T-Spine Pathologies Flashcards
How many joints are there in the thoracic spine?
136
The thorax functions as (one/multiple) units for movements and respiration.
one
What maintains the curvature of the T-spine?
Wedge-shaped vertebral bodies
The middle segments of the T-spine are designed for (more/less) mobility.
less
(true/false) Facet joint angles change in each level
True
Orientation of facet joints change by ___ degrees at either T11 or T12 allowing pure axial ROT to occur
90 degrees
What are the true ribs?
Ribs 1-7 (attach to the sternum)
What are the false ribs?
Ribs 8-10 (attach to the costal cartilages ABOVE them)
During inspiration, the ribs (elevate/depress) and glide ___.
elevate, posterolaterally
During expiration, the ribs (elevate/depress) and glide ___.
depress, anteromedially
The upper ribs are oriented primarily in the ___ plane and move like a _____ handle.
frontal, pump
The mid-lower ribs are oriented more in the ___ plane and move like a ___ handle.
sagittal, bucket
Cervical facet joints, ___-___ , can refer to the thoracic regions
C4-C7
With cervical facet joint MS pain, you will often see (hypotonicity/hypertonicity) of the musculature within the trigger points
hypertonicity
Facet joint pain in the thoracic spine refer (locally/distally) to the segment affected.
locally
With Thoracic Facet Joint MS pain, you will see hypomobility with ____ and ___ assessments.
Spring testing, PPIVMs/PAIVMs
Thoracic Disc herniations are more common in ____ within the ages ___-___ y/o.
males, 40-70 y/o
With thoracic disc herniations, the patient will have ___ pain or ____ pain.
posterior thoracic pain, anterior chest pain (can mimic a cardiac problem)
The spinal canal in the T-spine is (narrower/wider) than the rest of the spine.
narrower
What are some things that will cause a pt with a thoracic disc herniation experience pain?
compression, coughing, deep breaths, movements
How do you relieve symptoms of a thoracic disc herniation?
thoracic distraction
What is the most common thoracic rib dysfunction?
posterior rib subluxation
With thoracic rib dysfunctions, the patient will experience (unilateral/bilateral) thoracic pain but it can migrate (anteriorly/ medially/ laterally/posteriorly) along the rib.
unilateral, anteriorly
Those with thoracic rib dysfunction will commonly have painful thoracic ___.
ROT
definition: thoracic pain aggravated with prolonged postures that has a GRADUAL onset
postural dysfunction
Those with postural dysfunction have decreased thoracic ___ mobility.
EXT
With postural dysfunction, the patient will have ____ within the paraspinal muscle on BOTH sides.
hypertonicity
What muscles are often over-lengthened with postural dysfunction?
middle/lower traps
rhomboids
What muscles are often tightened with postural dysfunction?
upper traps
levator scapulae
pec minor
pec major
lats
Thoracic spine Fractures are often ___ and ___ injuries.
hyperflexion, axial loading
What is the most common type of thoracic spine fracture?
anterior wedge fractures
What type of radiograph will help identify an anterior wedge fracture?
lateral radiograph
definition: Fracture that involves the anterior, middle, and posterior columns of the T-spine
Burst fractures
What is a risk factor for atraumatic fractures in the elderly?
osteoporosis (Females > males, T9-T11)
When looking for osteoporosis in an elderly person, look for an area of increased ____ if they have an atraumatic fracture.
kyphosis
Thoracic spine fractures have significant pain and limitations in AROM of (some/all) directions
ALL
T-spine rib fractures most commonly occur with _____.
blunt trauma
T-spine rib fractures are more common in the (younger/older) population.
older (due to falls)
T-spine rib fractures causes pain with (inspiration/expiration)
inspiration
A fractured (T-vertebrae/rib) can cause a pneumothorax of the lung
fractured rib
What population are cardiac myocardial infarctions most common in?
men >40 y/o
women > 50 y/o
What are the symptoms with cardiac myocardial infarctions?
- Pain in chest, jaw, arm, upper T-spine
- Pallor
- Sweating
- Dyspnea
- palpitations
- Symptoms last >30 min
What are the symptoms with thoracic abdominal aortic aneurysms?
- “Tearing” pain in chest or back (Vascular related indication)
- Pulsating mass in abdomen (“heartbeat felt when lying down”)
- Worse with lying down
Where is pain referral for cardiac myocardial infarctions?
T1-T5
What population is most commonly affected by thoracic abdominal aortic aneurysms?
males > 50 y/o
Herpes Zoster lies dormant in ___ neurons until it manifests as shingles later in life
sensory neurons
What are the symptoms of herpes zoster (shingles)?
- HA
- Fever
- Malaise
- Burning, itching rash along unilateral dermatomal distribution
- Thoracic, cervical, or trigeminal dermatomes
Herpes Zoster is more common in (males/females) that are ____ y/o.
females, >50 y/o
What are the primary sites of cancer?
- lung
- breast
- kidney
- pancreas
- prostate
What are symptoms to look for when metastatic cancer is suspected?
- Constant pain
- Pain unrelieved with movements, positions, postures
- Night pain
- Unexplained weight loss (>10 pounds in 2-4 wks)
- Symptoms related to abnormal organ function
definition: anterior wedging of the vertebral bodies
scheuermann’s disease
What is another name for scheuermann’s disease in those who are 11-14 y/o?
juvenile kyphosis
Scheuermann’s disease is more common in (males/females).
males
What can scheuermann’s disease cause?
compression fractures of the vertebral bodies
What is a possible cause of scheuermann’s disease?
failure of the notocord tissue to develop
Those with Scheuermann’s disease have limited/painful thoracic ___ and ___.
EXT and ROT
