thoracic exams

Question 1

amoss sign

Answer 1

observe the patient getting off the bench. sign is present with pain or difficulty standing. possible thoracic sprain, subluxation, IVD syndrome or ankylosing spondylitis

Question 2

beevor’s sign

Answer 2

supine, patient asked to do a crunch sit up (or leg lift). observe patients umbilicus to asses position. cephalic drift of umbilicus indicates lower thoracic myelopathy, cuadal drift indicates upper thoracic involvment. noted from T7

Question 3

chest expansion test

Answer 3

patient inhales deeply and chest measurement is taken at 4th intercostal space, axilla, and T10 level, then exhale and measurements taken again. decreased expansion in absence of trauma indicates ankylosing spondylitis

Question 4

forestiers bowstring

Answer 4

patient flexes laterally with arms at side. if muscle contraction is ipsilateral/concave side test is positive. suggests ankylosing spondylitis

Question 5

rib motion test

Answer 5

supine. palpate rib cage while patient breathes in and out noting anterior posterior motion of rib cage. lack of motion on inspiration indicates depressed subluxated rib, expiration elevated subluxated rib

Question 6

schepelmans sign

Answer 6

side bend with arms above head. pain on concave side with radiation along associated rib indicates intercostal neuralgia. streching pain indicates intercostal myalgia. localized pain indicated subluxation vertebral or costal

Question 7

adams position

Answer 7

visualization of the spine from anterior then posterior looking for scoliosis
functional scoliosis - the curve changes with forward flexion
pathological/structural scoliosis - the curve does not change with forward flexion