Exam 6: Thoracic Spine (1-4) Flashcards by Madelynn Kahl

True or False:

The thoracic spine has the lowest lifetime prevalence of pain

True

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What percentage of the general population does Leboeuf-Yde et al estimate will have thoracic spine pain

13%

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What does the growing research and evidence suggest about manipulating the thoracic spine

Manipulation of the tspine will bring benefits to the tspine and cspine

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True or False:

Although clinical prediction rules are great at establishing rules, many of them have not been validated by research

True

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This term can be described as the concept that seemingly unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient’s primary complaint

Regional Interdependence

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The term can be described as the concept that a patient’s primary musculoskeletal symptoms may be directly or indirectly related to or influenced by impairments from various body regions and systems regardless of proximity to the primary symptoms

Regional Interdependence

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The upper tspine contributes mobility to perform functional tasks to both the ____ and ____

cspine and thorax

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True or False:

Restricted motion in the upper tspine will not have an effect on cspine or thorax motion

False

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A study showed that analgesic effects were (immediately, progressively, never) shown in patients with mechanical neck pain after manipulation of the tspine

immediately

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True or False:

PPT decreases immediately after tspine manipulation

False, it increases

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Manipulation will (increase/decrease) blood flow and (sensitize/desensitize) the nerves

increase, desensitize

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There is a very high prevalence that tspine pain that is not musculoskeletal related, it caused by ________

referred pain from visceral pathology

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When trauma does occur to the tspine, what are the top two injuries that occur in order

spinal cord trauma

2. Pneumothorax

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A study suggested that when injuries of the spine occur, there had to be ______ peak forces applied and should serve as a _____ note for clinicians to decrease these peak forces

excessive, cautionary

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What percent of PT schools teach TJM

97%

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The (cspine/tspine/lspine) is regularly manipulated where it is clinically indicated

tspine

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True or false there are sympathetic affects found in the hand when the thoracic spine is manipulated

True

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What are the sympathetic affects that are found after manipulating the T spine

The effects are found in the hand which will make the hands warmer due to the Increase in blood flow

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What are the four reasons why the thoracic spine is hard to treat

Because of the rib cage the sympathetic nervous system visceral disorders and limited research

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Where at in the thoracic spine is painmore likely to occur at

The C 7 T 1 Junction or T 12 and L1 Junction

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True or false the transitional zones in the thoracic spine are less mobile than the spinal regions after the pelvic girdle

False

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Is there more bone or more disc in the thoracic spine

Bone

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What can be accounted for the decrease in mobility of the thoracic spine

The ribs are in the way but also the 1 to 5 ratio of intravertebral disc height to vertebral body height

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What is the primary curvature of the thoracic spine

30° kyphosis

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The facet joints of the thoracic spine favor blank rotation

Axial

What are the four things to thoracic spine supports

The head neck upper limbs and viscera

What is the thoracic spine vulnerable to

Growth related deformities age related osteoporosis and flexion compression fractures

Kyphosis will either increase or decrease with age

Increase

What can be contributed to the normal kyphosis of the t spine

The height of the body is slightly higher posteriorly

Which three vertebral bodies of the T spine do not have paired costal Demi facets that face posterior laterally/ superior and inferior

T 10,11 and 12

Is flexion or extension more limited in the thoracic spine

Extension

What motions are allowed in the mid thoracic spine

Mostly rotation and some flexion

Which vertebral bodies resemble those of L1

T one to T 12

Did the spinal processes project more or less as they go down the T spine

Less

What is the segmental variation in the rib joints

The heads of 2nd to 10th ribs each articulate with two vertebral bodies the heads of the first 11th and 12th ribs articulate with only one vertebral body and the 11th and 12th ribs have no Costco transverse joints

The first seven pairs of ribs attached directly to the blank

Sternum

The first blank pairs of ribs attached directly to the sternum

Seven

The costal cartilage is of ribs eight through 10 attach where

To the cartridges above

Which ribs are floating ribs

11 and 12

What are the shapes of the upper and lower thoracic joints

Upper are convex/concave | Lower are planar

Are the upper or lower joints accounted for the spin or rotation

Upper

Are the upper or lower joints accounted for the slide or elevation in depression of ribs

Lower

What condition can be described as primary sprains or irritations of the costochondral junction

Costochondritis

Pain felt where is a sign of true rib pain

In the front of the ribs

What are the four ligaments that make up the neural archthe T spine

Ligamentum flavum interspinous ligament supraspinous ligament inter-transverse ligament

The capsular ligaments represent a bridge between what two structures of the thoracic spine

The neural arch ligaments in the ligaments of the vertebral bodies

Capsular ligaments are reinforced dorsally by what

Multifidus

The cats a little ligaments are reinforced eventually by what

Ligamentum flavum

What are the ligaments of the vertebral bodies

ALL & PLL

True or false the rotary muscles are functional muscles

False

True or false the multifidus is a functional muscle

True

What is the average range of motion and children that comes from the thoracic spine

What is the average range of motion found and young adults from the thoracic spine

True or false 3/4 of the total range of flexion is in the thoracic spine

False it’s only half

What is a principal function of the thoracic spine

Axial rotation

What is being measured when you measure the distance from the fingertips to the floor well trying to touch your toes

