T5 vertebra !
T5 is the fifth thoracic (mid-back) vertebra; it has joints for the ribs and helps form the cage that protects the heart and lungs.
Official name: T5
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What it is
The T5 mid-back vertebra, with joints on each side for the ribs.
What it does
Holds up the trunk and, with the ribs and breastbone, forms the rib cage, which protects the heart and lungs. The ribs make this part of the spine stiff.
Key facts
- Joints with
- T4 above and T6 below (discs, facet joints); heads of ribs 5 and 6; tubercle of rib 5 (costotransverse joint)
- Landmarks
- Typical thoracic: heart-shaped body; costal demifacets above and below; transverse costal facets; long sloping spine; T5–T8 spines most oblique, overlapping; aortic impression on left
Relations
- In front
- Esophagus with the left main bronchus crossing in front of it; the descending thoracic aorta lies against the left side of the body
- Lateral
- Heads of the fifth and sixth ribs with the sympathetic trunk on them; the azygos vein on the right of the body and the thoracic duct between it and the aorta
- Behind
- Rhomboids (lowest fibres), trapezius and erector spinae
- Contents
- Spinal cord at roughly the T7 segment
How to find it
There is no surface marker at T5 itself: it is found by counting down from C7 and T1, or up from T7 at the inferior angle of the scapula, remembering that each mid-thoracic spine tip lies over the body below.
On imaging
Lateral and AP thoracic radiographs; the level is found by counting ribs or down from C7–T1. On the AP view each pedicle is an oval; a missing one (winking owl sign) suggests a metastasis. The mid-thoracic spine is a common site of osteoporotic wedge fractures. CT details fractures; MRI shows marrow oedema of a recent fracture, tumour and the cord.
Common problems
- Compression fractures from osteoporosis, sometimes after a minor fall or even a cough.
- A rounded upper back (kyphosis) from posture, wedge fractures or Scheuermann disease in teens.
- Scoliosis: a sideways curve with rotation, often starting in adolescence.
How it is diagnosed
X-rays for fractures and curves (scoliosis is measured with the Cobb angle). MRI tells new fractures from old ones. A bone density scan (DEXA) checks for osteoporosis.
Treatment
- Osteoporosis fractures: pain control, a short time in a brace, and treatment of the osteoporosis.
- Painful fractures that do not settle: kyphoplasty or vertebroplasty (cement injected into the bone).
- Large or progressive curves: bracing in growing children, sometimes fusion surgery.
Clinical notes
- Injury of the thoracic duct in esophageal or spinal surgery leaks lymph into the chest: chylothorax tends to be right-sided below the crossing at T5 and left-sided above it
- Paravertebral and erector spinae plane blocks at mid-thoracic levels numb the chest wall after breast or thoracic surgery
- Esophageal cancer at mid-thoracic levels can invade the left main bronchus or the aorta in front of these vertebrae
- Open anterior approaches to the mid-thoracic bodies, for tumor or infection, are usually made through the right chest, away from the heart and the aorta, which lie more to the left
Development
Congenital kyphosis comes from failure of formation of the front of a body or failure of segmentation between bodies; failure of formation gives a sharper hump that tends to progress and can compress the cord.
Test yourself
Think of the answer, then tap the question to see it.
Why does a palpated spinous process in the mid-thoracic spine, as at T5, mark the level below its own vertebra?
Mid-thoracic spines slope the most: the tip of each lies level with the body of the vertebra below.
Which duct crosses from right to left behind the esophagus at about the T5 vertebra?
The thoracic duct; so chylothorax tends to be right-sided after injury below T5 and left-sided above it.
Which structure crosses in front of the esophagus near the T5 vertebra, forming its third normal narrowing?
The left main bronchus.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- vertebra thoracica V TA2 1059
- Official Spanish (DeCS)
- Vértebra dorsal D5 DeCS D013904
- English (TA2)
- T5
Related
- T4–T5 disc
- T5–T6 disc
- Posterior intercostal arteries
- Anterior longitudinal ligament
- Rib-to-spine ligaments
- Dura (dural sac)
- Endplates
- Mid-back facet joints
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Back, Thoracic Vertebrae.
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Representative model, for educational purposes only.
