PT3 - Linking The Upper Extremity And The Spine Flashcards
What are the anatomical links between the spine and the upper extremity?
- MSK
- neurological
- vascular (TOS)
- pain
What is they bony link between the upper extremity and the thorax?
- clavicle
How does the structure of the SC joint reflect the links between upper extremity and the thorax?
- lots of articular links e.g. ligaments, articular disc for shock absorption, subclavicular muscle
- breakdown in transfer of force = fracture of clavicle
What is an open chain movement?
- hand moving in space e.g. lateral raise
What is a closed chain movement
- distal end is anchored e.g. pull up
How many planes of movement are available at the scapulothoracic joint?
- 3 planes => sagittal, frontal + transverse
What is the impact of aging on the thorax?
- kyphosis
- reduced shoulder function
- not necessarily correlated to pain
- neurological link between axial spine + limbs = brachial plexus
What happens to the function of the brachial plexus when compromised?
- affect neurological function in upper extremity e.g. sensory/motor
- might also be a mechanical difference + inhibit movement available e.g. thoracic outlet
What is a common area of compromise of the brachial plexus?
- c-spine e.g. radiculopathy/radicular pain
Which structures can cause referred pain?
- any structures with nociceptive capability
What is referred pain?
- pain felt in a part of the body other than its source
Why does referred pain occur?
- thought to be erroneous signalling from one body part being mis-read at the dorsal horn level (or above) coming from a shared body area
What is referred pain also known as?
- convergence theory of referred pain
What is sclerotome referral?
- all connective tissue of MSK origin stems from sclerotome
- embryological development => migration to final destination pulling sensory/nociceptive nerve supply
- wherever tissue are irritated => pain may be felt some distance from site
What is angiotome referral?
- vascular tissue that has migrated e.g. capillary beds and arterioles during embryological development
- follows the path of connective tissue during migration, but diffuse in skin + subcutaneous tissue
- nociceptive supply to limbs => sympathetic fibres, T1-L2