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CATA 437 > thoracic spine > Flashcards

thoracic spine Flashcards

1
Q

T/S compression fx % and TP %

A

compression: 52%
TP fracture: 37%

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2
Q

T/S is important for what with scapula

A

scapular mvt

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3
Q

can be complex areas to assess why

A

both musculoskeletal injuries but also referred pain from viscera

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4
Q

Pain referred from visceral areas is usually what

A

Pain referred from visceral areas (lungs, heart and intestines) is usually poorly localized and vaguely delineated and is referred to as a segmental or multi segmental distribution

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5
Q

pain from lesion to MSK structure is brought on by what and why can influence visceral pain

A

Pain from lesions to MSK structures is brought on by posture and movement
However a cough, deep breath, PA or posture may influence visceral pain…

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6
Q

Subjective History Thoracic Spine

A
  • red flag from systemic problem
  • age/occupation: scheurmann’s (13-16) and idiopathic scoliosis ado female
  • boundaries of pain/pain presentation
  • pain with breathing
  • pain deep, superficial, shooting, burning, aching
  • coughing, sneezing straining
  • pain into leg, arm,head neck,
  • digestive problem
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7
Q

origin of ANS found where

A

between T1 and L2

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8
Q

ANS is responsible for

A

innervation of smooth muscle, cardiac muscle, glands, and blood vessels

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9
Q

Sympathetic and parasympathetic systems – have _ effect

A

opposite

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10
Q

SNS increase with what

A

Fight or Flight
Increase in stress, danger, physical activity, pain

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11
Q

SNS involve what activities

A

Involves E activities
Exercise, Excitement, Emergency, and Embarrassment

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12
Q

SNS reduce what

A

non essential activities
-> urinary and GI tract

Blood flow to organ is reduced, muscle is increased

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13
Q

T1-T5 innervate what

A

heart lung

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14
Q

T5-L2 innervate what

A

innervates stomach, intestines (up to distal ½ of large intestines), spleen and liver, pancreas

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15
Q

T10-L2 innervate what

A

distal half of large intestine, reproductive organs, urinary bladder, kidney

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16
Q

role of PNS

A

Stimulates activity to conserve and restore body resources
Concerned with keeping body energy use low

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17
Q

PNS is most active when

A

Most active in non stressful situations

SLUDD- salivation, lacrimation (tears), urination, digestion, defecation

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18
Q

what happen physiological after a meal and which system is actif

A

PNS
HR and BP and respiratory rates are low
GI tract activity high
Warm skin, pupils constricted

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19
Q

what is chest binding

A

Technique used to compress breast tissue in order to create a flatter appearance of the chest

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20
Q

in one Australian study _% of respondents had used binding

A

87

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21
Q

used of chest binding

A

For many transmasculine people, chest binding is considered a necessary rather than elective daily activity due to associated mental and emotional health
For some, it may be used as an interim measure before surgery can be obtained

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22
Q

concern with the use of binder

A

Rib fractures, back pain, chest pain, rib or spine changes, bad posture, shoulder pain, shoulder joint ‘popping’, muscle wasting, numbness, headache, overheating, fatigue, weakness, lightheadedness or dizziness, cough, respiratory infections, shortness of breath, heartburn, abdominal pain, digestive issues, breast changes, breast tenderness, scarring, swelling, acne, itch, skin changes, and skin infections

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23
Q

% of negative outcome from binder reported

A

97% of people reported at least 1 negative outcome (53% backpain, 53% overheating, 48.8% chest pain, 40% bad posture, 38.9% shoulder pain, 46.% SOB)

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24
Q

Common Thoracic Spine Pathologies

A

Scoliosis
Kyphosis
Scheurmann’s disease
Thoracic outlet syndrome
Rib fracture
Muscle strains- intercostals, scapular muscles, abdominals
Costochondral and chrondrosternal joint sprain
Manubriosternal and sternoclavicular joint sprain
Intervertebral facet joint sprain
Costovertebral and costotransverse joint sprain

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25
Q

spinous process position

A

Positioned obliquely downwards

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26
Q

explain the rule of 3

A

T1-T3:
TP at level of SP-same vertebrae
T4-T6:
TP ½ vertebral body above SP
T7-T9
TP at level of SP of vertebrae above
T10 Rules of T7-9
T11 Rules of T4-6
T12 Rules of T1-3

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27
Q

tubercle and head of ribs articulate with

A

with the vertebral and transverse costal facets on the thoracic vertebrae

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28
Q

posterior aspect of ribs articulate with

A

with the sternum via with the costocartilage

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29
Q

true ribs:
false ribs:
floating ribs:

