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Chapter 25
Chapter 25
T1 T9
Superior costal facets are Inferior costal facets are
circular to articulate with absent and there is no
head of 1st rib. direct articulation with the
Spinous process is 10th ribs.
horizontal and is long and T10
prominent as C7. No inferior costal facets
and no direct articulation
with the 11th ribs.
T11 T12
Articulates only with Possesses only two
heads of 11th ribs. costal facets for the
Transverse processes 12th ribs.
are small and do not Body, transverse
have articular facets processes, and
for tubercles of ribs. inferior facets are
similar to lumbar
vertebrae.
Rib Functions:
Protect heart, lungs, and great vessels against trauma
Provide attachment for skeletal and respiratory muscles
Facilitate postural alignment and upper extremity
function
ROM
Flexion and extension – More limited in upper
thoracic region (facets lie closer to frontal plane).
Flexion – 20–45 degrees
Extension – 20–45 degrees
Lee states:
If lateral flexion in frontal plane occurs first it is
accompanied by contralateral rotation BUT if rotation in
transverse plane occurs first it is accompanied by
ipsilateral rotation.
During Exhalation
Anterior and lateral aspects of ribs move
inferiorly.
Extension Flexion
Spinalis capitis, Levatores costarum
cervicis, thoracis Rectus abdominis
Longissimus thoracis Internal obliques
Semispinalis thoracis External obliques
Rotatores thoracis
Multifidus
Interspinales
Intervention
Consult with referring provider to determine if fracture
is stable.
Pain control – Medications, back braces, and physical
therapy modalities.
Moderate weight-bearing exercise (e.g., walking).
Resisted upper extremity exercise.
Balance training exercises.
Intervention
Usually limited to patients with painful deformity,
painful progression, and at least two years of
growth remaining.
Manage with bracing until skeletal maturity.
Strengthen spinal extensors.
Stretch hamstrings, pectoralis major, superior
rectus abdominus, and anterior longitudinal
ligament.
3 Types:
1. Nonstructural scoliosis
2. Transient structural scoliosis
3. Structural scoliosis (idiopathic accounts for
70–80% of cases of scoliosis)
Treatment
Specific soft-tissue mobilization followed by
exercises to maintain new mobility.
Passive stretch with diaphragmatic breathing for
restrictions in oblique abdominal length.
As stability/mobility progresses – Progress to full
arcs of motion.
Treatment
Improve impairments of shoulder girdle.
Modify traditional exercises to prevent
thoracic extension.
Self-mobilization techniques (promoting
thoracic flexion and rotation).
Parkinson’s Disease
3 Subsets
Type 1: Etiology of compression only
Type 2: Etiology of stretch only
Type 3: Etiology of compression and stretch