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COMP ORTHO > Thoracic > Flashcards

Thoracic Flashcards

1
Q

Biomechanics - the thoracic vertebrae are wider in what direction

A

wider ant-post than med-lat

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2
Q

Biomechanics - facets

A

Complete facets T1, T10-T12

Demifacets T2-T9

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3
Q

Articular processes - facet/zygagpophyseal joints are what

A

pedicle to lamina junction

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4
Q

Articular processes - motion at thoracic spine because of capsule

A

Flex is limited

Minimal axial rotation and LF

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5
Q

TP - what happens to shape throughout

A

TP length dec from T1-T12

these are where ribs attach

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6
Q

SP - what happened to orientation throughout

A

Upper - aligned horizontally
Middle - post and inf
Lower - short and projects posterior

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7
Q

Sternum - landmarks

A

Sternal notch at T3 body

Body at T5-T9 levels

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8
Q

Supporting structures - anterior instability

A 
PLL
interspinous ligament
supraspinous ligament
post disc
issue with those that limit flexion
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9
Q

Supporting structures - posterior instability

A

ALL
ant disc
issue with those that limit extension

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10
Q

Costovertebral and Costotransverse are what type of joinrs

A

Gliding

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11
Q

Ribs to sternum - attachments

A

1st to manubrium
2nd to junction
3-7 to body
8-10 to cartilage of 7th rib

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12
Q

Thoracic spine - sagittal, forntal, transverse plan ROM throughout

A

Sagittal (flex/ext) - inc from sup to inf
Frontal (lateral) - same
Transverse (rot) - decreases from sup to inf

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13
Q

Rib motion - sagittal plane

A

pump handle motion

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14
Q

Rib motion - frontal plane

A

bucket handle motion

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15
Q

With thoracic flex - what is rib motion

A

rib depression

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16
Q

With thoracic ext - what is rib motion

A

rib elevation

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17
Q

With thoracic rot what is rib motion

A

ipsilateral TP moves post pulling the rib and inc rib curvature
So if rot R, R closed, L is open
turning L, pushes ribs right (bone to bone) and pulls ribs left (ligaments)

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18
Q

With thoracic lateral flexion, what is rib motion

A

Ipsilateral will have rib approximation

Contralateral will have rib separation

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19
Q

Superincumbent weight exerts what type of moment on the thoracic spine

A

flexion
Moment inc from T1-T4 and then dec again
Greater kyphosis = greater flexion moment

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20
Q

Forward bending - what are the mechanics and muscles activated throughout

A

0 (standing straight) - less ES activity, Inc while bend forward
30 flex - ES stops firing, stretch will suspend body without contracting mm
90 flex - moment arm dec, ligaments not stretched as much, increase strain, dec stress, mm are silent

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21
Q

Thoracic - joints are designed for

A

compression, not shear! Kyphotic posture inc shear by 2.5x in standing!

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22
Q

S/S of facet dysfunction

A

Local sharp pain!

23
Q

SP of thoracic spine - rules of

A 
3s!
T1-T3 = in line with VB of same level
T4-T6 = in line with IVD of inf level
T7-T9 = in line with VB of inf level
T10 = inf body
T11 = inf IVD
T12 = same body
24
Q

Articulations - Manubriosternal, Xiphisternal

A

Synchondrosis
Ossifies in older adults
Manubrial rotation occurs with shoulder flexion

25
Q

Articulation - costovertebral

A

synovial joint

26
Q

Articulation - costotransverse

A

synovial

27
Q

Coupled movement

A 
Upper = like cervical = LF and Rot SAME direction
Lower = like lumbar = LF and Rot OPP direction
28
Q

If rib dysfunction and thoracic what tx first

A

Tx thoracic first!

29
Q

Pump handle action

A

during inspiration ribs 1-6 pull up and forward

manubrium elevation

30
Q

Bucket handle action

A

ribs 7-10 move up, backward, and medial to increase lateral dimension

31
Q

Caliper action

A

ribs 8-12 move laterally to increase lateral diameter

posterior and lateral during inhale

32
Q

Bucket bail lesion is what

A

bucket handle position is displaced more than pump handle because of its lateral position
usually from trauma

33
Q

Disc pathology in T spine

A

less common to be herniation

more commonly degeneration

34
Q

Scheuermann’s disease is what

A

Common in lower thoracic - related to schmorles nodes
vertical disc herniation into vertebral body, causes achiness and stiffnes
excessive kyphisis, loss of flex/ext

35
Q

Spinal tumors

A

MOST COMMON IN T SPINE!
Back pain will be primary sx with it being worst at night
Red flag if s/s cannot be reproduced with mvmnt

36
Q

Benign spinal tumors include

A 
Osteochrondroma
Osteoid osteoma
Osteoblastoma
Giant cell tumor
Hemangioma 
Eosinophilic granuloma
37
Q

Malignant spinal tumors include

A 
Plasmacytoma
Ewings sarcoma
Lymphoma
Osteosarcoma
Chondrosarcoma
Chondroma
38
Q

Ankylosing spondylitis is what

A

chronic inflammatory arthropathy, stiffening or fusion of spine and SI joints
More common and more severe in men
2nd most common in T SPINE

39
Q

Scoliosis - non structural

A

poor posture
nerve root irritation
leg length discrepancy

40
Q

Scoliosis - structural

A

genetic
idiopathic
wedge/hemi vertebrae contributes to rotation

41
Q

Scoliosis - curve pattern is named according to

A

apex of the curve and direction of the convexity

vertebral body rotates toward the convexity, rib post which is why we see rib hump with forward flexion

42
Q

Pectus carinatum

A

pigeon chest
sternum projects forward and downward
inc ant-post dimension of chest

43
Q

Pectus excavatum

A

funnel chest
sternum pushed post by overgrowth of ribs
and-post chest dimension dec

44
Q

Barrel chest

A

sternum projects forward and up
ant-post dimension inc
seen with emphysema

45
Q

Normal motion with breathing assessment

A

abdomen rises, lateral expansion, upper chest/accessory mm

46
Q

Rib motion with breathing assessment

A

supine

feel for ant/post motion during inhale/exhale

47
Q

Depressed rib - breathing assessment

A

will stop moving relative to others on inhale

48
Q

Elevated rib - breathing assessment

A

will stop moving relative to others on exhale

49
Q

Diaphragm attaches to

A

internal part of xiphoid process (sternal portion)
inner surface of lower ribs (costal portion)
L1-L3 (lumbar portion)

50
Q

Shoulder flexion can be used to assess

A

the upper 7 ribs

51
Q

Shoulder abduction can be used to assess

A

the lower ribs

52
Q

With right cervical rotation the R rib moves ____ and the L rib moves ___

A

R moves anteromedially

L moves posterolaterally

53
Q

With unilateral shoulder flexion you will get

A

thoracic rotation

54
Q

With bilateral shoulder flexion you will get

A

thoracic extension

COMP ORTHO (11 decks)

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