JOINTS OF THORAX.pptx
- 1. Joints of thorax Dr.M.VASANTHAKOHILA MBBS POST GRADUATE KILPAUK MEDICAL COLLEGE 18.04.2023 AN - 21.8 ,21.10
- 2. Joints • The joints of the thoracic spine can be divided into two groups – those that are present throughout the vertebral column, and those unique to the thoracic spine. • Present throughout Vertebral Column • There are two types of joints present throughout the vertebral column: • Between vertebral bodies – adjacent vertebral bodies are joined by intervertebral discs, made of fibrocartilage. This is a type of cartilaginous joint, known as a symphysis. • Between vertebral arches – formed by the articulation of superior and inferior articular processes from adjacent vertebrae. It is a synovial type joint.
- 3. Joints of the thoracic wall Between the • Vertebrae (intervertebral joints). • Ribs and vertebrae (costovertebral joints: joints of heads of ribs and costotransverse joints). • Ribs and costal cartilages (costochondral joints). • Costal cartilages (interchondral joints). • Sternum and costal cartilages (sternocostal joints). • Sternum and clavicle (sternoclavicular joints). • Parts of the sternum (manubriosternal and xiphisternal joints) in young people the manubriosternal (and sometimes the xiphisternal) joint usually fuses in the elderly.
- 4. Unique to Thoracic Spine • The articulations between the vertebrae and the ribs are unique to the thoracic spine. For each rib, there are two separate articulations – costovertebral and costotransverse. • Each costovertebral joint consists of the head of the rib articulating with: • Superior costal facet of the corresponding vertebra • Inferior costal facet of the superior vertebra • Intervertebral disc separating the two vertebrae • Within this joint, the intra-articular ligament of head of rib attaches the rib head to the intervertebral disc. Only slight gliding movements can occur at these joints, due to the close articulation of their components. • The costotransverse joints are formed by the articulation of transverse processes of a thoracic vertebra and the tubercle of the adjacent rib. They are present in all vertebrae except T11 and T12.
- 7. INTERCHONDRAL JOINTS • 7th-9th costal cartilages enters into contact with one another and articulate with every other by number of small synovial joints in Interchondral joint. • At some instances, they are also connected by ligaments. • 9th and 10th costal cartilages union is usually ligamentous
- 10. MANUBRIOSTERNAL JOINT • The manubriosternal joint is composed between the lower end of the manubrium sterni and upper end of the body of sternum. It is a secondary cartilaginous joint (symphysis) between manubrium and body of sternum. It allows minimal slipping movements of body of sternum on the manubrium during respiration. • The manubriosternal joint is not an average symphysis because as a rule bones taking part in the formation of a symphysis don’t go through bony union, but in many people after 30 years of age bony union does take place between the manubrium and the body of sternum.
- 11. The xiphisternal joint • The xiphisternal joint arises as a synchondrosis between the inferior sternebrae of the sternal body and the xiphoid process. • It can remain until the middle years of life, but usually ossifies to form a synostosis between the two sternal elements.
- 12. COSTOVERTEBRAL JOINTS • The Costovertebral joints are created by articulation of articular facets on the head of ribs and costal facets on the bodies of thoracic vertebrae. • The head of typical rib articulates with the body of numerically corresponding vertebra and also with the body of next higher vertebra.
- 13. Synovial type of plane joint
- 14. Costovertebral joint • The 1st, 10th, 11th, and 12th ribs joint with the bodies of numerically corresponding vertebrae. • Costovertebral joint of typical ribs got 2 joint cavities and those of atypical ribs have single joint cavity.
- 15. Ligaments • The thoracic spine is strengthened by the presence of numerous ligaments. • Present Throughout Vertebral Column • Anterior and posterior longitudinal ligaments: Long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs. • Ligamentum flavum: Connects the laminae of adjacent vertebrae. • Interspinous ligament: Connects the spinous processes of adjacent vertebrae. • Supraspinous ligament: Connects the tips of adjacent spinous processes. • (Note: In the cervical spine, the interspinous and supraspinous ligaments thicken and combine to form the nuchal ligament).
- 17. LIGAMENTS • Capsular ligament (joint capsule): It is the fibrous capsule that covers/encloses the joint and is connected to the articular margins. • Radiate ligament/triradiate ligament: It stretches from the anterior aspect of the head of rib and breaks up into 3 bands: upper, lower, and middle. The upper and lower bands are connected to the sides of upper and lower vertebrae. The middle band (also referred to as intra-articular ligament) gets connected to the intervertebral disc. • Intra-articular ligament: It stretches from the crest between the 2 articular facets on the head of rib to the intervertebral disc and splits the joint cavity into 2 parts.
- 18. Joint Type Articulation Ligaments Comments Intervertebral Symphysis (second- ary cartilaginous) Adjacent vertebral Anterior and bodies bound posterior together by IV disc longitudinal Costovertebral Joints of head of rib Synovial plane joint Head of each rib with superior facet of corresponding vertebral body and inferior demifacet or costal facet of vertebral body superior to it demifacet or costalof head of rib Radiate and intra- Heads of 1st, 11th, articular ligaments and 12th ribs (sometimes 10th) artculate only with corresponding vertebral body of corresponding vertebra Articulation of Lateral and tubercle of rib withsuperior transverse process costotransverse 11th and 12th ribs do not articulate with transverse process of corresponding vertebrae Costotransverse Costochondral joint Primary cartilaginous Articulation of lateral end of costal cartilage with sternal end of Cartilage and bone No movement bound together by normally occurs at periosteum this joint
- 19. Joint Type Articulation Ligaments Comments Interchondral Synovial plane joint Articulation between costal cartilages of 6th and 7th, 7th and 8th, and 8th and 9th ribs Interchondral ligaments Articulation between costal cartilages of 9th and 10th ribs is fibrous Sternocostal 1st: primary cartilaginous joint (synchondrosis) Articulation of 1st costal cartilages with manubrium of sternum 2nd-7th: synovial plane joint Articulation of the 2nd- 7th pairs of costal cartilages with sternum Anterior and posterior radiate sternocostal Sternoclavicular Saddle type of synovial joint Sternal end of clavicle with manubrium of sternum and 1st costal cartilage Anterior and posterior sternoclavicular ligaments; costoclavicular ligament This joint is divided into two compartments by an articular disc Manubriosternal Secondary cartilaginous joint (symphysis) Articulation between manubrium and body of sternum This joint often fuses and becomes a synostosis in older individuals Xiphistrnal Primary cartilaginous joint (synchondrosis) Articulation between xiphoid process and body of sternum
Editor's Notes
- #7: Synchondrosis-adjacent bones are united by cartilage.1.syn-joined by hyaline cartilage 2.symphysis-joined by fibrocartilage