Thoracic Spine

Question 1

whats the critical zone in the T spine?

Answer 1

T4-T9, spinal canal most narrow, disc herniation or injury here could lead to central cord compression

Question 2

whats the tension point

? (positive slump)

Answer 2

T6

Question 3

why can u have sympathetic probs when the disc is injured?

Answer 3

bc the sympathetic chain innervates the discs

Question 4

orientation of Z joints?

Answer 4

cervical= 45 degree angle with horizontal
thoracic= 60 deg.
lumbar= 90 degrees
T spine: upper Tspine (mimics C spine) 45-60 degrees from horizon, middle: 70-90 degrees from horizon, lower T spine (mimics L spine) 20 degrees from frontal plane

Question 5

coupled SB and rot. in T spine?

Answer 5

upper T spine= ipsilateral

lower T spine= contralat.

Question 6

what diagnosis presents w/ band like pain along the ribs

Answer 6

thoracic DDD

Question 7

in adam’s sign, which side is convex?

Answer 7

the side with the rib hump

Question 8

tx for TOS

Answer 8

first rib mobs, scalene stretches, pec stretch,, soft tissue, strengthen mid and lower traps

Question 9

patient profile: dec. thoracic kyphosis, hx of MVA and whiplash, stiff CTJ and mid thoracic spine, limited flexion?

Answer 9

flattened upper T spine

Question 10

patient profile: older person, limited arm elevation, loss of elastic end feel, stiff glides, hx of bad posture

Answer 10

generalized upper/mid thoracic stiffness

Question 11

patient profile: hat and glove N/T distribution, vague pressure headache, pain between scapulae. Agg: pulling/pushing, taking deep breaths.

Answer 11

T4 syndrome

Question 12

why does T4 syndrome occur?

Answer 12

symp. reaction to hypomobile joint from T2-T6, also from trauma or bad posture

Question 13

patient profile: pain with breathing, trunk rot, unilat. PA over CTJ, stiff rib mobs

Answer 13

costal joint derangement

Question 14

patient profile: traps spasming, neck pain, headaches, shoulder pain, radiculopathy, jaw pain, mid-back and chest pain, sternal pain, TOS syps

Answer 14

elevated first rib

Question 15

first rib test

Answer 15

stab. first rib rot. head to contralat. side, SB to ipsilateral side

Question 16

patient profile: pain with breathing, local pain, c/s hurts, local mm spasms, palpate a prominence anteriorly or concavity posteriorly at rib junction

Answer 16

rib subluxation

Question 17

patient profile: had a forceful rotation injury, now has pain shooting around/through chest wall. Agg: with ANY movements, breathing, c/s all painful

Answer 17

thoracic disc lesion

Question 18

test for thor. disc lesion?

Answer 18

beaver’s sign (belly button pulls to one side when do a crunch- one of ur ab mm isn’t working right)

Question 19

patient profile: swelling of cost. cartilage, local and superficial ant. chest pain. that is worse with breathing and trunk movement, hx of flu or other virus.

Answer 19

Tietze’s syndrome

Question 20

what is a systemic, rheumatic disease that starts in the SIJ and migrates up the spine. causes progressive stiffness, fusion of joints, pain and limited spinal mobility, happens in young boys mostly

Answer 20

anklyosing spondylitis

Question 21

what does fist vertebrae indicate?

Answer 21

osteopenia

Question 22

two spine pathologies that affect young ppl and cause kyphoscoliosis and premature disc degeneration

Answer 22

scheuermann’s disease- wedging discs

schmoral’s nodes- herniation of disc material into vert. end plates

Question 23

u want to mobilize ribs _______ to the joint line… which is what direction?

Answer 23

perpendicular, anteriolaterally

Question 24

want ___________ bone of the mobilizing hand on the rib

Answer 24

pisiform