Biomechanics of thorax

It consist of Rib Cage:Sternum Thoracic vertebrae Ribs KINEMATICS
Ribs and manubriosternum
Ribs and thoracic vertebrae
MUSCLES ASSOCIATED WITH RIB CAGE
Primary muscles of ventilation
Secondary muscles of ventilation
PATHO-MECHANICS

1. BIOMECHANICS OF THORAX Dr. Nidhi Ahya (Asst Prof) Cardio-Vascular & Respiratory PT DVVPF College of Physiotherapy Ahemednagar 414111 1 Dr.Nidhi Ahya(Asst Prof,COPT)

2. GENERAL STRUCTURE: Rib Cage: Sternum Thoracic vertebrae Ribs KINEMATICS Ribs and manubriosternum Ribs and thoracic vertebrae MUSCLES ASSOCIATED WITH RIB CAGE Primary muscles of ventilation Secondary muscles of ventilation PATHO-MECHANICS objective s 2 Dr.Nidhi Ahya(Asst Prof,COPT)

3. Consist : Ribs Thoracic vertebrae Sternum Provides a stable base for the muscles attachments Protection of lungs, heart, viscera Ventilation Thorax 3 Dr.Nidhi Ahya(Asst Prof,COPT)

4. Rib Cage: Sternum Thoracic vertebrae Ribs General structure : 4 Dr.Nidhi Ahya(Asst Prof,COPT)

5. 5 Dr.Nidhi Ahya(Asst Prof,COPT)

6. Sternum 6 Dr.Nidhi Ahya(Asst Prof,COPT)

7. Thoracic vertebrae 7 Dr.Nidhi Ahya(Asst Prof,COPT)

8. Ribs 8 Dr.Nidhi Ahya(Asst Prof,COPT)

9. Manubriosternal and Xiphisternal Joints 9 Dr.Nidhi Ahya(Asst Prof,COPT)

10. Costovertebral joint 10 Dr.Nidhi Ahya(Asst Prof,COPT)

11. 1 2 1 2 11 Dr.Nidhi Ahya(Asst Prof,COPT)

12. Costotransverse Joint 12 Dr.Nidhi Ahya(Asst Prof,COPT)

13. 13 Dr.Nidhi Ahya(Asst Prof,COPT)

14. Costochondral Joint 14 Dr.Nidhi Ahya(Asst Prof,COPT)

15. Interchondral joint 15 Dr.Nidhi Ahya(Asst Prof,COPT)

16. Kinematics 16 Dr.Nidhi Ahya(Asst Prof,COPT)

17. Expansion of thorax take place in three dimensions: Anterio-posterior (A-P) Transverse Vertical Dimensions of thorax 17 Dr.Nidhi Ahya(Asst Prof,COPT)

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20. Movement of rib cage is a combination of geometry governed by: 20 Dr.Nidhi Ahya(Asst Prof,COPT)

21. It is believed that CV and CT joints are mechanically interlinked Single axis passing through the centre both joints Axis of upper ribs lies close to frontal plane (allows motion in sagittal plane) Axis of lower ribs lies close to sagittal plane (allows motion in frontal plane) Single Axis of the motion 21 Dr.Nidhi Ahya(Asst Prof,COPT)

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23. Anteriorly : Thicker anterior articulation Costal cartilage is stiffer than the others 1 st chondrosternal joint is synchondrosis Limit mobility Posteriorly: CV joint has only one facet Increase mobility First rib: 23 Dr.Nidhi Ahya(Asst Prof,COPT)

24. Take place at anterior aspect of ribs at coronal axis Costal cartilage become more horizontal Ribs pushes sternum ventrally and superiorly Excursion of manubrium is less than the body 1 st rib has shortest length Length increase caudally till 7 th rib This discrepancy cause movement at MS joint Movement of Upper ribs 24 Dr.Nidhi Ahya(Asst Prof,COPT)

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26. Elevation occurs about axis of motion lying nearly in the sagittal plane Have more angled shape (obliquity increases 1 st -10 th ) Indirect attachment anteriorly to the sternum These factors allow the lower ribs more motion at the lateral aspect of the rib cage Increase the transverse diameter (BUCKLE HANDLE) Movement of lower ribs 26 Dr.Nidhi Ahya(Asst Prof,COPT)

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28. Depends up on the orientation of the zygoepiphyseal (ZP) joints orientation Orientation of ZP joints are in 20* off the frontal plane Movements of thoracic vertebrae 28 Dr.Nidhi Ahya(Asst Prof,COPT)

29. MUSCLES OF VENTILATION 29 Dr.Nidhi Ahya(Asst Prof,COPT)

30. Recruited for quite ventilation Diaphragm Intercostals ( Parasternals ) Sclaene These muscle promote inspiration Expiration is a passive process Primary muscles: 30 Dr.Nidhi Ahya(Asst Prof,COPT)

31. Accounts for 70-80% of inspiration during quite breathing Circular set of muscles arises from: Sternum Costal cartilage Ribs Vertebral bodies Diaphragm 31 Dr.Nidhi Ahya(Asst Prof,COPT)

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33. External and internal intercostals Only parasternal portion are considerd as primary muscles of ventilation Sub costal group of muscles Connects adjacent ribs to one another Intercostals 33 Dr.Nidhi Ahya(Asst Prof,COPT)

34. Scalene muscles 34 Dr.Nidhi Ahya(Asst Prof,COPT)

35. Attaches the rib cage to shoulder girdle, head, vertrbral column, or pelvis Assist with inspiration or expiration in situation of stress When trunk is stabilized, they moves: Vertebral column Arm head Accessory muscles of ventilation 35 Dr.Nidhi Ahya(Asst Prof,COPT)

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37. The newborn has a cartilaginous, and therefore extremely compliant, chest wall Chest wall muscles must act as stabilizers, rather than mobilizers Rib cage has more horizontal alignment of the ribs Angle of insertion of the costal fibers of the diaphragm also more horizontal Differences associated with neonates 37 Dr.Nidhi Ahya(Asst Prof,COPT)

38. Many of the articulations of the chest wall undergo fibrosis with advancing age : The inter-chondral and costochondral joints can fibrose , Xiphisternal junction usually ossifies after age 40 True synovial joints may undergo morphologic changes associated with aging, which results in reduced mobility Costal cartilages ossify, which interferes with their axial rotation Increased kyphosis : Decreases the mobility of thoracic spine and the rib cage Differences associated with elderly 38 Dr.Nidhi Ahya(Asst Prof,COPT)

39. GENERAL STRUCTURE Rib Cage: Sternum Thoracic vertebrae Ribs KINEMATICS Ribs and manubriosternum Ribs and thoracic vertebrae MUSCLES ASSOCIATED WITH RIB CAGE Primary muscles of ventilation Secondary muscles of ventilation 39 Dr.Nidhi Ahya(Asst Prof,COPT) summary

40. Write the kinematics of the thorax? 3mrks Write the upper ribs movement? 3mrks Write in detail muscles of ventilation? 5mrks 40 Dr.Nidhi Ahya(Asst Prof,COPT) Questions

41. Thank you Have a nice day…. 41 Dr.Nidhi Ahya(Asst Prof,COPT)