Spinous process, thoracic spine

Place one finger on the spinous process of the first thoracic vertebra Shde it down the spine, one vertebra at a time, to the sacrum. Are the spinous processes symmetric with respect to each other in all three planes ... 

Posteriorly, Chapman s reflexes are located in the soft tissues between the spinous process of a vertebra above and the transverse process of a vertebra below. For example, the posterior Chapman s point for the heart is located between the spinous and transverse process of the second and third thoracic vertebrae. The posterior points have the feel of a classic viscerosomatic reflex the operator will palpate what feels like a rubbery nodule. If the physician attempts to articulate a vertebral somatic dysfunction and the spine "bounces" away from the force, the possibility of a viscerosomatic reflex should be considered. 

The spinous processes face posteriorly and infe-riorly, the degree of inferior angulation varying with the area of the thoracic spine. The "rule oj 3s" is used to locate a vertebra s spinous process in relation to its transverse process. 

Rotation is the greatest motion in the larger part of the thoracic spine (Tl-TlO). The amplitude of rotation is markedly decreased in the lower part ofthe region. The articular orientation ofthe thoracic vertebrae allows them to rotate about a point in the center of the vertebral body. The articular orientation of the lower thoracic vertebrae, however, is similar to that of the lumbar vertebrae and permits rotation only about a point near the spinous process. This rotation is greatly resisted by shearing forces in the intervertebral disk. The extent of rotation is further diminished by the resistance afforded by the intact costal cage. 

Prior to inserting the electrode, the level of the spine must be identified. Two landmarks are used for the cervical and thoracic area, the spinous process of C7 (prominent) is identified and the count is done up or dovm accordingly. For the lumbo-sacral area, an imaginary line is drawn between the upper most part of the iliac crests. This line intersects the spinal column at the L3-L4 intervertebral level. The count proceeds up or down accordingly. 

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