Spinal Lecture 7 Flashcards Preview

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Flashcards in Spinal Lecture 7 Deck (71):
1

What are the main functions/purpose of the ribs?

Protection of lungs, heart, pericardium
Muscle attachment
Force transferal / attenuation
Stability to the thoracic as a result of it’s circular ring it forms

2

What are the main functions of the ribs?

Protection and movement

3

What occurs to the ribs as we age?

elasticity decreases with age therefore ribs become more rigid and fragile

4

How many pairs of ribs are there?

12

5

What is the ribs function with regard to breathing?

Help guide breathing and resist the elastic recoil of the lungs

During inspiration the ribs spin and rotate because the costocartilages can spin and twist allowing full movement

6

How many superior "true" ribs are there?

7

7

What connects the superior 7 ribs to the sternum?

Costal cartilages

8

Which ribs have costal cartilages that join?

Which ones don't attach to the cartilage?

8-10 rib cartilages join
11 & 12 have free ends not attaching to the cartilage (floating ribs)

9

What is the implications of ribs 8-10 merging with the costal cartilage above?

dislocate easier

10

What is the purpose of the intercostal muscles?

Add a layer of protection
Protect and guide ribs through their movement

11

What can rib one cause narrowing of?

Rib one influences the thoracic outlet space – when it moves it changes the angle and can lead to narrowing of this area

12

What is the intercostal spaces between ribs filled with?

intercostal spaces between ribs filled with intercostals muscles, nerves, veins and arteries

13

What plane are the superior ribs on?

superior ribs are on a more horizontal plane, less oblique than inferior ribs

14

Which rib is most oblique?

9th

15

Which ribs increase in length and at which rib do they start decreasing in length again?

ribs 1-7 increase in length and then decrease down to 12

16

Describe the movement of ribs 1-5

ribs 1-5 mov’t is more pump-handle like….axis of movement is posterior, anterior ends move up and down

17

Describe the movement of ribs 6-10

ribs 6-10 movement is bucket-handle like….axis of movement is medial, lateral sides move up and down

18

Describe the shaft of a typical rib

thin and flat
external convexity
grooved internally near it’s lower border—costal groove for intercostal nerve
lower border is sharp
upper border is rounded

19

A typical rib articulates with how many vertebral bodies

2

20

What angle does the rib come out from the vertebral body at?

Posterior and lateral angle

21

What is the purpose of the costal groove. What is an implication with regard to fracture?

The costal groove is where the nerve typically sits for protection
Implication: can be displaced during fracture which could affect the nerve, artery and vein

22

Describe the anterior end of a typical rib?

costal end
small concave depression for it’s cartilage’s lateral end
forms costochondral joint
can dislocate
(Like an ice cream cone)

23

How many ribs attach to the sternum?

7

24

Costal =
Chondra =

Rib = Costal
Cartilage = Chondra

25

What are the 4 articulations of the rib?

Sternochondral
Costochondral
Costotransverse
Costovertebral

26

describe the posterior end of a typical rib

vertebral end
has a neck, head, tubercle
the head has 2 facets which are separated by a transverse crest

27

In a typical rib what does the larger and smaller facets articulate with?

Lower, larger facet articulates with body of the corresponding vertebrae

the superior and smaller facet articulates with the body of the superior vertebrae

Forms costovertebral jt

28

Describe the neck of a typical rib

the neck is the flat part beyond the head
is oblique and faces superior and anterior
posterior inferior surface is rough and pierced by a foramina

29

Describe the tubercle of a typical rib

tubercle is posterior, external at junction of the neck and shaft
separated into medial articular facet and lateral non-articular facet
anterior to the TP of it’s corresponding vertebrae
forms the costotransverse joint

30

EXAM Q: T/F you can have an isolated costal problem without it affecting the vertebral segment but you can’t have an isolated vertebral problem without it affecting the rib

True

31

EXAM Q: deep inspiration and expiration keeps ribs 1 and 2 moving therefore decreases chances of ___________ occurring

thoracic outlet syndrome

32

Describe the costal cartilage

flat bars of hyaline cartilage
extend from the anterior ends of the ribs
allows for the elasticity and mobility of the thoracic cage

33

What do the upper 7 costal cartilage articulate with

The sternum

34

What do the 8-10th costal cartilages articulate with?

