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60 Cards in this Set
- Front
- Back
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General characteristics of thoracic vertebral levels?
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T1-2: Inferior transition of cervical lordosis
T3-12: Thoracic kyphosis T5-6: Apex T10-12: Transition to lumbar lordosis |
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Thoracic vertebrae functional divisions?
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Cervico-thoracic: T1-4
True thoracics: T5-9 Thoraco-lumbar: T10-12 |
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Thoracic vertebrae that contain 1 articular facet?
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1,10,11, and 12
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Thoracic vertebrae that contain no facet on TP?
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11 and 12
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5 extrinsic superficial back muscles?
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1. Trapezius
2. Latissimus Dorsi 3/4. Rhomboid major/minor 5. Levator scapulae |
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Innervation and general action of superficial, extrinsic back muscles?
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Connect upper limb to trunk (act primarily on the limb)
Receive nerve supply from anterior rami of cervical nerves. |
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3 intermediate extrinsic back muscles?
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Serratus posterior, superior and inferior
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General function of intermediate extrinsic muscles?
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Proprioception and minor respiratory assistance.
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BB (extension) muscle?
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Interspinales thoracis
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BB (extension) acting B/L muscles? (4)
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Intertransversari thoracis
Longissimus thoracis Iliocostalis thoracis Multifidus *3 thoracis muscles are erector spinae muscles |
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BB and rotation muscles? (2)
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Semispinalis thoracis
Rotatores thoracis |
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SB (lateral flexion muscles? (3)
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Longissimus thoracis
Intertransversari thoracis Iliocostalis thoracis |
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SB and Rotation (towards contralateral side) muscle?
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Multifidus
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Flexion of thoracic spine muscle?
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Abdominal muscles
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Headache muscle?
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Splenius capitis
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2 superficial intrinsic muscles?
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Splenius capitis and splenius cervicis
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Intermediate intrinsic function?
Muscles involved (Medial to lateral) |
Erector spinae muscles are primary extensors.
Spinalis, longissimus, iliocostalis |
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Deep intrinsic muscles? (4)
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Semispinalis thoracis
Multifidus Rotatores thoracis (longus/brevis) Levatores costarum (longus/brevis) |
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Deep intrinsic muscle involved in type I dysfunction? Type II?
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Type I: Semispinalis
Type II: Rotatores |
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Abdominal ganglia to consider and thoracic distribution? (3)
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Celiac (T5-9)
Superior mesenteric (T10-12) Inferior mesenteric (T12-L2) |
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T1-6 sympathetic innervation
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Heart and lungs
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T5-9 sympathetic innervation (6)
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Stomach, duodenum, liver, gall bladder, pancreas, spleen
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T10-11 sympathetic innervation (5)
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Small intestines, kidney, ureters, gonads, right colon (ascending)
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T12-L2 sympathetic innervation (3)
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Left colon (descending), prostrate and bladder
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OMT impact on somatic dysfunction?
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Decreases somatic afferent input which decreases somatosympathetic activity to the affected viscera
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FB/BB Mechanics
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Occurs in a sagittal plane around a transverse (horizontal) axis
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Typical and atypical ribs?
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Typical: 3-9
Atypical: 1,2,11,12 (maybe 10) |
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Characteristics of typical ribs? (5)
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Tubercle (articulates with costotransverse process of body)
Head (articulates with corresponding and superior vertebrae) Neck Angle Shaft |
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Ribs with synovial articulations?
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Ribs 2-7
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Accessory muscles of inspiration? (4)
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SCM, A/M/P Scalenes
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Principal muscles of inspiration? (3)
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Diaphragm, internal/external intercostalis
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Muscles of inspiration? (6)
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1. Scalene- lifts cage superiorly
2. Pec Minor- lifts ribs 3-5 3. Pec Major- lifts ribs 2-6 4. Serratus Anterior- lifts ribs 7-9 5. Latissimus Dorsi- pulls ribs 11/12 superiorly and laterally 6. Serratus Post Superior- Ribs 2-5 |
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Muscles of expiration (3)
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1. Quadratus lumborum- pulls ribs 11/12 inferiorly
2. Latissimus Dorsi- aids in expiration 3. Serratus Post. Inferior- Inserts ribs 9-12 |
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What are costal nerves derived from?
