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Thoracic and Cervical Quiz > Thoracic and Cervical > Flashcards

Thoracic and Cervical Flashcards

1
Q

Normal kyphotic convexity in the sagittal plane is between

A

20-40 degrees

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2
Q

Line of gravity falls anterior to

A

the vertebral bodies

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3
Q

what percent of axial trunk rotation occurs in the thoracic segments

A

80%

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4
Q

What forms the anterior wall of the thorax

A

sternum

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5
Q

Joints of manubrium

A

manubriosternal joints

sternoclavicular joints

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6
Q

Xiphoid process joint

A

sternoxiphoid joint

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7
Q

Sternocostal joints

A

The sternocostal joints also known as sternochondral joints (or costosternal articulations), are synovial plane joints of the costal cartilages of the true ribs with the sternum.

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8
Q

Ribs

A

1 to 7 increase in length
sternocostal joints
costochondral junction
chondrosternal junction

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9
Q

Ribs 2 to 7 display what type of motion

A

gliding

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10
Q

radiate ligaments

A

The radiate ligament connects the anterior part of the head of each rib with the side of the bodies of two vertebrae, and the intervertebral fibrocartilage between them.

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11
Q

ribs 8 to 12 are longer or shorter

A

shorter

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12
Q

ribs 11 and 12 have what attachment

A

no anterior attachment

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13
Q

costovertberal joints

A

heads of ribs 1 to 12

articulate with thoracic vertebral bodies

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14
Q

costotransverse joints

A

ribs 1 to 10

articulate with transverse processes

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15
Q

external intercostals

A

oblique and medial fibers

inhalation

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16
Q

internal intercostals

A

oblique and lateral fibers

forced expiration

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17
Q

muscle of respiration

A

external and internal intercostals
stabilize rib cage
play role in axial rotation of thorax

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18
Q

serratus posterior superior

A

elevates the upper ribs

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19
Q

serratus posterior inferior

A

stabilizes the lower ribs during contraction of the diaphragm

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20
Q

levatores costarum

A

elevates ribs

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21
Q

thoracic motion

A

limited flexion and extension

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22
Q

thoracolumbar flexion

A

70 to 85 degrees

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23
Q

thoracolumbar extension

A

45 degrees

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24
Q

lateral bending of thoracic

A

45 degrees

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25
Q

rotation of thoracic

A

30 to 40 degrees

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26
Q

lateral bending coupled with rotation in same direction

A

lateral bending and rotation

may be opposite directions in lower T spine

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27
Q

Unlikely but possible conditions

A

spinal stenosis
spondylolisthesis and spondylolysis
facet joint sprain
disc hernation

28
Q

Discogenic pain

A

disc degeneration rather than herniation

Involved: annulus fibrosis, nucleus pulposis, spinal nerve root
MOI: trauma
Complaints: typically asymptomatic and picked up on MRI as incidental finding
Neuro: dermatomes, myotomes, and abdominal reflexes could be affected but difficult to isolate
Diagnosis: MRI
Tx: TE, injection, surgery

29
Q

disc herniation is the thoracic spine is

A

very rare
typically below T8
must vulnerable segment between T11-T12 because of greater mobility

30
Q

Unstable spine predisposes a person to

A

neurologic injury and/or deformity

31
Q

Anterior column

A

ALL

anterior half of vertebral bodies

32
Q

Middle column

A

posterior half of vertebral bodies

PLL

33
Q

Posterior column

A 
pedicles
laminae
spinous processes
facet joints
supraspinous, interspinous, intertransverse ligaments
ligamentum flavum
34
Q

One column affected

A

usually stable

35
Q

Two columns affected

A

usually unstable

36
Q

Three columns affected

A

always unstable

37
Q

Isolated fx of posterior elements is

A

typically minor

38
Q

Compression fractures can be

A

traumatic
atraumatic (osteoporosis)
pathologic (malignancy)

39
Q

Most fractures in the t-spine occur closer to

A

thoracolumbar junction (T10-T12)

40
Q

Burst fracture

A

anterior and middle column

41
Q

wedge fracture

A

anterior column

42
Q

chance

A

transverse entirely through the bone

43
Q

Fracture of t-spine

A

MOI: trauma, axial overload, rapid flexion (seatbelt injury), extreme rotation or sheer
Complaints: pain, loss of function
ROM: limited and painful
Neurological exam: motor, sensory, reflexes can all suffer deficits
Dx: x-ray, CT
Tx: thoracolumbosacral orthosis, TE, surgery for unstable

