Magee Thoracic Spine

costovertebral joints join what to what
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ribs 1-7 = __ ribs and they articulate with the __ directlytrue; sternumribs 8 -10 = __ rib & join withfalse; costal cartilage of rib aboveribs 11-12 = __ ribsfloatingsternum made up ofmanubrium, body, xiphoid process look at pic for thoracic cagespinal canal in T-spine notably (narrower/wider). T4-T9 known as __ zone can be a source of adverse neurodynamics e.g. w/segmental stiffness __ considered to be a tension pointnarrower; critical; T6are thoracic HNP common?no as high as 60% 37% asymptomatic by one study not wear & tear like cervical or lumbar rib protectionthoracic outlet syndrome is a dx ofexclusionthoracic outlet syndrome types include all except: a) scalenus anticus syndrome b) costoclaivicular syndrome c) hyperadduction syndrome d) hyperabduction syndromehyperadduction syndromewhich syndrome is through the interscalene triangle a) scalenus anticus syndrome b) costoclaivicular syndrome c) hyperadduction syndrome d) hyperabduction syndromescalenus anticus syndrome (anterior scalene) pinches the nerves & vessels between scalene muscles & other structurescharacteristic of costoclavicular syndrome include all except: a) between clavicle & rib cage b) clavicular depression c) rib elevation ( by scalene hypertonicity) d) accessory 2nd rib e) pot fracture callusaccessory 2nd rib ** it' 1st rib pinches nerves under the collarbonewhat muscle DR the scapulapec minorhyperabduction syndrome is under the __ __pec minor pinches the nerve that runs under the pec minor when you lift your arm overheadthoracic outlet syndrome characterstics a) group of syndromes b) UE, chest, neck & shoulders c) sx produced from positional intermittent compression of brachial plexus, subclavian vein & arteryall of themtreatment of TOS includes all except: a) 1st rib mob b) pec minor & scalene stretching c) diaphragmatic breathing d) 2nd rib mob2nd rib mobscoliosis is in what age groupadolescent femalesscheurmann diseaseteenstrauma can causerib fx & malalignmentsscoliois is an __ onset from progressive effects & normally occurs to whominsidious; adolescent femalesREAD HISTORY BOXES FROM NOTES-be attentive to examine theshoulder, C-pine, L-spine with thoracic complaints isolated thoracic complaints do happen but less frequently than other area of the spinekyphosis can be forms such as a) humpback b) gibbus c) dowager' humpall of them humpback & gibbus caused by vertebral wedging i.e. compression fx dowager's hump --> osteoperosis, comp fxmajority of scoliosis is structural or functionalstructuralcurve designated by side ofconvexity & level of apextypes of curve areC & S curvesvertebral bodies rotate to the side of __ In T-spine this causes ribs to push posteriorly, causing __ __convexity; rib humpLOOK AT NOTES FOR EXAMINATION-UPPER THORACIC =C5-T3 fingers at s.process, PT directs movement from top of headlower thoracic =T3-T11 Pt's hands behind neck, PT directs pt movements from contact at pt's elbows/armswhat type of curve is the most commonR thoracic curve --> convexscheurmann's disease effects what age groupadolescents age 13-16traumas are typically common in thoracic spine MOI caused byrib fractures & malalignmentsfacet pain can causestiffness & local pain that can refersites & boundaries of pain: fx: __ disc:__ referral from viscera: __ scapular pain: __ costal cartilage: __focal may radiate along path of rib/intercostal space i.e. ruptured spleem common from cervical spine until proven otherwise costochondritis (no swelling), tietze syndrome (swelling can see +Ve SED rate)pain w/inspiration/expiration could be a sign ofproblems with rib movements - pulmonary - structural - scoliosis - fx/contusionparasthesia could be linked todisc lesionpain associated with eating/digestion could be fromvisceral such as gallbladder, stomach ulcers, kidney stonesvisceral pain is described as all except: a) vague b) dull c) indiscrete d) w/N & V e) sharpsharppain referred around the chest wall is coming from what origincostovertebral originnerve root pain can be verysevere paincough/sneeze could be indicative ofdural painactivities that are likely to aggravate costal cartilages arepush, pull, arm activitiesactivities to ease pain would bebracing the arms to increase accessory muscle useshould you be concerned with rash or skin alterations of the thorax such as herpes zoster/shingles, post herpetic neuralgiaYES shingles could cause unilateral spontaneous painalways screen with cervical & lumbar spine with thoracic complaints (T or F)Trueisolated thoracic problems do happen but less frequently than cervical & lumbar due to less wear & tear (T or F)Trueobserving breathing coming from __ or __primary or accessory muscle usepalpating the abdomen could identify whatvisceral problems or abdominal massmuscle spasm on R side is of what visceral organ a) gallbladder b) spleen c) kidneysgallbladdermuscle spasm on L side is of what visceral organ a) gallbladder b) spleen c) kidneysspleenmuscle spasm on lower T-spine bilateral is of what visceral organ a) gallbladder b) spleen c) kidneyskidneysAROM flexion = extension = side bend = rotation =20-45 25-45 20-40 35-50flexion & extension go fromC7 - T12if you side flex and their ipsilateral paraspinals tighten or there is a contracture what pathologies are consideredankylosing spondylitis or muscle spasmif rib stops moving on inspiration the rib is (elevated/depressed) & the (lowest/highest) rib is the key ribdepressed; highestif rib stops moving on expiration the rib is (elevated/depressed) & the (lowest/highest) rib is the key ribelevated; lowestcostovertebral expansion = __ - __ cm3-7.5functional assessment: thoracic spine- lifting - rotational tasks - activities that increase cardiopulmonary demand - Oswestry, Roland Morris (functional disability) - T-spine = stable, has effect on other parts of spinecutaneous testing: dermatomesfollow the ribsdermatomes can overlap __ loss of one levelmaskingcervical rotation lateral flexion test used forelevated 1st rib - each side turn to testing the opposite