LECTURE 4: T SPINE EXAM Flashcards
3 major areas of MSK dysfunction in t-spine in order of most likely to least
- CV joint (costo-vertebral)
- TL junction
- CT junction (cervico-thoracic)
Where does t-spine pain refer?
- groin, pubis
- lower abdominal wall
If someone coughs and they have pain in t-spine area, what could it be?
a bunch of things.
not just disc, but maybe ribs, etc.
if someone comes in with neck pain, what do you NEED to screen for?
trauma!!!
If with t-spine, what is common MOI?
not common trauma, but
trauma more RIB dysfunction
-insidious onset: THORACIC
Patient Health Questionaire 2 questions:
- over past 2 weeks, how often have you had little interest or pleasure in doing things?
- over past 2 weeks, how often have you felt down, depressed, hopeless?
OSPRO-YF: assesses ____
3 domains of psychosocial distress
1. negative mood
2. fear-avoidance
3. negative affect/coping
What are MSK causes of thoracic pain?
neurogenic:
-SC
-sensory nerve root infection
-nerve root palsy
-spinal stenosis
spondylogenic:
-articular
-soft tissue
-disc
How common is referred pain in t-spine?
very common!
DIFF DX:
1. visceral
2. serious
3. t-spine or ribs
*probably not MSK, gotta prove it is…
MSK pain tends to be…vague or sharp?
sharp and localized! movement changes it!
What should you do in systems review?
- clear visceral
- take vitals (clear serious)
- clear UMN (SPINAL CORD)
- then MSK/neuro
what bucket is very common in t-spine MSK dysfunction? What will it look like
postural dysfunction
how likely are thoracic vertebral fractures?
pretty common when osteoporotic (trauma could be from lifting a laundry basket)
*anterior wedge fractures
*burst fracture
*pain with all movements, hurts like crazy, compression test is SUPER POSITIVE
