Thoracic Spine Exam / Intervention / 2 Flashcards
thoracic back pain has potential for referred pain from blank
visceral organs
incidence of patients c/o thoracic back pain is blank compared to neck or low back pain
lower
potential sources of pain for thoracic
disk, ligaments, costosternal joint, costovertebral joint
subjective exam for thoracic
type of disorder, area of symptoms, behavior of symptoms, med surg and past history, special questions
special questions for thoracic spine
pain change with insp/exp?, pain affected by coughing/sneezing?, numbness/tingling, changes in digestion
questionnaire for lower thoracic spine pain
ozwestry
some important observations for thoracic objective exam
posture sitting/standing, gait analysis, integument, structural asymmetries
a scoliosis is blank but a lateral shift is blank
not treatable, treatable
PROM thoracic spine exam includes passive accessor motion testing… aka
joint play
AROM of thoracic is tested in blank position
sitting
thoracic spine AROM is actually testing blank spine more
thoracolumbar
normal thoracic AROM flexion
80 degrees
thoracic repeated movements are performed in blank position
sitting
three repeated movements for thoracic
flexion, extension, rotation
sequence of thoracic repeated movements is same as blank
cervical
patient’s blank should always be assessed before repeated movements testing
baseline symptoms
unilateral thoracic pain most often responds to blank
rotation
passive accessory motion testing (joint play) for thoracic will have patient in blank position
prone
joint play of thoracic include these
central vertebral pressure, unilateral vertebral pressure, transverse vertebral pressure, pa over angle of rib
joint play of thoracic that is performed in supine
a-p over costosternal joints
normal thoracic AROM extension
25 degrees
normal thoracic AROM rotation
45 degrees
normal thoracic AROM side bending
35 degrees
PROM is performed in blank position
sitting
PROM testing movements for thoracic
flexion, extension, rotation, side bending
three muscle performance tests for thoracic
mmt, resisted isometrics, endurance
three special tests for thoracic
general medical screenings, neuro involvement, thoracic outlet syndrome
ULNT test or SLR depending on location of symptoms for neurological symptoms of thoracic
slump test
examiner should test lumbar reflexes for neurological symptoms of thoracic
DTRs/MSRs
four tests for neurological symptoms of thoracic
slump, DTRs/MSRs, dermatomes, thoracic outlet special tests
special test for thoracic fracture
heel drop test
waitters helps predict someone with blank
cervical radiculopathy
if symptoms peripheralize and pain increases after repeated movements
derangement
for interventions like repeated movements, do not move past sagittal plane until you have fully changed blank
force application
men are more likely to get blank before heart attack
referred arm pain
cardiac problems can present in blank
thoracolumbar or mid thoracic spine
pulmonary system can present in the blank
scapula
end stage liver and gallbladder referred pain can be at blank
shoulder
if movements and roms are all about normal without pain and no provocation of symptoms then the pain is probably blank
not musculoskeletal
effective interventions for thoracic spine pain
thrust manipulation
directional preference if patient responds blank to repeated movements
favorably
directional preference moves in direction that blank/blank symptoms
reduces, centralizes
hypomobility interventions for thoracic spine
pt education, thrust manip, non thrus, soft tissue mobes, stretching, postural education
