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foundations > thoracic > Flashcards

thoracic Flashcards

1
Q

Rules of 3s

A
  • T1-3 SP at same level
  • T4-6 SP 1/2 level below
  • T7-9 SP 1 full level below
  • T10 1 full level below
  • T11 1/2 level below
  • T12 at same level
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2
Q

Ligamenta Flava

A
  • Assists in resuming posture after flexion

- Can cause stenosis

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3
Q

Radiate Ligament

A
  • Connect anterior head of each rib with bodies of 2 vert and intervertebral fibrocartilage
  • Triradiate (above, at level, below) except 1, 10, 11, 12 (biradiate - above and at level)
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4
Q

Multifidi: Jull, Hodges, Hides

A
  • Between TP and SP, sacrum to C2
  • stabilize vertebral column
  • pain inhibits
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5
Q

Critical Zone: artery of adamkiewicz

A

-T4-9 has 3mm of redundancy, watershead vascularization

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6
Q

Typical Ribs

A
  • Ribs 3-10

- Attached above and below and to intervertebral disc

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7
Q

Atypical ribs

A
  • Ribs 1, 2, 11, 12
  • Ribs 1, 11, 12 to T1, 11, 12 with unifacet
  • Rib 2 to T1 with 2 demifacets
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8
Q

Respiratory motion with thoracic flexion

A

Rib internal torsion

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9
Q

Respiratory motion with thoracic extension

A

Rib external torsion

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10
Q

Physiological motion of costal cage

A
  • Pump handle: upper/mid
  • Bucket handle: mid to inf ribs
  • Calipers: ribs 11-12
  • Torsional motion: internal/external, mid to lower ribs
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11
Q

Structural dysfunction: superior subluxation

A

First rib: exhalation dysfunction

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12
Q

Structural dysfunction: anterior/posterior subluxation

A

circumferential pain = sympathetic facilitation, traumatic force.
asymmetry of boney landmarks of UE

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13
Q

Structural dysfunction: internal or external torsion

A

rib stuck with dysfunctional vertebrae or chronic myofascial restrictions.

  • circumferential tenderness, hypertonicity of ipsilat intercostals
  • Inf edge post: internal torsion
  • Sup edge post: external torsion
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14
Q

Structural dysfunction: inhalation and exhalation

A

Often asymptomatic, no asymmetries.

Less problematic

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15
Q

Thoracic Scan: Compression

A

seated, arms crossed. push down through shoulders

ID: fracture

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16
Q

Thoracic Scan: Traction

A

seated, arms crossed, lift up

ID: disc/ligament

17
Q

Thoracic Scan: Breathing pattern

A

look at breathing, can put hands on ribs

18
Q

Thoracic Scan: Manubrial compression

A

pain provication

19
Q

Thoracic Scan: Upper sternal compression

A

pain provication

20
Q

Thoracic Scan: Lower sternal compression

A

pain provication

21
Q

Thoracic Scan: abdominal cutaneous relfex

A

pt in hooklying, drag sharp end of reflex hammer into belly button.
Look for asymmetry of inconsistency.
Upper: T6-10
Lower: T10-12

22
Q

Thoracic Scan: Beevor’s Sign

A

hooklying, pt lift head off pillow, look for deviation (will deviate away from dysfunction)

23
Q

Thoracic Scan: Aortic pulse

A

larger than 3 finger width, lack of normal lub-dub

24
Q

Thoracic Scan: Abdominal quadrant palpation

A

looking for rebound or pain

25
Q

Thoracic Scan: Sprin test

A
  • PA of SP pt in prone

- Rib spring PA, pt in prone

26
Q

Thoracic Scan: Soft tissue spring

A

due to segmental innervation soft tissue changes will be along same level of dysfunction. “idiot light”

27
Q

Thoracic Tests: AROM

A
  • Flexion, ext, rotation, SB

- in sitting, prone, prone pressup, arch/sag

28
Q

Thoracic Tests: Positional/motion testing

A

-Hands on TPs, pt flex/ext

29
Q

Thoracic tests: PIVM

A

-Flexion, extension, rot, SB

30
Q

Thoracic Test: PAIVM

A

combined motions: quadrants

31
Q

Thoracic Tests: Anterior translation

A
  • Pt prone
  • Stabilize inferior vert
  • Cranial hand on TP give P>A force to superior vert.
  • Positive = excessive translation, clunk, crepitus
32
Q

Thoracic Tests: Rotational stability

A
  • Pt prone
  • Stabilize inf vert at TP
  • Sprint opposite side of TP of superior vert to rotate the superior vert on inferior.
33
Q

Thoracic Tests: Posterior translation

A
  • Pt sitting
  • P>A vert inferior to one being tested, block ribcage
  • essentially an A>P of sup vert
34
Q

Thoracic Tests: Lateral stress test

A
  • pt sitting

- Palpate SP of inf vert, shear trunk toward PT

35
Q

Costal Cage Assessment: Key Rib

A
  • Rib within a group of ribs that is limiting respiration of others
  • Will have both structural and respiratory rib dysfunction
  • Inhalation: key rib above
  • Exhalation: key rib below
36
Q

Costal Cage Assessment: Bony landmarks

A

Look for asymmetries

37
Q

Costal Cage Assessment: Passive overpressure

A
  • Spring into internal torsion (flexion)

- Spring into external torsion (extension)

foundations (7 decks)

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