Thoracic CS Flashcards
1
Q
Anterior Tender Points
- Pain is ______ and ______
- The patient may give a history of comfort in ______
- The injury may have occurred with rapid ______ from a ______ position
- May present with increased ______
- Treated in ______
- If stretches are prescribed for several days later, generally use ______
A
Anterior Tender Points
- Pain is diffuse and posterior
- The patient may give a history of comfort in flexion
- The injury may have occurred with rapid extension from a flexed position
- May present with increased kyphosis
- Treated in flexion
- If stretches are prescribed for several days later, generally use extension
2
Q
Posterior Tender Points
- Pain is _____ and __________
- The patient may give a history of comfort in __________
- The injury may have occurred with the rapid __________ from a(n) __________ position
- May present with __________ curve of thoracic spine
- Treated in __________
- If stretches are prescribed for several days later, generally use __________
A
Posterior Tender Points
- Pain is specific and posterior
- The patient may give a history of comfort in extension
- The injury may have occurred with the rapid flexion from a(n) extended position
- May present with decreased curve of thoracic spine
- Treated in extension
- If stretches are prescribed for several days later, generally use flexion
3
Q
AT1 through AT7 L
- Location
- AT1
- AT2
- AT3
- AT4
- AT5
- AT6
- AT7
- AT7 L
- Tx Position
- Support of PT’s neck?
- Motion?
- How do you increase the motion?
- When can you use minor sidebending?
A
AT1 through AT7 L
- Location
- AT1
- Midline at the suprasternal notch
- AT2
- Midline where the manubrium meets the sternum
- AT3
- On the sternum at the level of the costal cartilage related to the named vertebra
- AT4
- On the sternum at the level of the costal cartilage related to the named vertebra
- AT5
- About 2-3 cm above the xiphoid junction
- AT6
- At the xiphisternal junction
- AT7
- At the tip of the xiphoid
- AT7 L
- Just inferolateral of AT7 on either side
- 2 Points
- AT1
- Tx Position
- Support of PT’s neck?
- Physician supports the patient’s head and neck with one arm and hand
- Motion?
- Flexion
- How do you increase the motion?
- Physician places a knee under the cervical and upper thorax spine if more flexion is neede
- When can you use minor sidebending?
- Minor sidebending toward may be needed for the lateral AT7 L
- Support of PT’s neck?
4
Q
AT1 through AT7 L
- Location
- AT8
- AT9
- AT10
- AT11
- AT12
A
AT1 through AT7 L
- Location
- AT8
- Halfway between AT7 and AT 9 approximately 4-5 cm inferior to the xiphoid process
- AT9
- Approximately 1-2 cm superolateral to the umbilicus
- DO AFTER AT7 and BEFORE AT8
- AT10
- Approximately 1-2 cm inferolateral to the umbilicus
- AT11
- Approximately 4 cm inferolateral to the umbilicus
- AT12
- Superomedial (internal) surface of the iliac crest on the mid-axillary line
- AT8
5
Q
AT7 to AT9
- Tx position
- Sidebend where?
- Rotate where?
- Flex or Extend?
- Leg on what side of PT?
- How do you support the PT’s head/neck?
A
RoAT7 to AT9
- Tx position
- PT Supine
- Being Patient
-
SB to tender point
- Use physician leg on the opposite side of the tender point to increase SB
-
Flex to the tender point
- Push your elevated femur against PTs upper thoracic spine while supporting PTs head/neck with your arm/hand
- Rotate away from the tender point
(LU) F STRA
Leg Up
6
Q
AT9 - AT12
- Tx position
A
AT9 - AT12
- Tx position
- PT Supine
- PT’s knees to 90º, hips to 135º
- Flex to the level of TP
- Rotation of knees to the side of TP
- Pull feet toward the side of the TP
- Can add a pillow to assist with flexion
-
F STRA
-
Rotation from the segment below TP being rotated toward TP
- This rotates the segment the opposite way
-
Rotation from the segment below TP being rotated toward TP
7
Q
Posterior thoracic tender points (PT1-12) and Lateral posterior thoracic tender points (LPT1-12)
- Where are the PT’s located?
