Thorax Flashcards
Vertebral spinal process at the level of the scapular inferior angle
T7
Vertebral body/transverse process at the level of the scapular inferior angle
T8
What is the major motion of the upper thoracic spine
Rotation
What is the orientation of the superior facets in the thoracic spine
Backwards, upwards, lateral (BUL in BUM BUL BUM)
Landmark for T2
Sternal notch
Landmark for T3
Spine of scapula
Anterior landmark for T4
Angle of Louis (2nd rib)
Dermatome level for T4
Nipples
Dermatome level for T10
Umbilicus
A 44-year-old male weightlifter comes in complaining of upper back pain. He was doing 400 lb. squats when suddenly, he experienced intense pain between the shoulder blades. Gentle palpation of the spinous processes shows pinpoint tenderness over the spinous process of the vertebra at the level of the spine of the scapula. Xray reveals a compressed vertebra and a fracture of the spinous process at that level. You diagnose a compression fracture and spinous process fracture at
T3
A 44-year-old female presents to your clinic with intermittent, severe, colicky pain in the right upper quadrant of the abdomen. She states that the pain is worse after greasy meals. A right upper quadrant ultrasound shows thickening of the walls of the gallbladder as well as gallstones. The surgeon is consulted. While waiting for her surgery, you decide to treat viscerosomatic reflexes (sympathetics) at what level?
T7
Treatment for hyperkyphosis
MFR of spine, pelvis, shoulders
Scapular mobilization
Physical therapy
Foam roller
Bracing or taping
Treatments for facet arthropathy
FJ blocks
Physical therapy
Radiofrequency ablations
Surgery
Treatment for spinal stenosis
Surgery
Treatment for herniated disc
NSAIDs
Epidural
Physical therapy
OMT
Time
Surgery
Treatment for degenerative disc disease
SCS
Align spine
Give space with HVLA
HVLA if foraminal stenosis present
Treatment for shingles
Antiviral
Vaccination (preventative)
Lymphatic treatments
OMT
Treatment for spinal infection
Antibiotics
Lymphatic treatment
Treatment for lateral recess stenosis
Physical therapy
Medication
Nerve ablations
Hemilaminotomy
Treatment for arthritis in costovertebral/transverse joint
Intraarticular injection
Surgery
OMT - Rib raising
A 55-year-old patient presents to the physician’s clinic with complaints of burning aching pain in the posterior back that it worse with deep inspiration and coughing. Which treatment might give the patient the most relief?
ME of the ribs
What is Fryette’s 1st principle
In neutral, side bend then rotate (type I dysfunction)
What is Fryette’s 2nd principle
Nonneutral rotate then side bend
Muscle involved in type I dysfunction
Erector spinae group (long restrictors)
Iliocostalis, longissimus, spinalis
Rotation/side bending in type I dysfunction
Opposite
Cause of type I dysfunction
Chronic process of poor posture
Muscle involved in type II dysfunction
Transversospinalis group (short restrictors)
Multifidus, semispinalis, rotatores
Rotation/side bending in type II dysfunction
Same
Cause of type II dysfunction
Trauma
What is Fryette’s 3rd principle
Motion in one plane affects motion in all other planes
Where are the SPs of T1 - T3, T12
Same level as body
Where are the SPs of T4 - T6, T11
Half level down (1/2”)
Where are the SPs of T7 - T10
One level down (1”)
