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Advanced Orthopedics > Thoracic Spine Lab > Flashcards

Thoracic Spine Lab Flashcards

1
Q

Thoracic serious pathology

A
  • Pulmonary Embolus
  • Myocardial Infarction
  • Pneumonia
  • Pleurisy
  • Thoracic Spine Compression Fracture
  • Rib Fracture(s)
  • Visceral Referral
  • Shingles(herpes zoster)
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2
Q

Osteoporosis risk factors

A
  • Female
  • Age ≥65
  • Caucasian & asian
  • Family Hx
  • Prior Fx after age 50
  • Diet for vitamin D
  • Physical activity
  • Tobacco use
  • Medications: glucocorticoids, anti-seizure drugs, & thyroid hormone
  • Low body weight
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3
Q

What deformity is characteristic of a compression fracture

A
  • Wedge deformity
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4
Q

Which ribs are true, false, and floating

A
  • True: 1-7
  • Flase: 8-10
  • Floating: 11-12
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5
Q

What are the different chest types

A
  • Barrel
  • Funnel
  • Pigeon
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6
Q

Describe the dynamics of respiration

A
  • Ribs move as a “bucket handle”
  • Sternum moves as a “pump handle”
  • Inhale: diaphragm contracts & lowers while ribs expand
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7
Q

Describe self assessment for diaphragmatic breathing

A
  • Begin by slow & deep breathing
  • Add pursed lip breathing: smell the roses & blow out the candles
  • Place both hands on lower ribs & feel for expansion AP & laterally
  • Place one hand on bellybutton & other on sternum
  • Try to breath with only expanding the diaphragm (lower hand moves > upper hand)
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8
Q

How can you increase motor control while diaphragmatic breathing

A
  • Add deep neck flexor isometric
  • Cue different regions of the ribs & diaphragm if needed
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9
Q

Describe a barrel chest

A
  • More rounded than a normal chest
  • Chest cavity has a 1:1 ratio for AP diameter to transverse diameter
  • Associated with COPD
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10
Q

Symptoms of a blue bloater/chronic bronchitis

A
  • Chronic productive cough
  • Purulent sputum
  • Hemoptysis
  • Mild dyspnea initially
  • Cyanosis
  • Peripheral edema
  • Crackles/wheezes
  • Prolonged expiration
  • Obese
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11
Q

Symptoms of a pink puffer/emphysema

A
  • Dyspnea
  • Minimal cough
  • Increased minute ventilation
  • Pink skin, pursed-lip breathing
  • Accessory muscle use
  • Cachexia
  • Hyperinflation, barrel chest
  • Decreased breath sounds
  • Tachycardia
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12
Q

Describe a funnel chest

A
  • AKA pectus excavatum
  • A dip in the sternum creating a “funnel”
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13
Q

Describe a pigeon chest

A
  • AKA pectus carinatum
  • Protrudes outward from the sternum creating a “peak”
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14
Q

Describe the lumbar locked position

A
  • Patient in on their knees and puts one forearm on the ground infant of them and rotate as far as they can to the opposite side
  • Potentially identifies any thoracic dysfunction
  • Compare symmetry
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15
Q

What are your landmarks for a thoracic PA spring test

A
  • Spine of scapula at T3
  • Inferior angle scapula at T7
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16
Q

Describe how to perform a mid-thoracic sitting manipulation

A
  • Distraction gliding manip
  • Position towel roll on the PT’s chest
  • Ask patient to criss-cross arms with elbows stacked & lean back onto the therapist
  • PT takes up the slack to achieve pre-thrust tension
  • Thrust is a chest bump with combined j-stroke lifting in & up to direct the force over the towel roll
17
Q

Describe a C-T junction sitting manipulation

A
  • Ask patient to place their hands behind their neck
  • Place towel roll just below the C-junction
  • PT links hands in behind & adducts elbows in around the patient’s ribs (laterally)
  • Ask patient to lean back & relax
  • Several reps of mini manias trying to feel pre-thrust tension
  • Deliver the thrust upwards with the hands & elbows while using a chest bump
  • Avoid pressing the neck forwards
18
Q

Describe how to perform a supine mid-thoracic manipulation

A
  • Ask patient to cross both arms over a thole roll & roll toward you
  • Position your hand on the T-spine region & take up the skin slack, may need to begin above the area
  • Have the patient roll back onto your hand keeping the skin lock
  • Use your body to apply a pre-thrust force through the patient’s elbows
  • Fine tune by flexing the pt’s head/neck to max load the hand on the spine
  • Use a body drop to deliver the thrust directed just above your hand on the spine
19
Q

Describe how to perform a prone thoracic manipulation

A
  • Ask the patient to lay prone
  • Assess spine with PA mobility test
  • Operator place hands on the transverse processes, contact point is the bilateral pisiforms
  • Take up the slack: twist and slide in opposite directions
  • Mini manips to fid the pre-thrust crispness
  • Deliver a HVLA (high velocity low amplitude) thrust with equal pressure bilaterally

Advanced Orthopedics (29 decks)

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