Thoracic Spine Flashcards
Where does T-spine sit?
T1 to T12
What is connected to T-spine?
rib cage
Superior facet
convex and posteriorly oriented
Inferior facet
concave and face anteriorly
Origins of facets in T-spine?
sagittal plane
T1-T3
same level
T4-6
half a level below
T7-9
one level below
T10
one level below
T11
Half a level below
T12
same level
Upper Thoracic spine
Upper T1-2 (acts of lower C-spine)
Mid thoracic spine
T3-9
fully functional spine
Lower thoracic spine
T10-12
acts as lumbar
Inferior angle of scapula
T7
What are last 2 ribs?
false ribs
What do ribs articulate with?
Vertebral body
Transverse process
sternum
How do ribs rotate with flexion?
anteriorly and glide superiorly
How do ribs rotate with extension?
posteriorly and glide inferiorly
Ribs compress with:
ipsilateral side with side bending
What discs have been found to have the most disease?
T6-T7
Thoracic outlet syndrome
Often have impairments of the scalene, first rib and pec minor due to their location of the subclavian artery
Thoracic flexion
20-45 degrees
Thoracic extension
20-45 degrees
Thoracic rotation
35-50
Thoracic lateral bending
20-40
How many degrees of thoracic extension is needed for arm elevation?
15 degrees
Kyphotic-Lordotic Posture
Forward Head Cervical spine is hyper-extended Scapulae abducted Thoracic kyphosis Lumbar spine lordotic/extension Hips are flexed
Flat Back Posture
Thoracic spine is flat
Upper thoracic spine is flexed
Upper cervical spine is extended
Lumbar spine is flexed
Sway Back Posture
Thoracic spine is in kyphosis/flexed position
Lumbar spine is flat or flexed
Pelvis posterior tilt
Hips are extended
Risk Factors for developing Thoracic Spine Pain
Concurrent musculoskeletal pain Growth/physical Lifestyle Backpack Postural problems Psychological Environmental factors
Pneumothroax
Collapsed lunge – air leaks into the space between lung and chest wall
Recent bout of coughing or strenuous exercise
Decreased breath sounds
Hyper –resonance on percussion
Decreased breath sounds
Cholecystitis
Inflammation of the gall bladder
T7-T9 region of the body
Right sided abdominal and interscapular pain
Most common in middle aged women & women after pregnancy
Symptoms worse w/ fatty foods
Peptic Ulcer
Sores that develop in the inside of the stomach and esophagus or small intestine
Burning, knowing
Symptoms usually relieved when eating food
Compression Fracture or Spinal Fracture
More common in those with osteoporosis
Age > 70 years of age
Long term corticosteroid use
History of trauma
Where is most common spinal fracture or compression?
T11-L1
Clinical Prediction rule for spinal fracture?
Female
> 70 years old
Trauma (minor for elderly and major for younger person)
Prolonged use of corticosteroids
Where is the emphasis of movement in T-spine?
frontal plane
Spine of scapular
T3/4
Thoracic pain or dysfunction may arise from
Thoracic spine structures Cervical spine structures Thorax/Rib Cage Gastrointestinal system/organs Cardiopulmonary System Renal System
Wells Criteria for PE
- Signs and symptoms of DVT (pain with palpation & swelling)
- PE more likely than other diagnosis
- Pulse greater than 100
- Previous hx of DVT or PE
- Immobilization or surgery in last 4 weeks
- Blood in urine
- Hx of cancer in last 6 months