The lower border of the one above

35

What is unique about the two lowest costal cartilages with regard to what they articulate with?

the lowest two have free ends that end in the abdominal wall

36

What happens to the length of the costal cartilages as you move inferiorly

Increase in length from 1-7
Then decrease in length down to the 12th

37

What happens to the chondral bars as we age

Decreased elasticity affecting overall mobility of the ribs

38

How can we prevent inelasticity in the ribs?

Keep the patient moving and breathing

39

What is the most curved and shortest rib?

Rib 1

40

Describe the shape of Rib 1

Broad and flat

41

What plane is rib 1 on?

Horizontal

42

Why is Rib 1 flat on top?

No costal muscles on top pulling it up

43

The head of the first rib only articulates with __

T1

44

Which rib is by far the smallest rib?

Rib 1

45

What is the only rib that can move superior?

Rib 1

46

Which rib articulates with the clavicle?

Rib 1

47

What muscles elevate the 1st rib during forced inspiration?

Anterior and middle scalenes

48

What muscle attaches on the inferior portion of rib 1?

Serratus anterior

49

How many grooves are found on the superior surface of rib 1

2

50

What are the two grooves on the superior surface of rib 1 separated by?

scalene tubercle

51

What is the anterior groove on rib 1 for?

Subclavian vein

52

What is the posterior groove on rib 1 for?

subclavian artery

53

At what point is rib 1 the highest? Which way does it slope?

Highest at the vertebral end and sloped obliquely downward

54

An upper chest breather will cause hypertrophy of what muscle? What will this lead to?

Hypertrophy of the scalenes, causing narrowing of the thoracic outlet

55

Describe the head of Rib 1

the head is small, round, and bears an almost circular facet which articulates with T1 vertebral body

56

Describe the neck of rib 1

the neck is rounded and ascends posterolaterally

57

Describe the tubercle of rib 1

the tubercle is wide and prominent and is directed up and backwards

58

What does the facet of rib 1 articulate with?

the oval facet articulates with the first thoracic transverse process

59

T/F the lungs will come up and poke higher then the first rib?

True

60

How long is rib 2 in comparison to rib 1?

2x the length

61

What tubercle is found on rib 2? What does this provide attachment for?

has a tubercle for the origin of serratus anterior and the insertion of the posterior scalene muscle (posterior to S.A. origin)

62

When taking deep breaths you should feel movement of the ___ and ____ – if disfunction of rib two there will be alterations to this movement

sternal angle and manubrium

63

Where is the facet of Rib 10 found?
What does it articulate with?

has a single facet on it’s head which may articulate with the IVD of T10 and it’s upper body

64

T/F Rib 9 and 10 only articulate with one vertebral body (T9 and T10 respectively)

True

65

How many facets does ribs 11 and 12 have?

each have a single large articular facet on it's head

66

Describe the neck and tubercles of ribs 11 and 12

They have no neck or tubercles

67

T/F the pointed ends of ribs 11 and 12 have a a lot of cartilage at the tip

False , a tiny bit of cartilage at the tip

68

Does ribs 11 and 12 articulate with the anterior aspect of the TP? Implications of this?

Don’t articulate with anterior aspect of TP – only articulate with vertebral body of 11 and 12 respectively – this will allow more rotation in the lower T-spine

69

What dictates rotation of the thoracic vertebrae?

The facet joint

70

Where does most rotation occur? C, T, L or S? Implications?

Almost all rotation will occur in the lower T-spine – very significant because when we walk you should be getting rotation, sports etc as well so if 9-12 are not rotating properly the consequence is rotation somewhere else where your not supposed to (lumbar spine, SI joint, Hips etc.) this will lead to injury or decreased performance

71

How rare is a cervical rib?
What are the consequences of having one?

Only seen in 1 in 500 individuals
Even rarer to see it bilateral


What do you think the consequences of having a cervical rib are?
Decreased ROM because the rib will restrict c7 and hightened posibilty of thoracic outlet