PTAP Spine and thorax
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