Orthopedics 1.11.99

Thoracic Spine

 

                Spine – L. = Thorn

                Throacic – Corslet (chest armor or soldier wearing) or chest

                Orhthopedics – Ortho – straight / pedic – foot

               

12 vertebrae

12 Ribs articulate with TP, Disc, and body

Ribs 1-7 – True ribs which articulate anteriorly and posteriorly

Ribs 8-10 are false ribs because they articulate using a common cartilage attached to the sternum

Ribs 11-12 are free floating ribs only attached to vertebrae

 

Costovertebral articulation – rib attachment to vertebra (can not palpate this on a live person)

-                      Synovial joints – fluid between articular surfaces surrounded by a synovial capsule

-                      Radiate ligament helps to stabilize this articulation

Costotransverse articulation – Ribs 1-10 articulate with TP (Ribs 11 & 12 do not articulate w/ TP)

-                      Synovial joint

-                      Stabilized by the costotransverse ligament

Costochondral articulation – Where ribs articulate with the costal cartilage

Sternalcostal articulation – where costal cartilage articulates with the sternum

 

Rib tubercle

Rib angle

Ribs 1, 10, 11, & 12 – each have a single articulation on the vertebrae

Ribs 2-9 typically articulate with two vertebrae and the IVD

Rib 1 articulates with T1

Rib 2 articulates with T1 & T2 & IVD

 

Demifacets are located on the vertebrae where the ribs attach

Ribs are to protect the vital organs and to support and shape us

 

Rib Motion

-                      1-6 display a pump-handle motion

-                      rib motioning in the A to P directions

-                      7-10 display a bucket handle motion

-                      The ribs motion superior and inferior

-                      11-12 display a caliper motion

-                      opens in a swinging motion anterior/superior to posterior/inferior

 

This motion is vital for normal cardiorespiratory function

 

Thoracic Spines

-                      Transverse processes go superior as they go lateral

-                      Spinous process move down and out (law of thirteen) – T7 is longest spinous process

-                      T1 is a transitional segment: the superior facets are like cervical spine and inferior facets are more like the Thoracic facets

-                      Thoracic facets are more flat in a horizontal spine

-                      T11 & T12 facets begin to turn more like the lumbar facets

 

ROM

-                      Flexion and extension (limited to the degree of fixed kyphosis) are @ 50 degrees

-                      Right and left lateral flexion are 30 degrees

-                      Right and left rotation is 30 degrees

 

 

Neurology

-                      Dermatomes are of segmental distribution

-                      Nerve roots travel through the intercostal spaces as intercostal nerves

-                      C8 nerve root exits between C7 and T1

-                      The thoracic nerve roots exit below the vertebra (T1 nerve root exits between T1 & T2)

-                      T4 dermatome is right at nipple line for men and just above nipple in women

-                      T7 dermatome is at the Xyphoid process

-                      T10 dermatome is at the imbilicus

-                      T12 is U-shpaed which follows the Iliac crest around down toward the pubis symphysis

-                      T1 dermatome is around neck and triceps area

-                      T2 – around neck and the axilla

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