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MSK > T4 Thoracic Spine > Flashcards

T4 Thoracic Spine Flashcards

1
Q

What is the most common disease affecting the thoracic spine?

A

Osteoporosis

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2
Q

The upper thoracic spine refers to ____
The lower thoracic spine refers to ____

A

-T1-T2
- T3 - T12

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3
Q

T1 (cervicothoracic junction) and T12 (thoracolumbar junction) are considered…

A

Transitional vertebrae, therefore they can begin to move in unison w/ their articulating vertebrae

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4
Q

The ribs contribute to…

A

Spinal stability, restricting forward bending, side bending, and rotation, protect viscera

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5
Q

Which are the atypical ribs and what does this mean?

A

Ribs 1,11 & 12
This means they articulate with one vertebral body are not united to a disc and articulate with the numerically corresponding vertebral body only

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6
Q

Define typical ribs

A

Typical ribs, articulate with two vertebral bodies to the numerically corresponding vertebral body and the IVD and the vertebral body above. They have a head with two facets on either side of a tiny crest.

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7
Q

Ribs 11 & 12 are…

A

Floating ribs

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8
Q

Ribs 1 & 2 articulate with the ___
Ribs 3-7 articulate with the ___

A
  • manubrium
  • sternum
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9
Q

When the mid thoracic spine (T3 - T9)
Flexes the ribs roll…
Extends …
Laterally flexes…
Rotates…

A
  • flexion: the ribs roll anteriorly and glide superiorly
    -Extension: the ribs roll posterior and glide inferiorly
  • Lateral flexion: the ribs approximate ipsilaterally and separate contralateral
  • rotation: the ipsilateral rib will posteriorly rotate. The contralateral rib will anteriorly rotate.
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10
Q

How many joints are there in the thorax?

A

136

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11
Q

How do we generate our core power?

A

With thoracopelvic rotation

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12
Q

What are the primary muscles of respiration during inspiration?

A

Diaphragm, levator costorum, external intercostals, internal intercostals

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13
Q

What are the secondary muscles of respiration during inspiration?

A

Scaleni
SCM
Trapezius
Serratus anterior and posterior
Pectoralis major and minor
Subclavius
Latissimus Dorsi
Serratus posterior superior
QL
Iliocostalis lumborum

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14
Q

What are the primary muscles of respiration during expiration?

A

Internal obliques
External obliques
Rectus abdominis
Transversus abdominis
Transverses Thoracis
Transverse intercostals
Internal intercostals

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15
Q

What is the primary muscle of respiration?

A

The diaphragm

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16
Q

The diaphragm is innervated by

A

C 3,4 and 5 phrenic nerve

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17
Q

During inspiration the volume is ____ and pressure is ____ in the abdominal cavity,

the volume is _____ and pressure is _____ in the thoracic cavity

A
  • decreased, increased
  • Increased, decreased
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18
Q

The “bucket handle” action of the ribs happens mainly at ribs ___

A

7 through 10

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19
Q

With the bucket handle action of the ribs, movement at the costovertebral jt happens around which axis?

A

AP axis

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20
Q

With the “pump handle” action, movement at the costovertebral jt happens around which axis?

A

ML axis

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21
Q

When we inhale the spine ____, the ribs _____ & rotate ______ and glide _____ where they meet the spine

A
  • Extends
  • Expands
  • Posteriorly
  • Inferiorly
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22
Q

When we exhale the spine ____, the ribs rotate ____ and glide ____ where they meet the spine

A
  • flexes
  • anteriorly
  • superiorly
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23
Q

Where is veryebral compression fracture common?

A
  • In the lower thoracic region
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24
Q

Vibra compression fracture occurs in older patients with the main cause being…

A

Osteoporosis

25
Q

What is the presentation of vertebral compression fracture?

A

Sudden onset of acute pain after minor trauma in older people for example, stepping off a curb, sudden movement, sneezing

26
Q

What are some signs and symptoms of scoliosis?

A
  • typically asymptomatic
  • Rib prominence, elevated shoulder and or prominent shoulder blade
  • Uneven, hip arm or leg lengths
  • Uneven musculature, impaired mobility, and muscle performance
  • Back pain is not usually considered a scoliosis symptom
27
Q

What are some complications of scoliosis?

