Thoracic & Ribs Clinical Presentations pt.2 Flashcards
disc disease is more common in what area
lower T-spine
central herniation is more pressing on what
spinal cord
posteriorlateral herniation is more pressing on what
spinal nerves
symptoms of disc disease in thoracic spine
back or chest pain
radicular pain
progressive/insidious
thoracic spine myelopathy
cord compression in the thoracic spine
what signs will you see with thoracic myelopathy
sensory/motor impairments
babinski’s
ankle clonus
gait dysfxn
hyper-reflexive
saddle parathesis
intercostal neuralgia
infection
mechanical compression
following thoracic Sx
symptoms of intercostal neuralgia
burning pain/paresthesia along intercostal nerve path
what is T4 syndrome
sympathetic reaction with hypomobile segment
who does T4 syndrome primarily occur in
women
what segments can T4 syndrome affect
T2-T7
what are the primary pain generators of T4 syndrome
thoracic IV disks
thoracic zygapophyseal joints
symptoms of T4 syndrome
glove like paresthesias uni/bilateral
neck/scap/bilateral UE pain
generalized HA
what positions increase symptoms of T4 syndrome
side lying or supine
prolonged static positioning
what 4 physical examinations will you see with T4 syndrome
tender spinous process
+ thoracic slump
+ ULTT
hypomobile thoracic segment
what is scoliosis named by
by the convexity
what are the symptoms for thoracic zygapophysial arthropathy
local and/or referred pain that goes to the same side
can also have chest pain
what testing will be painful with zygapophysial arthropathy
spring testing/hypomobile with joint mob testing
movement that closes z-joints
structural rib dysfunction
sublux of joint anterior or posterior
torsional rib dysfxn
rib held in rotated position
respiratory rib dysfxn
related to posture, may affect respiration
what symptoms will be felt with rib dysfxn
aggravated with deep inspiration, trunk rotation, sneezing/coughing
what will you see with rib dysfunction
diminished rib mobility
pain/hypomobile
limited/painful thoracic spine motion
in thoracic outlet syndrome what 3 things can be compressed
subclavian artery (ATOS)
subclavian vein (VTOS)
brachial plexus (NTOS)
what are the potential areas of compression with TOS
scalenes
cervical rib
pec minor
first rib
clavicle
clinical presentation/hx for TOS
hx neck trauma
cervical rib present
raynauds phenomenon
symptoms of TOS
UE pain, paresthesia, anesthesia, weakness
chest/anterior shoulder pain
sudden or insidious onset for TOS
typically progressive/insidious onset
what will you see in a pt with TOS
guarding surrounding musculature
pain w/ contra cervical lateral flexion
pain w/ stretching compressed muscles
vascular TOS associated with what
edema
cyanosis
coldness of hands
diminshed pulse (strength)
difference of 20mmHg in BP - lower on involved side
neurologic TOS associated with what
C8/T1 distribution LMN signs
atrophy of abductor pollicis brevis