44
Q

Rib Fracture more common in

A

ribs 5-9 and at the posterior angle

45
Q

Rib fracture

A

MOI: direct trauma, repetitive muscle contraction or forceful coughing can cause stress fx
Complaints: localized pain, pain with deep inhalation and trunk movement
ADL: breathing, lifting
Affects on ROM: may be decreased due to pain
Neuro: N
Dx: x-ray
Tx: rest, stabilization, NSAIDs

46
Q

Rib head displacement

A

costovertebral and costotransverse pain

47
Q

Costovertebral and costotransverse pain

A

articulation of rib head and neck with vertebral body and transverse process
MOI: blunt trauma, forceful coughing, poor posture, overuse
Comp: localized sharp pain with deep inhalation, trunk movement, or overhead arm movement; may report clicking sensation
ROM&Stren: trunk rotation may be limited due to pain; strength N
Dx: physical exam, r/o other conditions
Tx: mobilization/manipulation

48
Q

Costochondritis

A

irritation/inflammation of costochondral junction

MOI: acute trauma or repetitive stress
Comp: anterior chest wall pain, tenderness over affected joint
ADL: labored breathing, lifting
Affects on ROM: N
Dx: r/o cardiac pathology
Tx: rest, NSAID's
49
Q

Muscle Strain involved

A

potentially involved musculature: erector spinae, levator scapulae, trapezius, rhomboids, intercostals

50
Q

Muscle strain

A

MOI: acute
Complaints: spasm/tightness, no neuropathy, feels better at rest
ADL: active movements
Neuro: N
ROM&S: decreased strength and pain with active contraction
decreased AROM due to pain and weakness, decreased ROM due to pain
Dx: MMT, important to r/o other pathologies
Tx: decrease pain, soft tissue work, TE to restore function

51
Q

Trigger points

A

presence of palpably tight/stiff nodule or adhesion in the musculature
commonly involves: trapezius, levator scapulae, rhomboids, latissimus dorsi

52
Q

Trigger points MOI

A

MOI: acute, overuse, poor posture, or psychological stress
Comp: localized sharp pain with a referral pattern
ROM&S: may be decreased due to pain
Dx: physical exam, injection
Tx: massage, myofascial release, trigger point release, cupping, IASTM, dry needling, injection, TE

53
Q

Hyperkyphosis is

A

greater than 40 degree kyphosis angle

54
Q

scheuermann’s disease

A

juvenile form of kyphosis
affects vertebral body growth plate and causes wedge-shaped vertebral bodies at three or more levels and typically causes pain with flexion

55
Q

Hyperkyphosis

A

Age related: affects 20-40% of eldery population
Postural kyphosis: results of poor posture, weakened musculature
Can lead to pulmonary difficulties
Dx: measurement of Cobbs angle, standing lateral spine radiographs, kypohmeter
Tx: TE (breathing correction, thorax mobility, stability and strengthening, postural re-education)

56
Q

Scoliosis is

A

the c or s shaped curvature that is usually congenital

57
Q

During scoliosis the anterior vertebral body

A

rotates towrds the convex side –> rip hump on convex side

58
Q

Scoliosis Diagnosis

A

Complaints: pain, muscle fatigure and or spasm
ROM&S: limitations to trunk motion
muscles on concave side usually shortened and tight
muscles on convex side usually lengthened and weak
N: normal
Dx: physical exam, x-ray
Tx: TE, orthosis, surgery

59
Q

Forward head posture

A

commonly acquired postural deviation
poor seated posture, constant use of electronics
head forward in relation to shoulders, rounded shoulder, lower c-spine increased extension to maintain upright head posture

60
Q

Forward head posture diagnosis

A

Complaints: pain in involved musculature
ROM&S: decreased strength in involved musculature
Dx: occiput to wall distance (OWD)
Tx: TE, postural re-education

61
Q

Upper Crossed Syndrome tightness

A

tightness of suboccipitals
levator scapulae
upper trapezius crossed with tightness of pectoralis major and minor

61
Q

Upper Crossed Syndrome tightness

A

tightness of suboccipitals
levator scapulae
upper trapezius crossed with tightness of pectoralis major and minor

62
Q

upper crossed syndrome weakness

A

weakness of cervical flexors crossed with weakness of rhomnboids, muddle, and lower trapezius

62
Q

upper crossed syndrome weakness

A

weakness of cervical flexors crossed with weakness of rhomnboids, muddle, and lower trapezius

63
Q

Red flags and referrals

A

significant trauma
cardiopulmonary concerns (angina, SOB)
back pain associated with fever, nausea, vomiting)
Hoffman’s, babinski, clonus- upper motor neuron syndrome, spinal cord
Hx: cancer, unexplained weight loss, immunosuppression, prolonged use of steroids, IV drug user, UTI
pain that is constant, severe, progressive
Pain not relieved by rest
failure to respond to conservative treatment

Thoracic and Cervical Quiz (5 decks)

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