A
  • pulmonary/cardiac risks
  • Neurological complications in severe and progressive curves
  • Gastrointestinal disturbances
  • Intermittent back ache may occur
28
Q

True or false: radiating leg pain night pain or systemic complaints are normal symptoms of scoliosis

A

False: these are not normal symptoms of scoliosis, and require further investigation by medical doctor

29
Q

The curve labeling of scoliosis is dictated by the ____ side

A

Convex

30
Q

Scoliosis curve can have which shapes?

A

C curve or S curve

31
Q

What are transitional vertebrae when it comes to scoliosis?

A

Vertebrae between the curves

32
Q

What is the span of scoliosis?

A

The anatomical start, and end points of curve

33
Q

What is the apex of scoliosis?

A

Vertebra furthest from midline

34
Q

Scoliosis severity:

10° is…
10°-20° is …
20°-50° is…
50° is …

A

10° is normal
10°-20° is mild
20°-50° is moderate
50° is severe

35
Q

What are the labelling components of scoliosis

A

Right or left curve
Curve shape
Major and minor curves
Transitional vertebra
Span
Apex
Cob method
Severity

36
Q

With scoliosis, the vertebral bodies rotate to the ____ of the curve

A

Convexity

37
Q

True or false: Functional scoliosis is reversible and can be altered with forward or side, bending, and positional changes

A

True. Proper and consistent treatment may include therapeutic exercise, positional changes, and correction of contributing causes.

38
Q

To test for functional scoliosis we can use…

A

Adams forward Bend test

39
Q

Which type of scoliosis is a fixed deformity

A

Structural scoliosis

40
Q

What are the three types of structural scoliosis?

A

Idiopathic, congenital, neuromuscular

41
Q

What is the most common type of scoliosis?

A

Idiopathic

42
Q

What is congenital scoliosis caused by?

A

Disturbances in vertebral development, failures of formation or failures of segmentation of the vertebral bodies

43
Q

When does congenital scoliosis usually occur?

A

During the first six weeks of embryonic formation

44
Q

True or false: Neurological complications are common with congential scoliosis

A

False. Neurological complications may present but are not common.

45
Q

Neuromuscular scoliosis often presents as…

A

a long c-shaped curve from cervical to sacral region

46
Q

With children and adolescents what is a key component to the plan of care

A

Consistent monitoring of the curve progression

47
Q

In adults scoliosis treatment is usually focused on…

A

Releiving Pain

48
Q

True or false: Idiopathic scoliosis can be fixed or corrected.

A

False: This type of scoliosis is progressive and cannot be fixed or corrected

49
Q

Congenital scoliosis may be a progressive disorder in which usually involves…

A

Surgical intervention

50
Q

Forms of treatment and intervention are considered when the curve is between…

Bracing is considered when the curve is between…

Surgical interventions are considered when the curve is between…

A
  • 20° - 30°
  • 30° - 40°
  • 40°- 45°
51
Q

What will rib fractures present with…

A

will present with acute pain with all motions of the spine

52
Q

Rib dysfunction may present as…

A

atypical interscapular, chest, sternum, or arm pain

53
Q

What is the clinical presentation of rib dysfunction?

A
  • sharp pain (sometimes described as stabbing)
  • aggravated by specific movements
  • upper ribs aggravated by reaching
  • lower ribs aggravated with bending/twisting
  • pain will increase w/ sneezing, coughing, deep breaths
  • paraspinal tenderness/hyperalgesis
54
Q

Describe exhalation dysfunction…

A

A rib that fails to move fully into its inhalation position. This can be described as being “locked in exhalation”, exhalation restriction, limited in inhalation, or depressed.

55
Q

Describe inhalation dysfunction

A

A rib that fails to move fully into its exhalation position. This can be described as being locked in inhalation, an inhalation restriction, limited in exhalation or elevated.

56
Q

What is the most common cause of intercostal neuralgia?

A

Herpes zoster virus (shingles)

57
Q

What are the symptoms of intercostal neuralgia?

A
  • unilateral neurogenic pain that radiates around towards the sternum in the associated dermatome
  • sporadic episodes of acute pain or constant dull ache
  • pain can be stabbing, sharp, spasm-like, gnawing
  • pain increases with certain mevements, actions, activities (coughing, sneezing, laughing
58
Q

Costochondritis is relatively common as a primary condition and in combination with…

A

Coronary heart disease

59
Q

What does costochondritis (a.k.a tietze’s syndrome) present as?

A
  • pain and tenderness of the costochondral junctions
  • diffuse tenderness and multiple lesions

MSK (3 decks)

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