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Thoracic Spine Rule of Threes

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Thoracic Spine Rule of Threes

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Thoracic Spine Rule of Threes

Thor-axe Spine (3) Tree
Picmonic
The Thoracic Spine Rule of Threes is a simple tool to help physicians locate and identify the thoracic vertebrae’s spinous and bilateral transverse processes. The T-Spine can be broken down into four segments, T1-T3, T4-T6, T7-T9, and T10-T12. Each group will follow a different pattern to help palpate and localize the corresponding bony landmarks.
5 KEY FACTS
Spinous Process
Spy-nose Processor

The spinous processes of the thoracic spine point increasingly downward from T1-T9 and then slowly return back into a horizontal position from T10-T12. To help physicians identify which corresponding vertebrae and transverse process is being palpated, we use the Rule of Threes.

RULE 1
Rule 1: Same Segment
(1) Wand Same Segway

The first rule states that the spinous processes for T1-T3 are located at the same level of the corresponding transverse process. For example, if a physician palpates the T3 spinous process, then they are directly in line with the bilateral T3 transverse processes.

RULE 2
Rule 2: Half Segment Below
(2) Tutu Half Segway Below

The second rule states that the spinous processes for T4-T6 are located at a one half segment below of the corresponding transverse process. For example, if a physician palpates the T5 spinous process, then they are a half segment below the bilateral T5 transverse processes. To locate the T5 transverse process, they should palpate a half segment above and move laterally along the spine.

RULE 3
Rule 3: Full Segment Below
(3) Tree Full-glass Segway Below

The third rule states that the spinous processes for T7-T9 are located one full segment below of the corresponding transverse process. For example, if a physician palpates the T8 spinous process, then they are a one segment below the bilateral T8 transverse processes. To locate the T8 transverse process, they should palpate one segment above and move laterally along the spine.

Reverse It
Reversing

For the final thoracic vertebral spinous processes, we reverse the three rules for each subsequent segment. For T10, we follow Rule 3 (same as T7-T9). For T11, we follow Rule 2 (same as T6-T4). For T12, we follow Rule 1 (same as T1-T3).

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