T-Spine/Ribs Common Presentations Flashcards
integrity of what ligaments/structues is involved with vertebral fractures? (Hint: SIZL)
Supraspinous ligament
Interspinous ligament
Z-joint capsules
Ligamentum flavum
traditional compression fractures involve which column(s) of the vertebra?
anterior
common mechanisms of injury for traditional compression fx
-Axial loading in flexed position
-Traumatic: high energy flexion (axial load like a fall)
burst fractures involve which column(s) of the vertebra?
anterior and middle
what are the common mechanisms of injury for a burst fx?
-Vertebral segment subjected to high axial force (and/or flexion load)
-Ex: MVC, fall from a height, high-speed sports injury
where is the most common area to see burst fx?
thoracolumbar junction (T12-L1)
rotation/translation fractures are associated with what mechanisms of injury?
-Torsion/shear force
-Fall from a height
-Heavy object falling on body w bent trunk
which vertebral column(s) are usually involved in rotation/translation fx?
all 3 columnns (ant, middle, post)
dislocation (type of rotation/translation fx): the facet joints are intact, but dislocated.. what are the consequences of this?
-Can cause damage elsewhere
-Articular processes and/or superior vertebral body often get fractured
what can potentially be fractured with a distraction fx?
posterior elements
typical MOI of distraction fx
forced flexion or extension
what red flags should you be on the lookout for with vertebral fx?
Older age
Significant trauma
Corticosteroid use
Contusion/abrasion
what is the Roman cluster used for?
-Identifying the presence of an osteoporotic vertebral compression fx
-Can be used for screening or confirmation
what 5 things are included in the Roman cluster?
Age > 52
No presence of leg pain
BMI 22 or less
No regular exercise
Female
what is the Henschke cluster used for?
identifying the presence of a burst fx
what 4 things are included in the Henschke cluster?
Age > 70
Significant trauma
Prolonged corticosteroid use
Sensory alterations from trunk down
upper rib fx: what structures are you concerned about?
brachial plexus and vascular structures
lower rib fx: what structures are you concerned about?
pleura, lungs, abdominal organs
many simple rib fractures become stable in how many weeks?
6
who is at high risk for Scheurmann’s disease?
Manual workers who begin at early age
High intensity athletes
High BMI
Short sternum
what is the diagnostic criteria for Scheurmann’s disease?
Thoracic kyphosis > 45 deg
Wedging x 3 adjacent vertebrae > 5 deg
Thoracolumbar kyphosis > 30 deg
costochondritis typically resolves within how many years?
1
what gender/age is commonly associated with costochondritis?
older females (40-60)
is disc disease more common in the upper or lower T-spine?
lower
75% of disc herniations happen at what part of the T-spine?
T8-T12
why is disc herniation less common in the T-spine than other areas?
less movement, lots of structural stability
T4 syndrome: what gender is most common?
women (4:1)
what parts of the T-spine can be involved with T4 syndrome?
T2-T7
what is structural rib dysfunction?
anterior/posterior subluxation (partial dislocation) of costovertebral joint
what is torsional rib dysfunction?
rib is held in upward or downward rotation
what is respiratory rib dysfunction?
related to posture, may affect respiration
what is the most painful movement for someone with rib dysfunction?
rotation
T/F: costovertebral and costotransverse joints can refer pain to the chest
FALSE! These joints DO NOT refer pain to the chest
if you take BP on both sides and see this much of a difference, you’re gonna suspect VTOS
20 mmHg
what muscle can become atrophied with NTOS?
ABD pollicis brevis