A

true: 1-7
false: 8-10
floating ribs: T11-T12

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30
Q

which ribs is difficult to palpate

A

rib 1 , small broad and flat

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31
Q

rib one align with and which muscle primary attach to it

A

apex of right lunges, anterior scalene

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32
Q

costotransverse and Costovertebral joint refere pain where

A

along the ribs

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33
Q

which ligament attach to sternoclavicular and sternocostal joint

A

radiate ligament
interchondral ligament

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34
Q

what is the role of pump handle movement

A

elevation of ribs, increase in anterior-posterior diameter of thoracic cavity

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35
Q

role of bucket handle movement

A

elevation of rib, increase in lateral diameter of thoracic cavity

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36
Q

ribs that primarily do bucket handle movement

ribs that primarily do pump handle movement

A

bucket: false ribs 8-10
pump: true ribs: 1-7
combination of both ribs: 11-12

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37
Q

ribs movement with rotation to the right

A

Look at posterior aspect of ribs for direction of movement
Right ribs= external rotation
Left ribs= internal rotation

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38
Q

what are the respiratory muscle

A

diaphgram, serratus posterior/inf/sup, external intercostal, internal intercostal

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39
Q

muscle involve primary in force expiration

A

internal intercostal
diaphgram

40
Q

muscle involve in inspiration

A

external intercostal
diaphgram

41
Q

role of serratus post inf in respiration

A

aids in respiration and lower the ribs

42
Q

role of serratus post super in respiration

A

elevated the ribs

43
Q

action of thoracic diagram during inspiration and expiration

A

During inspiration lowers and flattens

During expiration it relaxes and ascends

44
Q

what is attach to diaphgram

A

Pleural tissue and pericardium are attached to the diaphragm

45
Q

which nerve run between pericardial sac and diaphgram

A

phrenic nerve

46
Q

fascial connection of diaphgram connected with

A

psoas major and QL

47
Q

Esophagus pierces diaphragm at

A

T10

48
Q

if you have a problem at T10 which disease could you also have

A

Gastroesophageal reflex disease

49
Q

if you have T8 compression what could be affected

A

Inferior Vena Cava
T8, compression will affect drainage
2/3 blood exits lower body via inferior vena cava
1/3 exits lymphatic system

50
Q

thoracolumbar fascia attached where and merges with

A

Attaches medially to thoracic and lumbar spine and laterally to costal angles, 12th rib

Merges with lats, glute med, glute max, T.A and int/ext obliques

51
Q

muscle strain of thoracic spine commonly occurs with

A

with coughing, twisting/rotation activities and heavy lifting
Acute with high energy mechanism or chronic overuse high rep mechanisms

52
Q

muscle strain of thoracic spine will display pain where

A

along the muscle with palpation, possible pain with deep breaths, movement of the spine that stretches or contracts the affected muscles

53
Q

rib stress fracture are common with which type of athlete

A

rower from continuous repetitive movement

54
Q

which part of ribs is commonly affect

A

Posterior ribs most commonly affects due to the pull of SA
Occurs most frequently after time off when endurance is not optimal

55
Q

which level of T/S is most susceptible to stress fracture

A

Level of T4-T7 is most susceptible to stress fractures and strains Rhomboids, lats, ES

56
Q

which dynamic is affected with rib fracture

A

T/S, rib cage and shoulder

57
Q

Incidence of symptomatic disc herniation is low/high

A

low

57
Q

disc herniation in T/S is more common in what age and which gender is more affected

A

40s-50s and male

58
Q

75% of T-spine herniation reported to be where

A

below T8

59
Q
A
60
Q

Disc herniation in T/S is associated with which type of pain

A

axial pain (localized to middle or low thoracic region near level of injury), radiculopathy

61
Q

scoliosis follow which law

A

1 -> SB and rotation are opposite

62
Q

non-structural scoliosis only have SB or rotation element

A

only SB

63
Q

how a scoliosis is named

A

Named for the point of the apex of the curve and the side of the convexity
ex: L T7 scoliosis

64
Q

explain the convex side of rib with scoliosis

A

ribs pushed posteriorly, angle gets sharper and overall volume is decreased

65
Q

explain the concave side of ribs with scoliosis

A

Concave side – ribs pushed anteriorly, widens the angle

66
Q

spinous process deviated toward which side with scoliosis

A

concave side,

67
Q

what is costochondritis

A

Inflammation of the cartilage that connects rib to sternum

worse with coughing and deep breathing

sharp, achy or pressure like pain

improve on its own

68
Q

TOS is more common in M or W

A

W

69
Q

common MOI of TOS

A

Common MOI
Repetitive OH movement
Faulty posture
Improper breathing
Traumatic=whiplash/falls

