PTAP Spine and thorax

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Joints in the spine and thorax

sternocostal joints costochondral joints costovertebral joints costotransverse joints intervertebral joints facet (zygapophyseal) joints

Costotransverse Radiate ligament

surrounds the head of the rib to the costal facet of the thoracic vertebrae

Thoracic vertebrae

total of 12. Costal facets are unique to t-spine, located on T1-10

Exhalation

depression and compression; internal intercostals serratus posterior inferior

Diaphragm - nerve

phrenic nerve

Diaphragm - action

-draw down central tendon of diaphragm -increase volume of thoracic cavity during inhalation

External oblique - insertion

anterior iliac crest abdominal aponeurosis to linea alba

Extension

Erector spinae group transversospinalis group quadratus lumborum

Actions of the thoracic and lumbar spine

Flexion extension lateral flexion BL rotation BL

Thorax definition

Includes the T spine and 12 pairs of ribs. Ribs 1-7 = true ribs (directly to sternum) ribs 8-12 = false ribs (via cartilage) ribs 11-12 = floating ribs (no attach.)

Quadratus Lumborum - nerve

Lumbar plexus T12, L1, 2, 3

Quadratus Lumborum - insertion

Rib 12 T process of 1-4 Lumbar vertebrae

External oblique - nerve

T5-T12

Rectus abdominis - nerve

T5-T12, Ventral Rami

Transverse abdominis - nerve

T7-12, L1, iliohypogastric and ilioinguinal, ventral divisions

Internal oblique - nerve

T7-T12 iliohypogastric and ilioinguinal ventral rami

Quadratus Lumborum - action

Unilateral: lateral pelvic tilt, trunk lateral flexion, assist to extend trunk Bilateral: fix rib 12 during forced inhalation and exhalation

Multifidi - action and nerve

Unilateral: rotate trunk to opposite side Bilateral: extend trunk Spinal nerves

Rotatores - action and nerve

Unilateral: rotate trunk to opposite side Bilateral: extend trunk spinal nerves

Spinalis - action and nerve

Unilateral: trunk lateral flexion to same side Bilateral: extend trunk spinal nerves

Iliocostalis - action and nerve

Unilateral: trunk lateral flexion to same side Bilateral: extend trunk spinal nerves

Longissimus - action and nerves

Unilateral: trunk lateral flexion to same side Bilateral: extend trunk spinal nerves

External oblique - action

Unilateral: trunk lateral flexion to the same side, trunk rotation to the opposite side Bilateral: flex trunk, compress abdominal contents

Internal oblique - action

Unilateral: trunk lateral flexion to the same side, trunk rotation to the same side Bilateral: flex trunk, compress abdominal contents

Diaphragm - origin

Xiphoid process ribs lumbar vertebrae

Transverse abdominis - insertion

abdominal aponeurosis to linea alba

Costotransverse ligaments

articulation between tubercles of ribs and t-vert. Found on ribs 1-10

Rectus abdominis - insertion

cartilage of ribs 5-7 ziphoid process

Diaphragm - insertion

central tendon

Transverse abdominis - action

compress abdominal

Costotransverse Ligament

connects the tubercle of the rib to the transverse process of the thoracic vertebrae

Inhalation

elevation and expansion; diaphragm external intercostals serratus posterior superior

Semispinalis Capitis - action and nerve

extend head and trunk cervical nerves

Rotation (contralateral)

external oblique multifidi rotatores

External oblique - origin

external surface of ribs 5-12

Rectus abdominis - action

flex trunk posterior pelvic tilt

Rib Bony landmarks -head -neck -tubercle -angle

head= articulates with the costal facets neck= bridge between the head and the tubercle tubercle= located on ribs 1-10 only; articulates w/transverse process angle= lateral border of the rib

Rotation (Ipsilateral)

internal oblique

Internal oblique - insertion

internal surface of lower 3 ribs abdominal aponeurosis to linea alba

Internal oblique - origin

lateral inguinal ligament iliac crest thoracolumbar fascia

Transverse abdominis - origin

lateral inguinal ligament iliac crest thoracolumbar fascia internal surface of lower 6 ribs

forced expiration

muscles that pull the ribs down and muscles that compress the abdomen, forcing the diaphragm upward

quiet expiration

passive; relaxation of the diaphragm and external intercostals, elastic recoil of the lungs, gravity on the ribcage

Quadratus Lumborum - origin

posterior iliac crest

forced inspiration

previous muscles, plus muscles that stabilize or elevate the shoulder girdle (elevation of the ribs)

quiet inspiration

primary diaphragm external intercostals deep inspiration is this, but more exaggerated

Rectus abdominis - origin

pubic crest pubic symphasis

Lateral flexion

quadratus lumborum external oblique internal oblique erector spinae group

Flexion

rectus abdominis external oblique internal oblique


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