Thoracic Spine

Question 1

Muscles that span between C spine to T spine

Answer 1

semispinalis capitis
splenius capitis
splenius cervicis

Question 2

muscles that span between thoracic and lumbar spine

Answer 2

multifidi
longissimus thoracis
iliocostalis lumborum
latissimus dorsi
fascia

Question 3

why is the thoracic spine almost always overlooked?

Answer 3

midback pain is usually less common and less severe than neck or low back pain

Question 4

what does injury do to joints?

Answer 4

pain alters mechanics
altered mechanics stress ill adapted tissues
structures cannot handle load
adaptive pattern begins

Question 5

what are the advantages to the thoracic spine being more stable?

Answer 5

they are less prone to aberrant motion and a degenerative cycle

Question 6

what could be tight or overactive if there is upper extremity movement dysfunction?

Answer 6

pec major/minor
anterior deltoid
subscapularis
latissimus dorsi
levator scapulae
upper trap
teres major
SCM scalenes rectus capitis

Question 7

what could be weak or underactive in UE movement dysfunction?

Answer 7

rhomboids
lower traps
posterior deltoid
teres minor
infraspinatus
serratus anterior
longus coli
longissimus capitis

Question 8

common joints involved in UE movment dysfunction

Answer 8

sternoclavicular joint
AC joint
thoracic and cervical facet joints

Question 9

possible injuries leading to UE movement dysfunction?

Answer 9

rotator cuff
shoulder instability
bicep tendonitis
TOS
headaches

Question 10

tight or overacitve muscles assoicated with LE movement dysfunction

Answer 10

tibularis
lateral gastrocnemius
soleus
IT band
lateral hamstring
adductor
psoas

Question 11

weak or underactive muscles associated with LE movement dysfunction

Answer 11

posterior tibialis
flexor digitorum longus
flexor hallucis longus
anterior tibialis
vastus medialis
pes anserine
gracilis
sartorius
semitendonosus
gluteus medius
hip external rotators
gluteus maximus
local lumbo-pelvic hip stabilizers

Question 12

common joints involved in LE movement dysfunction?

Answer 12

1st MTP joint
subtalar joint
talocrural joint
proximal tibio-fibular joint
SI joint
lumbar facet joints

Question 13

possible injuries associated with LE movement dysfunction

Answer 13

plantar fasciitis
posteiror tibia tendonitis
anterior knee pain
low back pain

Question 14

how do we assess the thoracic spine

Answer 14

breathing
posture assessment (kyphosis, upper cross)

Question 15

hyperkyphosis has negative effects on what?

Answer 15

scapular stability
cervical motion
respiration

Question 16

what does hyperkyphosis do to scapular stability?

Answer 16

results in scapular protraction

which leads to rounded shoulders with the scapula in a forward position

Question 17

scapular protraction leads to what?

Answer 17

shoulder pain
narrows joint space for movement
excss load on the ligaments in the shoulder
decreased shoulder strength

Question 18

paradoxical breathing

Answer 18

shoulders elevate

reliance on accessory muscles for inspiration

Question 19

diaphragm breathing

Answer 19

proper technique allows expansion of ribs laterally, greater space as opposed to elevation of ribs

Question 20

wall angel

Answer 20

stand against wall with arms abducted to 90 degrees, elbows bent at 90 degrees
try to flatten back
ask patient to nod-tuck the chin
do symptoms occur?

Question 21

when do they fail the wall angel?

Answer 21

if they can’t flatten the T-L junction
pain or tension felt
do symptoms occur when flattening back/tucking chin/passive over pressure into cervical flexion

Question 22

what is a wall slide?

Answer 22

exercise involving squatting down while raising arms

focuses mobility on thoracic spine

Question 23

what muscles can feel tight with a wall slide?

Answer 23

latissimus dorsi

pectoralis

Question 24

what do you do if you do feel tightness during a wall slide?

Answer 24

stretch or adjust prior to the exercise

Question 25

what does arm elevation screen for?

Answer 25

thoracic mobility

Question 26

when can there be decreased extension of the thoracic spine, what is tight?

Answer 26

latissimus dorsi

pec muscles

Question 27

what can you do in office?

Answer 27

active ROM
wall angel/wall slide/arm elevation
passive ROMS
assess P-A mobility
mobilize spine (genie, press P-A to gain extension)
adjust

Question 28

what are some other things you can do to increase thoracic extension?

Answer 28

use a foam roller and make sure the focus of extension is in the thoracic spine
cat/camel

Question 29

trunk stability push-up

Answer 29

hands in line with shoulders
thumbs in line with chin
perform push up, should elevate as a unit

Question 30

quadruped rollback

Answer 30

extension is noted during quadurped rollback

involvement of levator scapulae

Question 31

can you change posture?

Answer 31

it is difficult, but it is possible

need patient compliance

Question 32

brugger’s posture break

Answer 32

sit at edge of chair
turn feet out slightly
feet slightly wider than hip width
tuck chin slightly (retraction)
deep breath with abdomen
slowly exhale while rotating arms outward, spreading fingers wide, lifting sternum

Question 33

what are some common errors for good posture?

Answer 33

excessive lumbar extension
rib flare
upper throacic sinking
full scapula retraction