Thoracic Spine

manubrium

sternoclavicular joint

Articulation between the proximal clavicle and the sternum

sternal angle

articulates with second rib: between the manubrium and body

body of sternum

Xiphoid process of sternum

sternocostal joints

along the lateral aspect of the sternum: should feel a "step" when palpating from medial to lateral

palpate through 2-7

superior aspect of first rib

retract upper trap posteriorly and let finger land on top of first rib

anterior aspect of 2nd rib

Move fingers approximately 1" laterally along clavicle from the sternoclavicular joint and then just inferior to the clavicle

lateral ribs and intercostal spaces of the ribs

inferior aspect of 10th rib

from xiphoid process, move laterally along inferior border of rib

thoracic spinous process T1-T12

spinous process of T3 at level of spine of scapula

spinous process of T7 at level of inferior angle of scapula

lamina and facet joints of thoracic vertebrae

one finger width lateral to the spinous process

transverse process of thoracic vertebrae

two finger widths lateral to the spinous process

posterior ribs

three finger widths lateral to spinous processes

the rib articulates with the transverse process of the thoracic vertebrae at its same level

ex: rib #6 articulates with the anterior aspect of transverse process of T6

intercostal muscle

palpate in between each rib

diaphragm

palpate inferior to the 10th rib and pull up

scapular muscles

trapezius, levator scapulae, rhomboideus, serratus anterior, pectoralis minor

erector spinae

unable to differentiate between all the different muscles

palpate them as a group by having subject in prone extend spine

palpate on either side of spinous processes

functional movement assessment

thoracic rotation to right and left

a. with hands clasped out in front

b. arms crossed across chest

c. compare right side to left side

ideal is about 45 degrees of rotation