverse ligament
2) Facet capsule
3) Ribs
In the thoracic spine, there is about ____ degrees of ROTATION allowed
35
In the T-spine, facet mobility _____ caudally in regards to rotation
Decreases
True or False? Rotation in the T-spine is always accompanied by some lateral flexion.
TRUE
Rotation in the T-spine is limited/checked by..
1) Facet orientation
2) Rib cage
During rotation, the posterior portion of the rib on the side to which vertebrae is rotating becomes more..
Convex
During rotation, the anterior portion of the rib on the side to which vertebrae is rotating becomes more..
Concave
During rotation, the rib on the side opposite to which vertebrae is rotating..
Acts opposite to the rib on the side to which the vertebrae is rotating
If you rotate right:
The RIGHT ribs __A___ in convexity anteriorly
The RIGHT ribs __B___ in convexity posteriorly
The LEFT ribs __C___ in convexity anteriorly
The LEFT ribs ___D__ in convexity posteriorly
A) Decrease
B) Increase
C) Increase
D) Decrease
If you rotate left:
The LEFT ribs ___A___ in convexity anteriorly
The LEFT ribs ___B___ in convexity posteriorly
The RIGHT ribs ___C___ in convexity anteriorly
The RIGHT ribs ___D___ in convexity posteriorly
A) Decrease
B) Increase
C) Increase
D) Decrease
A typical rib includes..
1) Head
2) Facets for vertebral articulation
3) Neck
4) Shaft
5) Tubercle
The tubercle of the rib has a facet for..
Transverse process
Ribs are made of..
Trabecular bone
What causes the ribs to be easily fractured?
The fact that they are made out of trabecular bone
The posterior angle of the ribs is..
5-6 cm from the tubercle
Ribs 1-7 are known as..
true" ribs
Cartilages of ribs 1-7 attach..
Directly to sternum
Ribs 8, 9, 10 articulate with..
Sternum
Ribes 8, 9, and 10 articulate with the sternum through..
The costal cartilage above them
Why are ribs 8, 9, and 10 not considered true ribs?
Because they articulate with the sternum through the costal cartilage above them
Ribs 11 and 12 are known as..
floating" ribs
What are the characteristics of ribs 11 and 12?
1) No sternal attachments
2) No tubercles for transverse processes
3) No angles
Articulations of the Thorax include..
1) Anterior synchondroses (synarthrodial)
2) Anterior synovial (diarthrodial)
3) Posterior synovial (diarthrodial)
Major anterior joint types in the thorax include..
1) Synarthosis (not moveable)
2) Diathrosis (movable, synovial)
Articulations of the Thorax: Anterior synchondroses (synarthrodial)
1) Manubriosternal
2) Xiphisternal
3) Interchondral
Manubriosternal joint is what type of joint?
Synarthrosis
The manubriosternal joint unites..
Manubrium and sternum
The manubriosternal joint has..
A fibrocartilaginous disc
The manubriosternal joint's fibrocartilaginous disc connects..
Hyaline cartilage ends
Xiphisternal joint is what type of joint?
Synarthrosis/costocondral
True or False? The xiphisternal joint is a synarthrosis joint with no ligaments
TRUE
The Xiphisternal joint is formed by..
Rib articulating with costal cartilage at ribs 1 - 10
The Xiphisternal joint is surrounded by..
Periosteum
The Periosteum that surrounds the xiphisternal joint blends with..
The perichondrium
The interchondral joint is what type of joint?
Anterior transitional/synarthrodial
In the interchondral joint, 1 cartilage articulates with..
Another single cartilage
Costal cartilage of ribs 8, 9, 10, and sometimes 11 articulates with..
The costal cartilage above it, in order to connected to the sternum
With aging, the interchonral joints become..
Fibrocartilaginous and fuse
Articulations of the Thorax: Anterior Synovial (Diarthroidal)
1) Chondrosternal
What type of joint is the chondrosternal joint?
Synovial joint
The chondrosternal joint connects..
The rib cartilage to the sternum at ribs 2-7
Rib 1 is connected to the manubrium at..
Synchrondosis
True or False? There is slight gliding movement allowed at the chondrosternal joint
TRUE
The chodrosternal joint includes what stabilizing structures?
1) Capsule
2) Radiate ligament
3) Intra-articular ligament
Articulation of the Thorax: Posterior Synovial (Diarthroidal)
1) Costovertebral
2) Costotransverse
What type of joint is the costovertebral joint?
Synovial
The costo vertebral going is formed by..
Head of rib and costal facets of two adjacent vertebrae
Ribs 1, 11 and 12 articulate with..
One vertebrae only
What motions are included at the costovertebral joint?
1) Rotation
2) Gliding
The costovertebral joint includes what stabilizing structures?
1) Thin capsule
2) Radiate ligaments
3) Intra-articular ligament
Intra-articular ligament is..
A ligament in the middle of capsule that holds a rib to the disc
True or False? The capsule of the costovertebral joint can become sprained.
True. Synovitis can also occur
What type of joint is the costotransverse joint?
Synovial
The costotransverse joint is formed by..
Costal tubercle of the rib with a costal facet on the transverse processes of vertebrae T1-T10
The costotransverse joint includes what stabilizing structures?
1) Capsule
2) Superior ligament
3) Interosseous ligament
4) Lateral ligament
True or False? The costotransverse joint has a capsule and ligamentous structures that if sprained can become painful
TRUE
Movements of the Ribcage during thoracic ROM include..