70
Q

common entrapment sites of TOS

A

between scalene’s (ant/mid), 1st rib and clavicle, pec minor…

71
Q

what is ATOS and history finding

A

arterial TOS
claudication/rest pain of upper limb, excluding shoulder/neck, numbness, coolness,palor

72
Q

which test is positive with ATOs

A

EAST, ULTT, adsons test

73
Q

VTOS history finding and which test is positif

A

deep pain on movement or rest pain in upper limb, chest, shoulder
swelling and cyanotic discolouration

+Ve: EAST, ULTT, adson

74
Q

NTOS history

A

pain in neck, trapezius, shoulder, arm, chest, occipital headache
variable pattern upper limb weakness, numbness, paraesthesias

75
Q

which muscle is tender on palpation with NTOS

A

scalene triangle, subcoracoid space

76
Q

s/s with upper plexus NTOS (C5-C7)

A

sensory disturbance of arm, weakness/atrophy of deltoid, bicep and brachialis

77
Q

s/s with lower plexus NTOS (C8-T1)

A

sensory disturbance ulnar forearm and hand, weakness/atrophy of small muscle of hand, weak wrist and finger flexion

78
Q

normal kyphosis and what is considered abnormal

A

20-40 degree
abdnormal: 40-45 +

79
Q

scheuermann kyphosis occurs at what age and what is it

A

Can occur in young age (13-16)
Vertebrae grow at different rates during child’s growth spurt

80
Q

symptom of scheuermann kyphosis

A

Pain to follow after periods of exertion or long periods of inactivity

81
Q

what is dowager hump

A

increased kyphosis, from stress fracture of postmenopausal osteoporosis

82
Q

what is chest breathing

A

Whole body moves up
Tension through the neck musculature
Use of SCM, scalene, UFT to assist in inhalation
Abdomen moves up and in
Rib flare

82
Q

proper breathing mechanic

A
  • inhale through the nose
  • expansion of the abdomen- 360º (like a balloon)
  • slight anterior tilt of pelvis with inhalation
    -pump and bucket handle movement of the chest
  • no shoulder movement toward the ears
  • relaxation of neck musculature
83
Q

what is collapsed breathing

A

Whole body moves down
Shoulder’s hunched
Compression to the heart, lungs and organs
Chest and rib cage compress inferior
Belly projected forward and down like dead weight
Common in obese individuals and individuals suffering from depression

84
Q

what is frozen breathing

A

Entire outer layer of body contracts to constrict and suppress the rising movements of breath

Breath holding and tension

Stressful situations and cold environment

85
Q

what is reverse breathing

A

Abdomen contracts in on inspiration and out on expiration

Confusing to the body
Affects muscle movement and coordination patterns

86
Q

non emergency signs of dysfunctional breathing

A

Cranial movement of rib cage

Inward movement of abdomen

Movement of spine (flexion/ext)

87
Q

Signs of improper activation of core-stabilization during movements

A
  1. Elevation of the chest - brings the diaphragm away from ideal position for maximal activation
  2. Breath holding when performing tasks
  3. The inability to maintain the intra-abdominal pressure during the normal respiratory cycle
  4. Imbalanced abdominal activity with excessive contraction of the rectus abdominis, and lack of activity of the lateral and posterior parts of the abdominal wall
  5. Belly breathing pattern where only the front of the abdomen expands
  6. Concavities at the lower lateral abdomen
88
Q

what can compromised breathing

A

Position of chest and pelvis affect synchronization of diaphragm and pelvic floor

Elevated chest impairs the contraction of costal part of diaphragm

89
Q

how should chest and pelvis be during breathing

A

parallel

90
Q

finding with anterior subluxation of ribs

A

rib angle = less prominent and tender
anterior rib= more prominent
motion: restriction in inhalation and exhalation

91
Q

finding with posterior subluxation of rib

A

rib angle = more prominent and tender
anterior rib: less prominent
motion: restriction in inhalation and exhalation

92
Q

finding with sup first rib subluxation

A

rib angle: Superior aspect of first rib elevated (5mm) anterior to UFT

ant rib: Marked tenderness of superior aspect

motion: Restriction primarily in exhalation
(scalene hypertonicity)

93
Q

ant-post rib compression finding

A

shaft: Less prominent ant and post convexities
mid-axillary lines: More prominent
discomfort: Tenderness and tension of intercostal space above and below
motion: Restriction of respiratory activity

94
Q

lateral rib compression finding

A

rib shaft: More prominent ant and post
mid-axillary lines: Less prominent
discomfort: Tenderness and tension of intercostal space above and below
motion: Restriction of respiratory activity

CATA 437 (12 decks)

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