Thoracic Orthopedics

Question 1

procedure for Adam’s position

Answer 1

patient bends forward at the waist and Dr observes for scoliosis

Question 2

purpose of Adam’s position

Answer 2

to determine if patient has structural or functional scoliosis

Question 3

findings of Adam’s position

Answer 3

if scoliosis disappears when bending forward then functional scoliosis
if scoliosis remains when bending forward then structural scoliosis

Question 4

procedure of Amoss sign

Answer 4

Dr observes patient as they get up from a side lying position

Question 5

purpose of Amoss sign

Answer 5

Dr is looking for pain, weakness, or to see if patient has to use upper body strength to get off table

Question 6

findings of Amoss sign

Answer 6

positive sign is if there is pain or if patient needs to use upper body strength to get up

Question 7

procedure for Beevor’s sign

Answer 7

Dr observes umbilicus while patient does an abdominal crunch first and then a leg lift second

Question 8

purpose of Beevor’s sign

Answer 8

Dr is looking to see if umbilicus deviates

Question 9

findings of Beevor’s sign

Answer 9

the umbilicus will deviate to the opposite direction if there’s abdominal weakness
ex: deviation superior and left means weakness inferior and right

Question 10

procedure for chest expansion test

Answer 10

Dr uses a tape measurer wrapped around the rib cage to measure movement during inspiration and expiration

Question 11

purpose of chest expansion test

Answer 11

Dr is looking for normal chest expansion which is 1.5-3 inches

Question 12

findings of chest expansion test

Answer 12

if there is expansion less than 1.25 inches then patient may have rib fracture, sprain/strain, AS

Question 13

procedure for Forestier bowstring sign

Answer 13

Dr observes ROM as patient stands up and laterally bends from side to side

Question 14

purpose of Forestier bowstring sign

Answer 14

Dr is looking for unequal ROM from side to side

Question 15

findings of Forestier bowstring sign

Answer 15

AS* (especially if they have bilateral SI joint pain), muscle spasm, stacking

Question 16

procedure of Rib motion test

Answer 16

Dr places hands below “breasts” while patient inhales and exhales, then Dr places hands above “breasts” while patient inhales and exhales

Question 17

purpose of Rib motion test

Answer 17

assessing motion of the ribs

Question 18

findings of Rib motion test

Answer 18

if a rib doesn’t move during expiration there is an elevated rib
if a rib doesn’t move during inspiration then there is a depressed rib
ribs not moving may indicate rib subluxation, muscle strain, fracture

Question 19

procedure for Schepelmann’s sign

Answer 19

patient is seated and raises both arms overhead then laterally bends to the left and right

Question 20

purpose of Schepelmann’s sign

Answer 20

positive sign is intercostal pain

Question 21

findings of Schepelmann’s sign

Answer 21

if there is pain on the concave side then there is neuralgia (compression of intercostal nerve)
if there is pain on the convex side then there is myalgia (stretching of a muscle or fascia)