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52 Cards in this Set

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Rules of 3 of thoracic transverse processes.
T1-T3: located at level of corresponding spinous process.

T4-T6: located half a segment above the corresponding spinous process.

T7-T9: located at the level of spinous process of vertebrae above.

T10-T12: T10 follows same rules as T7-9. T11 follows same rules as T4-6. T12 follows same rules as T1-T3.
Landmark of inferior angle of scapula?
corresponds w/ spinous process of T7.
Level of sternal notch?
Level w/ T2
Dermatome of nipple?
T4.
Dermatome of umbilicus?
T10.
Vertebral facets joints
Between adjacent vertebral bodies.
Costovertebral joints
Between head of rib and vertebral body.
Costotransverse joint
Between articular part of the tubercle and the transverse process.
Costochondral joint
Between anterior end of rib and costal cartilage.
Diaphragm: during inspiration
Diaphragm contracts and descends.
Diaphragm: during expiration,
Diaphragm relaxes and ascends.
Diaphragm innervation.
By ventral rami of C3-C5 (phrenic nerve).
Diaphragm attachment:
By right and left crural attachment to the first two lumbar vertebrae on the left and first three lumbar vertebrae on the right.
Intercostal muscles function.
Help to elevate the ribs w/ inhalation.
Which muscle(s) elevate rib 1 during deep inspiration.
Anterior and middle scalenes.
Which muscles(s) elevate rib 2 during deep inspiration?
Posterior scalenes.
Pectoralis minor: origin and insersion?
Originates from medial border and superior surface of coracoid process of scapula and inserts on ribs 3-5.
Innervation of pectoralis minor.
Medial pectoral nerve.
Function of pectoralis minor.
Stabilizes the scapula by drawing it inferiorly and anteriorly against the thoracic cage.

Also helps elevate ribs 3-5 with deep inhalation.
Serratus anterior: origin and insertiion.
Originates from medial border of scapula and inserts on lateral surfaces of ribs 1-8.
Innervation of serratus anterior:
Long thoracic nerve.
Function of serratus anterior.
Protracts the scapula and facilitates bucket handle rib motion.
Bucket handle rib motion.
Serratus anterior.
Muscles of respiration:
Major: diaphragm and intercostal.

Minor: scalenes, pec minor, serratus anterior, quadratus lumborum, latissimus dorsi.
Quadratus lumborum: origin and insersion.
Originates from medial half of 12th rib and tips of oumbar transverse processes and inserts into iliolumbar ligaments and internal lip of iliac crest.
Quadratus lumborum: function
Extends and sidebends the lumbar spine (ipsilaterally).

Also fixes the 12th rib during respiration.
Latissimus dorsi: originates and insersion.
Originates from the spinous processes of T6-T12, iliac crest, and ribs 8 (9)-12.
Inserts thru the humerus.
Latissimus dorsi: function.
Extends, adducts, and medially rotates the humerus.
Elevates ribs 8(9)-12 w/ deep inspiration.
What drains to the thoracic duct (to left subclavian)?
Lymphatics from lower body, trunks from left head, arm, and thoracic viscera.

(rest drains to the right internal jugular).
True ribs.
Ribs 1-7.
Connects to the sternum by costal cartilages.
False ribs.
Rib8-10.
Not directly connect to sternum.
Floating ribs.
Rib 11-12.
Define. Pump-handle motion.
Increases the anterior-posterior dimension of the thorax. Anterior ends of ribs rise, causing the sternum to rise.
Define. Bucket-handle motion.
Increases the transverse dimension of the thorax. With inhalation, these ribs ascend and move laterally.
Define. Caliper motion.
Motion of floating ribs.
Pump-handle motion is within ribs _____?
Upper ribs (1-5).
Bucket-handle motion is within ribs _____?
Middle ribs (rib 6-10).
caliper motion is within ribs ____ ?
Lower ribs (11-12).
Inhalation dysfunction (or exhalation restriction)of ribs.
B/c ribs move cephalad w/ inhalation, a rib inhalation dysfunction occurs when one or a group of ribs get "stuck" in the inhalation position.

Pump-handle ribs will be positioned up anteriorly.

Bucket-handle ribs will be positioned up laterally.
Exhalation dysfunction (or inhalation restriction) of ribs.
B/c ribs move caudad w/ exhalation, a rib exhalation dysfunction occurs when one or a group of ribs get "stuck" in the exhalation position.

Pump-handle ribs will be positioned down anteriorly.

Bucket-handle ribs will be positioned down laterally.
Group dysfunction of ribs.
When 2 or more ribs are positioned in the inhalation or exhalation. There is usually one rib that's responsible for causing the dysfunction--it's referred as "key" rib.

In inhalation dysfunction, the key rib is the lowest rib.
In exhalation fysfunction, it's the uppermost rib.

Direct treatment toward the key rib.
Muscle energy rx rib 1:
Use anterior and middle scalenes.
Muscle energy rx rib 2:
Use posterior scalenes.
Muscle energy rx rib 3-5:
Use pectoralis miniro.
Muscle energy rx rib 6-9:
Use serratus anterior.
Muscle energy rx rib 10-11:
Use latissimus dorsi.
Muscle energy rx rib 12:
Use quadratus lumborum.
Bucket handle motion in what ribs?
Most obvious in longest ribs-- lower ribs, 6-10.

(rib 1-5 have bucket handle motion, but not their major motion).
"locked up"
-Restricted in inhalation (exhalation restriction)
-Somatic dysfunction where rib moves normally into inhalation, but exhalation motion is restricted.
"locked down"
-somatic dysfunction where ribs movs normally into exhalation, but inhalation is restricted.
Pump handle rib
--upper 5 ot 6 ribs .
Caliper motion
-Ribs 11 and 12.
-Muscle energy involving latissimus dorsi, quadratus lumborum, psoas major.