- In what order to you palpate them?
- Where are the LPT’s located?
A
Posterior thoracic tender points (PT1-12) and Lateral posterior thoracic tender points (LPT1-12)
- Where are the PT’s located? In what order to you palpate them?
- On the lateral edges of the inferior aspect of each vertebra’s spinous process
-
Palpate from:
- Lateral to medial
- Inferior to superior
- Posterior to anterior
- At about a 45° degree angle toward the inferolateral aspects of the spinous processes
- Where are the LPT’s located?
- On the lateral aspects of the transverse processes
Image: PT4 tenderpoints in purple and LPT4 tenderpoints in blue
8
Q
THORACIC RULE OF 3’S
- Location of the SPs of T1 to T3
- Location of the SPs of T4 to T6
- Location of the SPs of T7 to T9
- T10 is like
- T11 is like
- T12 is like
A
THORACIC RULE OF 3’S
- Location of the SPs of T1 to T3
- The tip of the spinous processes are in the same plane as the transverse processes of the associated vertebra
- Location of the SPs of T4 to T6
- The tip of the spinous processes are about half way between the transverse processes of its associated vertebra and the one immediately inferior
- Location of the SPs of T7 to T9
- The tip of the spinous processes are one level below the transverse processes of the corresponding vertebra
- T10 is like
- T7 to T9
- T11 is like
- T4 to T6
- T12 is like
- T1 to T3
9
Q
ALL POSTERIOR THORACIC (PT and LPT)
- PT Position
- General Motion
- The physician on what side of table?
- Head of Table
- Same Side of Tender Point
- Opposite Side of Tender Point
A
ALL POSTERIOR THORACIC (PT and LPT)
- PT Position
- Prone
- General Motion
- Extension
- The physician on what side of table?
- Head of Table
- PT 1 through 6
-
LPT 1 through 7
- L is upside down 7
- LPT 4 through 6 can also be opposite side of TP
- Same Side of Tender Point
- PT 7 through 12
- Opposite Side of Tender Point
- LPT 4 through 12
- Head of Table
10
Q
What is always the PT tender point treatment position?
A
E SARA
11
Q
PT1 – PT3
- PT arm placement?
- Physician hand placement?
- Support of patients head/neck?
A
PT1 – PT3
- PT arm placement?
- Arms hanging over the sides of the table
- Physician hand placement?
- Physician cups the point of the patient’s chin with a hand, with the palm on the side that will support the patient’s cheek and jaw
- Support of patients head/neck?
12
Q
PT4 – PT6
- PT arm placement?
- Physician hand placement?
- Support of patients head/neck?
A
PT4 – PT6
- PT arm placement?
- Arms extended forward and parallel to the head
- Physician hand placement?
- Gently lift the chin slightly to bring the head, neck and upper thoracic spine into extension
- Support of patients head/neck?
- Physician man use a knee or thigh to help support the patient’s head and neck or their supporting hand
13
Q
PT7 – PT9
- PT arm placement?
- PT head placement?
- Physician hand placement?
A
PT7 – PT9
- PT arm placement?
- Swimmer motion to induce sidebending AWAY from TP
- Extended arm should go back to neutral before starting Tx
- PT head placement?
- Rotate head AWAY from TP before Tx
- Physician hand placement?
- Pull up on the opposite shoulder to create extension and rotation away
- Sidebend and rotate the patient’s body to the level of the tenderpoin
14
Q
PT10 – PT12
- PT arm placement?
- PT head placement?
- Physician hand placement?
A
PT10 – PT12
- PT arm placement?
- Swimmer motion to induce sidebending AWAY from TP
- Extended arm should go back to neutral before starting Tx
- PT head placement?
- Rotate head AWAY from TP before Tx
- Physician hand placement?
- Physician grasps the contralateral ASIS and pulls the pelvis posteriorly
- This will cause extension and rotation away from the tender point
- Physician grasps the contralateral ASIS and pulls the pelvis posteriorly
15
Q
What is the general treatment position for all LPT tender points?
A
E SART
(LEEEEEEE)E SART
