thoracic spine

Question 1

what are considered true ribs and why?

Answer 1

1-7, because they attach directly to the sternum

Question 2

what are considered typical ribs and why?

Answer 2

3-9, because they have two facets for attachment on the corresponding vertebral bodies

Question 3

does the anterior or posterior rami supply the innervation for the majority of the thoracic PVM?

Answer 3

posterior

Question 4

why is T4-T9 known as the critical zone?

Answer 4

the spinal canal is small in diameter and has reduced blood supply

Question 5

during thoracic flexion which way do the ribs rotate?

Answer 5

anterior rotation

Question 6

during thoracic extension which way do the ribs rotate?

Answer 6

posterior

Question 7

is rotation greatest in the upper or lower thoracic spine?

Answer 7

upper

Question 8

what is significant about T6 with neurodynamics?

Answer 8

it is the tension point that when in cervical and thoracic flexion the upper part of the spinal cord moves towards the head and the lower part toward the lumbar region, the break point for that is T6

Question 9

what are the symptoms of T4 syndrome?

Answer 9

headaches, neck pain, upper extremity pain, bilateral stocking glove paresthesia

Question 10

what usually causes a flexion impairment in the thoracic spine?

Answer 10

rear ended accident, spine gets jammed into extension, stays there

Question 11

what are visceral causes of thoracic pain?

Answer 11

MI, dissected thoracic aortic aneurysm, peptic ulcer, acute cholecystitis, acute pyelonephritis

Question 12

what is the CPR for coronary artery disease? (5 things)

Answer 12

age (Male >55, female >65), known vascular disease, pain worse during exercise, pain not reproduced with palpation, patient assumes it is of cardiac origin

Question 13

what is a hallmark sign of peptic ulcer?

Answer 13

pain either triggered or relieved by eating

Question 14

what test can you use for cholecystitis and how is it performed?

Answer 14

murphys, put pressure over R subcostal region and ask patient to take big breath, test is positive if painful

Question 15

what should alert you to ankylosing spondylitis?

Answer 15

chest wall expansion below 2.5 cm

Question 16

what is normal chest wall expansion? what is it in ankylosing spondylitis?

Answer 16

5cm is normal, 2.5cm in ankylosin spondylitis

Question 17

do men or women most often get AS?

Answer 17

men

Question 18

what is the age range for AS?

Answer 18

15 to 40 y/o

Question 19

what occurs during kyphoplasty?

Answer 19

balloon is put in fx vertebra

Question 20

what occurs during vertebroplasty?

Answer 20

fx vertebra has cement injected into it

Question 21

what is the cobb angle?

Answer 21

difference in angle at T1 versus T12 for kyphosis

Question 22

at what point is the Kobb angle considered to be hyperkyphosis?

Answer 22

> 50 degrees.

Question 23

what is the 4 item cluster for cervical radiculopathy?

Answer 23

pos median nerve test, pos distraction test, rotation less than 60 degrees, pos spurlings test

Question 24

what does the CRLF test for?

Answer 24

elevated first rib

Question 25

which side is being tested during the CRLF test?

Answer 25

the side opposite the rotation (rotate left, testing the right)

Question 26

what is a contraindication for manipulation in the T-spine?

Answer 26

osteoporosis