Thoracic spine Flashcards
Thoracic outlet syndrome
Group of disorders that occur when vessels or nerves are trapped within the thoracic outlet.
3 types:
- neurogenic (most common)
- venous
- Arterial (least common)
causes:
- physical trauma (car accident)
- sports trauma
- anatomical disorders (extra rib)
- pregnancy
- repetitive injuries from jobs
age group:
- adults 20-50
risk factors:
- females more common 3:1
clinical presentation:
- neck and shoulder pain and stiffness
- numbness in fingers
- weakening grip
prognosis:
- with treatment 90% are healed
Intercostal Neuralgia
Painful condition of intercostal nerves in distribution of affected intercostal nerves
causes:
- traumatic injury
- thoracic wall tissue and nerve damage from thoracotomy, and herpes zoster
CP:
- band-like wrapping along the chest and back or in a thoracic dermatomal pattern
prognosis:
- prognosis is variable
- some pt have resolution whereas others can develop chronic pain, can be significant source of morbidity
Tietze syndrome
Rare inflammatory disorder.
Inflammation of costochondral cartilage of the ribs, specifically where the ribs attach to the sternum (sternocostal)
causes:
- generally unknown
- might be from tiny traumas in chest wall
CP:
- severe chest pain, can develop suddenly or gradually
- tenderness on palpation of costochondral cartilages
- severe coughing
- chest pain gets worse with:
– physical activity
– moving
– deep breathing or coughing
– putting pressure on your chest (seatbelt etc)
TTT:
- anti-inflammatory drugs
Precordial Catch Syndrome
Non-serious condition causing stabbing pains in chest of children
causes:
- irritation of nerves in the lining of the lungs
age group:
- children and adolescents
CP:
- stabbing chest pain that lasts a few minutes at most.
- pain localised to under the left nipple and only under left nipple
prognosis:
- doesn’t lead to further health problems, can produce anxiety in child and parent
- most people outgrow by their 20’s
Herpez zoster (shingles)
Viral infection that causes a painful rash
Can occur anywhere on the body
causes:
- caused by varicella zoster virus, which causes chickenpox. Stays in system after chickenpox and if it reactivates it causes shingles
age group:
- older people 50+
risk factors:
- age- as you get older risk increases
- weakened immune system- HIV
- cancer treatments- weaken your immune system
CP:
- pain, burning or tingling
- sensitivity to touch
- red rash
- fluid-filled blisters
- itching
- may have fever or headache
prognosis:
- shingles lasts 2-4 weeks then should pass
Costovertebral Joint Syndrome
Atypical chest pain unrelated to cardiac or pleura-pulmonary cause.
Abnormal mobility and/or a posterior subluxation of the rib producing a functional disruption between the rib and its 2 vertebral joints: costovertebral and costotransvere articulations
causes:
- when the trunk and rib cage are rotated
- can overstretch the structures supporting the joint resulting in a costovertebral joint sprain
age group:
- 20-70
CP:
- pain
- swelling/inflammation
- stiffness
- decreased ROM
- made worse by deep breathing, coughing or rotation movements
prognosis:
- no long term health affects
- recovery usually takes place in a few weeks
Post herpetic neuralgia
pain in a dermatomal distribtion which persists for 3 months or more after either onset or healing of the shingles rash
causes:
- HZ virus causes inflammation of the nerves under the skin of the affected area
age group:
- people 80+ have a 50% risk
- 70-79
RF:
- increasing age
- diabetes mellitus, respiratory disease, autoimmune disease, and severe immunosuppression
CP:
- aching, burning, itching, lancinating or sharp pain, unilaterally and in a dermatomal distribution
prognosis:
- satisfactory release achieved in less than half of cases
Acute Pancreatitis
Sudden inflammation of pancreas gland
If the enzymes become active to early within the pancreas itself, this can damage the pancreas
causes:
- 2 main causes:
–gallstones
– drinking too much alcohol
- rarer causes:
– trauma
– genetics
– if pancreas gets blocked due to pancreas cancer
RF:
- genetics that lead to excessive fat
CP:
- Sudden onset of abdominal pain, usually starting in upper abdomen. Accompanied by vomiting
- whole body inflammation in early stages of the disease
Scoliosis
When there’s twists and curves within the spine
Can be idiopathic (no known cause)
causes:
- cerebral palsy and muscular atrophy
- birth defects
- injuries or infection to spine
- previous surgery
- spinal cord abnormalities
age group:
- signs and symptoms typically begin in adolescents
- more common in children
RF:
- age
- girls have a much higher chance of curve worsening
CP:
- uneven shoulders
- pain shouldn’t occur too much if any
- waist uneven
- one hip higher than the other
- prominent one side of the back when bending forward
Pyogenic infection
Infection that is usually staphylococcus aureus.
Travels to the spine via the bloodstream.
causes:
- bacterial, fungus or TB can cause pyogenic infection of the spine
CP:
- stiff and painful back
- ROM decreased
- pt might have fever and might not be well
Tuberculosis
Bacterial infection that travels to the spine via the bloodstream
Spread through tiny droplets
Causes:
- Tiny droplets inhaled from the air off someone else who has a TB
- can travel from a different area of the body
RF:
- being in a confined space with someone who has TB
CP:
- back pain
- fever
- tiredness and fatigue
- back can become kyphotic
- loss of appetite
prognosis:
- see a GP if it lasts 3 weeks or longer or you cough up blood
Adult generative Scoliosis
Side-to-side curvature caused by degeneration of the facet joints and intervertebral discs over time.
The degeneration and resulting spinal asymmetry can occur slowly over time as a person ages.
causes:
- degeneration, discs loose height and water so they flatten and collapse
AG:
- older population, degeneration starts at 20 but affects are usually seen as pt’s get older 40+
CP:
- dull back ache or stiffness
- shock-like back pain that can radiate down the buttock and into the leg (sciatica)
