Thoracic Spine Exam

Question 1

Segmental flex/ext ____ as you move down the TS, and rot ____.

Answer 1

1. increases
2. decreases

Question 2

The upper ribs predominately show a ____ handle action and the lower ribs show a ____ handle movement pattern

Answer 2

1. pump
2. bucket

Question 3

What is the primary muscle of respiration?

Answer 3

diaphragm

Question 4

what is the primary role of the thoracic cage?

Answer 4

protection

Question 5

T or F: 15% of overall spinal pn is of thoracic origin

Answer 5

T

Question 6

T or F: TS pain is more predominant in later teenage years (prior to full skeletal maturity) and less common in adults 50+

Answer 6

T

Question 7

Where are vertebral compression fxs most common

Answer 7

T12-L2

Question 8

T or F: osteoporosis does not preclude/prevent all use of MT

Answer 8

T

Question 9

What is the difference btwn osteopenia and osteoporosis?

Answer 9

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)

Question 10

You would be concerned about inflammation (red flag) is pt’s sxs were provoked by:

Answer 10

1. coughing
2. laughing

Question 11

You would be concerned about Dry pleurisy (red flag) is pt’s sxs were provoked by:

Answer 11

respiration

Question 12

You would be concerned about spinal tumor (red flag) is pt’s pain increases with:

Answer 12

supine

Question 13

what is T4 syndrome?

Answer 13

sympathetic system involvement w/:
- UE paresthesia (glove)
-weakness w/ reduced TS movement
- tender palpation of T4
- sxs bilat/unilat

Question 14

T or F: TOS can be venous, arterial, or neurogenic in nature?

Answer 14

T

Question 15

Epigastric pain can refer to the ____ region

Answer 15

posterior mid-thoracic

Question 16

Which TS segment has the highest vascular risk due to a lack of secondary blood supply?

Answer 16

T4

(T4-T10 is an area of high vascular risk)

Question 17

What are 5 MSK causes of Thoracic pn?

Answer 17

1. disc-generated spinal pn
2. thoraco-lumbar jt dysfunction
3. fx
4. muscle strain/sprain
5. arthralgia

Question 18

T or F: the TS is the great compensator

Answer 18

T

Question 19

When is TS and/or rib fx suspected and radiograph indicated?

Answer 19

1. blunted trauma/injury to spine and/or ribs
2. acute thoracic pn from trivial strain or trauma >60 yo
3. inability to take deep breath
4. acute TS pn w/ risk factors for osteoporotic compression fxs

Question 20

What are 7 risk factors for osteoporotic compression fxs?

Answer 20

1. Caucasian
2. hx of smoking
3. early menopause
4. thin body build
5. sedentary lifestyle
6. steroid tx
7. excessive consumption of caffeine/alc

Question 21

What is the gold standard for diagnosing scoliosis?

Answer 21

Radiograph: measure Cobb angle (angle btwn most tilted vertebra above apex and most tilted vertebra below) ‘

** cobb angle must be > 10 deg

Question 22

A cobb angle of 10-15 deg indicates ___scoliosis

Answer 22

mild

Question 23

a cobb angle of 25-50 deg indicates ___ scoliosis

Answer 23

moderate

Question 24

a cobb angle of > 50 deg indicates ____ scoliosis

Answer 24

severe

Question 25

Does single or double curve scoliosis have a better prognosis?

Answer 25

double curves

(single curves progress more bc they aren’t balanced)

Question 26

Does a lumbar or thoracic curve progress more (aka poor prognostic factor)?

Answer 26

Lumbar progresses more

Question 27

What are 3 factors to consider for risk of progression of scoliosis?

Answer 27

1. chronological age of onset (early onset = inc risk)
2. Risser sign (% ossification of iliac epiphysis –>skeletal maturity)
3. cobb angle (imaging)

Question 28

Scoliosis curves are named according to ____ side and where the ____ occurs

Answer 28

convex, apex

Question 29

> ___ degrees = hyperkyphosis

Answer 29

40