Thoracic Spine and Ribs Review Flashcards
What structures are included in the Thorax?
Thoracic Spine
Sternum
Ribs (7 true, 5 False, 2 Floating)
122 Joints
What is included in ONE spinal level?
Intervertebral Joint
2 Facet Joints
2 Costotransverse Joints
4 Costovertebral Joints
*Most vertebra articulate with 2 ribs on each side
Where there is a joint, there is the possibility of ________________?
Movement Dysfunction
Main muscles of the erector spinae group
Spinalis
Longissimus
Iliocostalis
What are the two posterior deep muscles of the neck for extension, Lateral flexion and rotation?
Splenius Capitus
Splenius Cervicis
What muscles elevate and retract the scapula?
Rhomboid Major and Minor
(Dorsalscapular N)
How many planes of motion does the T Spine have?
All 3 planes of motion
What are the normal ranges of motion in the T-spine?
Flexion/Extension= 20-45
Sidebending= 20-45
Rotation= 35-50
What is the movement of “pump handle”
Superior and Anterior movement of the sternum
What is the movement of “Bucket Handle”
Elevation of later shaft of the rib
Primary Inspiratory muscles
Diaphragm and External Intercostal muscles
What are the accessory inspiratory muscles?
SCM
Scalenes
Pec Minor
Serratus Anterior
What are the Accessory Expiratory muscles?
Internal Intercostals
Transversus Thoracis
External Oblique
Rectus Abdominus
Internal Oblique
What happens during “Quiet Breathing”
expiration occurs due to recoil of lungs and rib cage
What is structural scoliosis?
Affects primarily infants/Children/teens
and is thought to be from disease, heredity, or idiopathic
What is functional scoliosis?
smaller rotational component and does not have structural change
Usually results from Muscle spasms, leg length discrepancy, poor posture habits, or pain
Responds to conservative treatment
What shape can scoliosis curves look like?
C or S shaped
Thoracic Curves
Lumbar Curves
Thoracolumbar Curves
How is scoliosis diagnosed?
Xray and Cobb Angle
Min Angle= 10 degrees
Cobb Angle 10-20 Degrees=
pt monitored to see if angle is progressing and is usually treated conservatively with PT
Cobb Angle 20-40 Degrees=
pt may have a back brace and has more intense physical therapy
Cobb Angle over 40 degrees=
They will have to brace, and surgery is needed
What are the 3 physical therapy treatment goals for scoliosis?
- Improve hypomobile areas for improved alignment through stretching concave side and STM, Joint Mob and stretch
- Strengthening and Stabilizing to restore balance to strengthen convex side
- Posture Education
What are 2 main dysfunctions in postural dysfunction?
Dowager’s Hump
Increased Kyphosis
What is the treatment for Postural Dysfunction?
involves cessations and reversal of deformity to the extent possible treatment for pain, patient education for posture, and HEP
What is the result of compression fracture?
Trauma or Osteoperosis
T-spine most vulnerable and women are at higher risk
What is the medical management for compression fracture?
Bracing, Vertebroplasty and Kyphoplasty
Treatment for Compression Fractures
Reduce pain and muscle spasms with exercises in spinal stabilization and flexibility to reduce compression from tight muscles. Patient education should be in body mechanics
Why should compression fracture patients avoid flexion exercises?
Compression fracture patients should avoid flexion exercises because of increased compression on the vertebral body with spinal flexion
What is ankylosing spondylitis?
an auto-immune disease that primarily affects the spine an causes chronic inflammation.
The cause is unknown but may have a genetic component and has no known cure
What are the symptoms for Ankylosing Spondylitis?
Pain or Stiffness in the lower back, buttocks and hips
As it progresses, it may spread to upper spine, rib cage, and SI Joint, Vertebral bones; compromising respiratory function and overall mobility
Why should there be extreme caution for joint mobs in ankylosing spondylitis patients?
due to joint fusion or osteopenia (low bone density)
What is costochondritis?
Inflammation of the cartilage in the rib cage where it attaches to ribs or sternum (costosternal joint)
What causes costochondritis?
Trauma, repetitive strain, respiratory Condition, or pathogens that cause inflammation
How does Costochondritis present?
TTP
Pain with deep breathing
certain torso movements
coughing and/or exertion
What is the early tx for costochondritis?
Reduce inflammation with modalities, manual tx, KT tape, posture education and activity modifications
Therex should include stretching trunk/rib mobility, postural alignment, and muscles that attach ribs
What is segmental dysfunction?
(misaligned vertebrae, restricted joint in the back)
improper movement or trauma that allows vertebral segments to get stuck
segmental dysfunction or somatic dysfunction
How is normal range of motion lost during segmental dysfunction?
Hypertonic muscles are preventing the segment from moving properly
What treatment should be performed on segmental dysfunction patients?
Manual to decrease hypertonic muscles and indirect treatments to move away from restrictive barriers to try to reset muscle proprioceptors and muscle control (positional release and strain counterstain
