Thoracic Assessment

Question 1

Observation: Gait: Thoracic

Answer 1

• Demeanour (may indicate pain level)
• Posture (head carriage, asymmetry)
• Muscle tone, spasm, asymmetry/atrophy
• Skin changes (sweating, erythema, (these both suggest autonomic response) hair
distribution, scars, pigmentation
• Level of T3 with spine of scapula
• Level of T7 with inferior angle of scapula
• Check medial border of scapula is parallel with SPs and approx 5cm lateral
• Shoulder heights are level
• Iliac crests are level and symmetric
• Deformity: kyphosis, scoliosis
• Chest wall shape - Barrel chest, pigeon chest (pectus carinatum) or funnel chest
(pectus excavatum)

Question 2

Screen: Thoracic

Answer 2

ALWAYS SCREEN THE ADJACENT REGIONS

• Screen pelvic levels for symmetry (incl. standing Flex test)
• Screen Lumbar spine (active flexion and S/B)
• Screen Cervical Spine (active S/B and Rot)
• Screen UEX (upper limb elevation)
• Screen first rib/ribs (respiration)

Question 3

Active ROM: Thoracic

Answer 3

(can do this standing or seated)

1. Flexion
2. Extension
3. Sidebending
4. Rotation

Question 4

Passive ROM: Thoracic

Answer 4

(seated)

1. Flexion
2. Extension
3. Sidebending
4. Rotation

Question 5

Active Resisted ROM: Thoracic

Answer 5

Perform seated
• Flexion
• Extension
• Sidebending
• Rotation

Question 6

Accessory ROM: Thoracic

Answer 6

Spring the SPs

Question 7

Palpation: Thoracic

Answer 7

• Multifidus
• Rotatores
• Erector spinae
• Diaphragm
• Lat dorsi
• Rhomboids
• Trapezius
• Pec’s
• Levator Scap
Etc
Don’t forget bony landmarks! - clavicle, SC jt, Sternum, ribs