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Sympathetic chain ganglia (white and gray rami)
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Rib motions?
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Pump Handle (1-5)
Bucket Handle (6-10) Caliper (11,12) |
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Bucket handle motion?
Palpation? |
Sagittal axis with a coronal plane
Palpated at mid axillary line |
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Pump handle motion?
Palpation? |
Transverse axis in a sagittal plane
Palpated at mid clavicular line |
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Caliper motion?
Palpation? |
Ribs externally rotate with inhalation.
Motion around a vertical axis in a transverse plane Palpated 3-5 cm lateral to transverse processes |
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Treating a specific rib when a group dysfunction is present
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B.I.T.E.
Bottom Inhalation Top Exhalation |
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Borders of:
Anatomical Inlet Functional Inlet Thoracic Outlet |
Anatomical Inlet:
Manubrium, 1st ribs, T1 Functional Inlet: Manubrium w/ Angle of Louis, first 2 ribs, and T1-4 Thoracic Outlet: Clavicle, 1st ribs, scapula |
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5 sites of entrapment for TOS
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1. Scalene anterior and medius
2. Clavicle and 1st rib 3. Pec. Minor and Ribs 4. Cervical ribs 5. Fascia distortion |
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Muscle Energy for Exhalation Somatic Dysfunction
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Rib 1: Anterior and middle scalene
Rib 2: Posterior scalene Rib 3-5: Pec. Minor Ribs 6-8: Serratus Anterior Ribs 9-12: Latissimus Dorsi Rib 12: Quadratus lumborum |
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Treating ribs with exhalation dysfunctions (rib held down) with muscle energy?
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Patient inhales deeply, physician resists and for 3-5 seconds the following is completed:
Rib 1: Raises head toward ceiling Rib 2: Turns head away 30 away from dysfunctional side, tilts head toward ceiling Rib 3-5: Patient pushes elbow of affected side toward opposite ASIS Rib 6-9: Push arm anteriorly Ribs 10-12: Adduct arm |
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Muscles that stretch in TOS?
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Middle and lower trapezius
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Muscles that become hypertonic in TOS?
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Scalenes
Pectoralis minor Sternocleidomastoid Serratus anterior |
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Muscle weakness in TOS?
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Middle/lower trapezius, serratus anterior and rhomboids
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Muscle overuse/trigger points in TOS?
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Levator scapulae and upper trapezius
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What is a trigger point?
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Discrete, focal, hyperirritable spot located in taut band of skeletal muscle
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Adson's test compression?
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Neck turned toward affected side to narrow interscalene space
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Halsted maneuver compression?
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"Exaggerated military posture"
Scapula retracted and depressed, chest protruding. Narrows costoclavicular space |
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East/Roo Test?
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Shoulders ER and abducted 90
Elbows flexed 90 |
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Wright's maneuver compression?
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Shoulder ER, abduction beyond 90
Compresses below pectoralis minor insertion |
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Cervical C0-C2 dysfunction leads to ___cardia?
What are specific effects for left and right sides? |
Bradycardia
Left: AV node dysfunction (blocks) Right: SA node dysfunction and bradycardia |
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Thoracic (T1-T6) dysfunction leads to ______cardia?
Specific effects of left and right sided SD? |
Tachycardia
Left: Ventricular fibrillation or ectopic pacemaker Right: Supraventricular tachycardia |
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Exhalation SD has _______ counterstrain point?
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Anterior
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Inhalation SD has a ________ counterstrain point?
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Posterior
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3 common sites of TOS?
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1. Scalene triangle
-Ant/Mid scalene, 1st rib 2. Costoclavicular space -1st rib, clavicle, mid scalene (posterior), costoclavicular ligament (anterior) 3. Subcoracoid space -Overlying ribs under pec minor attachment at coracoid process |
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What is proprioception?
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Subconscious self regulation of posture and movement through receptors in joints, tendons, and muscles combined with the vestibular system.
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Sequence of altered proprioception in relation to SD?
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Inappropriate CNS interpretation of position leads to poor body positioning, firing sequence, load distribution which causes the wrong muscles to be overly exerted and increases the risk of injury.
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Symptoms of chronic SD?
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Local effects involve vasculature and lymphatics. Systemic effects include neruomuscular compensation (postural decompensation and altered proprioception).
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