1: Thoracic Posture Flashcards
Normal arm position
1/3 or less of humeral head anterior to acriomion
cubital fossa face anterior
olecranon face posterior
hand faces body
How do you tell if arm position is too anterior?
humeral head is more than 1/3 in front of acromion
How do you tell if arm position is too abducted? Or Internally rotated?
abducted: distal end away from body
IR: palm posterior, cubital fossa medially, olecranon laterally
How do you tell if arm is too flexed or too extended?
If distal end is in front of or behind humerus
Lordotic/Kyphotic Posture
___ lumbosacral angle
___ lumbar
____pelvic tilt
____ hips
_____knees
____ankles
scapula? neck?
increased lumbosacral angle
increased lumbar lordosis
anterior pelvic tilt
flexed hips
hyperextended knees
plantarflexed ankles
scapula are abducted, neck extended
muscles that are tight, mm weak with Lordotic/Kyphotic Posture
neck extensors tight
hip flexors tight
lumbar extensors tight
weak neck flexors
weak upper back
weak erector spinae
weak hamstrings
weak abdominals
Swayback Posture
___ lumbosacral angle
___ lumbar
____pelvic tilt
____ hips
_____knees
____ankles
scapula? neck? t-spine?
decreased lumbosacral angle
flat lumbar
posterior pelvic tilt with anterior shift
hip extension
hyperextended knees
neutral/plantar flexed ankles
-scapula WINGED
-kyphotic upper t-spine, normal lower t-spine, shifted posteriorly
-forward neck (upper extended, lower flexed)
Flatback Posture
____ lumbosacral angle
___ lumbar
____pelvic tilt
____ hips
_____knees
____ankles
neck?
decreased lumbosacral angle
flat lumbar
posterior pelvic tilt
hip extended
neutral knees and ankles
flat t-spine (upper flexed,
lower flat)
head neutral or forward
cervical upper extended, lower flexed
What muscles are weak and what are tight in swayback posture?
weak:
-upper back extensors (scap mm)
-neck flexors
-hip flexors
-external obliques
tight:
-hamstrings
-internal oblique
-QL, erector spinae
What muscles are weak and tight in flatback posture
weak: hip flexors, scapular muscles?
tight: hamstrings, abdominals
Rib Quadrants: upper chest involves _
sternal ribs
Rib Quadrants: lower chest involves _
lower ribcage
Rib Quadrants: upper back refers to which body part?
between shoulder blades
Rib Quadrants: lower back refers to which body part?
lower part of the ribcage
Rib Quadrant Tests:
shoulder ER at side
upper back
1. patient supine, arm at side
2. elbow at 90°
3. let arm go out to ER
4. normal is 60°
if they can’t hit 60, may have upper back mobility limitation
Rib Quadrant Tests:
shoulder ER at 90
lower chest
1. supine, knees bent
2. shoulder abd 90°, elbow at 90°
3. bring arm into full ER
4. normal is 90°
if they can’t reach table with wrist, may have lower chest mobility limitation
Rib Quadrant Tests:
reach behind upper back
**lower back **
1. look straight ahead
2. reach overhead, touch opposite shoulder blade
3. watch for head looking down, arching back, shrugging shoulders
limited ability to touch shoulder blade or back arching may indicate lower back restriction
Rib Quadrant Tests:
reach behind lower back
upper chest
1. reach behind back, try to touch bottom of opposite shoulder blade
2. watch for arching, significant shoulder blade winging
limited ability or arching may indicate upper chest restriction
Thoracic AROM extension in longsitting assesses ___
assess T5 and below (lower t-spine mobility)
Longsitting with arms together placed overhead (have them grab elbows)
Have patient extend by bringing the elbows back.
*Assess for hinge points, reproduction of symptoms, and quality of motion.
thoracic AROM flexion
patient seated
cervical flexion segmentally
as they reach lower levels, have them slouch upper back and continue cervical flexion
*assess areas in mid and upper t spine hypomobility
thoracic AROM rotation
T5 and below
longsitting, arms hugging self
gently rotate
*look for hinge points, pain, quality of motion
Thoracic AROM sidebending
sit with hands behind head fingers interlaced
sidebend by bringing elbow down to one side
avoid lumbar spine motion
*assess hinge points, pain, quality
What is the CRLF?
cervical rotation lateral flexion test
1st rib hypomobility test
- PT passively rotates head away
- PT passively sidebend ear towards chest
- (+) if limited in lateral flexion movement compared to other side
first rib elevation blocks C7 transverse process
rib examination for superior ribs
pump handle
1. PT standing at head of patient, patient is supine
2. hands over upper ribs, below clavicle
3. deep breathe in, hold. breathe in a little more
4. breathe out hold. breathe out a little more
5. *assess rib expansion, rib depression symmetries
