Thoracic Spine Flashcards
whats the critical zone in the T spine?
T4-T9, spinal canal most narrow, disc herniation or injury here could lead to central cord compression
whats the tension point
? (positive slump)
T6
why can u have sympathetic probs when the disc is injured?
bc the sympathetic chain innervates the discs
orientation of Z joints?
cervical= 45 degree angle with horizontal
thoracic= 60 deg.
lumbar= 90 degrees
T spine: upper Tspine (mimics C spine) 45-60 degrees from horizon, middle: 70-90 degrees from horizon, lower T spine (mimics L spine) 20 degrees from frontal plane
coupled SB and rot. in T spine?
upper T spine= ipsilateral
lower T spine= contralat.
what diagnosis presents w/ band like pain along the ribs
thoracic DDD
in adam’s sign, which side is convex?
the side with the rib hump
tx for TOS
first rib mobs, scalene stretches, pec stretch,, soft tissue, strengthen mid and lower traps
patient profile: dec. thoracic kyphosis, hx of MVA and whiplash, stiff CTJ and mid thoracic spine, limited flexion?
flattened upper T spine
patient profile: older person, limited arm elevation, loss of elastic end feel, stiff glides, hx of bad posture
generalized upper/mid thoracic stiffness
patient profile: hat and glove N/T distribution, vague pressure headache, pain between scapulae. Agg: pulling/pushing, taking deep breaths.
T4 syndrome
why does T4 syndrome occur?
symp. reaction to hypomobile joint from T2-T6, also from trauma or bad posture
patient profile: pain with breathing, trunk rot, unilat. PA over CTJ, stiff rib mobs
costal joint derangement
patient profile: traps spasming, neck pain, headaches, shoulder pain, radiculopathy, jaw pain, mid-back and chest pain, sternal pain, TOS syps
elevated first rib
first rib test
stab. first rib rot. head to contralat. side, SB to ipsilateral side
patient profile: pain with breathing, local pain, c/s hurts, local mm spasms, palpate a prominence anteriorly or concavity posteriorly at rib junction
rib subluxation
patient profile: had a forceful rotation injury, now has pain shooting around/through chest wall. Agg: with ANY movements, breathing, c/s all painful
thoracic disc lesion
test for thor. disc lesion?
beaver’s sign (belly button pulls to one side when do a crunch- one of ur ab mm isn’t working right)
patient profile: swelling of cost. cartilage, local and superficial ant. chest pain. that is worse with breathing and trunk movement, hx of flu or other virus.
Tietze’s syndrome
what is a systemic, rheumatic disease that starts in the SIJ and migrates up the spine. causes progressive stiffness, fusion of joints, pain and limited spinal mobility, happens in young boys mostly
anklyosing spondylitis
what does fist vertebrae indicate?
osteopenia
two spine pathologies that affect young ppl and cause kyphoscoliosis and premature disc degeneration
scheuermann’s disease- wedging discs
schmoral’s nodes- herniation of disc material into vert. end plates
u want to mobilize ribs _______ to the joint line… which is what direction?
perpendicular, anteriolaterally
want ___________ bone of the mobilizing hand on the rib
pisiform
