Thoracic Spine Flashcards
True or False:
The incidence of patients with thoracic back pain is not as common as patients with neck or LBP
True
True or False:
Thoracic back pain can contribute to why someone with neck/LBP have long term symptoms
True
Can visceral organs have the chance to refer to other locations
Yes’m
Can the thoracic spine have nonmusculoskeletal pain
Sure thing
What are the sources of pain in the T-spine (9)
- Disc
- Ligaments
- Costosternal joint
- Costotransverse joint
- Costovertebral joint
- Intervertebral joints
- Muscles
- Nerves
- Myofascial tissue
What is the order of the subjective exam in the T-spine (5)
- Kind of disorder
- Area of symptoms
- Behavior of symptoms
- Present and past history
- Special questions
What is the most important part of the subjective exam
Behavior of symptoms
what are some special questions to ask (4)
- General health questions
- Meds
- Imaging
- Functional questionnaires
What are 2 functional questionnaires for the T-spine
- Roland Morris Disability Questionnaire
2. Functional Rating Index
What does pain changing during inspiration and expiration signifiy
Rib problem
What does pain affected by coughing, sneezing, or straining signify
Rib or disc
Pain through the front of the chest can be what
Disc
Can the T-spine affect nausea, not wanting to eat, and GI problems
You know it
How can the T-spine cause GI problems, not wanting to eat, or nausea
It is near sympathetic chain
If the symptoms are proximal to the inferior angle of the scapula what must you do
Cervical spine screen
What is the order of T-spine physical exam (9)
- Observations
- Cervical screen
- AROM
- Repeated movements
- PROM
- Passive accessory motion testing
- Muscle performance testing
- Special tests
- Palpation
What do you observe during the T-spine exam (4)
- Posture in sitting/standing
- Gait analysis
- Integument
- Structural asymmetries
What are the 2 structural asymmetries to look for in the T-spine
- Scoliosis
2. Lateral Shift
What is a lateral shift
They woke up with it one morning
What are the 5 directions of repeated movements for C-spine
- Protraction
- Retraction
- Retraction and extension
- Rotation
- Side bending
What is the norm for flexion of T-spine
80
What is the norm for extension of the T-spine
25
What is the norm for rotation of the T-spine
45
What is the norm for side bending of the T-spine
35
What does thoracolumbar motion mean
Thoracic and lumbar motion together
What are the 3 repeated movements for T-spine
- Flexion
- Extension
- Rotation
True or False:
You should always assess the patients baseline measures before and after testing
True
What plane of repeated movements do you start in for the T-spine
Sagittal plane
How do you assess PROM of the T-spine
Sitting
What are the PROM assessed in the T-spine (4)
- Flexion
- Extension
- Rotation
- Side bending
What does PIVM stand for
Passive intervertebral movement testing
What are the 5 passive accessory motion tests for the T-spine
- CVP
- UVP
- TVP
- PA over angle of rib
- AP over costosternal joints
What does resisted isometrics tells us
Reactivity of tissues
What does MMT tell us
Strength of tissues
Is TOS more chronic or acute than radiculopathy
Chronic
What does the slump test tell you
General mobility of nervous system
What are the 3 TOS special tests
- Roo’s test
- Adson’s test
- Allen manuever
What do the heel drop and percussion over spinous process look for
Fractures
How do you test for rib mobility (2)
- Rib springing
2. Cervical rotation lateral flexion test
True or False:
You should always look for thoracic pain above and below the level of pain
True
What are 4 systemic organs that can refer to the T-spine
- Cardiac
- Pulmonary
- Renal
- GI
Where can systemic organs refer to in the T-spine
- Mid thoracic spine to thoracolumbar spine
- Scapula
- Posterior costovertebral angle
- Lumbar spine
How long does it take for something to be considered a dysfunction
8 weeks
What does full PROM indicate about muscle
Organically weak
What non thrusts change ROM
3 and 4
What non thrusts change pain
1 and 2
What is directional preference
The direction that reduces symptoms or centralizes peripheral symptoms
What do you do for hypomobility of the T-spine (6)
- Patient education
- Thrust and non thrust manipulation
- Soft tissue mobz and stretching
- AROM/PROM into restricted movement
- Postural education
- Muscle performance testing
What do you do for hypermobility of the T-spine (5)
- Patient education
- Local modalities in acute/irritable conditions
- Motor learning/stabilization activities
- Strengthening
- Address postural muscle strength/endurance
True or False:
Hypermobility is very common in the T-spine
False
What do you do for pain/inflammation (5)
- Local modalities
- Patient education
- Grade 1 and 2 non thrust
- AROM/PROM in pain free range
- Progress toward mobility classification
True or False:
You can easily place people with inflammation in a classification
False
When should you do neuromobilization (2)
- Patient presenting with mechanical and neurological symptoms
- Patient presenting with positive neurodynamic testing
What are the ways to educate patients (5)
- Limitations concerning the stage of healing
- Learn how to manage symptoms independently
- Postural awareness
- Prevention of future episodes
- HEP
What does HEP mean
Home Exercise Plan
What should you educate the patient about for their HEP (4)
- What
- Why
- How often
- How long
What is the most important thing to do for patients
Make sure they believe and understand what is going on
True or False:
We should always encourage our patients
True
Motivation
You are almost done!!! DON’T QUIT NOW!!!! Want it as bad as you want to breath!!!!!!
