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53 Cards in this Set
- Front
- Back
Thoracic region mobility |
Stiffer and less mobile
Due to attachment to ribcage --- produces stability |
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Thoracic kyphosis |
Results from less anterior height of vertebral body and wedge-shaped disc
Avg 20 - 40 degrees
Apex of curve @ T7 - T8 |
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Vertebral body |
Heart shaped
Concave
Normal = T2-T9 Atypical = T1 and T12 |
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Concave joint surface |
Between T1 - T10 for articulation with the ribs Aka - costal facet
T1-T6 = concave joint faces anteriorly T7-T10 = concavity faces superiorly |
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Spinal cord tension points |
Occur at T4, T6, and T9 due to narrowing of spinal canal
Common site of tension due to whiplash |
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Thoracic rule of 3s |
Refers to the spinous processes and their corresponding vertebral levels |
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Thoracic rule of 3s
T1-T3 |
SP is level with its own body |
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Thoracic rule of 3s
T1-T3 |
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Thoracic rule of 3s
T4-T6 |
SP level with inferior disc of own body, superior disc of segment below |
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Thoracic rule of 3s
T4-T6 |
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Thoracic rule of 3s
T7-T9 |
SP level with TP of segment below |
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Thoracic rule of 3s
T7-T9 |
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Thoracic rule of 3s
T10-T12 |
SP inclination decreases until SP and TP are on same horizontal plane |
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Thoracic rule of 3s
T10-T12 |
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Facet joint angles |
20-30 degrees from frontal plane in upper tspine
Angle of inclination increases as you move lower along tspine
Changes into sagittal plane in lower tspine |
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Frontal plane orientation |
Allows for more rotation and sidebending (upper tspine) |
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Sagittal plane orientation |
Allows fro more flexion and extension (lower tspine) |
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Superior articular process (of inferior vertebrae) |
Faces lateral, posterior, and superior (LPS) |
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Inferior articular process (of superior vertebrae) |
Faces medial, inferior, anterior (MIA) |
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Capsular ligaments of facet joint |
Thin and loose
Strengthened by ligamentum flavum |
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Facet joint function |
Provide stability in thoracic spine
Protect against anterior translation (flexion/extension) in upper tspine
Protect against rotation in lower tspine when it changes to a sagittal orientation |
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T1 |
Superior aspect is concave (formed by uncinate process)
Uncinate processes articulate with the inferior body of C7 to form uncovertebral joints
Concave facet articulates with convex facet of 1st rib = costotransverse joint |
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T12 |
Superior articular facet oriented in frontal plane
Inferior articular facet oriented in sagittal plane (restricts rotation and mimics lumbar spine) |
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Rib articulation |
Articulates with 2 adjacent vertebrae and disc at the costovertebral joint (at tspine level and inferior aspect of tspine body above)
Occurs at the costal demi-facets |
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T1 and rib attachmet |
T1 articulates with both the 1st and 2nd rib
Costal facet articulates with 1st rib Demi-facet articulates with 2nd rib |
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T2-T9 rib attachments |
Demi-facets articulate with rib heads |
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Ribs and Tspine |
The ribs articulate with the superior demi-facet and costal facet (TP) of its vertebrae level as well as the inferior demi-facet of the vertebrae above it
Rib 7 = Costal facet (TP) of T7 and inferior Demi-facet of T6
T4 = Rib 4 on superior demi-facet and costal facet (TP) and rib 5 on inferior demi-facet |
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Ribs and T-spine |
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10th rib articulation |
Articulates with T9 and T10 |
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Costovertebral joint |
Compound synovial joint - where rib articulates with the demi-facet
Strengthened by the radiate lig (3 parts):
1. Superior -head of rib to vertebral body above 2. Middle - head of rib to the disc 3. Inferior - head of rib to vertebral body below |
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Rib attachments |
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Costotransverse joint |
Synovial joint - where rib articulate with costal facet (Transverse Process)
Strengthen by medial and lateral costotransverse ligaments from the rib tubercle to the TP
Supported by superior costotransverse ligament along rib neck to TP above |
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Rib attachments cont |
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Ribs 1-7 and the sternum |
Attach through costal cartilage |
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Ribs 8-10 and the sternum |
Attach through fused costal cartilage |
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Ribs 11 and 12 |
Floating ribs (anteriorly)
Attach to diaphragm and trunk muscles |
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1st rib sternocostal joint |
Synchondrosis joint --- increases stability of upper thoracic spine |
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2nd rib sternocostal joint |
2nd rib articulates with demi-facets of both manubrium and sternum
Synovial joint |
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Sternum facets and ribs |
Concave facets on sternum Articulate with costocartilage of 3rd-6th ribs |
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7th rib articulation |
Articulates with both xyphoid and sternum |
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Costocartilage of 1st and 2nd rib |
Articulates with manubrium and clavicle |
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Vertebral ligaments
Ligamentum flavum |
Attaches to laminae and pedicle to strengthen the anterior facet joint
Prevents flexion and spinal impingement during extension |
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Vertebral ligaments |
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Vertebral ligaments
Interspinous ligament and Supraspinous ligament |
Limits extension and A-P translation |
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Vertebral ligaments
ALL |
Plays no major role in stability
Limits flexion |
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Vertebral ligaments |
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Vertebral ligaments
PLL |
Prevents flexion and posterior translation |
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Intervertebral discs |
Thinner and narrower Rare to have a prolapse in Tspine 2% of back issues are in Tspine Issues occur at T7 or T8 (then T6 or T9) Most common sx = anterior chest pain |
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Sympathetic innervation mobilization |
Sympathetic nerve trunk (SNT) lies anterior to costotransverse (CT) joint
Mobilization of the CT joint can mobilize the SNT
Useful in tx of complex regional pain syndrome |
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Sympathetic innervation in tspine |
T1-2 = Head
T3-T7 = UE
T7-T12 = LE
T1-T12 = Trunk |
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Cervicothoracic Region |
Levels C6-T3 --- area of transition from hyper to hypo mobile
Hardest working -- contains shoulder girdle
Facet orientation changes from oblique to frontal (decrease in sagittal movements) |
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Pattern of pain and limitation at CT joint |
Clinical presentation: localized pn in CT junction w/ radiating pn in shoulder
Limited flex/ext and rot/SB to same side (ipsilateral) |
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Restricted cervical flexion
Causes |
CT junction restriction (HYPOMOBILE) Cervical disc Soft tissue restriction in cspine |