Thoracic & Ribs Clinical Presentations pt.2

Question 1

disc disease is more common in what area

Answer 1

lower T-spine

Question 2

central herniation is more pressing on what

Answer 2

spinal cord

Question 3

posteriorlateral herniation is more pressing on what

Answer 3

spinal nerves

Question 4

symptoms of disc disease in thoracic spine

Answer 4

back or chest pain
radicular pain
progressive/insidious

Question 5

thoracic spine myelopathy

Answer 5

cord compression in the thoracic spine

Question 6

what signs will you see with thoracic myelopathy

Answer 6

sensory/motor impairments
babinski’s
ankle clonus
gait dysfxn
hyper-reflexive
saddle parathesis

Question 7

intercostal neuralgia

Answer 7

infection
mechanical compression
following thoracic Sx

Question 8

symptoms of intercostal neuralgia

Answer 8

burning pain/paresthesia along intercostal nerve path

Question 9

what is T4 syndrome

Answer 9

sympathetic reaction with hypomobile segment

Question 10

who does T4 syndrome primarily occur in

Answer 10

women

Question 11

what segments can T4 syndrome affect

Answer 11

T2-T7

Question 12

what are the primary pain generators of T4 syndrome

Answer 12

thoracic IV disks
thoracic zygapophyseal joints

Question 13

symptoms of T4 syndrome

Answer 13

glove like paresthesias uni/bilateral
neck/scap/bilateral UE pain
generalized HA

Question 14

what positions increase symptoms of T4 syndrome

Answer 14

side lying or supine
prolonged static positioning

Question 15

what 4 physical examinations will you see with T4 syndrome

Answer 15

tender spinous process
+ thoracic slump
+ ULTT
hypomobile thoracic segment

Question 16

what is scoliosis named by

Answer 16

by the convexity

Question 17

what are the symptoms for thoracic zygapophysial arthropathy

Answer 17

local and/or referred pain that goes to the same side

can also have chest pain

Question 18

what testing will be painful with zygapophysial arthropathy

Answer 18

spring testing/hypomobile with joint mob testing
movement that closes z-joints

Question 19

structural rib dysfunction

Answer 19

sublux of joint anterior or posterior

Question 20

torsional rib dysfxn

Answer 20

rib held in rotated position

Question 21

respiratory rib dysfxn

Answer 21

related to posture, may affect respiration

Question 22

what symptoms will be felt with rib dysfxn

Answer 22

aggravated with deep inspiration, trunk rotation, sneezing/coughing

Question 23

what will you see with rib dysfunction

Answer 23

diminished rib mobility
pain/hypomobile
limited/painful thoracic spine motion

Question 24

in thoracic outlet syndrome what 3 things can be compressed

Answer 24

subclavian artery (ATOS)
subclavian vein (VTOS)
brachial plexus (NTOS)

Question 25

what are the potential areas of compression with TOS

Answer 25

scalenes
cervical rib
pec minor
first rib
clavicle

Question 26

clinical presentation/hx for TOS

Answer 26

hx neck trauma
cervical rib present
raynauds phenomenon

Question 27

symptoms of TOS

Answer 27

UE pain, paresthesia, anesthesia, weakness
chest/anterior shoulder pain

Question 28

sudden or insidious onset for TOS

Answer 28

typically progressive/insidious onset

Question 29

what will you see in a pt with TOS

Answer 29

guarding surrounding musculature
pain w/ contra cervical lateral flexion
pain w/ stretching compressed muscles

Question 30

vascular TOS associated with what

Answer 30

edema
cyanosis
coldness of hands
diminshed pulse (strength)
difference of 20mmHg in BP - lower on involved side

Question 31

neurologic TOS associated with what

Answer 31

C8/T1 distribution LMN signs
atrophy of abductor pollicis brevis