Intro Thoracic Spine

Question 1

The average thoracic kyphosis ranges from what to what degrees?

Answer 1

20 - 40 degrees

Question 2

The apex of thoracic kyphosis is usually at what level

Answer 2

T7 - T8

Question 3

What thoracic spine level is there a significant decrease in movement of the spinal cord leading to a tension point

Answer 3

T6

Question 4

What are the thoracic rule of threes

Answer 4

T1 - T3: SPs level with their own body
T4 - T6: SPs level with inferior disc
T7 - T9: SPs one segment below TPs
T10 - T12: SPs and TPs on same horiz plane

Question 5

What kind of joint is the costovertebral joint

Answer 5

Compound synovial joint

Question 6

The costovertebral joint is strengthened by what ligament

Answer 6

Radiate ligament

Question 7

The costotransverse joint is a joint between the what and what

Answer 7

Facets of TPs and rib tubercle

Question 8

The sternocostal joint between sternum and cartilage of first rib is what kind of joint

Answer 8

Synchondrosis

Question 9

If you get L sided chest pain in OSCE, what do you need to rule out first or automatic fail?

Answer 9

Cardiac involvement

Question 10

T spine coupling

Answer 10

Mid and lower can go either way but tend to follow lumbar spine (opp)

Question 11

Inspiration muscles

Answer 11

Diaphragm, external intercostals

Accessory: scalenes, SCM, UT, pec major/minor

Question 12

Expiration muscles

Answer 12

Abdominals and internal intercostals

Accessory: lats, QL

Question 13

Idiopathic scoliosis cause

Answer 13

Obscure

Question 14

What percentage of idiopathic scoliosis is genetic?

Answer 14

90%

Question 15

Idiopathic scoliosiis more common in male or female

Answer 15

Female

Question 16

3 types of idiopathic scolisos

Answer 16

Infant
Adolescent
Jeuvenille

Question 17

Scoliosis can continue after maturity due to

Answer 17

• strong genetic dose
• curve throws off balance of body
• poor muscle tone

Question 18

Lateral shift in thoracic spine is sign of

Answer 18

Serious pathology

Question 19

5 causes of kyphosis

Answer 19

Genetic, osteoporosis, spondylosis, pathologic fractures, Scheuermann’s

Question 20

Scheuermanns is what

Answer 20

Osteoporosis of the vertebrae

Question 21

Age for scheuermanns

Answer 21

10-20

Question 22

Problem occurs where for scheumernnsn

Answer 22

Where disc and vertebrae connect

Question 23

Schuermanns affects end plate?

Answer 23

Yes

Question 24

Scheumernns end plate dysfunction causes

Answer 24

Collapse of vertebrae anteriorly

Question 25

Scheumeranns pain sx

Answer 25

Pain slowly increasing as day goes on by heavy labor, never severe

Question 26

Scheumanns diagnosis

Answer 26

X ray 3 adj vertebrae showing minimum 5 degrees wedging and kyphosis angle >45

Question 27

Clinical sx AS

Answer 27

Mid low back pain/stiff > 3 mos Worse in AM lasting more than 1 hr Chest expansion < 2cm on full inhalation Pain better with activity, not rest Psoriasis, uveitis, iritis, chrons, colitis

Question 28

AS diagnosis

Answer 28

HLA-B27 positive X ray and MRI with fused spine LBP>3mos Limited chest expansion

Question 29

T spine disc issues Age Area of disc Worse than L/C spine? Chest pain PT t/x

Answer 29

40-60 Posterior or posterolateral Better because IV foramen bigger Anterior chest pain (rule out cardio) Extension based

Question 30

Costochondral conditions Caused by Pain and swelling where Acute costochondrosis aka

Answer 30

Trauma Bone/cartilage junction, 1in lat sternum Tietz’s syndrome

Question 31

Thoracic facet dysfunction Sx

Answer 31

Unilateral limitation and pain in rotation Asymmetrical segmental mobility and palpatory findings

Question 32

Costovertebral joint dysfunctions Main sx Restricted mainly in Pain with

Answer 32

Intense sharp pain unilaterally Side bend Deep breathing, sneezing, cough

Question 33

Diff diagnosis costovertebral jt dysfunction

Answer 33

Cardiac Pneumonia Pleuritis Rib fracture Herpes zooster Long thoracic nerve ANNT

Question 34

1st rib dysfunction Due to Need to rule out How to confirm Neuro sx

Answer 34

Trauma Presence of cervical rib X ray None

Question 35

How to confirm presence of cervical rib

Answer 35

If 1st rib higher up to 1cm = joint dysfunction 1st rib higher up to 2+cm = cervical rib

Question 36

C6-T3 (cervicothoracic region) coupling

Answer 36

Same

Question 37

Cervicothoracic region dysfunction Sx and motion

Answer 37

Pain and limitation with flx,ext, SB/rot to same side