Thoracic Spine Exam Flashcards
Segmental flex/ext ____ as you move down the TS, and rot ____.
- increases
- decreases
The upper ribs predominately show a ____ handle action and the lower ribs show a ____ handle movement pattern
- pump
- bucket
What is the primary muscle of respiration?
diaphragm
what is the primary role of the thoracic cage?
protection
T or F: 15% of overall spinal pn is of thoracic origin
T
T or F: TS pain is more predominant in later teenage years (prior to full skeletal maturity) and less common in adults 50+
T
Where are vertebral compression fxs most common
T12-L2
T or F: osteoporosis does not preclude/prevent all use of MT
T
What is the difference btwn osteopenia and osteoporosis?
osteopenia: low bone density (1-2.5 SD below age matched norm)
osteoporosis: porous bone that can lead to fxs (>2.5 SD below age matched norm)
You would be concerned about inflammation (red flag) is pt’s sxs were provoked by:
- coughing
- laughing
You would be concerned about Dry pleurisy (red flag) is pt’s sxs were provoked by:
respiration
You would be concerned about spinal tumor (red flag) is pt’s pain increases with:
supine
what is T4 syndrome?
sympathetic system involvement w/:
- UE paresthesia (glove)
-weakness w/ reduced TS movement
- tender palpation of T4
- sxs bilat/unilat
T or F: TOS can be venous, arterial, or neurogenic in nature?
T
Epigastric pain can refer to the ____ region
posterior mid-thoracic
Which TS segment has the highest vascular risk due to a lack of secondary blood supply?
T4
(T4-T10 is an area of high vascular risk)
What are 5 MSK causes of Thoracic pn?
- disc-generated spinal pn
- thoraco-lumbar jt dysfunction
- fx
- muscle strain/sprain
- arthralgia
T or F: the TS is the great compensator
T
When is TS and/or rib fx suspected and radiograph indicated?
- blunted trauma/injury to spine and/or ribs
- acute thoracic pn from trivial strain or trauma >60 yo
- inability to take deep breath
- acute TS pn w/ risk factors for osteoporotic compression fxs
What are 7 risk factors for osteoporotic compression fxs?
- Caucasian
- hx of smoking
- early menopause
- thin body build
- sedentary lifestyle
- steroid tx
- excessive consumption of caffeine/alc
What is the gold standard for diagnosing scoliosis?
Radiograph: measure Cobb angle (angle btwn most tilted vertebra above apex and most tilted vertebra below) ‘
** cobb angle must be > 10 deg
A cobb angle of 10-15 deg indicates ___scoliosis
mild
a cobb angle of 25-50 deg indicates ___ scoliosis
moderate
a cobb angle of > 50 deg indicates ____ scoliosis
severe
Does single or double curve scoliosis have a better prognosis?
double curves
(single curves progress more bc they aren’t balanced)
Does a lumbar or thoracic curve progress more (aka poor prognostic factor)?
Lumbar progresses more
What are 3 factors to consider for risk of progression of scoliosis?
- chronological age of onset (early onset = inc risk)
- Risser sign (% ossification of iliac epiphysis –>skeletal maturity)
- cobb angle (imaging)
Scoliosis curves are named according to ____ side and where the ____ occurs
convex, apex
> ___ degrees = hyperkyphosis
40
