Week 3

Question 1

three parts of the thoracic spine

Answer 1

cervico-thoracic
thoracic
tharco-lumbar

Question 2

Where is referred pain felt for lower cervical pathology

Answer 2

between and/or above scapulae

Question 3

Where is referred pain less commonly felt for lower cervical spine pathology

Answer 3

anterior chest wall

-episodic or related to exertion
may mimic angina

Question 4

4 regions of the the thoracc spine

Answer 4

1. vertebromanubrial - c7,t1, t2, ribs 1&2 and the manubrium

Vertebrosternal region - T3-T7, Ribs 3-7 and the sternum

3 - vertebrochondral region- T8-T10 and the 8,9,10th ribs

4 thoracolumbar junction
-T11 and T12 and the 11th/12th ribs

Question 5

Charateristics of the cervico-thoracic region

Answer 5

mobile region becomes interdependent with a rigid area

marked decrease in sagittal movement from C6/7 to C7/T1

Question 6

What happens in tropism

Answer 6

joints are faced different and only move with great stress
this leads to disc wearing

orientation differs more than 5-7 degrees

Question 7

Mobility of the thoracic spine is dependant on what

Answer 7

the relationship between the height and cross sectional area of discs as well as facet joint orientation

Question 8

Osteokinematic motion of the mid thoracic region during flexion

Answer 8

Vertebral body - ant translation, ant sagittal , slight distraction

Ribs - anterior rotation

Question 9

Arthrokinematic motion of the mid thoracic region during flexion

Answer 9

inferior facet of the superior vertebrae glides supero-anteriorly

rib = superior glide of the tubercle

Question 10

Osteokinematic motion of the mid thoracic region during extension

Answer 10

vertebral body - post translation, post sagittal rot, slight distraction\

ribs - post rotation

Question 11

Arthrokinematic motion of the mid thoracic region during

Answer 11

inferior facet of the superior vertebrae glides infero-posteriorly

ribs - inferior glide of the tubercle

Question 12

osteokinematic motion of the mid thoracic region during side flexion

Answer 12

vert body - ipsilateral translation, ipsi rotation in x axis, contra lateral rotation about the y axis
ribs- contra rib posteriorly rotates , ipsilateral rib anteriorly rotates

Question 13

Osteokinematic motion of the mid thoracic region during rotation

Answer 13

vert body- contralateral rot about the z axis, ipsi translation in the x axis
ribs = contra rib posteriorly rotates, ipsi rib anteriorly rotates

Question 14

Mechanical structures that are a source of pain

Answer 14

Tx vertebrae
dura mater
intervertebral discs
longitudinal ligaments
posterior thoracic muscles 
costotransverse joint
z-joints

Question 15

Trauma causes of pain for Tx

Answer 15

fracture of rib, spinous process, transverse process, vertebral arch or vertebral body
fracture dislocation
compression fractures
-A1- wedge compression
-A2- split fracture
-A3- burst fracture

Question 16

Degenerative conditions of the Tx

Answer 16

arthrosis ( degeneration of the z joint )

scheurmann's disease
-self limiting skeletal disorder
juvenile osteochondrosis of the spine 
7th and 10th Thx vert common
increased thoracic kyphosis, stiffness and immobility

Question 17

What is T4 syndrome

Answer 17

a clinical pattern that involves upper extremity paraesthesia and pain with or without symptoms into the neck and or head

autonomic nervous system provides a pathway for dysfunction of the thoracic spine to be expressed over the lower cervical spine and down the upper limb

Question 18

What is Tietze syndrome

Answer 18

benign inflammation (+ swelling) of one or more of the costal cartilages