The range of thoracolumbar flexion

What did the studies show that we’re done on people with and without a rib cage in the thoracic spine

The rib cage makes the spine twice a stiff as we would be without it

Loadbearing capacity of the T spine is up to blank times greater with the addition of the rib cage

3 to 4 times greater

What are the motions found of the thoracic vertebrae and ribs during flexion

The vertebrae translate and tilt forward | The ribs rotate anteriorly and inferior

What are the motions found of the thoracic vertebrae and ribs during extension

The vertebral bodies translate until posteriorly and backwards in the ribs rotate superiorly and posterior

What are the motions of the vertebral body and ribs during lateral flexion or side bending

The vertebral body will translate towards the side that is side bent and also tilt towards the side that is being so I’ve bent The ribs on the side that is being side meant to will anteriorly rotate and the opposite side will posteriorly rotate

During rotation of the thoracic vertebrae there is coupling a rotation with blank translation and blank lateral flexion

Contralateral rotation and ipsilateral SB

What are the motions of the thoracic vertebrae in ribs during rotation

Only rotation of the vertebral body and the ribs will posteriorly rotate towards the side that is being rotated and the opposite side will anteriorly rotate

Which vertebrae are considered the upper T spine and what do they function as

T1 and T2 function as part of the lower C-spine

Which vertebrae are considered the lower T spine and what do they function as

T 10 through T 12 function as part of the upper lumbar spine

Which thoracic vertebrae are considered the functional T spine

T3 through T9

Is there more difference in characteristics between the upper T spine and C-spine or between the lower teeth fine and upper lumbar

T spine and C-spine

What are two common patterns of clinical presentation of T spine pain

Pain from loading or symptoms related to movement motion restrictions

True or false the lower you go in the T spine the more problems you will find with loading

True

Compressive loads on the T spine increase caudally from what percent body weight at T1 to what body weight at T 12

9% at T1 and 47% at T 12

The thoracic spine was designed to handle increasing load demand by progressive increase in what three things

Vertebral body height endplate crossed sectional area and bone contact

Some studies have reported that the annulus in the thoracic spine is stronger or weaker than cervical and lumbar

Stronger

Load distribution across the surface of the end plate is blank in the lumbar spine and blank in the thoracic spine

Symmetrical in the lumbar but asymmetric in thoracic

What can be affected if the mobility in the upper thoracic spine is Restricted

Cervical spine motion and overall motion of the thorax will be affected

What are the clinical considerations of motion restriction in the thoracic spine

Motion of the cervical spine and shoulders are dependent upon normal mobility of the upper thoracic spine to flexed of an upper thoracic spine may reduce capability of muscles to provide cervicothoracic retraction to work in the functional range

True or false a pain response to PA mobs is more reliable at detecting symptomatic segments than stiffness alone

True

Osteoporosis affects men and women about a blank later

Decade

What will the x-ray of a positive osteoporotic T spine look like

Collapsed and plates and con cavities with a loss of vertebral height

True or false anterior osteophytes are common and can be asymptomatic

True

True or false fusion of the mid thoracic vertebrae is extremely common

False

Thoracic hypomobility can be aggravated by what three things

Breathing coughing and sneezing

What will hypo mobility in the thoracic spine due aging look like

Localized posteriorly and slightly off midline on one side that slightly radiates and chest wall pain is common

What joint might be involved in hypo mobility and aging of the thoracic spine

Costotransverse joint

Are vb or discs injured more during flexion or axial compression

True or false people with osteoporosis often fracture of vertebrae during extension

False during flexion

List the four traumatic thoracic injuries in order from least severe to most severe

End plate fracture, bone bruising, wedge compression, burst fracture

Disc Injuries are pre-dominant in blank spine and vertebral body injuries are predominant in the blanks fine

C t

Are facet joints injuries common in the cervical spine or thoracic spine

Both

True or false the transition zones are problematic for most people

True

What are the anterior elements that can be affected inflection compression trauma of the thoracic spine

Burst fracture disc disruption wedge compression fracture and plate fracture and bone bruising

Females have a blank percent lifetime risk of osteoporosis well males have blank percent

40 13

Are vertebral body fractures or hip fracture is more common

Vertebral body fractures are twice as common as hip fractures

Which vertebrae have the highest risk level for compression fx

T 11 T 12 and L1

What is the difference between a vertebroplasty and kyphoplasty

A vertebroplasty insert a balloon and has forgiveness and the sponge affect whereas kyphoplasty inserts cement and there’s no more sponge effect

True or false patience with osteoporosis are good candidates for a kyphoplasty

False

True or false a kyphoplasty will not correct an established Deformity of the spine

True

When is in osteoporotic compression fracture eligible for a kyphoplasty

Only if it occurs within eight weeks of the fracture

Are kyphoplasty meant to prevent pain or mimic normal anatomy again

Prevent pain

OK for plasty can result in an increase or decreased lung capacity

What does the evidence say about kyphoplasty and vertebral plasty’s

There is no significant evidence over conservative care or placebo and there is a high evidence of fracture above and below

True or false the medical concerns of kyphoplasty’s are well known

False

True or false US insurance may not cover kyphoplasty or vertebral plasty’s

True