1) Flexion
2) Extension
3) Side-bending
4) Rotation
During flexion, volume of the ribcage is..
Increased
During flexion, the costovertebral angle..
Increases
During flexion, the sternocostal angle..
Increases
During flexion, the chondrocostal angle of rib 10..
Increases
During extension, volume of the ribcage is..
Decreased
During side-bending, the volume of the contralateral ribcage..
Enlarges
During side-bending, the intercostal spaces of the contralateral ribcage..
Widen
During side-bending, the volume of the ipsilateral ribcage..
Decreases
During left lateral flexion, there is a(n) increase ribcage volume on the ______ side
Right
During left rotation, there is a(n) increase in ribcage volume on the _____ side
Left (the side in which you are rotating)
During rotation, there is a(n) ________ in ribcage volume on the side in which you are rotating
Increased
True or False? You get decreased rotation with age.
TRUE
Vertebral rotation must lead to..
Distortion of rib due to connections with rib
Distortion of the rib is achievable because..
Of rib and cartilage elasticity
What position maximally increases ribcage volume if you have pneumonia on the left side?
1) Flex and right side bending
2) Flex and left rotation
Muscles of Respiration include..
1) Diaphragm
2) External intercostals
3) Internal intercostals
4) Transverse thoracic muscles
5) Subcostal msucles
6) Sternohyoid, sternothyroid muscles
7) Scalene muscles
8) Rectus abdominis and lateral abdominal muscles
9) Latissimus dorsi, pectoralis minor, trapezius
Anteriorly, the diaphragm attaches to..
Posterior aspect of xiphoid and inner surfaces of lower 6 ribs and artilages
Posteriorly, the diaphragm inserts on..
1) Anterolateral bodies and discs of L1-L3
2) Arcuate ligaments
The arcuate ligaments include..
1) Medial arcuate ligament
2) Lateral arcuate ligament
Medial arcuate ligament arches over..
Psoas
Medial arcuate ligament attaches to..
1) L1, L2 bodies
2) L1, L2 transverse processes
Lateral arcuate ligament arches over..
Quadratus lumborum
Lateral arcuate ligament attaches to..
Transverse processes of L1, L2, L3, and rib 12
Central tendon of the diaphragm is a..
Noncontractile connective tissue fuses with pericardium
In regards to the central tendon of the diaphragm, the muscle fibers come...
Radially from tendon
What is the diaphragm's function during inspiration?
1) Diaphragm muscle fibers shorten
2) Dome moves caudally; flattens
3) Abdominal contents move caudally
4) Increased intra-abdominal pressure
5) As muscle shortening continues, lower ribs are pulled up vertically, slightly laterally for BUCKET HANDLE effect
What is the role of the external intercostal muscles in regards to respiration?
1) Rib elevators
2) Operate in both inspiration and expiration
The external intercostal muscles connect..
Ribs from rib 1-11
The external intercostal muscles run..
Down and anterior (hands in pocket)
What is the role of the internal intercostal muscles in regards to respiration?
1) Rib depressors
The internal intercostals are deep to..
The external intercostal muscles
The internal intercostal muscles run..
Down and posterior
What is the role of the transverse thoracic muscles in regards to respiration?
Rib depressor in active expiration
The transverse thoracic muscles are deep to..
The internal intercostal muscles
The transverse thoracic muscles run from..
The posterior sternum to the internal costal cartilage 3-7
What is the role of the subcostal muscles in regards to respiration?
Posterior rib depressors
Subcostal muscles are located..
On the inner aspect of the lower thorax
What is the role of the sternohyoid and sternothyroid muscles in regards to respiration?
Can operate under stress to elevate sternum, clavicle, and first rib
True or False? The scalene muscles are always operating
TRUE
What is the role of the scalene muscles in regards to respiration?
1) Contribute to quiet inspiration by fixing the first rib
2) Elevates sternum, clavicle, and first rib in times of stress
3) Cervical flexors
What pathology can be indicated by shortening of scalenes?
Shortening of scalenes --> lay down at night --> scalenes stretch over brachial plexus --> lose feeling in hands
What specific patients can we see the pathology of short scalene muscles?
1) Patients with forward head posture
2) Smokers
3) Asthmatics
What is the role of the rectus abdomens and lateral abdominal muscles in regards to respiration?
Assist with forced expiration
What is the role of the latissimus dorsi, pectoralis minor, and trapezius in regards to respiration?
Act as accessory muscles during stress to fix shoulder girdle and expand the thorax
What are the superficial muscles involved in the mobility of the thoracic spine?
1) Latissimus dorsi
2) Upper trapezius
3) Serratus anterior
4) Scapular stabilizers
What are the middle muscles involved in the mobility of the thoracic spine?
1) Erector spinae msucles
a) Iliocostalis
b) Longissimus
c) Spinalis
What are the deep muscles involved in the mobility of the thoracic spine?
1) Rotatores
2) Quadratus lumborum
3) Multifidus
What are some pathologies of the thoracic spine?
1) Scoliosis
2) COPD
3) Aging
T-spine: Scoliosis
#NAME?
An increased convexity in the right thorax results in..
Left side-bending --> Which results in right rotation --> Which results in right rib hump --> Which results in restricted lung capacity on left
T-Spine: COPD
#NAME?
T-Spine: Aging
#NAME?