thoracic spine Flashcards
what are considered true ribs and why?
1-7, because they attach directly to the sternum
what are considered typical ribs and why?
3-9, because they have two facets for attachment on the corresponding vertebral bodies
does the anterior or posterior rami supply the innervation for the majority of the thoracic PVM?
posterior
why is T4-T9 known as the critical zone?
the spinal canal is small in diameter and has reduced blood supply
during thoracic flexion which way do the ribs rotate?
anterior rotation
during thoracic extension which way do the ribs rotate?
posterior
is rotation greatest in the upper or lower thoracic spine?
upper
what is significant about T6 with neurodynamics?
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
what are the symptoms of T4 syndrome?
headaches, neck pain, upper extremity pain, bilateral stocking glove paresthesia
what usually causes a flexion impairment in the thoracic spine?
rear ended accident, spine gets jammed into extension, stays there
what are visceral causes of thoracic pain?
MI, dissected thoracic aortic aneurysm, peptic ulcer, acute cholecystitis, acute pyelonephritis
what is the CPR for coronary artery disease? (5 things)
age (Male >55, female >65), known vascular disease, pain worse during exercise, pain not reproduced with palpation, patient assumes it is of cardiac origin
what is a hallmark sign of peptic ulcer?
pain either triggered or relieved by eating
what test can you use for cholecystitis and how is it performed?
murphys, put pressure over R subcostal region and ask patient to take big breath, test is positive if painful
what should alert you to ankylosing spondylitis?
chest wall expansion below 2.5 cm
what is normal chest wall expansion? what is it in ankylosing spondylitis?
5cm is normal, 2.5cm in ankylosin spondylitis
do men or women most often get AS?
men
what is the age range for AS?
15 to 40 y/o
what occurs during kyphoplasty?
balloon is put in fx vertebra
what occurs during vertebroplasty?
fx vertebra has cement injected into it
what is the cobb angle?
difference in angle at T1 versus T12 for kyphosis
at what point is the Kobb angle considered to be hyperkyphosis?
> 50 degrees.
what is the 4 item cluster for cervical radiculopathy?
pos median nerve test, pos distraction test, rotation less than 60 degrees, pos spurlings test
what does the CRLF test for?
elevated first rib
which side is being tested during the CRLF test?
the side opposite the rotation (rotate left, testing the right)
what is a contraindication for manipulation in the T-spine?
osteoporosis
