TSPINE/RIBS Examination Flashcards
Special consideration for screening questions with Tspine/Ribs patient:
- Pain referral from cardiopulmonary/ hepatobiliary/ gall bladder/ esophageal/ renal systems
- Fracture (rib vs. vertebra)
- Neoplasm
- Ankylosing Spondylitis
- Screening for other non-musculoskeletal health condition or musculoskeletal condition where referral is indicated
What is the traditional cobb method when looking at imaging of kyphosis angle?
- Perpendicular extensions of lines drawn from superior border of T4 & inferior border of T9
- also used with anterior view to measure scoliotic curvature
Visually inspect for Dowager’s Hump:
- osteoporotic fractures with increase age)
- Can aid with muscular intervention
Visually inspect for Scheuermann’s disease:
- wedging of vert
- malnutrition, injury to end plates
Visually inspect for Scheuermann’s disease:
- wedging of vert
- malnutrition, injury to end plates
Visually inspect for Pectus Carinatum:
bird chested
Visually inspect for barrel chest:
COPD, CF
Visually inspect for pectus excavatum:
- concave curvature
- effect rib function – thoracic rom
What does the systems review help us find out?
What body regions:Anything else we need to look at in addition to our patient’s primary concern
UMN neuro screening tests include?
pathologic reflexes, coordination, hyper-reflexia
LMN Neuro screening tests include?
Diminished sensation, weakness, hypo-reflexia
What is the elimination Percussion test? Procedure? Positive test?
- Tests for compression fracture
- Procedure: lightly percuss along the length of the spine with a closed fist
- Positive Test: Pt reports sudden, sharp, severe pain
Clinical implications of percussion test?
Use cautiously if fracture is suspected
What is the Wright test?
Elimination test for TOS
Procedure of the Wright test?
- Patient seated and examiner to side
- Radial pulse palpated
- Pt is instructed to abduct the shoulder to 90 degrees & flex the elbows to 90 degrees, and horizontally abduct the shoulders
- The patient rotates the neck to the contralateral direction
- The position is held for 1-2 minutes
What is a positive Wright test?
reproduction of paresthesia or a decrease in radial pulse
What are the clinical implications of the Wright test?
- Generally limited research investigating diagnostic properties
- Neither +/- LR compelling with shifting post-test probability
What is the Adam’s Forward Flexion test?
Elimination test for scoliosis
What is the procedure for Adam’s Forward flexion test?
The patient is instructed to stand with the feet at shoulder-width, place the hands together, and slowly bend forward (reaching toward the floor)
What is a positive Adam’s Forward flexion test?
presence of an observable rib hump
Structural stress testing (AROM) thoracic flexion procedure:
Patient Position: sitting, fingers interlocked behind neck, elbows close to approximation
Procedure: The patient is instructed to bring the elbows toward the umbilicus
Structural stress testing (AROM) thoracic extension procedure:
Patient Position: sitting, fingers interlocked behind neck, elbows close to approximation
Procedure: The patient is instructed to bring the elbows toward the ceiling
Structural stress testing (AROM) thoracic rotation procedure:
Patient Position: sitting, arms crossing the chest
Procedure: The patient is instructed to rotate the trunk