A 56-year-old male presents to clinic with complaints of back pain that has been ongoing for about 3 weeks. The patient states that the pain started after moving around some equipment in his garage. He has tried ice and over-the-counter medications with only mild relief of his symptoms. Osteopathic structural examination reveals the left transverse process of T4 to be more anterior than the left. The rotational asymmetry does not change with positional changes. On physical examination, where is the spinous process of T4 located?