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MSK II > Thoracic > Flashcards

Thoracic Flashcards

1
Q

What is the rule of 3’s?

A

Spinous process 1-3 in line with the transverse process. 4-6 are 1/2 a spinal level below. 7-9 are 1 spinal segment below. 10 is 1 spinal level below, 11 is 1/2 a spinal level below, and 12 is at the same level

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2
Q

The spine of the scapula is in line with which vertebrae?

A

T3/T4

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3
Q

The inferior border of the scapula is in line with which vertebrae?

A

T7

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4
Q

The 12th rib is in line with which vertebrae?

A

T12

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5
Q

During which motion of the T-spine do the ribs perform anterior rotation and superior glide?

A

Flexion

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6
Q

During which motion of the T-spine do the ribs perform posterior rotation and inferior glide?

A

Extension

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7
Q

During which motion of the T-spine do the ribs perform compression on ipsilateral side and elevation on contralateral side?

A

Lateral flexion

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8
Q

The upper ribs perform the ___ motion while the lower ribs perform the ___ motion
Options: bucket handle and pump handle

A

Pump handle, bucket handle
o Upper ribs = pump handle = anterior to posterior
o Lower ribs = bucket handle = expand laterally (frontal plane)

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9
Q

T/F The cervical discs are larger than the thoracic?

A

True

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10
Q

Which spinal segment had the most likelihood of disc disease?

A

T6/T7

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11
Q

What are the glides for flexion:

A

Superior and anterior

20-45 deg

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12
Q

What are the glides for extension:

A

Inferior and posterior

20-45 deg

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13
Q

What are the glides for rotation:

A

Opposite direction of rotation

35-50deg

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14
Q

What are the glides for lateral sidebending?

A

Contraleteral facet slides superior

20-40deg

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15
Q

What degree of thoracic extension is needed for bilateral UE elevation?

A

15 degrees

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16
Q

Murphy’s sign is used for what organ disorder?

A

Gallbladder disorder(Cholecystitis)

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17
Q

This organ disorder is common in women post pregnancy and increase with the intake of fatty foods

A

Cholecystitis

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18
Q

This disorder s characterized by a burning, gnawing sensation coupled with vomiting or constipation. The patient will also comment on how eating relieves their pain.

A

Peptic ulcer

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19
Q

Severe flank pain, abdominal pain, HA, fever. You tapped on the costovertebral border and the patient felt pain.

A

Kidney problem

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20
Q

An elderly lady enters your clinic after a fall and complains of pain within her lower back. She has been using NSAIDS to relieve the pain for the past 10 weeks with no relief. She states she has not been able to sleep on her back. What might she have?

A 
Spinal Fracture 
o	More common in those with osteoporosis
o	Age > 70 years old
o	Long term corticosteroid use
o	History of trauma (fall, MVA)
o	Most common in T11-L1 levels
o	May have increased kyphosis- wedging of the vertebrae
o	Supine sign and percussion test
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21
Q

What is the osteopenia DEXA score:

a. -1 to -2.5
b. -1 to -1.5
c. 0 to -1

A

A

T score of -1 and above is normal

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22
Q

T/F Manual therapy is an absolute contraindication for osteoporosis patients

A

False, rule out compression fracture and attempt adjacent areas if indicated

23
Q

Name 3 risk factors for Osteopenia/Osteoporosis

A 
o	Women over 65
postmenopausal, low body fat, family hx, pregnancy at early age, sedentary
o	Lower body weight <127 lbs
o	Cigarette smoking
o	Rheumatoid arthritis
o	History of non-traumatic fracture
o	Excessive alcohol consumption
o	Diabetes, hyperthyroidism, menopause, chronic malnutrition or malabsorption
24
Q

T/F Compression fractures are wedge like fractures of the posterior part of the vertebral body

A

False, anterior

creates kyphotic posture

25
Q

T/F Manual therapy is contraindicated with acute compression fractures

A

True

26
Q

T/F Manual therapy is an absolute contraindication with chronic healed compression fractures

A

False, relative

27
Q

Juvenile disc disease:

a. Gibbus
b. Dowagers
c. Scheurmanns

A

C

28
Q

Postmenopausal osteoporosis with ant wedging/fracturing of upper T-spine

a. Gibbus
b. Dowagers
c. Scheurmanns

A

B

29
Q

Structural vs flexible thoracic kyphosis: can be changed or adapted, it’s a position the pt chooses to move in

A

Flexible

30
Q

Structural vs flexible thoracic kyphosis: no change in curve moving into extension

A

Structural

31
Q

Hyperkyphosis is any angle greater than:

A

40 degrees

32
Q

T/F: Kyphosis can lead to decreased lung capacity in the aging population

A

True

33
Q

Defect of the vertebral body creating anterior wedging. Often found in younger patients.

a. Gibbus
b. Dowagers
c. Scheurmanns

A

c

34
Q

Scoliotic curves are named for their concavity or their convexity?

A

Convexity

35
Q

T/F Vertebral bodies rotate towards the convexity

A

True, Spinous process rotates away

36
Q

T/F The ribs on the convex side push posteriorly

A

True, create the rib hump

37
Q

T/F the rib hump will be on the side of the convexity

A

True

38
Q

A Cobbs angle greater than 50 degrees requires what intervention?

A

Surgery

39
Q

T/F a cobbs angle of 10-35 degrees can be treated conservatively

A

True.
o Typically greater than 50 degrees requires a surgical consult
o 35-50 degrees possible consultation and surgery depending on guidelines
o 10-35 degrees treated conservatively
o Less than 10 degrees is a normal variation

40
Q

Stretch or strengthen the concavity

A

Stretch

41
Q

Stretch or strengthen the convexity

A

Strengthen

42
Q

Strengthen rotation to the same or opposite side of the rib hump?

A

Opposite

43
Q

Name a test for scoliosis

A

Adams forward flexion test

44
Q

• Inflammation and swelling of the costal cartilage
• Anterior chest pain, usually over 2nd and 3rd rib
• Pain with breathing on the affected side
• Pain may radiate into the shoulder
• Pain with lifting heavy items
• MOI- physical strain, repetitive coughing
Swelling

A

Tiezete Syndrome

45
Q

The single difference between Tiezete Syndrome and Costochondritis is what?

A

Swelling

46
Q

T/F Costochondritis goes away on its own

A 
True
o	Modalities for pain relief
o	Joint mobilization (rib mobilization, Thoracic spine mobilization)
o	Myofascial release
o	Postural education
47
Q

T/F Costochondritis can mimic a heart attack

A

True

48
Q

What anatomical location is costochondritis normally felt?

A

Sternum and ribs

49
Q

This syndrome is often misdiagnosed as shoulder imingement

A

2nd Rib syndrome

50
Q

• Anterior and superior subluxation of 2nd rib irritating dorsal rami and provides cutaneous distribution to the posterolateral shoulder

A

2nd rib syndrome

51
Q

Type I scapular dyskinesia

A

inferior angle dysfunction, ant tipping

52
Q

Type II scapular dyskinesia

A

medial border, internal rotation of scap

53
Q

Type III scapular dyskinesia

A

superior dysfunction
o Excessive early elevation of scapula
o Typically seen in insufficient rotator cuff
o Increased/over active deltoid muscle

54
Q
  • Feeling of crepitus when moving the scapula
  • Retraction
  • Protraction
  • Can be asymptomatic
  • Associated with winging scapula
  • Associated with shoulder pain/impingement
  • Associated with overhead throwing activities
A

snapping scapula

MSK II (4 decks)

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