Thoracic/Rib Conditions Flashcards

1
Q

thoracic outlet syndrome

A

neurovascular compression syndromes can involve either neural or vascular elements that supply the upper extremity

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2
Q

neurologic TOS

A

brachial plexus compression

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3
Q

vascular TOS

A

subclavian artery/vein compression or thrombosis

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4
Q

nonspecific TOS

A

patient has symptoms but no abnormal nerve conduction or angiography tests

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5
Q

clinical presentation of TOS

A

diffuse arm pain/numbness/tingling often into the 4th and 5th digit that is worse with overhead activity; neck or shoulder pain, thenar atrophy, diminished grip strength, hand/arm swelling. cold distal extremity, pallor or discoloration of the hand

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6
Q

Subscapular Crepitus

Snapping Scapula

Scapulothoracic Bursitis

A

local pain at the superior medial angle of the scapula, audible or palpatory crepitus, patient reports feeling a catch in the upper back, restricted scapular motion

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7
Q

clinical presentation of thoracocostal facet sprain

A

difficulty breathing, feels as if a rib is out of place, shallow breathing due to pain, local sharp pain over the joint

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8
Q

clinical presentation of costochondritis

A

moderate to severe sharp/shooting anterior chest wall pain, insidious onset, pain usually unilateral, localized but can radiate to chest, upper abdomen, or back; pain worse with coughing, sneezing, or deep inspiration, decreased with rest or ice

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9
Q

clinical presentation of costocartilaginous injury tietze syndrome

A

insidious, over-use, coughing; typically benign, self-limiting, non-suppurative in swelling of the chest wall, onset may be sudden or gradual; pain resolves in days to weeks but swelling may be present for months to years; pain with taking deep breaths, coughing, or difficulty breathing

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10
Q

clinical presentation of scoliosis

A

progressive: adolescent, idiopathic

acute: tumor, fracture, disc disease

loss of balance, falls, asymmetric stress on lower limbs, low body image

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11
Q

functional scoliosis

A

compensatory, postural, can usually be corrected with stretching, joint mobilization, strengthening, and postural training

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12
Q

structural scoliosis

A

idiopathic, congenital, mesenchymal disorder, trauma, vertebral neoplasm, metabolic

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13
Q

clinical presentation of postural syndrome

A

gradual onset of dull and achy upper back pain secondary to poor postural habits or prior neck/upper back injuries; better w stretching, LAD, worse w prolonged sitting or standing, difficulty sleeping, headaches, carpal tunnel, or TOS syndromes

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13
Q

thoracic radiculopathy

A

symptoms follow a dermatomal distribution and can cause pain and numbness that wraps around the front of your body; sharp pain in back that may worsen with coughing or sneezing

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13
Q

clinical presentation of thoracic myelopathy

A

difficulty walking, loss of urinary or bowl control, issues with balance and coordination, increased reflexes in the extremities or development of abnormal reflexes

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13
Q

clinical presentation of intercostal neuralgia

A

burning, sharp, or shooting pain; squeezing pressure sensation that wraps around the chest causing tingling or numbness; pain worse with physical activity, breathing, stretching, laughing, coughing, and sneezing; referred pain to shoulder blade or lower pelvis

13
Q

clinical presentation of rib fracture

A

pain with inspiration and dyspnea, reported after coughing spells, athletes with high force

14
Q

radiculopathy

A

condition involving nerve root

15
Q

myelopathy

A

condition involving spinal cord

16
Q

non-accidental rib fractures

A

osteoporosis in elderly; in pediatric patients, take appropriate clinical history

17
Q

where is most common location for Tietze syndrome?

A

2nd, 3rd, and 4th costosternal articulations

18
Q

possible surgery for TOS

A

1st rib removed

19
Q

if patient breaks out in rash

A

intercostal neuralgia: viral infection (shingles)

20
Q

if patient does NOT break out in rash

A

intercostal neuralgia: nerve entrapment

21
Q

how long should a patient wear a brace for scoliosis?

A

23 hours/day

22
Q

causes of rib fractures

A

athletes with high force, recurrent movements of the arms, after coughing spells

23
Q

risk factors for progression of scoliosis

A

presentation before menarche, incomplete skeletal maturity, thoracic major curve or double major curve, maternal age >30

24
Q

who is at highest risk for scoliosis?

A

adolescents; more common in females

25
Q

structures involved with TOS

A

pectoralis, anterior and middle scalene, 1st rib