Thoracic Diagnosis

Question 1

What is the “Pearl”?

Answer 1

Dysfunction in the thoracic region may be responsible for complaints referable to distant and seemingly unrelated areas

Question 2

What do we inspect?

Answer 2

1. Scapular position
2. Lateral curves
3. A-P curves
4. Respiration
5. Costal cage asymmetry

Question 3

Name 5 landmarks their levels

Answer 3

1. Vertebrae promninens (C7)
2. Angle of Louis (T2) (sternal angle)
3. Spine of scapula (T3)
4. Inferior angle of scapula (T7)
5. Iliac crest (L4)

Question 4

Give a location for viscerosomatic tissue texture changes?

Answer 4

Rib angles and costovertebral articulations

Question 5

Tissue texture changes for transverse processes

Answer 5

Anterior/posterior component

Question 6

Spinous process tissue texture changes

Answer 6

Extended dysfunctions

Question 7

Rules of 3

Answer 7

a) T1-T3 = same level as spinous
b) T4-T6 = transverse processes 1/2 up from spinous
c) T7-T10 = transverse processes 1 up from spinous
d) T11 = transverse process 1/2 up from spinous
e) T12 = transverse process same level as spinous

Question 8

Type 1

Answer 8

Rotation/sidebending go to opposite sides and into CONVEXITY

Question 9

Type 2

Answer 9

Single segment same side (non-neutral)

Question 10

Type 3

Answer 10

Motion in one segment in any plane affects the rest

Question 11

Where is type 2 commonly found?

Answer 11

Upper thoracic

Question 12

What is Kappler’s Corollary?

Answer 12

If head is flexed or extended, which is more restricted?

Question 13

4 things with Type 1

Answer 13

1. Related to short leg mechanics and pelvic sideshift
2. Seen in idiopathic scoliosis
3. Seen in postural patterns from repetitive activity
4. Seen in long standing viscerosomatic reflexes