Thoracic Anatomy

Front 1

Thoracic region mobility

Back 1

Stiffer and less mobile

Due to attachment to ribcage --- produces stability

Front 2

Thoracic kyphosis

Back 2

Results from less anterior height of vertebral body and wedge-shaped disc

Avg 20 - 40 degrees

Apex of curve @ T7 - T8

Front 3

Vertebral body

Back 3

Heart shaped

Concave

Normal = T2-T9

Atypical = T1 and T12

Front 4

Concave joint surface

Back 4

Between T1 - T10 for articulation with the ribs

Aka - costal facet

T1-T6 = concave joint faces anteriorly

T7-T10 = concavity faces superiorly

Front 5

Spinal cord tension points

Back 5

Occur at T4, T6, and T9 due to narrowing of spinal canal

Common site of tension due to whiplash

Front 6

Thoracic rule of 3s

Back 6

Refers to the spinous processes and their corresponding vertebral levels

Front 7

Thoracic rule of 3s

T1-T3

Back 7

SP is level with its own body

Front 8

Thoracic rule of 3s

T1-T3

Back 8

Front 9

Thoracic rule of 3s

T4-T6

Back 9

SP level with inferior disc of own body, superior disc of segment below

Front 10

Thoracic rule of 3s

T4-T6

Back 10

Front 11

Thoracic rule of 3s

T7-T9

Back 11

SP level with TP of segment below

Front 12

Thoracic rule of 3s

T7-T9

Back 12

Front 13

Thoracic rule of 3s

T10-T12

Back 13

SP inclination decreases until SP and TP are on same horizontal plane

Front 14

Thoracic rule of 3s

T10-T12

Back 14

Front 15

Facet joint angles

Back 15

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

Front 16

Frontal plane orientation

Back 16

Allows for more rotation and sidebending (upper tspine)

Front 17

Sagittal plane orientation

Back 17

Allows fro more flexion and extension (lower tspine)

Front 18

Superior articular process (of inferior vertebrae)

Back 18

Faces lateral, posterior, and superior (LPS)

Front 19

Inferior articular process (of superior vertebrae)

Back 19

Faces medial, inferior, anterior (MIA)

Front 20

Capsular ligaments of facet joint

Back 20

Thin and loose

Strengthened by ligamentum flavum

Front 21

Facet joint function

Back 21

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

Front 22

T1

Back 22

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

Front 23

T12

Back 23

Superior articular facet oriented in frontal plane

Inferior articular facet oriented in sagittal plane (restricts rotation and mimics lumbar spine)

Front 24

Rib articulation

Back 24

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

Front 25

T1 and rib attachmet

Back 25

T1 articulates with both the 1st and 2nd rib

Costal facet articulates with 1st rib

Demi-facet articulates with 2nd rib

Front 26

T2-T9 rib attachments

Back 26

Demi-facets articulate with rib heads

Front 27

Ribs and Tspine

Back 27

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

Front 28

Ribs and T-spine

Back 28

Front 29

10th rib articulation

Back 29

Articulates with T9 and T10

Front 30

Costovertebral joint

Back 30

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

Front 31

Rib attachments

Back 31

Front 32

Costotransverse joint

Back 32

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

Front 33

Rib attachments cont

Back 33

Front 34

Ribs 1-7 and the sternum

Back 34

Attach through costal cartilage

Front 35

Ribs 8-10 and the sternum

Back 35

Attach through fused costal cartilage

Front 36

Ribs 11 and 12

Back 36

Floating ribs (anteriorly)

Attach to diaphragm and trunk muscles

Front 37

1st rib sternocostal joint

Back 37

Synchondrosis joint --- increases stability of upper thoracic spine

Front 38

2nd rib sternocostal joint

Back 38

2nd rib articulates with demi-facets of both manubrium and sternum

Synovial joint

Front 39

Sternum facets and ribs

Back 39

Concave facets on sternum

Articulate with costocartilage of 3rd-6th ribs

Front 40

7th rib articulation

Back 40

Articulates with both xyphoid and sternum

Front 41

Costocartilage of 1st and 2nd rib

Back 41

Articulates with manubrium and clavicle

Front 42

Vertebral ligaments

Ligamentum flavum

Back 42

Attaches to laminae and pedicle to strengthen the anterior facet joint

Prevents flexion and spinal impingement during extension

Front 43

Vertebral ligaments

Back 43

Front 44

Vertebral ligaments

Interspinous ligament and Supraspinous ligament

Back 44

Limits extension and A-P translation

Front 45

Vertebral ligaments

ALL

Back 45

Plays no major role in stability

Limits flexion

Front 46

Vertebral ligaments

Back 46

Front 47

Vertebral ligaments

PLL

Back 47

Prevents flexion and posterior translation

Front 48

Intervertebral discs

Back 48

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

Front 49

Sympathetic innervation mobilization

Back 49

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

Front 50

Sympathetic innervation in tspine

Back 50

T1-2 = Head

T3-T7 = UE

T7-T12 = LE

T1-T12 = Trunk

Front 51

Cervicothoracic Region

Back 51

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)

Front 52

Pattern of pain and limitation at CT joint

Back 52

Clinical presentation: localized pn in CT junction w/ radiating pn in shoulder

Limited flex/ext and rot/SB to same side (ipsilateral)

Front 53

Restricted cervical flexion

Causes

Back 53

CT junction restriction (HYPOMOBILE)

Cervical disc

Soft tissue restriction in cspine