These often-overlooked ligaments of the body serve important functions in maintaining appropriate alignment between the ribs and spine. The most common state is straining of the costovertebralcostotransverse joint complexes as a result of hyperextension of the ligament. When the ribs are elevated, they are projected laterally and anteriorly leading to an increased transverse and anteroposterior diameter.
This is probably due to the strong costovertebral ligamentous attachment to the rib head and tubercle, with its propensity to injury owing to its presence on either side of the rib neck. The airway pressure becomes slightly positive at that point, allowing air to flow out of the lungs. The second through sixth ribs move in a similar axis to the seventh through 10th ribs.
Georges university school of medicine, grenada, west indies this is an open access article distributed under the terms of the creative commons attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. Fortunately, the strong costovertebral and costotransverse ligaments stabilize these joints and also add a degree of flexibility the costovertebral complex is mandatory for respiratory movement of the chest wall.
It is speculated that these ligaments add a protective mechanism against traction and compression of the nerves by maintaining proper positioning of the nerves in the intervertebral foramen the skeletal makeup of the thorax includes the thoracic vertebrae, intervertebral discs, ribs, sternum and costal cartilages. Strong inspiration can reduce intrapleural pressure as low as -30 mm hg the muscles of forced expiration that pull the rib cage downward are the internal intercostals and the abdominal recti primarily, with minor contributions from the quadratus lumborum, subcostals, transverse thoracic and serratus posterior inferior. All of the above motions and loads cause stress to the costovertebral attachments at both the vertebral body and the transverse process.
These are a few of the conditions and diseases that can affect the costovertebral and costotransverse ligaments. Innervation of the costovertebral ligaments is supplied by the lateral branch of the thoracic dorsal rami of c8 and t1 to t11. The costovertebral ligaments make the actions of the costovertebral joints and intervertebral movement possible.
Movement at the costovertebral joint in a side-to-side (gliding) axis results in the raising and lowering of the sternal end of a rib. However, the diaphragm is instrumental in the event the intercostal muscles are paralyzed or the thorax becomes immobile the second method for lung expansion is the elevation of the ribs, which increases the anteroposterior and transverse diameter of the chest cavity. Thoracic back pain caused by osteoarthritis of a single costovertebral joint is a poorly recognised condition. Note the relationship of these ligaments to the dorsal root ganglia shown in this illustration. As with every human structure, these ligaments are subject to pathology either from trauma or an intrinsic disease process.
Schematic drawing of the internal aspect of the posterior thorax noting the radiate ligament attaching the head of the rib to the vertebral body. Although small and short in size, they are abundant, comprising 108 costovertebral ligaments in the normal human thoracic spine, and they are essential to its stability and function. There is a group of these receptors that is sensitive to caudal rib movement, known as expiratory receptors, and a group that is sensitive to rostral rib movement, or inspiratory receptors. These mechanoreceptors are also sensitive to tension and can alter the strain of the surrounding ligaments. At the thoracic level, a direct ligamentous connection between the extraforaminal thoracic spinal nerves and surrounding structures exists, consisting of a superior and inferior component.
As the length of the transverse process varies (with its concomitant costotransverse articular surface), the leverage that is exerted on the costovertebral joints varies as well. Therefore, the following review was performed to better elucidate their anatomy, function and involvement in pathology. Additionally, with the increase in popularity of minimally invasive spine approaches, knowledge of these ligaments is important to spine surgeons. The range of motion at any one of the thoracic joints is small, but the frequency of movement of these joints is extremely great. In flexion-extension, the range of motion begins at four degrees at t1 and increases incrementally to 12 degrees at t12.
The content published in cureus is the result of clinical experience andor research by independent individuals or organizations. Since the 11th and 12th ribs (floating ribs) do not have any anterior connection to the sternum, they are devoid of costotransverse joints. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. With an increasing interest in minimally invasive approaches to the thoracic spine and an improved understanding of the function and innervation of these ligaments, surgeons and clinicians should have a good working knowledge of these structures. Effects of surgical joint destabilization on load sharing between ligamentous structures in the thoracic spine a finite element investigation. As with every human structure, these ligaments are subject to pathology either from trauma or an intrinsic disease process. These often-overlooked ligaments of the body serve important functions in maintaining appropriate alignment between the ribs and spine. It is possible to obtain excellent short- and intermediate-term relief from pain with resection arthroplasty in appropriately selected patients. The effect(s) of a six-week home-based exercise program on the respiratory muscle and functional status in ankylosing spondylitis. This type of injury occurs after a sudden movement involving twisting, bending or overextension of the spine.The costovertebral joint is the articulation between the costal facte or ... Due to being at the top of the rib cage, the first costotransverse joint is the most vulnerable. ..... 5 to 10 repetitions, 3 sets; Rotation exercises while seated: sitting tall, back ...